IntroductionThe rights of trans people are protected by a range of international and regional mechanisms. Yet, punitive national laws, policies and practices targeting transgender people, including complex procedures for changing identification documents, strip transgender people of their rights and limit access to justice. This results in gross violations of human rights on the part of state perpetrators and society at large. Transgender people's experience globally is that of extreme social exclusion that translates into increased vulnerability to HIV, other diseases, including mental health conditions, limited access to education and employment, and loss of opportunities for economic and social advancement. In addition, hatred and aggression towards a group of individuals who do not conform to social norms around gender manifest in frequent episodes of extreme violence towards transgender people. This violence often goes unpunished.DiscussionThe United Nations Development Programme (UNDP) views its work in the area of HIV through the lens of human rights and advances a range of development solutions such as poverty reduction, improved governance, active citizenship, and access to justice. This work directly relates to advancing the rights of transgender people. This manuscript lays out the various aspects of health, human rights, and development that frame transgender people's issues and outlines best practice solutions from transgender communities and governments around the globe on how to address these complex concerns. The examples provided in the manuscript can help guide UN agencies, governments, and transgender activists in achieving better standards of health, access to justice, and social inclusion for transgender communities everywhere.ConclusionsThe manuscript provides a call to action for countries to urgently address the violations of human rights of transgender people in order to honour international obligations, stem HIV epidemics, promote gender equality, strengthen social and economic development, and put a stop to untrammelled violence.
The Global Commission on HIV and the Law was established in 2010 to identify and analyse the complex framework of international, national, religious and customary law shaping national responses to HIV and the well-being of people living with HIV and key populations. Two years of deliberation, based on an exhaustive review of international public health and human rights scholarship, as well as almost 700 testimonials from individuals and organizations in more than 130 countries, informed the Commission's recommendations on reform to laws and practices that criminalize those living with and vulnerable to HIV, sustain or mitigate violence and discrimination lived by women, facilitate or impede access to HIV-related treatment, and/or pertain to children and young people in the context of HIV. This paper presents the Commission's findings and recommendations as they relate to sexual and reproductive health and rights, and examines how the Commission's work intersects with strategic litigation on forced sterilization of women living with HIV, legal reform on the status of transgender individuals, initiatives to improve police treatment of female sex workers, and equal property rights for women living with HIV in sub-Saharan Africa and Latin America.
The right to health has been variously influenced by a web of laws and structures. Health is legislated primarily by the states, causing variances in laws and implementation systems across states. The Parliament has also legislated on health in some instances, thereby creating national laws on certain issues, such as the Medical Termination of Pregnancy Act, the Transplantation of Human Organs Act and so on. Policy planning also articulates priorities in the context of health, for example through the National Rural Health Mission, and proposals on universal health coverage. Illustrating certain national and state legislations and key Supreme Court rulings, this chapter reveals the complexity that confronts effective health planning in India and offers insights that are required to achieve positive health outcomes for society.
Although over 15 years in the making, the HIV legislation has recently been passed in India. This Act is unique in many respects, and hopefully a precursor to broader health sector legislation. The process of law making in this instance included a robust consultative process with civil society and other stakeholders involved with HIV. Some of the unique aspects of the Act, as it was eventually passed, include an anti-discrimination provision to cover violations by the private sector, and concrete provisions to ensure informed consent while seeking HIV-related testing and treatment, and confidentiality of HIV status. However, the law fails to recognise the enhanced vulnerability to HIV that some people - sex workers, transgender people, men who have sex with men, and people who use drugs - face, which should have been addressed by extending anti-discrimination guarantees to these communities, thereby providing a legal tool to access health, employment, educational, and other sectors; while also serving public health imperatives to encourage marginalised people towards health-seeking behaviour without fear of stigma and mistreatment. Yet, at least the legislation does protect these criminalised communities from punishment when they access or are provided HIV-related services and commodities, which could otherwise be tantamount to a crime. Another drawback of the law is the diluted obligation of the State to provide antiretroviral treatment to those in need. The legislation also provides options to redress grievances, which are localised, less formal and intimidating, and more accessible than courts, thereby recognising that implementation and actualisation of rights is critical to the success of the law, and efforts to control HIV.
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