Addressing the intersection of criminalisation, discrimination and stigma Susan Timberlake Chief, Human Rights and Law

1. Addressing the intersection of criminalisation, discrimination and stigma Susan TimberlakeChief, Human Rights and Law DivisionUNAIDS SecretariatGeneva

2. Exploring the intersection Discrimination (unfair treatment) Stigma (attitudes) Criminalisation (laws & practices)

3. More countries reporting programmes to reduce HIV-related stigma and discrimination 89% of countries consistently reporting on the NCPI since have programmes to reduce HIV-related stigma and discrimination, compared to 39% in 2006. * Based on preliminary data analysis of Global AIDS Progress Reports 2012

4. …Yet insufficient responses to stigma, discrimination & criminalisation • Low coverage:Mostly pilots, small projects • Limited scope:More focus on stigma reduction, little on programmes to address discrimination and criminalisation • Limited funding:Reference in NSP but not budgeted; often not included in GF proposals (See UNDP, UNAIDS & GF study in 2011)

5. Persistence of stigma, discrimination and punitive laws • 29%of countries reportno legal protection against HIV-related discrimination (NCPI, 2010) • 67%of countries report “laws and regulations that present obstacles for vulnerable sub-populations” (NCPI, 2010) • 78 countries criminalize same sex sex; 6 death penalty • 116+countries criminalize some aspect of sex work • 46countries/areas have HIV-related travel restrictions • 56 have HIV-specific laws criminalizing HIV transmission • Most criminalize drug possession and many criminalize harm reduction measures

6. Pushbacks: Is it “discrimination” or the “right thing to do”? Various claims • Stigma is society’s way of expressing disapproval of immoral behaviour and its consequences • Criminal law has different objectives than public health, such as upholding values and punishment • Laws criminalising same-sex relations, sex work and drug use are, and should be, based on moral and religious norms • Criminal law reduces risky behaviour and sexual/drug networking, so reduces transmission • No evidence that de-criminalising same sex relations, sex work, HIV transmission or drug use reduces HIV infection

7. Addressing stigma, discrimination and punitive laws as a goal of HIV response

8. Comprehensive approach to stigma reduction requires • Political and cultural initiatives:champions, celebrities, movies, commitments • Social change:communities mobilizing, voices amplified; creating change/demand through knowledge of rights; existence/value recognized; attitudes/laws changed • Programmatic responses:population estimates; stigma measurement/reduction; programmes to improve law, law enforcement, access to justice; sensitization of religious leaders; empowerment of women, reducing violence and harmful gender norms

9. Programmes to reduce stigma, discrimination and increase access to justice • Stigma reduction programmes to change attitudes • HIV-related legal services • Programmes to reform and monitor laws relating to HIV • Legal literacy programmes (“Know your rights”) • Training and sensitization of law enforcement agents, judges and lawyers on HIV and human rights • Human rights training for health care workers • Programmes to eliminate discrimination against women in the context of HIV

10. Way forward on stigma, discrimination and punitive laws • Move from stigma measurement to stigma reduction(including through 7 key programmes) • Evaluate and build further evidenceon programmes to reduce stigma, discrimination, punitive laws and relationship to health outcomes • Reach beyond traditional health partners(Parliaments, judiciary, religious/community/traditional leaders, police, NHRI, human and women rights) • Support community mobilisation for change: empowering people living with HIV and key populations to challenge stigma, discrimination and punitive laws • Ensure adequate and sustainable fundingto address stigma, discrimination and punitive laws

11. Thank you!