Let's end HIV/Aids stigma now

Let's end HIV/Aids stigma now

Today, Thailand joins countries around the world to mark Zero Discrimination Day in order to highlight the urgent need to take action against discrimination.

Over the past decade, progress has been made in the response against HIV. More people living with HIV know their status and are accessing treatment while Aids-related deaths are on the decline.

However, stigma, discrimination, exclusion and inequality continues to make people vulnerable to HIV and hinders access to and uptake of HIV prevention, testing, treatment and support services. People living with HIV, key populations and other vulnerable groups continue to face stigma and discrimination based on their health status, sexual orientation, gender identity or other grounds. Discrimination and other human rights violations may occur in health-care settings, barring people from accessing health services and enjoying quality health care.

Discrimination hampers efforts to end the Aids epidemic and achieve healthy lives for all.

In 2015, Thailand committed to the Sustainable Development Goals (SDGs), which include the targets of ending the epidemics of Aids, tuberculosis and malaria, and tackling hepatitis, by 2030. Other SDGs are also critically important in reaching this goal, including reducing inequalities. The Political Declaration on Ending Aids, adopted by Thailand and the other Member States at the United Nations General Assembly High-Level Meeting on Ending Aids, reinforced that, in reaching all of the SDG goals, no one must be left behind and that discrimination, including in health care, must be ensured.

Zero discrimination is at the heart of Thailand's response to HIV. Thailand has been acknowledged as a pioneer in reducing stigma and discrimination in health-care settings in Asia through its innovative system-wide response. Since 2015, the country has implemented the 3-by-4 Package for stigma-free health facilities across four pilot provinces, which was later expanded to 16 provinces, with comprehensive interventions to address and remove barriers to access health services. The programme aims to sensitise health and non-health personnel through participatory training and e-learning modules, to ensure they have the necessary capacity to provide discrimination-free health care. The package also contains a monitoring system that systematically measures stigma and discrimination through surveys. The collected data is subsequently used to increase awareness, inform interventions, and serve as a catalyst for system-wide actions. The National Code of Conduct on HIV Prevention and Management in the Workplace is also instrumental in helping prevent and reduce HIV stigma and discrimination.

To scale up action to address and eliminate all forms of HIV-related stigma and discrimination, Thailand is proud to announce the national rollout of the 3-by-4 Package and the launch of a new initiative, Thailand Partnership for Zero Discrimination, which is co-convened by the National Sub-Committee on Human Rights Protection and Promotion under the National Aids Committee, in collaboration with the Department of Disease Control, the Ministry of Public Health, Bangkok Metropolitan Administration (BMA), the Foundation for Aids Rights, Thailand People Living with HIV Networks (TNP+), CDC Thailand, UNAIDS, Unicef and UNDP on Zero Discrimination Day. This new partnership will revitalise strategic alliances among stakeholders to implement and scale up programs towards ending HIV stigma and discrimination.

Bangkok is at the forefront of creating an enabling environment free from stigma and discrimination as one of the critical strategic approaches of the Fast Track Cities Initiative. With the Bangkok Partnership for Zero Discrimination, the BMA in collaboration with the Ministry of Public Health, UNAIDS, PEPFAR, civil society and key populations, will facilitate a platform to promote and advance the well-being and dignity of everyone.

The greater involvement of communities, people living with HIV and key populations is a core value for the success of these interventions. Communities are involved in the entire process from programme planning and implementation to monitoring at all levels. Their participation not only boosts access to services for hard-to-reach communities but also helps ensure a rights-based approach is used.

Vision without action is just a dream, but with actions, we can make a difference. The world should unite to eradicate stigma and discrimination in all its forms. Thailand's zero discrimination initiatives are providing quality care to people living with HIV and key populations. As these efforts expand, Thailand can reach the ultimate goal of ending Aids by 2030.

Co-authors are Taweesak Lertprapan, deputy governor of Bangkok; Suwannachai Wattanayingcharoenchai, director general, Department of Disease Control, Ministry of Public Health; and Patchara Benjarattanaporn, UNaids country director for Thailand.

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