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Human Rights Programme

South Africa’s constitution and legal framework is rooted in the recognition, protection and promotion of human rights. But there are significant gaps when it comes to realising the human rights of all those who live in South Africa, particularly when it comes to HIV, STIs and TB.

Some groups of people are more vulnerable to contracting HIV and TB. These same groups also face enormous barriers when it comes to accessing and staying in health and other support services. South Africa’s AIDS response has largely focused on medical models of prevention, treatment and care but while these interventions are important, research shows that human rights and gender-related barriers are driving the spread of HIV, STIs and TB and severely hampering our progress towards ending AIDS.

Some of these barriers include:

  • Stigma (including self-stigma)
  • Discrimination and human rights violations against people living with HIV, people with TB and key and vulnerable populations.
  • Silence and a moral lens on issues of sex, gender identity and sexuality
  • Gender inequality, harmful gender norms and gender-based violence
  • Punitive and/or discriminatory laws and policies
  • Lack of knowledge of human rights and legal literacy
  • Limited access to justice for human rights violations
  • Socio-economic inequality

While HIV-related stigma has declined over time, key and vulnerable populations continue to experience high levels of HIV and TB-related stigma and discrimination. According to a recent study in South Africa, despite 95% of key populations intending to seek healthcare, only 25% did, due to previous experiences of stigma, amongst other factors[i].

Leaving no-one behind

As part of its strategy (2017-2022), The Global Fund committed to support all countries that apply for grants to include and scale up programmes to remove human rights-related barriers to health services. Goal 5 of South Africa’s National Strategic Plan Ground the response to HIV, TB and STIs in human rights principles and approaches – provides a critical background to the Global Fund Human Rights Programme. In addition, Goal 3 recognises the importance of empowering and reaching all key and vulnerable populations in the response to HIV, TB and STIs, ensuring that no one is left behind, and Goal 4 recognises the need to address the social and structural drivers of HIV, TB and STIs such as poverty, human rights violations and gender inequality. South Africa’s National Human Rights Plan sets out a comprehensive response to human rights-related barriers to HIV and TB services and gender inequality for people living with HIV, people with TB, and for key and vulnerable populations.

There are evidence-based programmes and approaches that work to remove human rights and gender-related barriers to HIV and TB services for key and vulnerable populations. NACOSA is one of four principal recipients responsible for the implementation of the Global Fund’s Human Rights Programme which builds on this evidence as well as learnings from previous programmes, tools, trainings, reporting mechanisms, and legal and human rights guidance.

The aim of the programme is to address human rights-related barriers and gender inequality that increase risk and prevent key and vulnerable people from accessing services. Its objectives are to:

  • Reduce stigma and discrimination amongst people living with HIV or TB
  • Facilitate access to justice and redress for people living with, and vulnerable to, HIV and TB.
  • Promote an environment that enables and protects human and legal rights and prevents stigma and discrimination.

human rights programme graphic

NACOSA’s Human Rights programmingThe Human Rights Programme will be implemented across all nine provinces and Global Fund-supported districts.

NACOSA’s programme implementation will include the following interventions:

  • Stigma and discrimination reduction: training organisations to help create an enabling environment to both prevent violence and enhance violence response.
  • Human rights defence: training, support and referrals for the collection, recording and reporting of human rights violations.
  • Legal support in the form of paralegals to support people who have reported human rights violations as well as strategic litigation and advocacy.
  • Handling disclosure of GBV: training for organisations and staff on the World Health Organisation’s LIVES protocol (Listen, Inquire, Validate, Enhance safety and Support).
  • Know Your Rights: legal literacy training for organisations.
  • Support for and partnership with key and vulnerable populations networks, such as the South African Network of People who Use Drugs (SANPUD)
  • Mainstreaming the reduction of harmful gender norms across all our programmes, including community mobilisation and advocacy.

Successful, integrated and comprehensive efforts to reduce and remove human rights and gender-related barriers will empower and enable key and vulnerable populations to reduce their vulnerability. This will also improve access, uptake and adherence to HIV and TB-related health care services thus reducing the spread and impact of HIV, AIDS and TB. It will further support South Africa’s ability to achieve its public health goal to end AIDS, TB and STIs as public health threats.


[i] Duby, Z et al. (2018) Scared of going to the clinic: Contextualising healthcare access for men who have sex with men, female sex workers and people who use drugs in two South African cities.