A/HRC/41/47 VI. Conclusions and recommendations A. Conclusions 90. The main underlying causes of ongoing discrimination against women and children affected by leprosy, including family members are: (a) at the macro level of global health, the association between the limited public apprehension of leprosy, on the one hand, and the mercantilization of health and the patriarchal nature of biomedicine on the other; (b) at the intermediate level of State governance, discriminatory laws, widespread absence of reparation and awareness-raising measures to counter the iatrogenic stigma created by past State prophylactic segregation, lack of a multisectoral approach to leprosy and persistence of social iniquities that have not been addressed; (c) at the micro level of social life, pervasive harmful stereotypes, wrongful stereotyping and violence; (d) at the individual level, the internalization of stigma as an extreme form of dehumanization. 91. Harmful stereotypes and traditional practices and institutionalized, structural and interpersonal discrimination intersect with the already subordinated social location of women and children in many societies, with severe manifestations of physical, sexual and psychological violence and systemic informal segregation. The low participation of both social groups in civil society organizations, health services, decision-making processes and institutional bodies enhances the weakness of the responses from State monitoring systems and policies to map and address discrimination and violence on the grounds of leprosy, strengthening women’s and children’s structural invisibility, social subordination and institutional neglect. The narrow understanding of leprosy as a biological condition hinders much-needed efforts to tackle the social, economic, cultural and political dimensions of leprosy as a social category that, throughout history as well as in contemporary societies, has been used mainly to exclude. Without the de facto recognition that all human rights are inalienable, indivisible, interdependent and interrelated and that they all must be fulfilled on a non-discriminatory basis, alongside a multisectoral strategy that can disaggregate leprosyrelated discrimination into the distinct realities of different groups and cultural backdrops, women and children affected by leprosy will surely continue to be left behind. B. Recommendations 1. General recommendations 92. The Special Rapporteur calls upon States to take all necessary measures to: (a) Review existing legislation to ensure that it is in line with international human rights standards and abolish and/or amend all discriminatory laws in force as an immediate obligation;38 (b) Implement the principles and guidelines for the elimination of discrimination against persons affected by leprosy and their family members as a road map for enforcing enshrined international human rights and achieving substantive equality;39 (c) Systematically approach, consult and involve in decision-making processes that directly affect their lives persons affected by leprosy and their representative organizations, with the guarantee of all measures for ensuring the 38 39 In line with general comment No. 6 (2018) on equality and non-discrimination of the Committee on the Rights of Persons with Disabilities. In agreement with general comment No. 20 of the Committee on Economic, Social and Cultural Rights. 17