A/HRC/44/46/Add.2 Annex Report of the Special Rapporteur on the elimination of discrimination against persons affected by leprosy and their family members on her visit to Brazil I. Introduction 1. The Special Rapporteur on the elimination of discrimination against persons affected by leprosy and their family members, Alice Cruz, undertook an official visit to Brazil from 7 to 14 May 2019. The purpose of the visit was to evaluate the improvements made and the challenges the country faces in eliminating discrimination against persons affected by leprosy and their family members and to provide the Government and key stakeholders with constructive recommendations. Given that leprosy is referred to as Hansen’s disease in Brazil, that term will be used in the present report. 2. During her mission, the Special Rapporteur visited the capital, Brasília, in the Federal District. She also visited Pará, a highly endemic state, and Rio de Janeiro, a state with a low incidence of Hansen’s disease. The aim was to assess the main factors sustaining ongoing discrimination against persons affected by Hansen’s disease and their family members with regard to the distinct epidemiological, socioeconomic and cultural realities within the country. 3. The Special Rapporteur met with federal and local government representatives in the cities of Brasília, Rio de Janeiro and Belém, with the Federal Public Defender and with staff of the public defenders’ offices at the federal and state levels. She also met with the United Nations resident coordinator and country team; the Pan American Health Organization coordinator for Hansen’s disease in the region; the more prominent academics in the fields of hansenology (leprology), public health, history and social sciences at the leading South American public health research centre (Fundação Oswaldo Cruz); law and health-care professionals and public health managers; members of civil society organizations and national and international non-governmental organizations (NGOs); and members of MORHAN, the national Movement for the Reintegration of Persons Affected by Hansen’s disease, both its national coordination and regional branches. In addition, the Special Rapporteur visited several communities and former Hansen’s disease colonies, where she met with persons affected by the disease and their family members. She made every effort to make the visit interdisciplinary and to give all stakeholders a voice. She also endeavoured to make the visit a catalyst to enable dialogue and to build bridges between different stakeholders in order to foster more effective responses to discrimination. 4. The Special Rapporteur expresses her appreciation to the Government of Brazil for its initial invitation and for the support it provided in the organization and facilitation of the visit, in close coordination with the regional and local authorities. She also thanks the public and private institutions and civil society organizations that provided valuable substantive inputs and assistance in the coordination of the visit. She is particularly grateful to MORHAN, to the persons affected by the disease and their families. II. Hansen’s disease in Brazil 5. Hansen’s disease, known globally as leprosy, remains a significant public health problem in Brazil. Brazil is the world’s fifth largest country by both population and total area, and the largest and most populated Latin American country. It is composed of 26 states and one federal district. According to World Bank indicators on poverty and inequality, in 2017, 26.5 per cent of the population of Brazil was living in poverty, and 7.4 per cent was living in extreme poverty. Over a third of the population had restricted access to basic sanitation and 15 per cent had no access to the water supply network. Such data is relevant for understanding the epidemiological features of Hansen’s disease in the country. 6. According to the World Health Organization (WHO), Brazil has the second highest absolute number of new cases of Hansen’s disease in the world. In 2018, Brazil accounted 2