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Agenda for zero discrimination in health care

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Agenda for zero discrimination in health careUNAIDS and the Global Health Workforce Alliance are launching an Agenda for Zero Discrimination in Health Care. The agenda supports a vision for a world where everyone, everywhere, enjoys health services without discrimination and where the health workforce is empowered to provide discrimination-free services to all.

Many people around the world face barriers to accessing quality health-care services and realizing the highest attainable standard of health. The multiple reasons for this vary across countries and communities. Even where health-care services are available and of good quality, people often experience or fear stigma and discrimination, which prevent them from accessing the health services they need and are entitled to receive.

A new report by Asia Catalyst produced in collaboration with eight community-based organizations in Cambodia, China, Myanmar and Viet Nam has documented discriminatory practices in health-care settings specifically against people living with HIV. Findings include experiences of involuntary HIV testing, involuntary disclosure of status, segregation, arbitrary additional expenses imposed due to HIV status and medical advice against pregnancy and for sterilization on the sole basis of HIV status.

The agenda offers a space for collaboration between countries, the World Health Organization, UNAIDS, other United Nations and intergovernmental organizations, professional health-care associations, civil society, academics and others to take coordinated action for achieving zero discrimination in health care.

The agenda will prioritize coherent joint actions in three critical areas:

  • Political support: by increasing political commitment through mobilization of all key constituencies, to secure prioritization of this agenda at all levels.
  • Implementation: by fostering scale-up of implementation of effective actions to achieve discrimination-free health care.
  • Accountability: by promoting monitoring and evaluation frameworks and mechanisms to build evidence, monitor progress and ensure accountability.

The action plan outlines seven priorities; these include: building and sharing evidence and best practices; standard-setting; ensuring meaningful engagement of the people most affected by discrimination in the development, implementation and monitoring of policies and programmes; and strengthening the leadership of professional health-care associations.

A virtual community of practice has been created to mobilize more partners around the shared vision and action plan, to join contact ghwa@who.int. 

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“Non-discrimination in health-care settings is urgent in order to end the AIDS epidemic, and it is possible to achieve. Member-states have a legal obligation to ensure non-discrimination. It is also a precondition for sound public health. It is possible to eliminate discrimination through an actionable agenda, with joint efforts and the right scope and scale of programmes. The time to act is now.”

Luiz Loures, UNAIDS Deputy Executive Director 

“Getting to the goal of zero discrimination in health-care settings is linked to the development of institutions and systems able to provide just, people-centred health services. At its core this requires access to appropriately trained, well-supported health workers with a minimum core set of competencies.”

Jim Campbell, Executive Director, Global Health Workforce Alliance

“People living with HIV, especially young people, men who have sex with men, transgender people, people who sell sex and people who use drugs struggle to be heard and respected at clinics and hospitals. Stigma Index data from more than 65 countries and more than 65 000 people living with HIV interviewed show that 10% to 40% faced denial of care by health providers. On a positive note, the Stigma Index has resulted in partnerships with hospitals, health systems and ministries to put in place programmatic and policy responses to such discrimination. Such programmes need to be scaled up so that everyone can access non-judgemental services.”

Julian Hows, Knowledge Management Officer, Global Network of People Living with HIV (GNP+)