Joint United Nations statement on ending discrimination in health care settings

United Nations entities recall that a central principle of the 2030 Agenda for Sustainable Development is to “ensure that no one is left behind” and to “reach the furthest behind first”. Recognizing that discrimination in health care settings is a major barrier to the achievement of the Sustainable Development Goals (SDGs), United Nations entities commit to working together to support Member States in taking coordinated multisectoral action to eliminate discrimination in health care settings.

Discrimination in health care settings takes many forms and is often manifested when an individual or group is denied access to health care services that are otherwise available to others. It can also occur through denial of services that are only needed by certain groups, such as women. Examples include specific individuals or groups being subjected to physical and verbal abuse or violence; involuntary treatment; breaches of confidentiality and/or denial of autonomous decision-making, such as the requirement of consent to treatment by parents, spouses or guardians; and lack of free and informed consent.

National laws, policies and practices can also foster and perpetuate discrimination in health care settings, prohibiting or discouraging people from seeking the broad range of health care services they may need. Some laws run counter to established public health evidence and human rights standards. Evidence demonstrates the harmful health and human rights impacts of such laws.

Reviewing and strengthening laws to prohibit discrimination in the provision and distribution of health care services, as well as in relation to education and employment in the health sector. Laws and policies must respect the principles of autonomy in health care decision-making; guarantee free and informed consent, privacy and confidentiality; prohibit mandatory HIV testing; prohibit screening procedures that are not of benefit to the individual or the public; and ban involuntary treatment and mandatory third-party authorization and notification requirements. All stakeholders should support the clear dissemination, implementation, and monitoring of adherence to such laws and regulations and their translation into policies and practice.

Reviewing and repealing punitive laws that have been proven to have negative health outcomes and that counter established public health evidence. These include laws that criminalize or otherwise prohibit gender expression, same sex conduct, adultery and other sexual behaviours between consenting adults; adult consensual sex work; drug use or possession of drugs for personal use; sexual and reproductive health care services, including information; and overly broad criminalization of HIV non-disclosure, exposure or transmission.