A/HRC/41/27
often not aware of their rights, they were unable to seek remedies when their rights were
violated. Law enforcement and judicial officials themselves were not necessarily aware of
relevant human rights provisions.
33.
In response to the issues raised, Judge Pazmiño pointed out that courts alone would
not bring change without pressure from rights holders, and called upon civil society,
academia and the media to pressure States to implement courts’ decisions. Ms. Asuagbor
pointed out that, even though the State was the primary duty bearer for human rights, the
promotion of human rights should not be left to States alone, given that the political will to
prioritize human rights was often insufficient. In order to improve people’s awareness of
their rights, she called upon civil society to conduct awareness-raising campaigns and to
empower rights holders so they could seek legal remedy for violations of their rights. Mr.
Golosceapov called for improving national collection and disaggregation of data on gender,
HIV and disability. Mr. Gurung called for the strengthening of human rights accountability
mechanisms.
D.
Delivering on the “leave no one behind” promise: addressing stigma,
discrimination, violence and abuse
34.
The panel was composed of the Independent Expert on protection against violence
and discrimination based on sexual orientation and gender identity, Victor Madrigal-Borloz;
Suzanna Aho Assouma, member of the Committee on the Rights of the Child; Eszter
Kismodi, editor of the journal Sexual and Reproductive Health Matters; and Ruth Morgan
Thomas, of the Global Network of Sex Work Projects. The panellists highlighted the
central role of human rights in leaving no one behind, and advocated for a people-centred
and inclusive response to HIV, and called for an end to all forms of inequality, stigma,
discrimination, violence and abuse.
35.
The Independent Expert pointed out that the right to health lay at the intersection of
a human rights-based approach and the Sustainable Development Goals, which also had the
aim of leaving no one behind. Lesbian, gay, bisexual and transgender persons faced specific
challenges and barriers that were at the root of discrimination and violence – demonization,
pathologization and criminalization – which were the drivers of negation and stigma.
Criminalizing environments had a negative impact on access to health-care services and
health-related information. The 2030 Agenda could not be achieved while the
criminalization of sexual orientation or gender identity remained the norm in 70 States. The
Independent Expert then drew attention to the nefarious effects of the pathologization on
health-related laws and policies, and called for measures to eradicate the conception of
certain forms of gender as a pathology. The Independent Expert also pointed out that
violations to the right to health of lesbian, gay, bisexual and transgender persons were
enabled by denial. In a context of negation and criminalization, knowledge about a State’s
population and its diversity was lacking, and had a detrimental impact on health
programming, including in the response to HIV/AIDS. Health programming required
evidence-based interventions. The Independent Expert stressed that the majority of trans
and gender-diverse persons did not have their gender recognized by the State. This legal
vacuum encouraged discrimination and allowed for violence, leaving such acts unpunished
and to de facto criminalization, with a serious impact on the right to health.
36.
Ms. Assouma pointed out that the States members of the African Union had pledged
at the Abuja summit to allocate 15 per cent of their national budget to health. Budget
allocations to health, however, did not usually exceed 8 per cent, and how much was
actually allocated to children was unclear. Ms. Assouma advocated for providing HIVrelated health services to mothers and children, and suggested focusing on capital cities to
prevent mother-to-child transmission of HIV. Remote rural areas in sub-Saharan African
countries did not provide adequate HIV/AIDS health care. Lack of quality health-care
services predisposed newborn children to the vertical transmission of HIV. Home births
remained the norm in large territories, despite the risks of mother-to-child transmission.
Stigma and discrimination prevented women from seeking or gaining access to HIV-related
health services, and women did not always know where to obtain treatment. Discrimination
affected follow-up, as mothers often did not return after the first visit. Ms. Assouma called
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