Year Two: Targeting Institutions

The second phase of the campaign will focus on institutional reform and responses. This will include looking at the issue of stigma and discrimination from the human rights and legal perspectives. It will advocate institutional reform across different sectors. At the political level, it will focus on advocating policy law reform, as necessary, and increasing efforts towards the enforcement of legal rights. At the implementation level, it will address ways in which existing interventions can be strengthened and expanded, and new interventions can be planned and implemented to help reduce stigma and discrimination and resulting human rights violations.

Writing Research-Based Issue Papers and Reports

Issue papers and reports will highlight the levels of stigma and discrimination across the world. These papers and reports will be based on experience and data collected and analysed over the last few years, and will cover all sectors.

Stigma and Discrimination on the Agenda of International Conferences and Reports

Efforts will be made to include the issue of stigma and discrimination on the agendas of various international conferences, especially the regional conferences on HIV/AIDS in Latin America¹, Asia² and Africa³ in 2003. The PLWHA conference⁴ will also be an important forum for the discussion of stigma and discrimination. The annual report of the UN Secretary-General will highlight the existing situation and report on progress made on the Declaration of Commitment on HIV/AIDS. Countries and NGOs submitting national reports to various United Nations forums, such as the UN General Assembly, the Economic and Social Council, the Human Rights Commission and Committees that monitor the implementation of various human rights treaties, covenants and conventions, will be encouraged to report about HIV/AIDS-related stigma and discrimination, and resulting human rights violations. Regional human rights bodies, where they exist, should also be reported to. Country-level conferences and meetings should also feature stigma and discrimination on their agendas.

Review and Reform of Laws, Legislations and Regulations

Each country will be encouraged to undertake a review of its existing laws and regulations that reinforce or legitimize stigma and discrimination in light of international human rights laws. Countries will be encouraged to find ways of advancing the law reform agenda. The judicial system will be encouraged to play a role in promoting such reviews and enforcing changes through judgements. Also, grievance and redress systems should be put in place to ensure that stigma and discrimination do not occur in the workplace.

The various HIV/AIDS resolutions passed by the Commission on Human Rights and the Sub-Commission on the Promotion and Protection of Human Rights, as well as General Comments and Concluding Observations of the UN Human Rights Treaty Bodies, such as the Committee on Economic Social Cultural Rights, should be referred to when national laws are reviewed.

Promoting Non-Discriminatory Laws

The various international human rights treaties, conventions and covenants that countries have signed, as well as HIV/AIDS resolutions passed by the United Nations Human Rights Commission, should be translated into local languages and disseminated widely to create awareness within countries and to influence and inform the law reform process.

Combating HIV/AIDS-related stigma and discrimination often involves a variety of strategies. If, for example, human rights law is found to be too restrictive in a particular instance, labour law, for example, may also have provisions prohibiting discrimination in employment. Information about the various ways of seeking redress needs to be made available.

Health Care Provision Practices

The health sector and its service institutions will be encouraged to review their policies, professional codes of conduct and practices to prevent and redress stigma and discrimination. Each institution should be encouraged to undertake a review of their practices and make appropriate changes. Training of health-care providers on dealing with stigma and discrimination should be undertaken. Procedures for taking action against those who discriminate should also be put in place. The monitoring of such policies, professional codes of conduct and practices should form part of country reports to the United Nations Human Rights Commission and to the committees that monitor the implementation of various human rights treaties, covenants and conventions.

Hospital charters are a means of communicating the standards of care that people can expect from the institution. The campaign will encourage public and private hospitals to review their charters and incorporate provisions that clearly indicate that there will be no discrimination against people living with HIV/AIDS or those belonging to vulnerable groups.

Workplace Policies

The workplace is another environment in which stigma and discrimination occur. The International Labour Organization (ILO) Code of Practice on HIV/AIDS and the world of work provides guidance to different actors in the world of work and outlines options for them to choose from and to adapt those that are relevant to their needs. Employee orientation programmes should include issues of stigma and discrimination and people's rights with respect to HIV/AIDS. Grievance redressal systems should be put in place, whereby people can make their complaints if they are stigmatized or discriminated against. This will go some way towards ensuring that stigma and discrimination do not occur in the workplace. Competent authorities should be encouraged to create rules regarding unfair dismissal and treatment of workers affected by HIV/AIDS. Employees and employers must be made aware of the way such rules operate.

GIPA Policies

The principle of Greater Involvement of People Living with or Affected by HIV/AIDS (GIPA) calls for the creation of an environment that enables PLWHA to be involved in the response to the epidemic. As set forth in the ILO Code of Practice, the development and implementation of HIV/AIDS workplace policies and programmes should involve PLWHA in the UN System, in the public sector and in the private sector. There should be deliberate policies to encourage PLWHA to disclose their HIV status in an effort to 'normalize' the epidemic.

GIPA Pilot Projects in Malawi and Zambia have shown that PLWHA are a critical asset in fighting stigma and discrimination. By breaking the silence around HIV/AIDS and by acting as role models for their communities, they contribute to changing attitudes, perceptions and behaviours about HIV. Therefore, opening space for PLWHA, through recruitment, capacity development and policy design, is an effective empowerment strategy in the fight to protect human rights.

Faith-Based organizations

The role of faith-based organizations in reducing stigma and discrimination is pivotal. Messages to the faithful often determine people's response and attitudes towards people infected or affected by HIV/AIDS, and vulnerable populations. Faith-based organizations have been at the forefront of providing care and healing to people living with HIV/AIDS. Their direct involvement in care sends a positive signal to communities. These faith-based organizations can also play a role in normalizing HIV/AIDS in the community by discussing issues with their followers and allowing for respectful funeral services. The campaign will reach out to the leaders of these faith-based organizations and encourage them to take a proactive role in the fight against HIV/AIDS and in preventing and addressing HIV/AIDS-related stigma and discrimination.

Codes of Conduct of Professional Bodies

The campaign should reach out to professional bodies such as doctors' associations, nurses' associations, business coalitions, and chambers of commerce, encouraging them to adopt codes of conduct with respect to HIV/AIDS. These bodies will also be encouraged to discuss the issue of stigma and discrimination among their members and to develop a plan of action to address HIV/AIDS-related stigma and discrimination from within their bodies.

Programming for Stigma and Discrimination

All institutions involved in HIV/AIDS prevention and care will be encouraged to address the issue of stigma and discrimination in their existing programmes. This should include a review of activities as well as the education and involvement of their workforce.

Creating Mechanisms to Address and Redress HIV/AIDS-Related Discrimination

Each country will be encouraged to utilize, create or strengthen mechanisms whereby people who have been stigmatized and discriminated against can confidentially make their complaints and, where appropriate, receive redress. Existing mechanisms such as the office of the ombudsman, national human rights commissions or legal aid should be encouraged to address issues of HIV/AIDS-related stigma and discrimination within their mandates.

Hearings From the Public

National AIDS Commissions should be encouraged to hold hearings (public and in-camera) about cases of HIV/AIDS-related stigma and discrimination, and to document these. Such hearings should be used to inform national policy as well as programme and law reform.

Notes

1. Community Fora, Havana, Cuba, 5-13 April 2003.
2. 7th International Congress on AIDS in Asia and the Pacific (ICAAP), Kyoto, Japan, 27 November-1 December, 2003.
3. 13th International Conference on AIDS and STIs (ICASA), Nairobi, 21-26 September 2003.
4. 11th International Conference for People Living with HIV/AIDS, Kampala, Uganda, 26-31 October 2003.