A/HRC/37/57 Intersecting and multiple discrimination 29. Persons with albinism are discriminated against on the basis of intersecting grounds, largely based on disability and colour. According to reports and direct observation, discrimination based on colour exacerbates the consequences of disability, in particular when there is high degree of contrast between the colouring of persons with albinism and that of the dominant population. According to Patricia Lund, in sub-Saharan Africa for example, “this appearance, so strikingly different from normally pigmented family members and the rest of the black community, results in problems of acceptance and social integration for those affected.”22 30. In other words, discrimination against persons with albinism should be understood as a specific situation stemming from the intersection of both disability and colour. Also, multiple discrimination affects subgroups and individuals among people with albinism. For instance, persons with albinism who are women and those affected by HIV/AIDS face aggravated discrimination.23 31. Therefore, an understanding of the challenges and identification of promising practices to ensure the right of persons with albinism to the highest attainable standard of physical and mental health require a holistic approach. Such an approach should also address the contextual and exogenous determinants that underpin specific situations at the intersection of both disability and colour, which manifest themselves with different degrees of severity according to the specific context. IV. Issues and challenges 32. The most pressing health issue faced by persons with albinism is skin cancer. That fact has been firmly established on the basis of several studies and consultations with civil society organizations, particularly those working with persons with albinism. In addition to skin cancer, other urgent health issues include visual impairment and mental health. 33. Persons with albinism are also subject to other health problems not linked to the condition of albinism. Those include common conditions and illnesses to which they have become more vulnerable, owing to poverty and pre-existing discrimination and neglect of albinism in the health and social services system, in general. Organizations of persons with albinism reported specific health problems, such as malnutrition and dehydration, tropical diseases, such as malaria and typhoid fever, infectious diseases, HIV/AIDS, cholera and chronic non-communicable diseases. 34. At present, the enjoyment of the right to the highest standard of mental and physical health by persons with albinism is far from a reality. As a consequence, health issues and intersecting discrimination in the context of exogenous factors have an impact on the enjoyment of other human rights, such as the right to life and socioeconomic rights. A. Impact of health issues on the right to life 35. The most serious health issue affecting the enjoyment of the right to life by persons with albinism is their susceptibility to skin cancer. In addition, the discrimination and stigmatization arising from skin colour leads to immediate life-threatening crimes in contexts in which witchcraft-related misbeliefs and harmful practices are widespread. High susceptibility to skin cancer 36. It has been indicated in several reports that most persons with albinism in subSaharan Africa die from skin cancer between the ages of 30 and 40 years. 24 In the case of 22 23 24 8 P.M. Lund, “Oculocutaneous albinism in southern Africa: population structure, health and genetic care”, Annals of Human Biology, vol. 32, No. 2 (2005), pp. 168–173, at pp. 168–169. Submission of the Association Ivoirienne pour la Promotion des Femmes Albinos. Submissions of Connexion Worldwide and the Source of the Nile Union of Persons with Albinism.