JOINT POSITION ON POST-2015: What a Stand-alone Health Goal Needs to Deliver for Highly Marginalized & Stigmatized Young People

Dear colleagues and advocates,

In advance of and parallel to upcoming high-level events and meetings in New York (the High-Level Event on The Contributions of Women, the Young and Civil Society to the Post-2015 Development Agenda, the 58th Session of the Commission on the Status of Women, and the 47th Session of the Commission on Population and Development), it is imperative that civil society and government express the importance of prioritizing young people, especially those most marginalized and stigmatized, in the post-2015 agenda.

We hope you can and will join us in this effort. Please lend your organization’s support by March 28th as we will re-release this statement for the Commission on Population and Development.

Stand with us and send your organization’s endorsement to [email protected]


What a Stand-alone Health Goal Needs to Deliver for Highly Marginalized & Stigmatized Young People

For consideration in the development of the final report of the Open Working Group on Sustainable Development Goals, the discussions and outcomes of the High-Level Event on the Contributions of Women, Youth and Civil Society to the Post-2015 Development Framework, and in the discussions and outcomes of the Commission on the Status of Women and the Commission
on Population and Development.

Young people living with and affected by HIV – especially young women and girls living with HIV, young people who engage in sex work, young men who have sex with men, young transgender people and young people who use drugs – belong to the most marginalized and stigmatized groups across the world. In many countries, the existence of lesbian, gay, bisexual and transgender (LGBT) people and men who have sex with men is ignored or denied. This denial, in combination with discrimination, violence, punitive legislation, and harmful attitudes and norms around “appropriate” sexual behavior, poses a major barrier to young people’s ability to access quality health services and fully realize their human rights – including their sexual and reproductive health and rights (SRHR).

Many countries have championed SRHR during Open Working Group negotiations, the ICPD Beyond 2014 review, and in the 2012 Bali Global Youth Declaration and the 2011 Political Declaration on HIV/AIDS. Many civil society organizations have likewise called for prioritizing SRHR for young people, especially those of young people living with and most vulnerable to HIV. The final negotiations on the post-2015 development framework must reflect this strong support for promoting the health and human rights, including the SRHR, of young people living with and affected by HIV.

We strongly support the wide consensus that the unfinished business of the health MDGs (4, 5 and 6) must be incorporated in the new framework and unified under a single health goal. We also support the wide consensus that a stand-alone health goal must include cross-cutting commitments to ensuring gender equality and eliminating all forms of gender-based violence, realizing social justice and universal access to health, and promoting human rights, including SRHR. The right to health with its implied imperative of narrowing health inequalities should be central to the post-2015 health agenda. In accordance with international human rights law and standards, everyone has the right to the enjoyment of the highest attainable standard of health, free from violence, coercion, stigma and discrimination.

Link Up aims to advance the sexual and reproductive health and rights of one million young people affected by HIV across five countries in Africa and Asia. The programme is being implemented by a consortium of partners led by the International HIV/AIDS Alliance. For more information visit the Link Up Project website.

We firmly believe the health goal should be outcome-focused and account for all factors that affect health and wellbeing at all ages of life. Given the higher vulnerability of young people to poor sexual and reproductive health, and in particular that of the most marginalized and stigmatized, a stand-alone health goal must support young people’s rights to control all aspects of their sexuality and their reproduction.

At minimum, a health goal should include targets on:
Universal health coverage, including a) universal and equitable access to quality health care, in particular for young people and adolescents, that includes comprehensive sexual and reproductive health care and rights information; universal comprehensive sexuality education that promotes respect for human rights, freedom, non-discrimination, gender equality and nonviolence; prevention and treatment of sexually transmitted infections (STIs) and HIV prevention, treatment, care and support services; contraceptive and family planning commodities, including emergency contraception, safe abortion and post-abortion care and services, and b) financial risk protection, including comprehensive social protection for people living with HIV;

Health outcomes, including ending preventable newborn, child and maternal morbidity and mortality, especially for young women, and preventable morbidity and mortality from communicable and non-communicable diseases, including working towards zero AIDS-related deaths and zero new cases of HIV both through sexual transmission and drug use;

Addressing structural drivers of inequality, which includes ensuring that no one is denied quality health care, including HIV prevention, treatment, care and support and sexual and reproductive health care, due to their age, gender, HIV status, or sexual orientation and identity and eliminating all discriminatory laws that contradict the right to health.

All new health investments and the development and implementation of post-2015 goals, targets and indicators must be firmly based on human rights, including sexual and reproductive rights.

Data to measure progress towards any new post-2015 goal, including the health goal, should be disaggregated at minimum by age, gender, ethnicity, location, disability, sexual orientation, gender identity and other factors that drive marginalization and increase health risk. There is a lack of evidence-based data on many marginalized groups, including young people under the age of 20, rendering marginalized groups invisible and lacking access to health and social services. The post-2015 framework must support a “data revolution”, as proposed by the UN Secretary General’s High Level Panel on post-2015 to ensure no one is left behind.

However, to avoid increased risk for certain populations, data on sexual orientation and gender identity must be collected voluntarily and through strictly monitored confidential systems that employ sound informed consent processes. This requirement helps ensure respect for the privacy and rights of those who choose to disclose their sexual orientation or gender identity. It is, furthermore, in accordance with global human rights standards and ratified treaties.

Strong and inclusive accountability mechanisms at the country level are critical and complementary aspects of promoting the
health and human rights of the most marginalized and most stigmatized. These mechanisms must oversee human rights and health commitments and secure broad participation of communities, including young people living with and most affected by HIV, along with transparency and accountability in health resource allocation and spending.

Lessons learned from the HIV response demonstrate that communities and community-based organizations contribute significantly to progress by increasing outreach and access to services, as well as by delivering direct and appropriately tailored services. They also help ensure the voices of the most marginalized are heard and their needs and priorities put forward and reflected in national policies, plans and budgets. The accountability mechanisms to be built into the post-2015 framework should draw from the experiences of the HIV response, and ensure the meaningful engagement of communities and community-based organizations, including organizations of women living with HIV, young people, young people living with HIV, sex workers, men who have sex with men, and other marginalized groups. Communities must be involved at all levels of the design, implementation and monitoring and evaluation of the post-2015 development agenda.


This paper was developed in collaboration with the following Link Up partners:

Click here to find out more about Link Up Project

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