Friday March 1 is Zero Discrimination Day, established 10 years ago by UNAIDS to protect the rights of everyone and build healthier societies. The evidence is clear: only by protecting everyone’s rights, can we protect everyone’s health. It is evident that public health is undermined when laws, policies, practices or norms enshrine punishment, discrimination or stigma on vulnerable and marginalized communities pushing them to be furthest left behind. This increases their vulnerability to HIV infection and obstructs their access to HIV prevention, treatment, care, and support services and holds back progress towards the end of AIDS. In Eastern and Southern Africa, 3,100 adolescent girls and young women aged 15-24 are newly infected with HIV every week. HIV thrives where there are inequalities and rights are not respected. When girls’ rights to education and empowerment through access to information on sexual and reproductive health are realized, then their vulnerability to HIV is greatly reduced. Evidence from research shows that when a girl completes Secondary school, her risk of acquiring HIV is reduced by 50%. Simply because she is able to make informed and more responsible decisions. The good news is that 50 million more girls are in school today than in 2015. This is a hard-fought gain! In 2018, Rwanda decriminalized sex work and same sex relationships, one of the key enablers for access to equitable and quality HIV and health services. This has greatly contributed to the decrease in the prevalence of HIV from 50% to 35.5% and 11% to 6.5% among female sex workers and men who have sex with other men, respectively. A lot of efforts are invested in further creating an enabling environment to reach other population groups most affected by HIV, including other priority groups that are at high risk of HIV like adolescent girls and young women, and to improve their access to HIV services. The stigma index survey among people living with HIV in Rwanda reported that HIV related stigma and discrimination were low at 13%, though high among refugees at 23%. But the same survey indicated that adolescents, women and key populations faced more stigma and discrimination than any other group of People living with HIV. In addition, confidentiality and fear of disclosure of HIV status without consent was a major concern for people living with HIV. Double stigma and discrimination are likely to happen in particular in key population groups such as transgenders and drug users. The “Rights” path strengthens entire societies, making them better equipped to deal with the challenges we face today and those that are emerging. HIV and AIDS programs effectiveness are inherently anchored in the equalities and inclusion agenda. That is precisely why Rwanda’s HIV programme is a success story; largely due to the progressive enabling policy and legal environment that is in place. This was achieved through years of successful advocacy efforts by civil society and key populations and the receptiveness of the government to expand human rights for all and giving the space to marginalized communities to meaningfully engage in the HIV response. But let’s not let the success achieved so far mask the fact that the finishing line is yet to be reached, and that a closer look is required at the populations that are missing or left behind; children and adolescents among them. Reaching the last mile of ending AIDS as a public health threat in Rwanda requires more focus, efforts and resources because of the need to find the missing populations that are marginalized and that are furthest left behind, which are the most difficult to reach. Notwithstanding, Rwanda is giving hope and showing that the path to end AIDS is possible, through the inclusion agenda and putting communities on the frontlines. May Rwanda shine the light for other countries showing them that protecting everyone’s right to health is not a favor to any group, but is the way that we can protect everyone’s health, end AIDS and create happier societies for all. Hind Hassan Abdalgalil is the UNAIDS Rwanda, Country Director.
