Q&A with Alia El-Yassir, Director of the Department for Gender Equality, Human Rights and Health Equity, World Health Organization

In this interview, we speak with Alia El-Yassir, Director of the WHO Department for Gender Equality, Human Rights and Human Equity. Alia highlights the integral role of human rights in building health systems and services that are inclusive and ensure the dignity and security of all. ?

This interview has been edited for clarity. ?

Why is tackling discrimination and protecting human rights so important???

Throughout my career in advocating for gender equality and women’s rights, I have witnessed firsthand the profound impact that discrimination can have on access to health services and on health outcomes.??

I worked for many years in the occupied Palestinian territory as part of the UN system, also participating in the humanitarian response there. I saw, first-hand, the extended restrictions on mobility and physical access to healthcare services, as well as restrictions on medical equipment/supplies for the Palestinian population in the West Bank and Gaza Strip, imposed by Israeli authorities.???

This routine system of restrictions that obviously affected health outcomes for the whole population was also compounded by gender-based discrimination that led to more medical referrals for men than women due to harmful gender norms and stigma associated with the health system referral procedures. And so, the health outcomes for women and girls tended to be even worse than for men and boys because of layered construct of social, political, physical, and many times economic barriers both within the health system as well as in the broader context of their lives.?

When people are denied access to health services, or when they receive substandard care because of discrimination, their right to health, but also at times to their right to life, security and dignity are compromised.?

I strongly believe that tackling discrimination and protecting human rights in the context of health is crucial not only to improve health outcomes but also to create a world where every individual can achieve their full potential and to fully contribute to our collective wellbeing.??

How do discrimination and stigma obstruct access to health services and impact people’s health???

Stigma and discrimination manifest at various levels within societies and obstruct access to health services in many different ways. They translate into discriminatory laws and policies. But even when protective laws and policies are in place, or there is the declared imperative of “leaving no one behind”, negative societal norms and discriminatory attitudes on the part of healthcare providers, coupled with internalized stigma, can prevent people from accessing the care they need. Combined with limited availability of services and high out-of-pocket costs, this results in already excluded and discriminated against groups being disproportionately affected.??

This being said, it is important to continue strengthening legal protections against discrimination and measures to ensure that laws and policies do not inadvertently pose barriers to health and wellbeing.???

Collecting, analyzing and using data disaggregated by various social stratifiers can play a crucial role in determining who is most affected by stigma and discrimination in accessing health services.? But we also need wider data and evidence, including in relation to gender identity and diversity, to understand the processes of discrimination and exclusion that make communities invisible in health information systems.? Such data and analyses help, on the one hand, to inform the design of interventions, and on the other, to monitor the delivery of good health outcomes for all members of a population, as well as accountability for injustices.?

One of the most important lessons we have learnt is that it is crucial to involve communities in the design, implementation and monitoring of health programmes. This helps ensure that services are people-centred, meaning that they are designed with specific needs and considerations of individuals in mind so that their health needs are addressed holistically.????

And finally, tackling stigma and discrimination in health and ensuring equitable access to health services cannot be a task for the health sector alone. Decisive actions in other sectors, including education (to combat biases and misinformation), labour (to promote fair treatment) and justice (to enforce anti-discrimination laws) are indispensable to address social and structural determinants of health, including discrimination.??

What needs to be done to ensure that leaders protect the human rights of everyone, including LGBTQ+ people? What partnerships are needed???

First of all, it is very important to recognize that human rights are an integral, not an optional, part of health systems and services.

This is not only to achieve better health outcomes but also to ensure dignity and security of each individual. Health services and programmes need to be designed to be inclusive, respecting and promoting dignity, autonomy and equality, even in crisis and emergency settings.??

We need to shift public discourse to view health not just as a medical issue but as a human rights issue. Programmatic health responses must be reoriented to prioritize human rights. This involves having protective laws and policies in place, as well as educating health professionals on the specific health needs of LGBTQ+ populations, on anti-discrimination measures, and on contributing to access to justice for any violation of rights.???

Global health actors need to work more closely with the human rights movements, including LGBTQ+ advocates at global, regional and country levels. Partnerships between health sector actors, human rights experts, advocates and communities can help ensure that health strategies are informed by human rights, thereby addressing underlying determinants effectively.??

By embedding human rights into the core of health responses, leaders can ensure improved health outcomes and contribute to creating a more just and equitable world where no one is left behind.??

What are your hopes and aspirations for ensuring the rights of all and the health of all?

My hopes and aspirations for the future revolve around creating a world where there is no differentiation in the intrinsic value of every human being, and no discrimination. A world where we celebrate diversity and solidarity as part of our humanity.? I envision a society where health equity is a reality and every person, regardless of their race, background, identity or sexuality has access to quality health services that respect their rights and dignity.?

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Alia El-Yassir brings a wealth of experience in advancing gender equality and women's empowerment to her role as Director for Gender, Equity, Diversity, and Rights for Health at the World Health Organization. Previously, she served as UN Women Regional Director for Asia and the Pacific, and Representative to the Kingdom of Thailand, as well as UN Women Regional Director for Europe and Central Asia, and Representative to the Republic of Türkiye. Alia has been dedicated to gender equality within the United Nations system since the Fourth World Conference on Women in 1995. She has held various roles supporting UN Women's global work, and has extensive experience managing normative, coordination, and operational efforts within diverse development and humanitarian contexts at the country level. Through her country, regional, and global work, she has fostered strong partnerships to advance the rights of all women and girls.?