Addressing human rights-related barriers to health
Human rights and gender-related barriers to health have long blocked national responses to HIV, TB and malaria, including: stigma and discrimination; gender inequality and violence; punitive practices, policies and laws; and social and economic inequality. The Global Fund’s Sustainability, Transition and Co-financing Policy now requires all countries, regardless of income level, to include programs to address these barriers in their proposals.
Seven key program areas that are effective in reducing human rights-related barriers to HIV and TB services include:
- Stigma and discrimination reduction
- Training for health care providers on human rights and medical ethics
- Sensitization of lawmakers and law enforcement agents
- Reducing discrimination against women in the context of HIV and TB
- Legal literacy
- Legal services
- Monitoring and reforming relevant laws, regulations and policies
In addition, for TB there is a need to ensure confidentiality and privacy, mobilize and empower patients and community groups, address policies regarding involuntary isolation or detention for failure to adhere to TB treatment, and make efforts to remove barriers to TB services in prisons. For malaria, among other things, the Malaria Matchbox Tool should be used to assess inequities in access to malaria services as well as human rights- and gender-related risks and vulnerabilities, meaningful participation of affected populations should be ensured, and access to malaria services for refugees and others affected by emergencies improved.
To assist implementers in rolling out these programs, the Global Fund developed and issued technical briefs on HIV, human rights and gender equality; TB, gender and human rights; malaria, gender and human rights; human rights and gender programming in challenging operating environments – countries or regions affected by natural disaster, conflict or poor governance; and human rights in the times of COVID-19.
Many lessons have been learned in recent years as programs to reduce human rights-related barriers to services have been implemented and scaled up.