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An enabling legal framework that protects and promotes human rights and gender equality helps vulnerable and key populations to protect and promote their health.
An enabling legal framework that protects and promotes human rights and gender equality is imperative to fostering the health and development of all people and attaining the United Nations 2030 Agenda for Sustainable Development and the Sustainable Development Goals. Rights-based health responses help vulnerable and key populations to protect and promote their rights to non-discrimination, equality and freedom from violence, allowing them to:
- Access effective health information and services without discrimination
- Reduce their health risks
- Participate meaningfully in the design, development, implementation, monitoring and evaluation of services, and
- Realize their human rights to equality, health and development.
Rights-based programmes support health programmes to be effective, efficient and able to reach all populations in need by addressing issues such as discrimination, violence, gender inequality and limited autonomy, that make it difficult for some populations to access essential services to protect and promote their health.
Without efforts to protect and promote health rights, health services may fail to reach vulnerable and key populations and achieve their anticipated health outcomes. These populations, and the organizations that support them, may be unable to operate and to participate in the design, delivery and monitoring of successful health responses.
Populations who struggle to realise their basic human rights, including their rights to access health and social services, are vulnerable to health risks.
Vulnerable and key populations include populations that live in poverty without access to safe housing, water, sanitation and nutrition; those who are stigmatized, discriminated against, marginalized by society and even criminalized in law, policy and practice. These populations may struggle to fulfil their human rights, including their rights to access health and social services. They live in environments of inequality where they are unable to thrive, feel safe and actively participate in all aspects of society. Communicable diseases such as HIV, TB and malaria, and non-communicable diseases such as cancers and chronic respiratory illnesses, disproportionately impact on vulnerable and key populations.
In September 2018 India's Supreme Court banished a law criminalizing consensual same-sex sex, overturning more than 150 years of anti-LGBT legislation. The court ruled, that discrimination on the basis of sexual orientation is a fundamental violation of basic human rights.
Rights-based health programmes work to address critical enablers - the various legal, political, social, cultural and economic factors that make these populations more vulnerable to infection or illness, or that create barriers to their access to prevention, treatment, care and support services.
The Global Fund prioritises key populations in HIV, TB and malaria responses
Three of the world’s most serious communicable diseases – HIV, TB and malaria – disproportionately affect those populations least able to protect their rights and access non-discriminatory, quality and affordable health care.
Key populations are defined by the Global Fund as populations that have a high epidemiological impact from AIDS, TB and malaria, combined with reduced access to services and/or being criminalized or otherwise marginalized.
The Key Populations Action Plan says: “Depending on the context, this might include groups such as orphans, street children, people with disabilities, people living in extreme poverty, mobile workers and other migrants. Some occupations – in particular mining – and contexts may enhance the risk of TB even more by limiting access to healthy environments. Children and pregnant women – in particular women with HIV - are particularly vulnerable to malaria as their immunity is reduced. In many African countries women and girls who are not marginalized – and so would not be defined as “key affected women” – are highly affected by HIV, and must be considered as a vulnerable population. Depending on the local context, vulnerable populations require focused efforts and resources that address their enhanced needs and protect and promote their human rights, even though they do not fall under the general definition of “key populations”. The Global Fund’s new funding model directs resources to priority services where needs are greatest in order to achieve impact.”
The Global Fund also recognizes vulnerable populations – those who have increased vulnerabilities in a particular context, but may not fit the criteria above – such as adolescent girls and young women and people with disabilities.