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Reaching zero discrimination in healthcare settings and towards are key and vulnerable populations is one of our main objectives in Brazil. Actions to reach zero discrimination has been a call from civil society for several years. Currently, the UCO is supporting
- a second round of the Stigma Index 2.0 with adaptations for Brazil and a gender section that was developed in collaboration with GNP+, civil society in Brazil, cosponsors and the Ministry of Health.
- Distribution of legislation monitoring monthly to all key stakeholders. The monitoring system allows us to catch bills/law proposal that can negatively impact the HIV response and people living with and affected by HIV/AIDS.
- Developed a zero discrimination online course (with education credits) to healthcare providers. The course was designed with inputs from civil society, MoH and University of Rio Grande do Sul. It has been adopted by two states and the MoH. CDC has integrated a shorter version of the course into their PEPFAR activities in 4 cities to address stigma and discrimination in healthcare settings. UNAIDS is soon help develop a recognition/certification guidance for health units that meet defined criteria to be referred as Zero Discrimination or friendly clinics.
- Negotiated the signing of the Global Partnership for the elimination of all HIV related discrimination by the Ministry of Human Rights and the Ministry of Health. Within this partnership, analysis and policy reform are taking place.
- Brazil is a member of the Global Council on inequalities, AIDS and pandemics which will provide Brazil with a leadership role and opportunity to advocate for policies to address inequalities (including eliminating stigma and discrimination) within the context of pandemics.
- The UCO is highly active on social media and manages our highly visited UNAIDS Brazil website where fake news are demystified and correct information shared with the public. Our communications team ensure that human rights and addressing stigma and discrimination are central in our communication pieces.

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UCO has undertaken a stigma index study in partnership with PLHIV networks, WFP, UNICEF, NAC, MoH, PEPFAR partners. This report has informed the development of a legal literacy programme which the NAC is implementing across the country. In addition, the UCO in collaboration with UNDP, USAID, CSO, PLHIV, MoH, has undertaken a legal environment assessment which is going to inform the HIV prevention roadmap to be developed in 2024.

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In Iran, UNAIDS technically supported a legal environment assessment financially supported by the GF. UCO continued w supporting development of the ethical framework for the NSP and paralegal framework for adolescents at risk of or living w HIV. Also again thru UCO coordination, Stigma Index 2 was financially supported by the GF and was conducted by collaboration of PLHIV network, Iranian Center for HIV Research, GNP+ and other stakeholders. Meanwhile, by UCD advocacy the country joined Global Partnership in 2018 and set health care setting, humanitarian setting and community setting as its priorities in the GP to end HIV related Discrimination. A protocols were developed for addressing HIV S&D in medical and humanitarian settings and relevant service providers were/are trained. Also similar exercises are ongoing for Justice setting and community settings. The exercise has been planned to take place for education and workplace settings in 2023-24. Asa result, the first ever anti discrimination bylaw was issued and distributed in health care settings.

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Nuha Ceesay, Initiatives Against Stigma and Discrimination 

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Nuha Ceesay, Initiatives Against Stigma and Discrimination 

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Discrimination against people living with HIV and key population is the silent killer that drives the HIV epidemic underground and thereby create a fertile ground to spread.

There are many areas that UNAIDS has been engaged  and advocate for an inclusive HIV response that leaves no one behind.

The first entry point is in the national strategy plans and policies. UNAIDS works  closely with key stakeholders to ensure that the HIV response is anchored on the key core human rights principles and that there are specific measurable objectives and targets to track HIV related stigma and discrimination.

We work very closely with civil society on community led monitoring which has defined tools to monitor the manifestation of HIV related stigma at service delivery levels and within communities.

UNAIDS also work with  human rights institutions such as Malawi Human Rights Commission as well civil society to continuously advocate for the elimination of all forms of stigma in inline with Results Area 5 of the Global AIDS Strategy.

Malawi adopted a progressive HIV Prevention and Management Act in 2018 and UNAIDS in its advocacy continuously calls for the popularization and implementation of this law.

One of our key areas of work is monitoring human rights violations and providing support to  LGBTQ+ people whose rights have bene violated . This work is done by working closely with key population led organizations as well as the Malawi Human Rights Commission.

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UNAIDS supported the Ghana AIDS Commission in the development of the "Strategic Plan for the response to Human Rights-related Barriers to HIV and TB Services (2020-2024)" and is supporting the monitoring of progress trough the establishment and continuty of the Human Rights Steering Committe established by GAC.
UNAIDS is also coordinating efforts with the Global Fund and PEPFAR, GAC and CSOs to develop a plan under the framework of the Focal Countries Collaboration Initiative as a key tool to achieve the goals of the National HIV and AIDS Strategic Plan and the Strategic Plan for the response to Human Rights-related Barriers to HIV and TB Services (2020-2024).
UNAIDS has been a critical partner to design interventions to be included as part of the Breaking Down Barriers initiative supported by the GF.
UNAIDS is supporting the finalization of the Stigma Index 2.0.
UNAIDS and UNDP are supporting trainings on Stigma and Discrimination in healthcare facilities poviding HIV care iN Greater Accra Region.
UNAIDS continues advocating with government entities for Ghana to join the Global Partnership to eliminate all forms of HIV related stigma and discrimination.

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Mozambique is part of the Global Initiative to End all forms of Discrimination, through the country focus. We are working with the National Commission to Fight AIDS in three directions:
1. Enhance capacity of Human Rights Technical Working Group members to implement Human Rights Interventions to reduce stigma e discrimination barriers on the six settings based on UNAIDS global guidance.
2. Strengthen the Government of Mozambique and Civil Society Organizations at the provincial level to coordinate Human Rights interventions by establishing a Human Right reference group with focus on Stigma &Discrimination at provincial level.
3. Strengthen capacity of the National Commission to Fight AIDS and the Ministry of Health to monitor/track Human Rights interventions and strategic planning.

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Since the Launch of 2021-2026 Global AIDS Strategy and the adoption of 2021 UN General Assembly Political Declaration for Ending Inequalities: Ending Aids by 2030 UNAIDS Zambia has taken Key intervention to Combat Stigma and discrimination:

1) The Review of the previous National Strategic Plan on HIV/AIDS has included the evaluation of the situation on Stigma and Discrimination at National level by Conducting the Stigma Index 2.0.  The stigma index Study 2.0 has been conducted under the leadership of National Aids Council, in partnership with Zambia Network of People Living with HIV/AIDS, with Technical and Financial support from GFATM and UNAIDS. The Results have been analyzed to agree on how better to plan strategic interventions in the new 2023-2027 Zambia HIV/AIDS Strategic Framework

2) The Development of the 2023-2027 Zambia HIV/AIDS National is in Line with the 2021-2026 Global Aids Strategy and Breaking Barriers interventions to combat stigma and discrimination have been included. The strategic Plan was developed under the leadership of National AIDS Council with Technical and financial support from UNAIDS. All the National Stakeholders working on HIV/AIDS response have been consulted particularly the Civil Society including the PLWHIV and Key Populations Consortium.

3)  UNAIDS together with National Aids Council have provided strategic guidance, Technical and Financial support to Zambia Key Populations Consortium the last 3 years to build their capacity and ensure they are part of National Platforms on HIV/AIDS response so that their voice can be heard. They are now part of the different planning and resources Mobilisation process.

4)  Resources Mobilisation from Particularly PEPFAR and GFATM for implementation of interventions to combat stigma and discrimination in Zambia.

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In South Africa, UNAIDS is working with the NAC Human Rights Technical Committee which includes members from different government departments including health, education, social development, police, and constitutional justice and correctional services; the Human rights commission, Drug Commission and different NGOs and community-led organizations on the following:

(1)  Advocating for people-centred approaches to enhance access to inclusive, non-judgemental and non-discriminatory community-based services through community-based and community-led organisations and networks that implement proven stigma-reduction approaches in community, workplace, education, healthcare, justice and emergency settings.

(2)    Supporting the promotion of community-based and community-led redress and rapid-response mechanisms to ensure enhanced access to legal and other services. This is being done through establishing community-based ambassadors at health facilities and police stations, scaling up community-based and community-led crises response teams and mechanisms to increase linkage to services (e.g., community-led WhatsApp groups) and awareness-raising to enhance access to and use of established helplines (i.e., AIDS Helpline, GBV Helpline, LifeLine, Childline, Mental Health Helpline

(3)    Supporting the implementation of the Stigma Index 2 and advocating for regular rapid assessments to inform stigma-reduction initiatives, and the development and implementation of a TB stigma assessment tool to inform TB-related stigma reduction intervention.
(4) Supporting community-led monitoring of human rights violations.

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UCO in UZB doing a lot to create stigna free environment. We work together with communities of people living with HIV, mass media, organize different education and information session with young people. Using the social media and covering the Uzbek population also help us a lot to disseminate information about HIV, its prevention and treatment.

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The ONUSIDA office in Morocco was at the forefront of initiating the first national strategy on HIV/AIDS. Morocco has recently crafted its new integrated strategy for 2024-2030, centered on Human Rights, HIV/AIDS, Tuberculosis, and viral hepatitis. The ONUSIDA office in Morocco is deeply engaged in these initiatives, aiming to tackle the stigmatization and discrimination associated with these diseases. We are fervently behind this new strategy, which seeks to curtail stigmatization, discrimination, and inequalities that obstruct access to vital services.

As a leading organization in the battle against HIV/AIDS, we have endorsed this Moroccan initiative, which lays emphasis on the protection of human rights and the well-being of individuals. We recognize the imperative to champion these rights while simultaneously countering stigmatization and discrimination. In this context, we are dedicated to amplifying our partnerships in this realm to ensure maximum reach and impact on vulnerable populations.

The mission of ONUSIDA Morocco also encompasses the fortification of communities. We are unwavering in our belief about the pivotal role they undertake in orchestrating the anticipated changes at the grassroots level. We acknowledge their unmatched potential in advocating for and advancing human rights, and we persistently channel our energies towards guiding and capacitating them in this quest.

Strategic insights remain a foundational component of our actions. We are convinced that leveraging credible and timely data is paramount to steering our initiatives, evaluating their resonance, and ensuring resource efficacy. Therefore, we place a premium on bolstering capacities related to strategic intelligence to ensure an evidence-grounded and effective response.

Significantly, Morocco undertook its second Stigma-Index study, the latest in 2022, modeled on the revamped Stigma-Index 2.0 framework.

To conclude, our unwavering support for this strategy and the gamut of initiatives directed at envisioning a Morocco devoid of AIDS remains undiminished. We champion the ethos where every individual, irrespective of their health disposition, deserves dignity and respect. Our steadfast commitment remains to collaborate seamlessly with our partners and the larger community to make this collective vision a tangible reality.

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In Pakistan and Afghanistan, the level of access to HIV-related information and services is extremely low and stigma and discrimination (S&D) is a major barrier. Examples of joint efforts include (Pakistan): sensitization of leaders (Parliamentarians, interfaith initiative working with religious leaders), law enforcement agencies (police, prisons), media (journalists), healthcare workers (ART centre staff). For all of these initiatives, we are working closely with UN (UNDP, UNFPA, UNICEF, WHO, UNODC), government (federal and provincial levels), communities (APLHIV, CBOs representing KPs), CSOs and other development partners (USAID, FCDO, bilateral donors).

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Cambodia has recently (Dec 2022) joined the Global Partnership and Lao PDR joined in 2020. The MCO has mobilized resources and technical support to develop an action plan to deliver on this commitment. By the end of 2023, both countries will have actions plans in 3 settings and at least one activity implemented. Cambodia is developing its new NSP, therefore the action plan will be built in. Government, CSOs, communities, UNJT, other health development partners are involved in the discussions. We are hoping to get additional funds from PEPFAR to implement at least one more additional action plan activity by the end of the year.

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In Chad, the law protecting the PLHIV and providing the legal framework of the AIDS response was adopted by the parliament in December 2020 and promulgated in 2021 by the Head of State. A Stigma index study was conducted in 2021 to inform the new NSP 2021-2025. Following this study, campaigns have been organized targeting health settings singled out as place of stigma and discrimination. Partners include government institutions (NAC, NACP, Minister of Justice, Ministry of Health, Parliament), UN agencies (UNICEF, UNDP, UNAIDS, UNFPA, UNESCO), bilateral (USA, France, EU), civil society (PLHIV network, health CSO platform)

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In India Stigma and Discrimination are a powerful cross cutting theme of the UN Joint Team on AIDS.  In all of the work we do we try to ensure that there is an element that actively contributes to combating stigma and discrimination. Earlier this year with ILO and UNDP we support the Transgender Employment Marketplace in partnership with 30 public and private sector organisations, exploring job opportunities for the TG community.

India was one of the first countries that pilot-tested the Stigma Index 1.0 tool in Delhi and Manipur in 2007. Further rollout was carried out in Tamil Nadu in 2011 by the Family Planning Association of India, with support from the UKAid. The Positive Women Network of India (PWN+) also implemented the stigma index in the North-eastern States in 2015 and the findings were shared with NACO and other stakeholders. This year UNAIDS in partnership with the National Network of People Living with HIV and AIDS in India are exploring options for  additional rollouts for 2024.
Just a flavour of the work being udertaken in partnership with UNAIDS.

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Togo and Benin have recently done the stigma index. In Togo we also did a revision of existing laws (our national consultant became later the general prosecutor of the supreme court!). In Benin, a new HIV-law has been made and will be brought to parliament in 2023. Togo also developed a new strategic plan for human rights and gender. In the preparation for the GC7 proposal, a pre-dialogue was organized with KP groups and with people living with HIV to agree amongst them upon themes for that proposal and to prepare them to be able to better defend their interests. Among the three selected themes in both countries there were stigma and discrimination as well as Community Led Monitoring (CLM). They are as of now better represented in the GF proposals. Earlier this year, we advocated also (even if it was already the case) for an accent on these activities in the ROP proposals for both countries. Most of this work has been done on our office funds. After reflection, it may a good idea to build a larger/stronger coalition around stigma and discrimination in a more formal setting.

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Combating Stigma and Discrimination - Martin Odiit, Tanzania

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Combating Stigma and Discrimination - Martin Odiit, Tanzania

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The Joint United Nations Team on HIV and AIDS assisted Tanzania in aligning the National Strategic Plans (Multisectoral and Health) for HIV to the Global AIDS Strategy 2021 to 2026. As a result, the national multisectoral plan for HIV includes a theme on “Breaking down barriers and reducing inequalities”.  The Joint UN Team contributed to the regional legal environment assessment (LEA) report and facilitated to review of National stigma and discrimination reduction strategy ensuring incorporation of recommendations from the LEA and UNDP/UNAIDS policy briefs on creating an enabling environment for key and vulnerable population programming.  The Joint UN Team is now engaged in supporting preparation of stigma and discrimination plans for local government authorities. The partners that the Joint UN Team works with include Ministry of Health, the National AIDS Council, Local Government authorities, civil society, faith based organizations, parliamentarians, religious leaders, development partners including the Global Fund and PEPFAR.

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Combating stigma and discrimination in Jamaica (Richard AMENYAH)

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Combating stigma and discrimination in Jamaica (Richard AMENYAH)

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Jamaica is part of the Global Strategic Initiative of eliminating all forms of stigma and discrimination. This Global Partnership prioritizes creating an enabling environment and documenting and responding to human rights violations. This multi-stakeholder platform is chaired by the State Minister of Health and brings together Communities/networks of PLHIV and key population groups, Civil Society organizations, public health providers, technical partners/donors.

The UN Joint team has provided technical assistance in the development of a multi-year plan for human rights programming implemented by each partner. An M&E plan has been developed together with an online dashboard that tracks performance and facilitates the generation of scorecards for results.

With the support of USAID for the Fast Track Cities, UNAIDS has engaged the Jamaican Network of Sero-positives to engage workplaces and certify them as having ‘’Stigma Free Spaces’’. UNAIDS has also provided technical assistance the network with funding from the Global Fund to conduct the Stigma Index 2.0 survey to measure the extent of stigma and discrimination in Jamaica.

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Some examples of initiatives to combat stigma and discrimination in the countries of the Southern Cone. Alberto A Stella

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Some examples of initiatives to combat stigma and discrimination in the countries of the Southern Cone. Alberto A Stella

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In Argentina, with the work of multiple actors, with the strong participation of UNAIDS and the UNJT, the new Law for comprehensive care for HIV, viral hepatitis, other STIs and Tuberculosis was drafted and promulgated, with a human rights and gender perspective and with a broad framework of social protection. This law provides a solid conceptual and normative framework to promote a society free of any form of discrimination. The Global Alliance against S&D was launched in Argentina and works with the authorities and UNAIDS to disseminate the law and update provincial laws. The organization Rajap (Network of positive youth) carried out the study "Stigma and Discrimination Index with an extensive chapter on gender and the information generated is used for the design of public policies.
With the support of UNAIDS, Argentina is a champion country of the Quito Process in HIV care for migrants with human rights perspectives. Recently, in Chile, UNAIDS supported a seminar "Migrants Speak" that gathers experiences of migrants in a regular or irregular situation regarding access to health and the promotion of social environments free of xenophobia.
An experience of horizontal cooperation channeled by UNAIDS allows the work of an expert from the LGTBI Federation with the transgender organizations of PAraguay for drafting the Gender Identity Law and the advocacy agenda.

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Education and awareness campaigns: UNAIDS regularly capacitates various actors (law/medical students, police officers, businesses, officials of the national human rights institute, etc) to increase knowledge about HIV, dispel myths and misconceptions, and promote empathy and understanding for people living with HIV.

Training healthcare professionals: UNAIDS participated in the update of the protocol USAID implementers use to train healthcare professionals to non-discriminatory care to people living with HIV. This year we launched an online (with synchronous activities) course on HIV and human rights/stigma for medical science teachers of the only public university of Guatemala, hence providing the necessary tools and knowledge to these teachers so they can adequately capacitate their students – in a cost effective and sustainable way.

Policy changes: UNAIDS supported the review process of the HIV policy and HIV law (still to be adopted by Congress) to better protect the rights of people living with HIV and eliminate discrimination in various settings, such as healthcare, education, and employment.

Legal protection: UNAIDS supports a network of lawyers to provide legal protections against HIV /sexual orientation /gender identity related discrimination

Support for affected communities, and addressing self stigma: UNAIDS funds a LGBT migrants shelter to provide support services and counseling to those living with HIV. This includes creating safe spaces and peer support group for individuals to share their experiences, and providing mental health and legal support.

Collaboration with media: UNAIDS  regularly shares information with media outlets aims to promote accurate and non-stigmatizing portrayals, challenging stereotypes, reducing fear, and fostering empathy, eg around zero discrimination day, IDAHOT, etc

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Marc SABA - Initiatives taken to combat stigma and discrimination.

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Marc SABA - Initiatives taken to combat stigma and discrimination.

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At the country level, we have strengthened the capacity of the civil society organizations on protecting and advocacy for human rights and to report cases of violation of vulnerable populations rights. We supported them to establish an observatory of human rights which aims to report stigma and discrimination cases including any discrimination or inequalities in accessing to HIV services. UNAIDS country office worked jointly with many partners such as Global Fund, PEPFAR, UNDP and civil society organizations including key populations. We have also played a high-level advocacy towards the government senior officials and have mobilized key partners like USA, UNDP, the Resident Coordinator Office, the E.U to stop a criminalizing law against same sex. Lastly, we advocated for the inclusion and provision of resources to address stigma and discrimination in the current Global Fund concept note.