Ending discrimination in health care settings

Jim Campbell, Director, WHO Health Workforce Department
Gottfried Hirnschall, Director, WHO Department of HIV and Global Hepatitis Programme
Veronica Magar, Team leader, WHO Gender, Equity and Human Rights Mainstreaming Team

It's a sad reality that discrimination in health care is widespread across the world and takes many forms. It violates the most fundamental human rights and affects both users of health services and health workers, based on issues including ethnicity, sexual orientation, harmful gender stereotypes, asylum and migration status, criminal record, and other prejudices and practices.

Discrimination runs counter to global commitments to reach universal health coverage and the Sustainable Development Goals. It undermines investment in health systems, deters people from accessing or seeking health services, divides, disempowers, and deprives people of their basic dignity.

Discrimination runs counter to global commitments to reach universal health coverage and the Sustainable Development Goals.

- Jim Campbell, Director, WHO Health Workforce Department
Gottfried Hirnschall, Director, WHO Department of HIV and Global Hepatitis Programme
Veronica Magar, Team leader, WHO Gender, Equity and Human Rights Mainstreaming Team

Discrimination also affects the social determinants of health. For many people, their interaction with the health system is their only connection to a state institution, directly shaping their very experience of citizenship and all too often, serving to reinforce their exclusion from society.

The Joint UN Statement on ending discrimination in health care settings, launched by former WHO Director-General Margaret Chan and UNAIDS Executive Director Michel Sidibé, and endorsed by the heads of agencies at ILO, IOM, OHCHR, UNDP, UNESCO, UNFPA, UNHCR, UNICEF, UNWOMEN, and WFP, calls on partners to commit to ending discrimination in health care settings through joint and coordinated action.

The statement lays out three priorities:

  1. Discrimination does not occur in a vacuum. Health workers and their own rights are at the centre of this agenda – with labour rights, working conditions and gender inequalities inextricably tied to addressing discrimination in health care settings and a health work force that is largely female. We must move beyond the single narrative – by which health workers are perpetrators of discrimination – to recognize the importance of supporting health workers not only to fulfil their roles and responsibilities, but also to claim their rights.
  2. A strong evidence base coupled with robust legal frameworks are critical to advancing accountability for discrimination in health care. And yet laws very often contradict the evidence base. We must work to bring laws into line with established public health evidence and human rights standards.
  3. The need to address the underlying causes of discrimination within and beyond the health system. This can only be achieved by working across sectors, agencies and more actively engaging with civil society organizations representing both health workers and affected communities. Governments, agencies and community leaders must unite in declaring discrimination in healthcare unacceptable.

In February 2017, nine countries launched a new network to promote quality, equity and dignity in health care, and to promote cross-country exchange and planning around quality of care. The network is driving efforts across the countries to promote quality of care, especially for mothers in marginalised communities, and generating important lessons for other countries battling high rates of newborn mortality.

While many partners within and beyond WHO are already working on addressing discrimination in health care settings, this agenda seeks to reconcile these efforts behind a common agenda. As we continue to advance towards universal health coverage, discrimination will be an important frontier issue requiring a holistic and united response.

In taking up this call, the Fourth Global Forum on Human Resources for Health, in November 2017, offers an opportunity to take this agenda forward, and to better elaborate the rights, roles and responsibilities of health workers. We hope you will join us in moving ahead with this shared vision for a world free from discrimination in healthcare.