A/HRC/21/42 77. Access to justice must not only be provided for in the law, but be ensured in practice. States should ensure accountability mechanisms that are accessible, affordable, timely and effective.50 Stigmatized individuals are often affected by a range of barriers in accessing the courts and other mechanisms, including physical, economic or linguistic barriers. States should take measures to ensure physical access to buildings, for instance for persons with disabilities (see Convention on the Rights of Persons with Disabilities, art. 13), adopt legal aid schemes, and provide relevant information in local languages, among other relevant measures. VII. Conclusions and recommendations 78. Stigma plays an insidious role in perpetuating, “justifying” and ultimately creating impunity for human rights violations. It also serves to silence and erase issues, and exclude individuals and communities from access to water and sanitation, preventing some people from exercising their civil, cultural, economic, political and social rights. Most often, stigmatized individuals are the ones whose lives and health are placed directly in jeopardy by lack of access to water and sanitation. 79. The human rights framework requires States to prioritize the most marginalized, and to ensure their access to information, empowerment and effective participation. States must identify challenges, duty bearers and solutions through bottom-up local diagnostics, ensure accountability and tie any measures taken to substantive human rights standards. This process is as essential in combating stigma as the substantive parameters it hinges upon. The process of having the conversation, of including people in the discussion, and finding solutions together, has the potential to effect shifts in attitudes and behaviours and to lead to lasting and transformative changes. 80. Only by addressing stigma will States be able to fully realize the human rights to water and sanitation, and ensure non-discrimination or the prohibition of inhuman and degrading treatment. Comprehensive and holistic measures to prevent, address and provide for redress in cases of stigma and punish the perpetrators where stigma results in the violation of human rights are indispensable. States must refrain from any activities that perpetuate and institutionalize stigma, and must protect individuals from human rights abuses committed by third parties, including, for example, service providers, the media, community members and family members, that are rooted in stigma as a deeply entrenched sociocultural phenomenon. To that extent, States must act with due diligence. They must go beyond enacting formal legal provisions and take positive action to meet their obligations effectively and make a legitimate and reasonable effort to prevent and combat stigma. 81. Stigma must be addressed in its external and internalized dimensions in order to combat it effectively. Information, participation and empowerment must be the starting point of any measures to combat stigma. Many stigmatized groups are well organized, make claims on their rights, and educate society at large. States and other stakeholders should further empower stigmatized groups and individuals to claim their rights and to confront and challenge stigma and the people who stigmatize them. All relevant stakeholders, including individuals, communities, families, civil society organizations, networks of stigmatized groups, the media and donors, among many others, have responsibilities to combat stigma and should work together. 50 20 Committee on Economic, Social and Cultural Rights, general comment No. 9 (1998) on the domestic application of the Covenant, para. 9.