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The Indian government should enact and enforce national
legislation prohibiting discrimination against people living with HIV/AIDS and
their families in health facilities, schools, places of employment, and other
institutions. Protections from discrimination should include mechanisms for
victims and their guardians to lodge complaints and receive rapid redress;
these mechanisms should be publicly communicated.
The National AIDS Control Organization (NACO) should provide
greater leadership to states on preventing and addressing discrimination
against people living with and affected by HIV/AIDS and, for children
especially, in the areas of education, health, and care:
o
NACO should provide technical assistance to states on providing
protection and should intervene directly in cases of discrimination;
o
The director of NACO should speak publicly about the rights of
children affected by HIV/AIDS, with particular attention to discrimination in
education, health, and care;
o
NACO should include in the third phase of the National AIDS
Prevention and Control Policy provisions regarding education, health, and care
of children affected by HIV/AIDS.
All government departments at the state and national level,
including those responsible for education, health, and child protection, should
take measurable steps to implement NACO guidelines regarding discrimination
against people living with and affected by HIV/AIDS as relevant in their work.
All departments should actively monitor for and respond rapidly to cases of
discrimination. In particular:
o
The Ministry of Education and state education departments should
ensure that no children are excluded from school or discriminated against in
school because of their or their caregivers’ HIV status. All schools should
receive guidelines on preventing discrimination before it occurs and responding
to individual cases, and protocols for enrolling HIV-positive children that
address maintaining the confidentiality of the child’s HIV status, addressing
the parents’ concerns, and accommodating any special needs the child may have.
States should monitor schools’ compliance and insist that state-aided private
schools and any other school that they license should adhere to the guidelines.
o
The Ministry of Health and Family Welfare and state health
departments, with assistance from international donors, should ensure that
children living with HIV/AIDS receive all available medical care, including
antiretroviral treatment, and use all possible means to remove barriers to
their receiving care. In particular, they should prohibit government hospitals
from discriminating against people living with HIV/AIDS, set guidelines for
maintaining the confidentiality of HIV statuses of persons using health
services, and explore ways of better regulating the private sector. They
should also ensure that medical staff have the means to protect themselves from
hospital-based HIV transmission, including protective clothing and post-exposure
prophylaxis. In implementing the government’s antiretroviral drug program,
they should ensure that services are offered in a way that maintains the
confidentiality of participants’ HIV status and that the program reaches
marginalized children, including street children, children in orphanages and
other residential institutions, and Dalit and low-caste children.
o
The Ministry of Social Justice and Empowerment and its
state-level counterparts should require orphanages and other institutions that
they license comply with non-discrimination policies and provide children in
their care with accurate, age appropriate information about HIV/AIDS.
o
The Department of Women and Children in the Ministry of Human
Resource Development should prohibit discrimination against HIV/AIDS-affected
children in all Integrated Child Development Services (ICDS) institutions. The
department should also explore using ICDS institutions to provide women and
girls with information about HIV/AIDS and their rights.
In cooperation with professional associations and HIV/AIDS
experts, the Indian government should vastly expand training programs on
HIV/AIDS for teachers, health workers, lawyers, social workers, other
government officials, others caring for children, and students of these
professions. The government should ensure that these programs provide accurate
and comprehensive information about HIV/AIDS, gender inequality that helps put
women and girls at risk of HIV transmission, and government policies on
non-discrimination and confidentiality. Training should be offered, and
required, regularly. NACO and the state AIDS control societies should evaluate
the content and impact of training that has already been done and use this to
improve future training.
The Ministry of Education and state education departments should
ensure that all students, including those in non-formal education, at the
earliest possible level, receive age-appropriate information on preventing
HIV/AIDS, keeping in mind the low numbers of children, especially girls, who
enroll at the secondary level. This would be in accord with the
recommendations of the National Workshop on School AIDS Education Programme in
February 2003, and of the 2002U.N. General Assembly Special Session on
Children. HIV/AIDS education should cover the correct and consistent use of
condoms as the most effective way to prevent HIV transmission during sexual
intercourse, including in long-term unions. It should also include information
on gender inequality that helps put women and girls at risk of HIV transmission
in India.
The Ministry of Education, the Ministry of Social Justice and
Empowerment, NACO, and their state-level counterparts should work together to
provide all out-of-school children with accurate and comprehensive information
about HIV/AIDS. As a first step, they should immediately institute regular
HIV/AIDS education for all children in government institutions. NGOs and other
groups that work directly with children should provide children with accurate
information about HIV/AIDS, if they are not doing so already.
The government should address gender discrimination in
employment, divorce, inheritance, and property laws, and longstanding practices
of discrimination against girls in education and health that make women and girls
especially vulnerable to HIV transmission and imperil their ability to care for
their children. The government should implement the recommendations of
the Law Commission of India on amendments to existing laws relating to sexual
assault so as the ensure prosecution of all instances of sexual violence,
including marital rape. The Indian parliament should pass the proposed
legislation the Protection from Domestic Violence Bill, introduced in 2002.
The National Human Rights Commission and state human rights
commissions, without waiting for individual cases to be filed, should
investigate cases of schools, health care providers, and institutions, both
public and private, discriminating against HIV/AIDS-affected children.
Indian medical organizations, including the Indian Medical
Association and the Indian Academy of Pediatrics, should publish guidelines for
health workers on not discriminating against people living with HIV/AIDS and on
the importance of protecting the confidentiality of the HIV status of their
patients.
Bilateral and multilateral donors, including the U.N. country
team, should:
o
Support the immediate passage of strong antidiscrimination
legislation that protects the rights of people living with HIV/AIDS and their
families.
o
Consider a high-level summit or strategy meeting on protecting
the rights of children affected by HIV/AIDS in India.
o
Ensure that their support for health and education programs
contributes to the prevention of discriminatory treatment of children affected
by HIV/AIDS.
o
The International Labour Organization (ILO) and all U.N.
agencies, including the Joint United Nations Programme on HIV/AIDS (UNAIDS),
the U.N. Development Programme (UNDP), the U.N. Population Fund (UNFPA), the
U.N. Children’s Fund (UNICEF), the U.N. Development Fund for Women (UNIFEM),
and the World Health Organization (WHO), should recognize that children
affected by HIV/AIDS require the widest possible response by U.N. agencies
where relevant to their mandates, should create a mechanism for better working
together in a coordinated way on the issue, and should support the government’s
efforts to implementation the recommendations in this report. UNICEF should
especially focus on HIV/AIDS-affected children who are the most marginalized
and the most under-served, including Dalit, indigenous, and street children.
- The Ministry of Health and
Family Welfare and state health departments should develop guidelines and
train health professionals on pediatric AIDS and the psychological care of
children affected by HIV/AIDS.
- The Department of Family
Welfare within the Ministry of Health should integrate provision of
comprehensive information about HIV/AIDS into all family planning and
reproductive health programs.
- Recognizing the private health
sector’s role, the Ministry of Health and Family Welfare should vastly
expand training on HIV/AIDS for the private sector, monitor for
discrimination, and create incentives for good practices.
- The Ministry of Health and
Family Welfare and state health departments should improve services for
child survivors of sexual assault, including access to legal, medical, and
counseling services, and post-exposure prophylaxis (PEP).
- Donors should support expanded
treatment for women and girls, especially PEP for rape victims.
The Ministry of Education and the state education departments
should develop and implement a plan to address the barrier to education that
school fees and related costs create for HIV/AIDS-affected children and others,
paying special attention to barriers that these costs create for girls. They
should ensure that, to the degree possible, any existing programs specially
target HIV/AIDS-affected girls in a way that does not further stigmatize them.
The Indian government should ratify the 1960 Convention Against
Discrimination in Education.
The World Bank, DFID, the European Commission, and the government
of India should, in implementing the U.S.$500 million project on elementary
education approved in 2004, should give consideration to ensuring that
HIV/AIDS-affected children have equal access to all programs under the project.
The Indian government, U.N. agencies, and other research
institutions should systematically collect information about children living
with and affected by HIV/AIDS and use the findings to inform policies and
programs for children affected by HIV/AIDS. As a precursor, they should
analyze existing data about children and about HIV/AIDS from all sectors, for
example calls to the government-run hotline Childline, to map what is already
known. In accord with the recommendations of the Committee on the Rights of
the Child, these bodies should ensure that, to the extent possible, existing
data is disaggregated by age, gender, and children belonging to vulnerable
groups.
NACO should include provisions for the care and protection of
children in the third National AIDS Prevention and Control Policy.
The Ministry of Social Justice and Empowerment and its
state-level counterparts should immediately take steps to implement
alternatives to institutionalization, including fostering and other forms of
community-based care. They should develop and implement a plan for the gradual
deinstitutionalization of children. They should also provide assistance to
families in caring for children affected by HIV/AIDS, and make utmost efforts
to locate other relatives who are willing and capable of ensuring care for
children when their parents can no longer care for them. For children who
cannot remain with their families, they should provide and supervise foster
care.
The Department of Women and Children, in the Ministry of Human
Resource Development, should ensure that HIV/AIDS-affected children have access
to ICDS heath and nutrition programs in a way that does not further stigmatize
them.
The government should create the proposed National Commission for
Children with enforcement powers and a clearly defined mandate that includes
children affected by HIV/AIDS. The commission should investigate the links
between HIV/AIDS, child marriage, and child labor.
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