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Response stories

“I have my right to work”: the resilience of a person living with HIV working in a hospital in North Macedonia

A person living with HIV who takes antiretroviral medications can work. In North Macedonia the Law on Labor Relations and the Law on the Prevention and Protection from Discrimination both prohibit discrimination based on health status, which includes HIV. However, in this case, an attempt was made to prohibit a person living with HIV from continuing to work at his place of employment, a city hospital in one Macedonian town.

“Don’t come to work.”

In August 2023, the person underwent an HIV test at the hospital where he works as auxiliary medical staff. When the test came back positive, the information was shared with all of his colleagues. That same day, he received a call from a doctor informing him that he should not report to work the following day. At the same time, the individual had other health issues, so he sought medical assistance at the same hospital where he had worked for almost 35 years. The same doctor who informed the individual that he should not report to work declined to examine him. The individual left to seek medical assistance in another place. In the meantime, the person started taking antiretroviral medicines. 

After the visit to the hospital, the person took medical leave due to additional health conditions that necessitated bed rest. After his health issues were resolved, he wanted to return to work. However, his family doctor and the medical commission, which is in charge of awarding medical leave, continued to extend his medical leave without his consent and any specific reason, citing the fact that he is a person living with HIV. Soon after, he was directed to a doctor, who specialized in labor medicine, to evaluate his ability to work. According to the relevant legislation, if a person living with HIV is on medical leave for 10 months or less, he or she must have an assessment to determine his or her ability to work.

REAction and outcome

A REActor met with the individual and suggested he obtain a report from his doctor at the Clinic for Infectious Diseases and Febrile Conditions, stating that he is well and has no reason not to work. After receiving the report, the Association Stronger Together from Skopje filed two complaints: one with the director of the hospital where the individual works and one with the state Health Insurance Fund. The letter to the director described the violations committed by the staff, such as the denial of healthcare, the disclosure of medical data, and insults directed at the employee, and demanded that the hospital should initiate an investigation and punish the perpetrators, while also undertaking measures to stop the harassment of the employee. The Hospital was also notified that Stronger Together and other civil society organizations would be ready to provide legal support to the person with HIV should he decide to take the matter to court. The letter to the Health Insurance Fund indicated that the family doctor and the medical commission are providing medical leave to those who don’t need it and by default, spending the Fund’s money without justification; additionally, the letter enunciated that the extension of the medical leave was without the patient’s consent. Following the complaints, there was a reaction by the Hospital, which allowed the person to return to work and he has not reported any other breaches of his rights afterward.


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Victory in the protection of privacy: the history of dormitory housing in Uzbekistan

Let’s stop discrimination: protecting children’s rights in kindergartens in Uzbekistan

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News Response stories

Entitlement or preference? The world celebrates Health Day

April 7 marks World Health Day, founded by the World Health Organization (WHO) in 1950. This day recalls the importance of health for all people in the world and emphasizes the need for access to skilled health care as a fundamental human right. In this context, providing life-saving services such as opioid substitution therapy (OST) to people from key populations is critical. This approach enables patients to manage physical dependence, reduce the risk of transmission of infectious diseases (e.g. HIV or hepatitis), and improve quality of life.

However, despite the proven effectiveness of OST, many people around the world (including in the Eastern Europe and Central Asia region) face barriers to accessing this treatment due to stigmatization, lack of access to health services, or legal restrictions. This creates serious obstacles for those in need of assistance.

For example, recent changes to the Ministry of Health’s January 24 Order to the opioid substitution therapy program in Georgia have made significant adjustments. Under the previous rules, patients participating in the program had the opportunity to receive a two-day dose of medication if they were unable to visit a healthcare facility, and this dose could be picked up for them by a family member or other authorized person. However, under the changes made, this right has been limited and patients or their authorized representatives must now visit the service center daily.

The changes also affected the ability to provide patients with pharmaceuticals in special cases. Previously, there was an option to receive a five-day supply of medication when long-term home treatment exceeding two months was required, or a seven-day supply for those with a pronounced disability or active tuberculosis. However, the amendments have completely abolished this exceptional regulation. Under the previous regulation, patients could also be given a dose if they had to move around the country (the principle of business travel). The innovations have abolished this regulation and now, even in cases of exceptional need such as business travel or ill health, patients can only be given a one-day dose.

Kazakhstan also has a serious problem with violations of the rights to health care and health maintenance for people who use psychoactive substances. These problems have been identified, including through the REAct, on appeals related to obstacles in accessing medical services for clients. This situation covers several aspects:

– Lack of access to free medical care, including tests and abortions, for persons without compulsory social health insurance.

– Limited access to a guaranteed amount of free medical care for people who use psychoactive substances.

– Insufficient drug supply and diagnosis of diseases among persons in detention centers.

According to the Order of the Minister of Health of the Republic of Kazakhstan from September 23, 2020, № KR DSM-108/2020, treatment of people who use psychoactive substances is carried out within the guaranteed volume of free medical care in regional Mental Health Centers (MHC). Anonymous treatment is available only on a paid basis. However free medical care does not provide the necessary range of services for social, psychological, pedagogical, labor, cultural, economic, and legal support for people from the community.

The theme of this year’s World Health Day is “My Health, My Right” and aims to support and recognize the right of everyone, wherever they are, to access high-quality health care, education and health information, and freedom from discrimination. This means that it is worth taking another opportunity to draw public attention to such violations of people’s rights to quality and timely health care and the need to develop a model that complies with human rights principles and international standards while taking into account the needs of patients, their families and the interests of organizations providing addiction treatment services. And legislate to guarantee the provision of a full range of assistance for the treatment and rehabilitation of everyone who needs it. 

Health is everyone’s right, as is equal access for all people to qualified care.


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Showing strength: International Transgender Day of Visibility

March 8 in Eastern Europe and Central Asia: the struggle for the rights of women from vulnerable groups continues

Categories
Response stories

Confidentiality of people living with HIV in Uzbekistan: care for loved ones and protection of rights

The client is a person living with HIV and has been registered at an AIDS center since 2020. He lives in X district of A city together with his spouse and two minor children. The family receives a disability pension and is on the low-income list. One day, on their return from the bazaar, the husband and wife learned from a neighbor that the secretary of the Mahali committee had invited them to a meeting. The woman was not told the reason for the conversation, but the couple’s HIV status was revealed to her. This breach of confidentiality angered them and the couple slowly asked that information about their disease not be disseminated, as it could hurt their children and was against the law.

Thereafter, the REActor entered into a dialog with the Mahali committee secretary. He emphasized that disclosure of information about the status of HIV-positive people violates their rights to confidentiality. The family was advised to contact a lawyer or human rights organization to advocate for their interests.

This story underscores the importance of protecting the confidentiality of HIV status for the well-being of the family. No one should suffer from disclosure of their medical status, and everyone has the right to have their personal information protected.

Original Source (in Russian)


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Public appeal to the Ministry of Health of Georgia: assessment of changes in legislation on substitution therapy program

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News

Showing strength: International Transgender Day of Visibility

March 31 is International Transgender Day of Visibility, which is dedicated to supporting, recognizing, and raising awareness of the rights of transgender people around the world. It is a time to raise important issues related to the transgender community and stimulate public dialog about the importance of respect and equality.

In the Eastern Europe and Central Asia (EECA) region, the visibility and rights situation for transgender people remains complex and multifaceted. Laws and policies in individual countries restrict community rights, including access to health care, gender reassignment, and protection from discrimination. In 2023 alone, national REActors documented 1,109 complaints from members of the LGBTIQ community in the region. The most common violations of the rights of transgender people are discrimination, insults, harassment, threats, and, alas, often it even comes to attacks. An example happened in Armenia with a transgender girl, an activist, and an employee of a local NGO. While testing and counseling a client for HIV, she was attacked by a stranger. With the participation of REActors, it was possible to record the facts of the crime and ensure the initiation of a criminal case. Another egregious case occurred in Tajikistan – a transgender woman was detained without reason by law enforcement officials and her personal belongings were confiscated. Interrogations began. This put the victim in an extremely difficult situation. REActors were able to provide legal defense by finding a lawyer willing to take on the case and defend her rights. They were also able to raise the necessary funds for the client to leave the country safely. Thanks to their support, after two months, the case was closed and the belongings were returned.

The fight to protect the rights of transgender people in the EECA region remains relevant and important. A lot of work is still needed, but the situation is gradually changing for the better, mainly due to the active role of transgender people themselves in this process. They invest a great deal of interest in creating changes that directly affect their lives and well-being (because for the majority of authorities, who are usually people who are not uncomfortable with gender conformity, alas, these issues may seem less important or irrelevant). Local non-governmental organizations and community groups are also actively working for the benefit of transgender people in the EECA region, providing them with support, information, and protection from discrimination and violence. These efforts play an important role in raising awareness and creating a safe and supportive environment for transgender people. It is important to continue to mobilize public opinion, give support to the transgender community, and work to create laws and policies that protect their rights and dignity.

On International Transgender Day of Visibility, each of us can do something important to show our support. Here are a few ways you can do that:

1. Education and awareness: learn more about transgender issues, history, and the fight for transgender people’s rights. The more we know, the better we can support their fight for equal rights and opportunities.

2. active listening and support: listen to the stories and experiences of transgender people without judgment. Support them by expressing your support and solidarity. Have an open dialog and be willing to listen to their needs and experiences.

3.         Participate in events: take part in events to commemorate International Transgender Day of Visibility. These can be rallies, public lectures, marches, or other events to raise awareness and support for the transgender community.

4. Utilize social media: share transgender people’s stories, relevant articles, and resources to spread the word about March 31 and the importance of supporting this community.

5.         Financial support: support organizations and charities working to benefit the transgender community. You can make donations or participate in fundraisers to help fund support and advocacy programs.

6.         Fight for rights: engage in active resistance to discrimination and violence against transgender people. Support legislative initiatives and policies to protect their rights and ensure equality before the law.

7.         Respect Identity: respect and recognize everyone’s gender identity. Use correct pronouns and respect their choice of name and expression of their gender.

Showing support and solidarity with transgender people is an important step towards creating a society where everyone can feel respected and protected, regardless of gender identity.


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March 8 in Eastern Europe and Central Asia: the struggle for the rights of women from vulnerable groups continues

HIV Criminalization Awareness Day: fighting for justice and understanding

Categories
Response stories

Public appeal to the Ministry of Health of Georgia: assessment of changes in legislation on substitution therapy program

The Public appeal of Georgian NGOs to the Ministry of Health reflects serious concerns about the recently introduced changes to the legislation regulating the substitution therapy program. Drug policy experts, as well as representatives of public associations, raise important questions about how these changes will affect the rights and quality of life of patients enrolled in this program.

According to the change made on January 24 of this year in Order No. 01-41/N of the Minister of Labor, Health and Social Protection of Georgia “On Implementation of Substitution Treatment of Opioid Addiction”, the rules of administration of the substitution program were regulated differently.

According to the existing regulations, patients included in the substitution treatment program, in case of inability to report to the drug institution, could receive/withdraw the drug intended for substitution treatment for a maximum of 2 days with the help of a family member or other authorized person. Under the changes, beneficiaries have been restricted from this right, and they or their proxy must go to a service center every day. The change also affected the possibility of providing the patient with a pharmaceutical product in special cases.

According to the revision effective until January 24, in case of need for long-term (more than 2 months) treatment at the patient’s apartment, it was possible to receive 5 days’ supply, and to persons with pronounced disabilities and active form of tuberculosis, it was possible to receive the product in the amount of 7 days’ supply at the same time. With the implemented changes, the said exceptional regulation was canceled altogether.

Also, the current order no longer provides for the possibility of receiving a dose of no more than 4 days for the patient in the case of justifying the reason for moving within the country (the so-called business trip principle). With the new change, even in the conditions of any exceptional and objective need, (including during a business trip or due to health conditions) it is possible to provide only 1-day allowance to patients.

As a result, it is important to ensure consultation and discussion with health and addiction professionals and experts. This will help to develop a model that is consistent with human rights principles, and international standards and that carefully considers the needs of patients, their families, and the interests of organizations providing addiction treatment services.

Center for Social Justice

Georgian Harm Reduction Network

Alternative Georgia

Georgia Network of People who Use Drugs (Genpud)

New Vector

Association of Narcologists of Georgia

Public Union “Bemons”

Phoenix 2009

National Network for the Protection of Human Rights

Association of Psychologists and Psychotherapists

Rubicon

Information and Medical Psychological Help Center

Association HERA XXI

“Hepa Plus”

Original Source


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Response stories

The fight for patients’ rights has led to changes in a hospital in Kazakhstan

In the city of N, in the complicated trauma department of the city clinical hospital, an event that shook one woman’s life and led to major changes in the institution’s policies took place.

As part of his outreach work, the REActor visited a client who had been hospitalized the previous day in the department. During the encounter, he noticed a blue plastic bracelet worn on the client’s arm containing her personal information, ward abbreviation, room number, and information about her HIV-positive status. When asked by the REActor about the significance of this information, the client explained that bracelets with similar data were common among patients and that the information about her HIV status had been added after the ward manager made rounds.

The REActor attempts to have the confidential information removed from the bracelet was resisted by the ward manager, who asserted that he was well versed in clinical protocol and did not consider it necessary to take into account the comments of “amateurs”.

Having understood the situation, the REactor sent a complaint to the chief physician of the hospital. Thanks to this complaint, an immediate order was given to remove confidential information from the patient’s bracelet. The department head was reprimanded and then fired due to multiple prior violations, including disregard for patient rights.

This story is an example of how determination and fighting for justice can lead to systemic change. It emphasizes the importance of respecting patients’ rights to privacy and protection from discrimination based on their health. The REActor was able to bring change to a previously unjust system, demonstrating that everyone has the right to have their interests respected and protected.


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Georgia’s new legislation on substitution therapy program raises public concerns

Protecting the rights of HIV-positive couple in Uzbekistan: comprehensive assistance and solutions

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News Response stories

Discussions on strategies to combat HIV/AIDS and tuberculosis brought together key national experts in Georgia

A civil society forum on HIV/AIDS and tuberculosis, organized by the United Coordinating Council of the Country for Actions Against HIV/AIDS, Tuberculosis and Malaria, was held on 26 February in Tbilisi, Georgia. The event brought together important participants and experts to discuss plans to strengthen the health system and ensure the sustainability of programs to combat these diseases.

Maka Gogia, Georgian Harm Reduction Network, and David Otiashvili, NGO Alternative Georgia facilitated the forum, which provided a platform for the exchange of views and experiences. The participants discussed current initiatives, the role of civil society in their implementation, and the directions of the updated strategic plans to fight HIV/AIDS and TB. Also, during the forum, the national REActor presented relevant information regarding the REAct annual report.

The forum touched upon various aspects of the problem, including financing of programs, new approaches to prevention, and issues of access to medicines. The event was attended by representatives of both governmental and non-governmental sectors, as well as international organizations, including the Global Fund. The prospects of work under the regional project #SoS_2.0 for 2024, the effectiveness of programs to prevent HIV transmission to men who have sex with men, and other important issues related to infectious disease control were also discussed.

At this meeting CSOs and drug user community talked about existing drug policy and new restrictions within OST program that significantly worsens the condition of disabled people and other patients with severe chronic diseases. With the changes, the standards of legal protection of the persons who are employed deteriorate, and it is possible that business trips are of decisive importance for the performance of their professional activities, overall, it reduces the degree of integration of program patients into society and worsens their situation. Participants agreed to join their efforts to continue advocate activities to remove restrictive regulation in the program.

According to the participants, the forum was a significant step towards a more effective fight against HIV/AIDS and tuberculosis, providing a fruitful dialog and exchange of experience among various stakeholders.


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Public appeal to the Ministry of Health of Georgia: assessment of changes in legislation on substitution therapy program

Georgia’s new legislation on substitution therapy program raises public concerns

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Response stories

Protecting the rights of HIV-positive couple in Uzbekistan: comprehensive assistance and solutions

The AIDS Center approached ISHONCH VA HAYOT with an unusual case that became a challenge for a young couple about to get married. In the process of preparing documents for the civil registry office, the two of them were found to be HIV positive. This fact, which was previously unreported, was unauthorized disclosed by medical professionals, causing rumors and condemnation in the surrounding community.

The couple approached the NGO ISHONCH VA HAYOT to ask for help. National REActors provided them with comprehensive support:

– Counseling and information: the young couple received detailed counseling about HIV infection, treatment options, and available support resources. This helped them realize that they were not alone in their situation and that there are many resources for people living with HIV.

– Psychological support: the NGO provided the young couple with psychological support to help them cope with emotional stress and fear of public opinion. This was an important step towards restoring their self-esteem and confidence.

– Peer support group: REActors referred them to a peer support group for people living with HIV where they could socialize and share experiences with others facing similar challenges. This created a strong supportive environment for the couple.

– Legal assistance: the young couple received legal assistance from NGO specialists who helped them protect their rights and deal with the liability of medical professionals for improper disclosure of confidential information.

This story demonstrates the importance of supporting and protecting the rights of young people facing HIV, as well as the role of NGOs in providing comprehensive assistance and addressing such situations.

Original Source (in Russian)


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March 8 in Eastern Europe and Central Asia: the struggle for the rights of women from vulnerable groups continues

March 8, International Women’s Day, a time not just for congratulations, but an opportunity to once again draw the attention of global society to key issues related to the protection of women’s rights. In the countries of Eastern Europe and Central Asia (EECA), women from vulnerable groups face daily (!) special problems specific to this region and challenges in fighting for their rights. These include access to health care, education, protection from discrimination and violence, and the ability to participate in public life. In the last year alone, REActors documented 1,109 referrals, the majority of which were from women from vulnerable groups.

Women facing HIV often face double discrimination – because of their gender and the stigma associated with the virus. A woman can be evicted without explanationunfairly accused of HIV infection, and psychologically traumatized. In many countries in ЕЕCA, access to adequate medical care and social support for this group remains inadequate.

Female sex workers also face serious challenges, including violenceassault by partners or relatives, exploitation, and lack of protection from government authorities. Sexual violence crimes, particularly when the victim is a sex worker and the perpetrator is a government official, are exceptionally difficult due to the complexity of provable charges, which remain largely victim-dependent, and the lack of the necessary framework to reduce the risk of retraumatization of the victim. Laws about sex workers often discriminate against them and fail to provide the necessary rights and protections. To date, none of the Central Asian countries have ratified the Istanbul Convention.

In EECA countries, LGBTIQ women often find themselves in a particularly vulnerable situation due to double discrimination based on gender and sexuality. They may be intimidated, physically abused, threatened and harassed.

Women who use drugs also face the threat of violence, poverty, and lack of access to health and social services. In many countries in the EECA region, drug policies put additional pressure on women and their rights.

March 8 is not just a holiday, but also a day of struggle for rights. It should be noted that it is important not only to be aware of them but also not to be afraid to fight for them. Many women from vulnerable groups may feel isolated or helpless due to stigma and discrimination, but uniting and solidarity can make their voices stronger.

Reaching out to national REActors and non-governmental organizations (NGOs) specializing in women’s rights and the protection of vulnerable groups is also important. They are the ones who can provide counseling, legal, and psychological support, and other services to help protect women’s rights. Through prompt intervention, the woman is not left alone with the problem or her abusers. Her voice becomes stronger and the fear of fighting for herself recedes because she has much-needed, relevant support. 

Also, in addition to individual action, organizing into collectives and social movements is important. Collective strength can be decisive in fighting for changes in laws, policies, and public opinion about women’s rights and interests.

It is important to remember that no one should be left alone in the fight for their rights. March 8 is not just a tradition from the Soviet past to give flowers. It is a real opportunity for women from vulnerable groups to find support, inspiration, and strength to continue their struggle. Together, we can make greater progress towards equal rights and opportunities for all women, regardless of their social status or identity.


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Global challenges, local responses: how the Eastern Europe and Central Asia region fights discrimination

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News Response stories

Georgia’s new legislation on substitution therapy program raises public concerns

On February 15, a press conference organized by the Georgian Harm Reduction Network was held in Tbilisi, Georgia, on the problem of access to treatment for people who use drugs. The main issue was changes in legislation regulating opioid substitution therapy (OST).

Drug policy organizations, health experts, and public associations expressed their concern about the changes made to the legislation on OST. They believe that such changes will not adequately protect the rights of patients participating in the program.

It was noted at the event that the innovation will significantly worsen the situation of people with disabilities and other patients with severe chronic diseases. According to the new rules, doses will no longer be provided in case of the need to move within the country (the principle of a business trip). Even in cases of justified and objective reasons (including travel or health problems), only a one-day dose will be available to patients.

Nongovernmental organizations call on representatives of the Ministry of Health of Georgia to open a dialogue on this issue. They propose to create an inclusive platform where public and professional organizations, as well as health experts, could discuss the problems of OST programs and jointly develop a model based on human rights principles, and international standards and taking into account the interests of patients, their families and medical institutions.


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Global challenges, local responses: how the Eastern Europe and Central Asia region fights discrimination

On March 1, Zero Discrimination Day is celebrated around the world to draw attention to the problem of discrimination in all forms and manifestations and to take action to overcome it. It was initiated by UNAIDS, the Joint United Nations Program on HIV/AIDS, and was first observed in 2014. And 10 years later, this day again reminds us of the need for a more just and equitable society where everyone can feel protected and respected regardless of their characteristics and identity.

Zero Discrimination Day is important not only as a moment of awareness of discrimination but also as an opportunity to emphasize the importance of protecting human rights for all without exception. The key message is that everyone, regardless of race, sex, sexual orientation, gender identity, religion, or other characteristics, has inviolable rights that must be protected and respected. This day helps to mobilize public awareness and strengthen the efforts of citizens, human rights organizations, government agencies, and other stakeholders to combat discrimination and promote human rights. Today, in all regions of the world, various activities, including educational campaigns, seminars, conferences, forums, and rallies, are organized to raise awareness of the problem of discrimination and promote respect for differences. This includes the Eastern Europe and Central Asia (EECA) region.

According to the latest data presented in the REAct Regional Digest for 2023, the issue of discrimination remains one of the most pressing challenges for representatives of vulnerable groups to HIV/AIDS. Based on referrals in all 14 countries in the region where REActors work, the key trends and areas where this offense has been most acute over the past year include:

– Social exclusion and stigmatization: members of vulnerable groups face social exclusion and stigmatization by those around them. They may be rejected by their families, friends, and society at large due to misunderstanding, prejudice, and lack of provable information. 

– Denial of health care: some health care facilities or medical personnel may refuse to provide services to people from the community because of fear of infection, bias, or lack of training on issues such as HIV or viral hepatitis.

– Problems at work: according to national REActors statistics, vulnerable people may also face discrimination in the workplace, including dismissal and denial of benefits or wages.

– Access to education: key populations are sometimes denied access to educational institutions because of their (or a close relative’s) HIV status, which can lead to restrictions on learning and career opportunities.

– Biased public opinion: communities may face biased opinions and myths, for example, about HIV status or the LGBTIQ movement in society, which leads to additional disadvantages and discrimination.

The fight against discrimination requires a comprehensive and systemic approach at different levels of society. According to REAct observations, in the EECA region the main focus should be on:

– Legislation and reforms in the justice system: the adoption of laws and policies that protect rights and prevent discrimination based on any characteristic, including race, sex, sexual orientation, gender identity, disability, etc. These laws must be effectively implemented and accompanied by training and monitoring measures. As should ensure fair and impartial adjudication of discrimination cases in the courts.

– Education and awareness: conducting educational campaigns and programs that will help raise awareness of discrimination, and develop tolerance and respect for differences. This includes inclusive lessons in schools, training for employers, and events for the public.

– Supporting victims of discrimination: promoting support and protection mechanisms for those who experience discrimination. This can include legal, and psychological support and access to social services and medicine.

– Working with communities and civil society: it is important to create conditions for active participation, such as supporting non-governmental organizations working in the field of human rights.

– Working with employers and businesses: ensuring equal opportunities in the workplace and preventing discrimination in hiring, promotion, and dismissal. This includes educating employers about the principles of equality and fairness and establishing mechanisms for employee complaints and appeals.

On Zero Discrimination Day, human rights advocates actively advocate for effective laws and policies to prevent discrimination and protect the rights of all people, including vulnerable groups. But let us remember that not only on March 1, but every day is an opportunity to draw attention to this issue and promote a society based on equality, justice, and respect for human rights.


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HIV Criminalization Awareness Day: fighting for justice and understanding

February 28 is HIV Criminalization Awareness Day. It has been observed since 2022 and was organized by the Sero Project, a non-profit organization, in collaboration with the Elizabeth Taylor AIDS Foundation. The day commemorates the criminalization, stigma, and discrimination of people living with HIV/AIDS and calls for action to overcome these issues.

Since the beginning of the AIDS epidemic in the 1980s, the encounter with the immunodeficiency virus has sparked not only a medical struggle but also social, cultural, and legal challenges. One of which is the criminalization of HIV, where people are criminalized because of their HIV status or for transmitting the virus to others without warning or consent. The criminalization of HIV has serious consequences. It can prevent people from seeking health care or getting tested for HIV for fear of being arrested or discriminated against. It hinders effective HIV/AIDS prevention and treatment, increasing the risk of spreading the virus.

Although HIV criminalization is gradually decreasing in many countries, stigma and discrimination in the Eastern Europe and Central Asia region remain serious problems that require further efforts by governments, civil society organizations, and society at large. But there have been positive developments in this complex process in recent years:

In Tajikistan, an important step towards decriminalization of HIV was taken in early 2024 – a new resolution of the Plenum of the country’s Supreme Court calls on the judiciary to more objectively consider issues related to criminal liability under Article 125 of the Criminal Code of Tajikistan. The ruling obliges courts to be guided by new norms that take into account international standards and recommendations, including the concept of “Undetectable = Untransmissible” approved by UNAIDS and WHO. According to this concept, people living with HIV, receiving antiretroviral treatment, and having an undetectable viral load are unable to transmit HIV.

According to information provided in the Eurasian Women’s Network on AIDS report “HIV Criminalization Scan in Eastern Europe and Central Asia 2018-2022”, in Kazakhstan, a draft law “On Amendments to the Criminal Code of the Republic of Kazakhstan on Liability for Transmission of Human Immunodeficiency Virus (HIV)” was developed in 2022. This proposal envisages the complete abolition of Article 118 of the Criminal Code of the Republic of Kazakhstan due to the need to implement the Concept of Legal Policy of the Republic of Kazakhstan until 2030 and to bring national criminal legislation in line with international standards and recommendations in the area of criminalization of HIV transmission.

In Uzbekistan, the situation with HIV criminalization remains one of the most serious in the region, and improving the situation requires the joint efforts of the Government, civil society organizations, and the international community. Under article 113 of the country’s Criminal Code, “the spread of a venereal disease or HIV infection/AIDS, according to which knowingly exposing a person to a risk of infection or exposure to HIV infection/AIDS is punishable by imprisonment from five to eight years. And infection of another person with HIV infection/AIDS due to non-fulfillment or improper fulfillment of professional duties by a person – is punished by a fine from one hundred to two hundred minimum wages or compulsory community service from three hundred sixty to four hundred eighty hours or corrective labor up to two years or restriction of freedom from two to five years or imprisonment up to five years.” 

In the country, HIV criminalization is manifested through various forms of discrimination in access to medical care, employment, education, and other spheres of life, but thanks to the work of non-governmental organizations, the situation within society and at the state and international levels is gradually changing. Thus, in January 2022, the Eurasian Women’s Network on AIDS, in cooperation with the Alliance for Public Health, presented an alternative report on the implementation of the Convention on the Elimination of All Forms of Discrimination against Women by the Republic of Uzbekistan. This report was submitted for the 81st session of the UN Committee on the Elimination of Discrimination against Women. As a result of its consideration of the report, in its concluding recommendations to the 6th periodic report of Uzbekistan, the Committee made the following recommendations:

– Decriminalize the endangerment and transmission of HIV/AIDS through sexual contact between consenting adults. This includes repealing articles 113 of the Criminal Code, as well as articles 57 and 58 of the Code of Administrative Offenses.

– Repeal discriminatory legislation that denies women infected with HIV/AIDS the right to adoption, guardianship, and foster care.

In Georgia, under current legislation, persons living with HIV can be held liable for transmitting the virus or endangering others. According to Article 131 of the Criminal Code of Georgia, established as early as 1999, a person who is aware of his/her HIV-positive status is obliged to notify his/her spouse/sexual partner of his/her HIV status. Despite the existence of this article for a long time, data on criminal cases initiated under it until 2018 is virtually non-existent. According to information provided by the Supreme Court, there have been no prosecutions under Article 131 between 2018 and 2022.

Around the world, organizations are holding events, awareness campaigns, and actions to support HIV Criminalization Awareness Day. They are calling on governments and civil society to take action to protect the rights and dignity of people living with HIV because it is critical to ensure that the rights of this key group are protected and to focus on medical care, awareness, and education rather than punitive measures. It is worth remembering: not just February 28 – but every day is an important day to fight for justice, respect, and the elimination of discrimination.


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Celebrating LGBTIQ history month in Eastern Europe and Central Asia: a journey of resilience and progress

Empowering social justice in Eastern Europe and Central Asia: a call to collective action

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Celebrating LGBTIQ history month in Eastern Europe and Central Asia: a journey of resilience and progress

February is LGBTIQ History Month – a time to shine a spotlight on the actions and achievements of members of the LGBTIQ community throughout history. While the recognition and celebration of history are global, it’s essential to acknowledge the unique experiences and challenges faced by LGBTIQ individuals in different regions, particularly in Eastern Europe and Central Asia (EECA).

The history of LGBTIQ rights and activism in EECA is complex and varied. Discrimination, violence, and harassment remain widespread, fueled by cultural, religious, and political factors. In some countries, laws targeting LGBTIQ individuals continue to exist, restricting their rights to freedom of expression, assembly, and association.

There are 57 organizations in the REAct system providing health services to members of the LGBTIQ community. In 2023 alone, 1,109 referrals were documented and this number remains among the leaders:

Registered casesOther countriesUkraine
Key group (people, who use drugs)1279707
Key group (people living with HIV)16831152
Key group (sex workers)1054347
Key group (LGBTIQ)1109437

Main types of perpetrators (by countries where REAct works and for all years). As a rule, violence against victims is perpetrated by private individuals.

Police516
Family, relatives300
Acquaintances173
Hate group175
Husband/wife, intimate partner137
Other specialised doctor, NOT related to HIV/AIDS and TB101
Client of sex worker82
 Employer104
Representative of the same key group72
Neighbours96
AIDS center or other doctor related to HIV/AIDS65
Business, shops, service sector56
Hospital, inpatient facility57
Homeowner or landowner42
Special law enforcement services35
Military, army25
Political representatives21
University21
Migration service (state service15
Border guards13
Media and journalists13
School10

Main types of violations (by countries where REAct operates and for all years)

Hate speech, verbal abuse913
Threatening, intimidation, harassment867
Violence by individuals based on hatred571
Extortion, blackmail260
Public outing, defamation208
Eviction, coercion to leave the residence188
Arbitrary arrest or detention167
Misuse of power by law enforcement165
Other breach of privacy151
Sexual assault/abuse148
Domestic/intimate partner violence130
Excessive use of force by law enforcement118
Destruction of property, motivated by hatred108
Dismissal, denial of employment99
Denial of protection and investigation by the police81
Refusal to provide hospital care and other medical service74
Psychological mistreatment in public health facility68

Thus, in modern Tajikistan, representatives of the LGBTIQ community face serious violations of their rights. Detentions under Article 241 of the Criminal Code (distribution of pornography) have become more frequent in the country. The grounds for such charges are personal intimate photos found on the phones of the accused or intimate correspondence. Renata’s story is an important example of the continuing struggle for rights and freedom and emphasizes the need to support and protect those who face discrimination and persecution because of their gender and sexual identity.

Kazakhstan recorded an incident involving Danara, a 25-year-old queer woman and LGBTIQ activist. Her story was a powerful example of the struggle to ensure equal rights and non-discrimination in the workplace, regardless of their sexual orientation.

In Armenia, a trans woman, activist, and employee of a local NGO was attacked. Thanks to her courage and determination, her attacker was apprehended and a criminal case was opened. Her story served as a reminder that everyone can and should fight for their rights and the rights of others.

However, despite these challenges, there have been significant strides towards equality and acceptance in recent years. One of the key aspects of LGBTIQ history in this region is the resilience and courage of activists who fight tirelessly for their rights from grassroots movements to organized protests. To challenge discriminatory laws and societal attitudes. The visibility of LGBTIQ issues has increased thanks in part to the efforts of activists, organizations, and allies. Pride events, film festivals, and other cultural initiatives have helped to raise awareness and foster a sense of community among LGBTIQ individuals.

Moreover, there have been notable advances in terms of legal recognition and protection for LGBTIQ rights in certain countries. For example, Estonia has legalized same-sex partnerships, while others have introduced measures to combat discrimination based on sexual orientation and gender identity.

It’s also important to recognize the role of international organizations and human rights bodies in promoting LGBTIQ rights in EECA. The European Union, the Council of Europe, and the United Nations have all called on countries in the region to respect and protect the rights of LGBTIQ individuals. These efforts help to push for legislative reforms and provide support to local activists and organizations.

By standing in solidarity with LGBTIQ individuals and supporting their rights, it is worth noting that LGBTIQ History Month provides an opportunity to honor the achievements and contributions of community in EECA, while also acknowledging the challenges it continues to face. However through activism, advocacy, and solidarity, we can strive to create a world where everyone, regardless of sexual orientation or gender identity, can live with dignity, equality, and respect.


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Tajikistan has taken the first step to protect the rights and eliminate discrimination of citizens living with HIV

Empowering social justice in Eastern Europe and Central Asia: a call to collective action

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Empowering social justice in Eastern Europe and Central Asia: a call to collective action

The World Social Justice Day, observed annually on February 20th, stands as a poignant reminder of the ongoing struggle against unemployment, social exclusion, and poverty. This globally recognized day, as mandated by the United Nations General Assembly, underscores the critical importance of social development and justice in fostering peace and security within and among nations. As we navigate through the complexities of the modern world, it is increasingly evident that social development and justice are not only fundamental rights but also indispensable prerequisites for sustainable peace and prosperity. As the International Labour Organization points out in its latest World Employment and Social Outlook report, as of 2023

– 241 million workers lived in extreme poverty. 

– 423 million workers lived in moderate poverty. 

These alarming numbers underscore the urgent need for concerted efforts to address the root causes of working poverty and boost economic opportunities globally.

It resonates profoundly across Eastern Europe and Central Asia (EECA) as well, where socio-economic disparities, conflicts, and institutional weaknesses have strained the fabric of social cohesion. Against this backdrop, there is a pressing need to galvanize efforts towards fostering a more inclusive and equitable society.

As we approach the halfway mark towards realizing the ambitious goals of the 2030 Agenda, it becomes imperative to intensify our endeavors toward promoting inclusive and sustainable economic growth, employment, and decent work for all. Central to this endeavor are the four interconnected dimensions of social justice: ensuring universal human rights and capabilities, facilitating equal access to opportunities for employment and productive activity, promoting fair distribution outcomes, and facilitating just transitions amidst significant societal transformations.

Despite pockets of resilience observed in labor markets during the preceding year, the global economic landscape remains fraught with uncertainties, exacerbating structural inequalities and leaving millions marginalized. Projections indicate a further deterioration in the global unemployment rate in the 2024 year, with EECA bearing a disproportionate burden. Alarmingly, millions within this region continue to grapple with extreme or moderate poverty, highlighting the urgent need for targeted interventions to address the root causes of working poverty and enhance economic opportunities.

In response to these challenges, governments across EECA must prioritize initiatives aimed at bolstering domestic economies, fostering regional cooperation, and providing targeted support to vulnerable economies. Furthermore, there is a pressing need for a comprehensive approach that leverages education, social protection, and environmental sustainability as catalysts for transformative change.

In the context of the rights of working representatives from key groups such as people living with HIV, sex workers, and LGBT+ individuals, there is a need for special attention to their vulnerability and protection of their rights in the workplace. In many countries in EECA, these groups face systematic discrimination and stigma, which creates additional barriers to obtaining decent employment and protection in the labor market.

Kyrgyzstan:

Case: A woman was fired because of a history of incarceration and drug use, although she had already been reinstated. After she was accused of stealing a cell phone, she was fired and deprived of her full salary.

Solution: The client was provided legal advice by REActors and accompanied at her place of employment. After negotiations and the presentation of camera video proving her innocence, she was reinstated and received compensation for moral damages.

Kazakhstan:

Case: A man living with HIV came to REActors after he was denied employment (as a massage therapist) at a private medical center. He was rejected because of his HIV+ status and was also neglected.

Solution: The client was counseled on the rights of PLHIV patients and the Labor Law of the Republic of Kazakhstan. The REActors accompanied him to the medical center, where they drafted a pre-trial statement and spoke with the head doctor. After explanations, they apologized and offered him a job (but the man refused).

Azerbaijan:

Case: REActors were approached by a client who was working on a construction site. He was supposed to be paid 15 manat per day (about 8 euros), but he received only 5 manat and the remaining 10 manat was to be paid every 2 weeks. At the end of the term, he was fired and paid nothing, with the excuse that he was from a community of people, who use drugs.

Solution: After consulting with a lawyer, the REActors met with the foreman and explained to him that illegal dismissal is punishable, regardless of whether the worker was officially employed or not. He agreed to pay the man 140 manat and the client dropped further complaints.

In light of these (and other) cases, regional and national human rights programs should include measures to protect the rights of workers from these key groups. This includes ensuring workplaces free from discrimination based on HIV status, sexual orientation, or gender identity, as well as ensuring equal access to employment opportunities and social protection.

Human rights organizations and government bodies should collaborate to develop and implement policies aimed at strengthening the rights of workers from key groups. This may involve awareness campaigns about workplace rights, training for employers and employees on non-discrimination principles, and creating mechanisms for recourse for rights protection (as REAct instrument).

To ensure the successful integration of these groups into the work environment, attention must also be paid to their specific needs and vulnerabilities. This may include providing access to HIV and LGBT+-related medical services, as well as creating safe and supportive working conditions for sex workers.

The commemoration of the 2024 World Day of Social Justice serves as a rallying cry for renewed commitment and collective action. By bridging existing divides and forging strategic alliances in support of the Global Coalition for Social Justice, societies can unlock their full potential and pave the way for sustained reductions in poverty and inequality. Moreover, by fostering inclusive growth and social cohesion, these efforts can contribute significantly to peace, stability, and intergenerational solidarity across the region.

In EECA, the imperative to advance social justice transcends mere moral obligation; it is a strategic one and essential for building resilient and equitable societies capable of withstanding the myriad challenges of the 21st century. Adopting a multidimensional approach to protecting the rights of working representatives from key groups will not only ensure equal opportunities in the labor market but also contribute to creating a more just and inclusive society of this diverse region.


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The first open webinar on drug policy was held in Georgia

Georgia hosted its first public webinar on drug policy on January 30. The webinar was organized by FTF as a wrap-up event of the project – drugpolicy.ge. It was the first of its kind in Georgia, aimed at collecting and processing objective and relevant information, as well as providing the public with facts based on open sources and uncensored.

The first part of the webinar was devoted to a presentation of the project itself. The second part was a discussion on drug policy to strategize on how to implement plans. One of the national REActors also spoke as part of this discussion, presenting the key results of the system in the country and the challenges faced by clients.

The organization of the webinar was supported by the European Union and the Open Society Foundation. It is important to note that the content of the webinar is solely the responsibility of its organizers and does not represent the official position of the European Union and the Open Society Foundation.


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Tajikistan has taken the first step to protect the rights and eliminate discrimination of citizens living with HIV

The Plenum of the Supreme Court of Tajikistan has adopted a new resolution aimed at humanizing judicial practice under Article 125 of the Criminal Code of Tajikistan on HIV transmission.

The ruling recommends that courts take into account international standards and recommendations in the field of HIV/AIDS, in particular the principle of “Undetectable = Untransmissible” (U=U), which will allow for a more objective approach to assessing each case. This means that people living with HIV, taking ART, and achieving a non-transmissible viral load can no longer be criminalized for putting them at risk of HIV transmission. 

The Alliance for Public Health applauds the country’s intentions towards HIV decriminalization, in fact, in the first and second cycle of the regional #SoS_project, many interventions focused on advocacy activities as well as direct assistance to those affected by repressive HIV policies. 

“The depressing legacy of the Soviet Union in many post-Soviet countries is essentially discriminatory legislation. Under Article 125 of the Criminal Code, women are mostly prosecuted, while today women living with HIV, taking treatment, and giving birth to healthy children, all people with HIV live as long as without it. Families where partners with different HIV statuses do not transmit the disease to each other live happily, and this is happening not only somewhere in the world, but in neighboring countries like Tajikistan.” – said Tеtiana Deshko, Director of the International Programs Department, Alliance for Public Health.

The decisions adopted at the Supreme Court Plenum also mark Tajikistan’s first step in improving the justice system, which will allow for a fairer interpretation of existing laws. That said, it has yet to establish new humane laws and the Criminal Code of Tajikistan still criminalizes putting people at risk of HIV transmission.

“Therefore, human rights defenders in Tajikistan have a lot of work to do together to advocate for further legislative changes and we regularly provide the evidence base to REAct, the largest community-based monitoring tool in Eastern Europe and Central Asia, to achieve our goals,” – summarized Tеtiana Deshko.

Since 2020, REAct in Tajikistan has registered more than 2,700 referrals from people living with HIV and people at risk. Due to the criminalizing laws in place, people are constantly subjected to discrimination and stigma. The most frequent violators of victims’ rights are the close environment (family, relatives) – 66%, law enforcement, and judiciary – 15%, and medical and health care workers – 10%.  These figures demonstrate the pervasive and all-encompassing stigma that people from vulnerable groups face at every turn, often from those closest to them. It is the threat of criminal prosecution for having HIV that is the main reason for violence and humiliating treatment of victims.

In addition, women are particularly vulnerable, as they are the first to find out their status (often during medical examinations in connection with pregnancy) and the first couple to be prosecuted under Article 125 of the Criminal Code of Tajikistan. On average, every third woman who applied to REAct suffers from physical violence from her close environment (husband, sexual partner, relatives). It is often the HIV status that is the main cause of violence and at the same time the main obstacle to seeking protection from the police. 

In 2023 alone, REAct human rights defenders registered more than 40 cases from people accused under Article 125. Of these, 15 cases under Article 125, Part 1 of the Criminal Code of Tajikistan became strategic and were taken for support by REAct lawyers and partner organizations. Unfortunately, despite the professional work of lawyers and appeals to the international standards of WHO, only 3 cases ended in favor of the accused, the rest were sentenced to imprisonment from 6 to 18 months.

REAct human rights activists shared their stories

Punishment without crime. 

HIV-positive single mother Nikora (name changed) was sentenced to 1.5 years in prison under Part 1 of Article 125. She was given a suspended sentence until her child reached the age of eight. The fact that the court gave Nikora a real criminal sentence without taking into account the negative HIV test results of all “victims” and the absence of claims against Nikora from their side is egregious. 

In the court case, the woman was accused of putting four men with whom she had unprotected sex over the past four years at risk of contracting HIV because she had failed to report her registration with the AIDS Center since 2015. 

A court without a victim 

A female resident, who injected drugs, worked as a volunteer in an NGO. A criminal case was initiated on **.**.2018 under part 1. of article 125 of the Criminal Code of RT. The victim in this case was a man. During the trial, the man stated that he did not agree with the fact that he was recognized as a victim. After the criminal case was initiated, based on the conclusion of a commission examination, it was found that the man did not have HIV. At the trial, the woman’s lawyer asked: “Did the defendant offer to use a condom during sexual contact?”, to which the man replied: “Yes, but I refused. I know that she has this disease, but I love her, I will live with her, and I have no claims or demands against her.”

The legislation of the Republic of Tajikistan refers Article 125 part 1 to cases of private-public prosecution, which means that these cases are initiated on the application of the person who suffered from the crime, but in case of reconciliation, the proceedings on them are not subject to termination. Thus, the defendant was sentenced – 1 year and 2 months of imprisonment under part 1 of article 125 of the Criminal Code of the Republic of Tajikistan.

“The diversity and wide range of appeals about violations of the rights of people living with HIV in Tajikistan is striking. We see that literally at every step, whether it is home, school, polyclinic, or civil registry office – HIV status is a verdict. Surprisingly, it is in Tajikistan that we record the highest level of response to human rights violations. Thanks to the effective support of peer counselors and paralegals (REActors) from nongovernmental organizations, more than 70% of appeals are resolved positively for the victim/s through medical and social support, legal advice, and direct intervention by the reactor in the situation. In a country with repressive legislation, the only thing left for human rights defenders is to educate perpetrators about HIV to practically reduce stigma towards HIV-positive people and explain ways of HIV transmission and prevention.” – shared Victoria Kalyniuk, Regional Coordinator of REAct in EECA countries.

This Supreme Court decision is an important step in the overdue reform of laws and practices related to people living with HIV in Tajikistan. It is important that this decision becomes part of routine practice on the ground and leads to changes in the situation for people with HIV. The abolition of Article 125 of the Criminal Code should follow and permanently change outdated norms and practices.


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Drug policy of zero tolerance and double standard practices. ENPUD analytical paper on the situation in Kazakhstan

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Response stories

Victory in the protection of privacy: the history of dormitory housing in Uzbekistan

In today’s world, ensuring the protection of individual rights and freedoms is an integral part of our society. Recently, an incident occurred in one of the dormitories in Uzbekistan that raised the important issue of protecting women’s privacy rights.

Zhon (name changed), a resident of the dormitory, was confronted with an order from the head of the dormitory prohibiting men from entering the women’s rooms. This order contradicted basic principles and violated women’s right to privacy. Together with the lawyer, she filed an application to the prosecutor’s office and an appeal to the head of the dormitory to cancel this absurd order.

Thanks to the client’s active position and legal support, the prosecutor’s office explained to the head that such an order was a direct violation of the constitutional rights of Uzbek citizens. The incident was successfully resolved, and now women in the dormitory can meet with friends without unreasonable obstacles.

It is important to remember that the protection of women’s rights to privacy is an integral part of respect for human dignity. This case reminded everyone of the importance of protecting the personal freedoms of every citizen.

Original Source (in Russian)


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Let’s stop discrimination: protecting children’s rights in kindergartens in Uzbekistan

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Response stories

Let’s stop discrimination: protecting children’s rights in kindergartens in Uzbekistan

Nowadays, the obligation to discuss and protect the rights of every individual, especially those who influence the future – children – comes to the forefront. Recently, Guli (name changed) turned to REActors for help, as her child was excluded from kindergarten due to the status of the mother.

Unfortunately, the child was a victim of stigmatization. Together with the client, an application and appeal to the prosecutor’s office was filed to protect the child’s rights and hold the kindergarten staff responsible for discrimination.

Thanks to legal support and active efforts in fighting for the rights of the child, the prosecutor’s office worked with the head of the kindergarten and the responsible employee involved in the disclosure of the mother’s status. The child was reinstated in his rights to education and the employee who violated the child’s rights was dismissed.

The incident was settled amicably, given the client’s desire to avoid publicity and scandal. It is important to note that the protection of children’s rights is one of the key principles of justice in society. Such cases of discrimination must be addressed and stopped promptly so that every child has equal opportunities for education and development.

Original Source (in Russian)


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Fighting for privacy: personal data protection in Uzbekistan

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