1 March is internationally known as Zero Discrimination Day.
Discrimination undermines human dignity and is a violation of human rights. As stated by the Joint United Nations
Programme on HIV and AIDS (UNAIDS), the effects of discrimination aren’t isolated to the suffering of an individual person or group experiencing a particular incident: Discrimination undermines social cohesion; it prevents society from benefiting from a richer and deeper pool of talent; and it stigmatises people living with and most at risk of HIV, while undermining HIV treatment and prevention efforts.
This year on Zero Discrimination Day, UNAIDS is focussing on the importance of eliminating discrimination in healthcare settings. Research conducted by the Southern Africa Litigation Centre (SALC) in 2016 in Botswana, Malawi and Zambia, illustrates discrimination experienced by women living with HIV, by people with disabilities, by sex workers, and by lesbian, gay, bisexual and transgender (LGBT) persons when accessing healthcare.
Persons with disabilities struggle to access health information and to access HIV testing and sexual and reproductive healthcare services confidentially. When the barriers to access are overcome, people with disabilities describe facing verbal and physical abuse by healthcare workers particularly when accessing sexual and reproductive healthcare services.
Women living with HIV in southern Africa continue to face stigmatising behaviour and practices in healthcare settings, including being sterilised without their informed consent and being prosecuted and imprisoned for breastfeeding. In addition, women’s vulnerability to HIV is exacerbated by social and conditions and cultural practices that compromise their abilities to negotiate safe sexual practices, to access healthcare services and to enjoy the social determinants of health. SALC has supported litigation in Lesotho, Swaziland, Botswana, Malawi and Zambia that illustrates how legal regimes discriminate against women in the ownership, inheritance and enjoyment of property rights.
Criminal sanctions against same sex sexual acts continue to be applied in a number of southern African countries to deny LGBT persons the freedom to associate and to access public services. LGBT persons fear being reported to police by healthcare workers and experience both direct and indirect discrimination in healthcare settings that inhibits their ability to access health and HIV treatment and prevention services according to their needs. This is despite that laws, policies and ethical frameworks affirm the right to equality and freedom from discrimination and that in the region have affirmed that LGBT persons are not criminalised as persons, that they retain their human rights including freedom from discrimination.
Transgender persons in southern Africa experience discrimination and harassment in their daily lives – at work, at home, while they are walking on the street, or when they use public facilities such as banks, restaurants, hospitals, airports, and in dealings with the – simply because they do not conform to gender identity norms. A booklet published by SALC on “Laws and policies affecting transgender persons in southern Africa” illustrates how discriminatory practices are entrenched in legal frameworks despite the constitutional and human rights guarantees of equality and dignity for transgender persons.
Sex workers are vulnerable to discrimination and violence in all spheres of their lives.conducted by SALC illustrated how sex workers in Zambia experience violence, harassment and abuse by police officials, which practices are further illustrated in litigation in Zimbabwe Women assumed to be sex workers in Malawi have been subjected to forced HIV testing and public disclosure of their HIV status. SALC’s research in Botswana, Malawi and Zambia has further shown how this abuse is continued in healthcare settings where sex workers are inhibited from accessing post-exposure prophylaxis to prevent HIV transmission, have been denied treatment for sexually transmitted infections, and are sexually coerced and raped by healthcare workers.
On this Zero Discrimination Day, we call on states in southern Africa to confront the lived experiences of discrimination faced by people who are disproportionately affected by HIV and by vulnerable groups including women, adolescents, men who have sex with men, LGBT persons, sex workers, prisoners, people who use drugs, migrants, and people with disabilities.
States must eliminate legal and policy barriers to the enjoyment of equality for these persons; confront cultural, social and economic practices that heighten vulnerability to discrimination; and ensure that justice is accessible when discrimination and human rights violations occur.
For more information, see SALC’s Publications:
