Background

A decade long struggle of the civil society and the Government to make the legal framework of the country more enabling and responsive to the needs of the People Living with HIV bore fruit on April 11th 2017. The HIV/AIDS Prevention and Control Bill (2014) finally got passed by the Lok Sabha after being marred with controversies and debates for over ten years. With the final hurdle being cleared for the Bill to be enacted as a legislation, India would soon join the likes of Fiji, Cambodia, Mangolia, Papua New Guinea China, Philippines and Vietnam to have an Omnibus of National HIV Law.

The main aim of the anti-discriminatory Bill is to provide legislative framework to protect and secure the human rights of People Living with HIV. The Bill makes practicing of stigma and discrimination, a penal act. The critical areas covered under the Bill are:

  • The Bill makes it obligatory for Central and State Governments to provide Anti Retro Viral Therapy to the HIV patients.
  • The Bill prohibits acts of discrimination on the basis of one’s HIV status and safeguard the rights of PLHIVs in the critical sphere of education, employment, insurance and accommodation.
  • The Bill mandates informed consent or HIV testing, research and medical treatment and prohibits forced disclosure of one’s HIV status except in cases of orders passed by the court.
  • Each State Government is required to appoint an ombudsman to inquire into complaints of related to the violation of the act and the provision of health care services. The ombudsman is required to submit a stock taking report every six months to the State Government. Furthermore, the cases related to PLHIVs shall be disposed off on priority basis.
  • The Bill requires every establishment, that keeps HIV-related information of protected persons, to ensure data protection measures to maintain confidentiality of information.

Stigma Reduction: An Integral part of the HIV Bill

 HIV-related stigma is recognized as a key obstacle to HIV prevention, care, and treatment besides adding to psychological distress for the affected. Fear of, and actual experience with, stigma and discrimination associated with HIV often negatively influence an individual’s willingness to seek HIV testing, disclose his or her HIV status to others, ask for (or give) care and support, initiate or sustain safer sex or safer injecting drug use practices, and begin and adhere to treatment.

HIV-related stigma is a complex phenomenon as attitudes towards the epidemic and those infected and affected are not new but shaped by deeply entrenched prejudices and traditional power hierarchy in society. There are multiple factors like caste, gender, sexuality, age, education and levels of knowledge about HIV etc affecting the levels of overt/ covert expressions of stigma experienced by an individual.   

Stigma and discrimination continue to undermine prevention, treatment and care of people living with the HIV and AIDS. It hinders those with the virus from telling their partners about their status. It threatens their access to health care. It increases their vulnerability to physical violence. And HIV-related stigma affects people’s ability to earn a living, making it even more difficult for them to lift themselves out of poverty. 

UNDP’s Work in Addressing Stigma

Stigma and discrimination is a cross cutting area of focus under the National AIDS Control Programme -Phase IV ( NACP-IV). NACP-IV is committed to enhance activities to reduce stigma and discrimination at all levels particularly at health care settings.  

Stigma reduction and creation of a barrier free and stigma free society lies at the core of UNDP’s efforts towards addressing HIV. In its long standing partnership with the National AIDS Control Organization, UNDP, India has responded by looking at each layer of the multi-layered phenomena called stigma. The HIV Project of UNDP India, in partnership with the National AIDS Control Organisation (NACO), Ministry of Health & Family Welfare, Government of India, aims to reduce stigma faced by people affected by HIV by supporting community action, addressing the need to reform laws that impede effective HIV response, and improving access to entitlements and services, including sustained access to medicines.

UNDP in the last decade has continuously advocated with the government for mainstreaming of HIV and for creating an enabling environment for the People affected by HIV for increased and stigma free uptake of services.

Global and National Efforts to Address Stigma

Significant steps have been taken at both global and national levels towards evidence gathering of stigma in multiple settings. The outcome of these studies have informed the design of interventions for tackling stigma. At the global level, The People Living with HIV Stigma Index provides a tool that measures and detects changing trends in relation to stigma and discrimination experienced by people living with HIV. It aims to address stigma relating to HIV while also advocating on the key barriers and issues perpetuating stigma - a key obstacle to HIV treatment, prevention, care and support.   India was among the 70 countries where the study was conducted. The study was conducted between December 2010 to September 2011 in the State of Tamilnadu. Study findings indicate that self-stigma among the PLHIV respondents was incredibly high, with the marginalized groups expressing more self-stigma reportedly based on their sexual identity or behaviors.

To support the NACP, the International Center for Research on Women (ICRW) with the United Nations Development Programme (UNDP), has: 

  • adapted an existing global HIV stigma reduction framework for the Indian context;
  • pilot tested the framework in five settings in India;
  • synthesized lessons learned about the feasibility and relevance of the framework for use by the NACP and other global stakeholders in informing stigma reduction interventions and measurement.  The global framework adapted for the Indian context was developed by a consortium of stigma researchers and was based on a systematic review and synthesis, supported by UNAIDS, of the research literature. 

The framework highlights practical entry points for stigma and discrimination reduction programming and measurement, and is intended to inform the integration of stigma reduction activities into national AIDS responses. India is the first country to pilot the global framework and assess its feasibility and appropriateness for guiding stigma-reduction efforts.

National Priority in the light of Passing of HIV Bill

 With the  HIV Bill only a step away from becoming an Act, the National priority in the context of HIV is to expedite the implementation and operationalization of the Bill. This would require coordination  and constant interactions with State AIDS Control Societies, community members,  health and non health Government department and other important stakeholders to seek their inputs in effective and efficacious implementation of various elements of the of the Bill.

Work Done so Far

 Stigma reduction being the core of NACP -IV is a cross cutting issue. The bill makes antiretroviral treatment a legal right of HIV/AIDS patients. The Bill makes it obligatory for the central and state governments to provide for antiretroviral therapy (ART) and management of opportunistic infections (infections that take advantage of weakness in the immune system and occur frequently). It prohibits specific acts of discrimination by the state, or any other person, against HIV-positive people, or those living with such people.

The Bill takes a serious view of the stigma arising out of the HIV infection that impacts the various spheres of life of an individual and results in her/ his denial of basic human rights. Addressing of stigma at various levels and settings is regarded as an imperative by the HIV and AIDS Bill. In light of the approval of the HIV Bill, the development of a separate Stigma Guideline is mandatory.

Foreseeing the passing of the HIV Bill , UNDP in partisanship with National AIDS Control Organization understood the development of the National Stigma Reduction Guideline as stigma reduction is the mainstay of the HIV Bill. stigma guidelines in 2016 and the same was presented to the NACO Technical Resource Group members on Stigma Reduction. The comments provided by the members have been incorporated and the guidelines has to be now developed as per the NACO agreed framework. Currently, UNDP and NACO are in the process of developing the National Stigma Reduction Guidelines

Immediate Need :

The fact that HIV Bill would soon become an Act. As per the rules of the Government of India, an act comes into force only when the rules regarding the specific acts are developed and passed. The Rules an act lay down conditions and per-requisites for the operationalization of the various elements mentioned under the act.  

The HIV/ AIDS Bill lays don provision related to non-discrimination and  prohibition of termination of employees on the basis of their HIV status, establishment of grievance  redressal mechanisms, appointment of Ombudsman to deal with the complaints etc . All these provisions require a legal understanding so that they can be adequately translated into appropriate rules .

 

 

 

Duties and Responsibilities

The main objective of this assignment is to take lead in examining the legal aspects of the provisions laid down by the HIV Bill develop rules for its implementation and operationalization.

Tasks to be Undertaken by the Consultant:

 The Consultant would provide technical assistance to NACO and SACS in developing implementation framework outlining the legal implications and procedures for establishing systems. This would include:

  • Detailed examination of the HIV Bill to mark the provisions that require legal  perspective for their implementation;
  • Secondary data collection and literature review of the existing guidelines and  Departments to understand the functioning of the similar mechanisms as laid down in the HIV Bill;
  • Development of Rules of the HIV Bill ( State and Central level). 

Competencies

Functional Competencies:

  • Demonstrated experience in working on the legal  and human rights aspects related to the marginalized section of the society. 
  • Prior experience of working with the Government and civil society in addressing the legal and human rights issues of the most marginalized. 

Core Competencies:

  • Acts as a team player, facilitates team work and shares knowledge with others; 
  • Excellent linkages with a range of government, non-government, technical and academic agencies, globally and nationally;
  • Approaches work with energy and a positive, constructive attitude;
  • Generates new ideas and approaches, researches and documents best practices and proposes new, more effective ways of doing things;
  • Responds positively to critical feedback and differing points of view;
  • Demonstrates comprehensive knowledge of non-conventional and cost-effective construction and applies it in work assignments.

Required Skills and Experience

Academic Qualification:

  • Bachelors in Law. 

Professional Experience:

  • 10+ years of experience in the field of Public health  with a focus on the HIV sector . 

Documents to be submitted.

  • Financial Proposal- Consultant shall specify his/her all-inclusive  per day consultancy rate; any travel with prior UNDP approval will be handled separately as per rules;
  • Updated CV with contact details of three referees.

Payment Schedule:

  • Submission of chaptarised framework for development of rules and timelines of the  submission  of draft documents : 30%
  • Submission of  zero draft of rules of the HIV/ AIDS Bill : 30%
  • Submission and acceptance of 1st draft of rules of the HIV/ AIDS Bill after incorporating the comments from the TRG: 40% 

Evaluation Criteria:

Cumulative analysis:

The award of the contract shall be made to the individual consultant whose offer has been evaluated and determined as:

  • Responsive; 
  • Having received the highest score out of a pre-determined set of weighted technical and financial criteria specific to the solicitation;

Technical Criteria weight - 70%;

Financial Criteria weight - 30%.

Only candidates obtaining a minimum of 49 points (70% of the total technical points) would be considered for the Financial Evaluation.

  • Educational Qualification- 10
  • Experience in the field of Public health – 15  
  • Experience in the field of HIV- 10
  • Experience in assignments dealing with exploring legal issues – 15
  • Prior experience in working with UNDP- 20  

Notes:

  • Any kind of miscellaneous charges i.e. internet, phone etc. would not be reimbursed; Tickets will be issued considering the most direct and economical option and Consultants are not eligible for DSA;
  • Individuals working with institutions may also apply, contract would be issued in the name of institution for the specific services of individual;
  • Please note proposals without financial proposal will not be considered.

For any clarification please write to sandeep.sharma@undp.org