A/HRC/44/46/Add.2 20. The explanatory statement of Executive Order No. 373/2007 (subsequently Law No. 11520/2007) details the historical background of the Brazilian policy of institutional segregation. Officially, the compulsory isolation of persons affected by Hansen’s disease in Brazil was abolished in 1962 under Decree No. 968. However, the pace at which secluded persons were released differed as a result of local and regional realities, hence de facto segregation continued until as late as 1986. 21. Article 4 of Law No. 11520 provides for full rehabilitation and ensures free access to orthotic devices, prostheses and other assistive devices and technologies for the beneficiaries of the special pension. 22. As part of the compulsory isolation policy, a large number of the children of persons affected by Hansen’s disease were separated from their parents and grew up without any contact with their biological parents. These children were sent to orphanages, nurseries and “preventoriums” – institutions created by the State for their segregation from society immediately after birth. Minas Gerais was the first state to adopt a law granting reparation to persons who were separated from their parents owing to this official policy (state Law No. 23137/2018). Minas Gerais Decree No. 47560/2018 establishes the criteria for the concession of this benefit. These norms are applicable in the State of Minas Gerais only. B. Institutional framework 23. The two governmental bodies directly involved with Hansen’s disease in Brazil are the Ministry of Health, which is responsible for the health care of persons affected by Hansen’s disease, and the Ministry of Women, Family and Human Rights, which is responsible for the implementation of Law No. 11520. 24. The development and monitoring of the National Hansen’s Disease Strategy 2019– 2022 is the responsibility of the National Office for Hansen’s Disease Coordination, under the Secretariat of Health Surveillance of the Ministry of Health. In accordance with the WHO global strategy,14 the National Hansen’s Disease Strategy is based on three strategic pillars: strengthening management of the programme at the three levels of governance; fighting Hansen’s disease and its complications; and fighting discrimination and promoting inclusion. 25. Guidelines for the surveillance, care and control of Hansen’s disease and on preventing its transmission are based on active case detection, timely treatment, prevention of physical impairments and contact tracing. The National Office for Hansen’s Disease Coordination encourages the participation of both persons affected by the disease and experts in the field, which has contributed to the quality of technical responses to the disease in the country. Brazil has sometimes diverged from WHO policy in the past, researching the WHO guidelines in-depth before implementing them nationally, as in the recent case concerning chemoprophylaxis with a single dose of rifampicin (post-exposure prophylaxis) for individuals who had been in contact with persons diagnosed with Hansen’s disease. The concerns over possible resistance to rifampicin and stigmatization of such individuals that were raised by experts and persons affected by Hansen’s disease were duly taken into consideration when deciding on this matter. Private-public partnerships are also a core part of the national strategy. Projects implemented by partnerships between the Ministry of Health and MORHAN, Novartis Brazil, DAHW Brazil, the Sasakawa Health Foundation and the Pan American Health Organization are currently under way. Both state and municipal authorities are responsible for the implementation of the strategy. 26. Health councils at the three levels of administration are key mechanisms for monitoring the proper implementation of the strategy. The Special Rapporteur became aware of this fact during her visit, especially given the level of autonomy of the states and the municipalities in the management of resources and the disparate implementation of the national strategy within the country. 27. Presidential Decree No. 9759/2019 regulates and limits the councils, which are federal public collegiate bodies, and restricts the exercise of fundamental freedoms and 14 6 WHO, Global Leprosy Strategy 2016−2020: Accelerating towards a leprosy-free world (New Delhi, 2016).

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