A/HRC/44/46/Add.2 rights, such as participation in decision-making, monitoring and accountability. Such councils have been critical for guaranteeing the civil and political rights enshrined in the International Covenant on Civil and Political Rights, to which Brazil is a party, and have also paved the way for the participation in public affairs of marginalized groups, such as persons affected by Hansen’s disease.15 The elimination of these key mechanisms would reinforce the exclusion of these individuals, constituting a major setback to their enjoyment of social, economic and cultural rights, and a retrograde step with regard to the enforcement of core international human rights. 28. An interministerial pension evaluation committee within the Ministry of Women, Family and Human Rights, composed of experts and representatives of MORHAN, oversees the special pensions provided for under Law No. 11520. According to the available data, the committee had received around 12,997 applications by October 2018, of which 9,011 were granted and 3,986 were rejected, resulting in a successful applicant rate of around 70 per cent.16 29. One example of good practice aimed at enforcing the human rights of persons affected by Hansen’s disease that was documented during the visit was the creation of the National Observatory on Human Rights and Hansen’s disease. The Observatory receives reports of and monitors human rights violations of persons affected by Hansen’s disease. Its mission is to fight institutional discriminatory practices. The initiative is the result of a partnership between the Public Defender’s Office of the State of Maranhão, MORHAN and the Sasakawa Health Foundation. This institutional experiment is fit for replication at the national and state levels. IV. Main challenges and opportunities A. Social determinants of Hansen’s disease 30. Hansen’s disease is classified by WHO as a tropical neglected disease closely linked to poverty.17 According to WHO, infectious diseases contribute to lifelong disadvantage, perpetuating the vicious cycle of poverty and infection.18 There is evidence demonstrating the socioeconomic and environmental root causes of Hansen’s disease in Brazil. Independent research shows the linkage between the incidence of Hansen’s disease, poverty rates and inequality indicators, such as household crowding. 19 Independent research also points to the socioeconomic profile of persons diagnosed with Hansen’s disease, who often have a low level of education, a low income and precarious work, and live in areas with poor infrastructure and poor access to goods and services.20 15 16 17 18 19 20 In its general comment No. 25 (1996) on participation in public affairs and the right to vote, the Human Rights Committee defines the conduct of public affairs as a broad concept covering all aspects of public administration and the formulation and implementation of policy at all levels (para. 5). See www.mdh.gov.br/navegue-por-temas/pessoa-com-deficiencia/programas/hanseniase. See www.who.int/neglected_diseases/diseases/en/. WHO, Global Report for Research on Infectious Diseases of Poverty (Geneva, WHO, 2012). Leila Posenato Garcia and Gabriela Drummond Marques da Silva, “Doenças transmissíveis e situação socioeconômica no Brasil: análise espacial” (Brasília, Instituto de Pesquisa Econômica Aplicada, 2016); Lúcia R.S. Freitas, Elisabeth C. Duarte and Leila P. Garcia, “Leprosy in Brazil and its association with characteristics of municipalities: ecological study, 2009–2011”, Tropical Medicine and International Health, vol. 19, No. 10 (2014); Lorena Dias Monteiro and others, “Determinantes sociais da hanseníase em um estado hiperendêmico da região Norte do Brasil”, Revista de Saúde Pública, vol. 51 (2017); Carlos Souza, “Hanseníase e determinantes sociais da saúde: uma abordagem a partir de métodos quantitativos – Bahia, 2001–2015”, PhD dissertation, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, 2018. Marli T.C. Duarte, Jairo A. Ayres and Janete P. Simonetti, “Perfil socioeconômico e demográfico de portadores de hanseníase atendidos em consulta de enfermagem”, Revista Latino-Americana de Enfermagem, vol. 15 (2007); Viviane A.S. Lopes and Etuany M. Rangel, “Hanseníase e vulnerabilidade social: uma análise do perfil socioeconômico de usuários em tratamento irregular”, Saúde Debate, vol. 38, No. 103 (2014); Lúcia M.F. Helene and Maria J.L. Salum, “A reprodução 7