A/HRC/38/42 this means that leprosy-related discrimination affects in different ways a person according to his or her social status and capital. 66. Tackling leprosy-related discrimination based on an approach that acknowledges the intersection of leprosy with other social phenomena of oppression and violence does not mean blurring leprosy into the wider picture of social inequities, inequalities and injustice. On the contrary, that would only increase discrimination and strengthen the structural violence experienced by persons affected by leprosy and their family members by contributing to their invisibility. 67. Tackling leprosy-related discrimination on the basis of an approach that acknowledges the intersection of leprosy with other social phenomena of oppression and violence means producing in-depth analysis and knowledge, contextualizing interpretations on social and cultural milieus and developing more accurate and effective tools. Intersectionality is key for analysis, but responses for action must come from other tools. 68. Given the multiple and multilayered discrimination against persons affected by leprosy and their family members, one of the more important tools to be developed and improved is affirmative action, in order to balance the terms that establish not only opportunities, but also outcomes, for persons affected by leprosy. 69. In fact, formal equality in law can result in increasing inequalities, marginalization and invisibility when it fails to recognize the different conditions that specific groups experience and struggle with. From the acknowledgement of such differences, the concept of material equality was born, which aims at a substantive analysis of social realities and practices that goes beyond legal dogmatics or a formal analysis of legal equality. 50 70. One of the several tools able to generate material equality is affirmative action, which means creating mechanisms or policies that allow for protecting and supporting specific social groups that dwell in structural disadvantage, thus enabling equality of opportunities and/or outcomes and eliminating the barriers to the achievement of real and effective equality. 51 Measures of affirmative action can take many forms and their use, characteristics and goals for addressing the structural discrimination of persons affected by leprosy and their family members must also be dependent on the context of implementation. Vulnerability and intersectorality 71. As detailed in previous chapters, leprosy is not a residue from the past. On the contrary, leprosy is a contemporary disease closely linked with structural vulnerability. The impact of leprosy on the lives of persons affected is still severe and depends on the capacity of States to ensure: (a) functional, and culturally and gender-sensitive access to health services; (b) early diagnosis; (c) high-quality medical care during treatment and after; and (d) social policies that fit the specific needs of persons affected by leprosy (regarding gender, education, housing, work and disability, among others) and access to them. This means that the impact of leprosy on the lives of persons affected is proportional to their vulnerability and resilience. 72. The concept of vulnerability refers to the diminished capacity of an individual or group to anticipate, cope with, resist and recover from any hazard. People differ in their exposure to hazard and leprosy-related discrimination is undoubtedly a factor that increases vulnerability. However, vulnerability also increases the impact of leprosy on the lives of persons affected. 73. Vulnerability must be understood as a political, economic, social and cultural condition and not as an ontological feature of a group of persons. That is to say, any 50 51 14 Roxana Arroyo Vargas, “Igualdad un largo camino para las mujeres”, in Igualdad y no discriminación, el reto de la diversidad, Danilo Caicedo Tapia and Angélica Porras Velasco, eds. (Quito, Ministry of Justice, Human Rights and Religious Affairs, 2010), pp. 421–447. Judith Salgado Álvarez, “Lidiando con la diferencia. Respuestas desde la justicia constitucional ecuatoriana y colombiana”, in Igualdad y no discriminación, el reto de la diversidad, Danilo Caicedo Tapia and Angélica Porras Velasco (Quito, Ministry of Justice, Human Rights and Religious Affairs, 2010), pp. 483–546.