UNDP’s Work on Human Rights, Key Populations and Gender

UNDP is guided by several principles related to promotion of human rights in all of its work. These include: (1) Respect for and promotion of human rights and gender equality as set out in the United Nations Charter, the Universal Declaration of Human Rights and other international treaties, and (2) Meaningful engagement of people living with HIV, key populations, other excluded groups and affected communities is essential for effective health policy, programming and governance.

As a founding co-sponsor of the Joint United Nations Programme on HIV/AIDS (UNAIDS), under the UNAIDS Division of Labour, UNDP is mandated to convene the work on removing punitive laws, policies, practices, stigma and discrimination that block effective responses to AIDS and to co-convene the work of HIV prevention among key populations together with the United Nations Population Fund (UNFPA) as well as efforts to increase investments and efficiency in the use of resources for HIV, jointly with the World Bank. UNDP also leads the follow-up work to the recommendations of the Global Commission on HIV and the Law and is represented on the Global Fund Human Rights Reference Group.

UNDP manifests its commitments to uphold and promote these principles in many ways, a number of which are highlighted in this text. UNDP has significant experience supporting design, implementation and evaluation of Global Fund programs to remove human rights and gender related barriers to accessing health services. For example, UNDP has served as the Principal Recipient (PR) for four Global Fund regional grants in South Asia, the Western Pacific, Africa, and the Caribbean. Each of these grants focuses on strengthening the legal and policy environment for key populations, challenging stigma and discrimination, and building community capacity to effectively address human rights and gender barriers to access to and uptake of HIV, TB and malaria services.

In addition, UNDP has significant experience in leading or supporting, together with other technical partners, the development of programmatic guidance and policy tools to support human rights, gender and key populations. For instance,

• In Pakistan, UNDP with support from the Global Fund and in partnership with local community-based organizations, the Government, UNAIDS and WHO has launched a new PrEP initiative in early June 2022. The initiative is working closely with key population communities to provide PrEP through networks of peer outreach workers and drop-in centres. In addition, government health care workers stationed at existing antiretroviral (ART) treatment centres are being trained on delivering safe and effective PrEP services.
• In Zimbabwe, as part of a comprehensive package of prevention services, the current Global Fund HIV grant managed by UNDP supports initiation of PrEP for key populations, including sex workers, through a combination of fixed sites providing prevention services, and outreach conducted by NGO partners such as the Centre for Sexual Health and HIV/AIDS Research Zimbabwe (CeSHHAR). Under this grant, in 2021, a total of 3,307 sex workers (99% of them female) at substantial risk of being infected with HIV were initiated on PrEP. This achievement partly owes to an outreach service approach adopted by CeSHHAR which targeted new hot spot areas to serve sex workers, following the relaxation from COVID-19 restrictions that allowed travelling and gathering for outreach services. CeSHHAR mobilized 350 micro-planners who reside in the areas of the hot-spot sites, and who were trained and deployed in October 2021. The micro-planning approach involves strengthening programmes for sex workers and other key populations, through peer-based outreach.
• In Kyrgyzstan, people living with HIV, people who use drugs, TB patients and members of key populations frequently face stigma, discrimination, and rights violations. With Global Fund and UNDP support, the Partner Network which gathers 26 Civil Society Organizations (CSOs) working on HIV and TB launched an electronic system to register rights violations, called REACT. This was part of the “Street Lawyers” project which provides peer-to-peer legal support to protect and promote human rights of key populations, people living with HIV and TB patients in Kyrgyzstan. ‘Street Lawyers’ are trained employees of service NGOs, who work with their clients on different cases, ranging from administrative issues, such as obtaining passports and benefits, to more complex rights violations, brought to court with the help of professional lawyers. 1,116 cases of human rights violations were documented in 2020-2021.

UNDP led the work of the Global Commission on HIV and the Law, which reviewed the relationship between legal responses, human rights and HIV and made many recommendations aimed at strengthening legal and policy environments with the ultimate goal of better health outcomes for the most marginalized and HIV-vulnerable populations. In many instances, national legal protections have preceded, not followed, broader recognition of rights. Laws have a teaching effect; laws that discriminate validate other kinds of discrimination. Laws that require equal protections reinforce equality. Often, laws must change before fears about change dissipate. UNDP is currently leading the follow-up work on the recommendations of the Global Commission, a significant portion of which is dedicated to key populations.

To further this work, UNDP produced the Legal environment assessment for HIV: An operational guide to conducting national legal, regulatory and policy assessments for HIV and the Legal environment assessments for TB: An operational guide, which includes step-by-step guidance on how to undertake a national Legal Environment Assessment, with concrete case studies, tools and resources. Similarly, UNDP has gone further to produce a guidance document on Transforming Legal Environment Assessment (LEA) Recommendations into Action. Although still in draft form, this guidance is already being used to shape National Action Plan meetings in, Malawi, Nigeria and Seychelles.

For key populations, a number of programming tools exist for men who have sex with other men (MSM), sex workers and transgender people. Each of these tools offers practical advice on implementing HIV and STI programmes for and with MSM, sex workers and transgender people, respectively: Implementing Comprehensive HIV and STI Programmes with Men Who Have Sex With Men: Practical Guidance for Collaborative Interventions (MSMIT); Implementing comprehensive HIV/STI programmes with sex workers: practical approaches from collaborative interventions (SWIT); Implementing Comprehensive HIV and STI Programmes with Transgender People: Practical Guidance for Collaborative Interventions (the “TRANSIT”).

The Gender Checklist has been developed to support the integration of gender-responsive components into the implementation of HIV programmes supported by the Global Fund. Additionally, UNDP’s Roadmap on mainstreaming gender into national HIV strategies and plans is a tool to guide government and civil society actors in the implementation of gender-transformative programming in the context of national HIV efforts. Discussion Papers on Gender, HIV and Health, Gender and TB and Gender and Malaria have been developed that summarize and analyse the evidence base related to the specific vulnerabilities and needs of both men and women. The What Works for Women and Girls: Evidence for HIV/AIDS Interventions web site provides a comprehensive compilation of the available evidence necessary to inform country-level programming.