A/HRC/16/69
5.
Persons with disabilities
23.
Few respondents mentioned persons with disabilities and their participation in HIV
programmes. Brazil noted that persons with disabilities were wrongly thought not to
exercise their sexuality, and that they could thus be disregarded in HIV decision-making. At
the Geneva consultation, a representative of the Government of South Africa observed that
persons with disabilities were excluded not only from HIV decision-making processes, but
also from basic HIV information. Meetings and consultations were held in venues not
accessible to persons with disabilities. HIV information was provided in formats not
accessible to persons with hearing and visual impairments. Women and children with
hearing or sight impairments and other disabilities were at a high risk of physical and
sexual violence, but addressing these risks was not a programme priority.
E.
Lack of access to health services
24.
Many of the Member States that provided information for the present study cited
greatly expanded care for HIV, especially access to antiretroviral therapy, as the most
important human rights achievement in their HIV responses. Nonetheless, respondents and
presenters at the consultation pointed out that stigma, discrimination and fear of criminal
prosecution kept many people living with and vulnerable to HIV from seeking health
services they needed, including HIV prevention and treatment services. Several respondents
cited the urgent need to help health workers to be part of the solution to HIV-related stigma
in health services rather than part of the problem. UNAIDS cited widespread stigma and
mistreatment of people living with HIV in public health services in India and the lack of
mechanisms of redress for these abuses. In 2008, the Supreme Court of India had issued
interim directions to ensure access to care for people living with HIV at public hospitals.
Such judicial remedies appeared to be rare elsewhere. The Government of Mexico
emphasized the need to address both HIV-related prejudices and homophobia among health
service providers.
25.
Several respondents reported that people living with HIV, sex workers, people who
use illicit drugs and men who have sex with men were often excluded from health services
because they were unable to get health insurance or feared being mistreated by health-care
providers. In some cases, people living with HIV could be covered for antiretroviral therapy
paid for by donor funding, but might be unable to obtain affordable care for opportunistic
infections and other problems. The World Food Programme noted that, although food and
nutrition assistance should be part of comprehensive HIV care, it rarely was.
26.
At the Geneva consultation, the Director of the International Harm Reduction
Association reported that, among the people who use drugs worldwide, half of those who
needed access to sterile syringe programmes did not have it, and less than half who need
opioid-substitution therapy could obtain it. Quoting from a report issued by the Association
in 2010, he pointed out that international donor support for these measures in middle-and
low-income countries amounted to about US$ 0.03 per person who injects drugs. UNAIDS
noted in its submission that one barrier to expanded services was the ambiguous legal status
of needle exchange and the above-mentioned therapy in some countries. The representative
of Lebanon at the Geneva consultation reported that moving forward with the much needed
opioid-substitution therapy required getting a ministerial decree giving the therapy clear
legal grounding. Even when some structural barriers were removed, as in Lebanon, the
challenge remained to mobilize resources to provide services at a scale that met demand.
27.
The inaccessibility of humane treatment for drug dependency was underscored by
several informants. ESCAP, Asia Catalyst and non-governmental organization
representatives at the Geneva consultation highlighted human rights concerns relating to
compulsory drug detention centres in several Asian countries where people suspected of
10
GE.10-17842
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