Building resilience of street-connected children during COVID-19: turning rights into practices through CINI method.

This article examines the methods and opportunities for SCC's meaningful participation that recognize their agency and are aligned with General Comment No. 21 (GC21) to the United Nations Convention on the Rights of the Child (UNCRC) on Children in Street Situations (UNCRC, 1989). This article explains the application of CINI's core practice models which explains the child centrality in development practices for "turning rights into practice for children" derived from the Sustainable Development Goals, principles of Human Rights, UNCRC, and General Comment No. 20 (2016). The Institutional knowledge was practiced through child-led action research with street- connected children which resulted in the development of agency among SCC, peer researchers, and child advocates for resilience building within their community during COVID-19. Child in Need Institute (CINI) has been working with SCC since 1989 and has derived a rich body of experience from the interventions. CINI applied participatory approaches to practice, research, decision-making, and policy development; thus, facilitating children in the process of systematically gathering information with their peers, identifying key issues and problems faced by SCC, and securing support from duty bearers that were required for the survival within their situations. Drawing on the approach undertaken and the tools used in the participatory research and advocacy, this article reflects upon the processes and strategies that worked out in facilitating SCC's ability to exercise agency and resilience through evidence generation and advocacy during COVID-19 and the associated lockdown and beyond. Through capacity building on research tools, leadership and communication skills, SCC can build concrete evidence of their vulnerabilities and the gaps that pose as barriers to their access to existing support mechanisms. This evidence helps them to prioritize the solutions that are required to bring changes in their lives and that of their peers, with which they can advocate at different platforms that promote dialogs and negotiations between children and duty-bearers. A participatory research project funded by Wellcome Trust focused on the vulnerabilities faced by street-connected young people and the access to services available to them. It revealed the lack of understanding regarding SCC and their invisibility in data and planning of support services, the gaps in access to healthcare services, the social determinants of health including safety, and their exclusion in platforms for dialogs with duty bearers. They took these issues to local government leaders, service providers, and national and international advocacy platforms; and suggested solutions to local and world leaders to bring changes in their situations. This resulted in a marked increase in the responsiveness of service providers toward SCC during the period of COVID-19, and the increased agency and negotiation skills of peer leaders to support their communities and demand solutions during the period of COVID-19 and associated lockdown.

Securing the rights and health of domestic workers: the importance of ratifying the ILO's C189.

This commentary highlights the critical importance of ratifying the International Labour Organization's (ILO) Domestic Workers Convention No. 189-2011 (C189) to secure the rights and health of domestic workers (DWs) worldwide, particularly in light of the World Health Organization's World Health Day 2024 theme 'My Health, My Right'. The ILO's C189 represents a significant advancement in labour rights, offering protection to a highly feminised sector where women make up 80% of the estimated 50-100 million DWs worldwide. The ILO's C189 aims to address the marginalisation and exploitation that DWs have historically faced by ensuring that they receive the same protections as other workers. This encompasses measures against abuse, harassment and violence, and the establishment of a secure and healthy working environment, as outlined in Article 13. The commentary emphasises the urgent need for the enactment of legal frameworks in countries such as Indonesia, where many of the approximately 10 million DWs encounter shocking abuses both within the country and abroad. The ratification of the C189 and the enactment of national laws, such as Indonesia's Draft Law on the Protection of Domestic Workers (RUU PPRT), are essential for the safeguarding of the rights and health of DWs. The commentary compares Indonesia with the Philippines, as the latter has been a signatory to the C189 since 2012 and has enacted its National Domestic Workers Act in 2013. The ratification of the C189, therefore, is imperative for igniting the protection and advancement of labour rights for DWs globally. This ILO's C189 represents a significant first step in addressing the long-standing and complex issues of marginalisation and exploitation prevalent in this predominantly female sector. It is also essential that the potential obstacles and concerns related to the ratification and implementation of the ILO's C189 are addressed collaboratively by stakeholders and not viewed as justifications for inaction.

Rights-based sexual and reproductive health services: a call for improved access for youth.

Constituting a valuable resource, youth deserve more attention regarding their rights through increased access to sexual and reproductive health services. Limitations in health service delivery for youth should be overcome, whether pertaining to restrictive legislation and policies or technical approaches. Clear clinical guidelines will improve quality of care thereby complying with national commitments to international legal instruments. It is apt for both decision-makers and service providers to celebrate International Youth Day on Monday 12 August, by paying special consideration to innovative approaches for the delivery of youth-friendly sexual and reproductive health services that are adaptable to local circumstances.

Constituant une ressource précieuse, les jeunes méritent davantage d'attention quant à leurs droits grâce à un accès accru aux services de santé sexuelle et reproductive. Les limites de la prestation de services de santé destinés aux jeunes doivent être surmontées, qu'elles soient liées à des législations et politiques restrictives ou à des approches techniques. Des directives cliniques claires amélioreront la qualité des soins, respectant ainsi les engagements nationaux envers les instruments juridiques internationaux. Il convient que les décideurs et les prestataires de services célèbrent la Journée internationale de la jeunesse le lundi 12 août, en accordant une attention particulière aux approches innovantes pour la fourniture de services de santé sexuelle et reproductive adaptés aux jeunes et adaptables aux circonstances locales.

The use of specialized (medical) knowledge in the criminal process: the practice of the European Court of Human Rights.

OBJECTIVE: Aim: This article is aimed at raising awareness and stimulating scientific discussion on the necessity of involving qualified medical professionals in conducting criminal procedural actions that involve intervention in human somatic rights, in order to further improve the legal instruments ensuring compliance with the European Court of Human Rights (hereinafter referred to as the ECHR) standards in this field. PATIENTS AND METHODS: Materials and Methods: In preparing the article, the following issues were worked out: the provisions of international legal acts; legal positions of the ECHR related to the use of medical knowledge in the criminal process; scientific studies of various aspects of the use of medical knowledge in the criminal process. The methodological basis of the research is dialectical, comparative-legal, systemic-structural, analytical, synthetic, complex research methods. CONCLUSION: Conclusions: The use of medical knowledge in the criminal process generally takes two forms: (a) expert and (b) ancillary. The expert form, particularly forensic medical examination, must adhere to a set of criteria reflected in the practice of the ECHR. Personal searches involving penetration into human body cavities generally align with the requirements of the he European Convention on Human Rights (hereinafter referred to as the Convention), provided certain conditions are met, including medical considerations. The criterion for the admissibility of coercive collection of biological samples for examination is the existence of samples independent of the individual's will.

Under siege: The role of settler colonialism in targeting healthcare systems.

This article looks at the effects of armed conflict on healthcare systems in Gaza at the intersection of international humanitarian aid, settler colonialism and the ethics of war. Since October 7, 2023, there has been a systemic assault on the health services in Gaza, rooted in colonial expansion. I begin with an overview of human rights and the concept of medical neutrality. This is followed by biopolitics within Gaza and the contradictions in international law regarding the ethics of war. Explained through the lens of historical revisionism, postcolonial theory and biopolitics, I attempt to highlight how healthcare systems are increasingly becoming targets of armed conflict in Gaza as a war strategy.

[The proposal for a regulation on the recognition of parenthood: An attempt to recognize surrogacy in the European Union?] / La propuesta de reglamento sobre el reconocimiento de la parentalidad: ¿un intento de reconocer la gestación subrogada en la Unión Europea?

Within the European Union, EU, a proposal for a Regulation on the recognition of parenthood has been in the pipeline since December 2022. If approved, the filiation of a child will be determined by the law of the country where the pregnant woman habitually resides, even if it is a non-EU Member State. The text obliges States to recognize birth certificates issued by third countries establishing the parentage of a child born from surrogacy agreements. In this paper, we analyze how the proposal interferes with the exclusive competences of EU Member States to regulate parentage and with the rules of international human rights law, including the European Court of Human Rights' case law.

Medicamentos de alto costo: el difícil equilibrio entre los derechos individuales y los derechos colectivos / High-cost medicines: the difficult balance between individual and collective rights

[RESUMEN]. Los medicamentos son bienes especiales que cubren necesidades de salud de la población. En las últimas décadas, la industria farmacéutica modificó su estrategia de investigación y desarrollo, y migró su interés desde la exploración de fármacos destinados a enfermedades crónicas padecidas por gran parte de la población hacia la búsqueda de medicamentos para pocas personas que tienen enfermedades raras. Esta falta de masividad en los consumidores se traduce en una oferta selectiva de pocos productos dirigidos a ciertas patologías que tienen un precio muy elevado, lo cual hace difícil tanto el acceso de los pacientes como el brindar cobertura desde los financiadores de la salud. En este artículo se recorre la temática de los medicamentos de alto precio y se incorpora al debate el contexto sanitario, cultural, jurídico, político y económico que la rodea. Se hace hincapié en las diferencias existentes entre los distintos fármacos en términos de eficacia para cambiar el curso natural de las enfermedades para los cuales son indicados, en la construcción del precio al cual estos medicamentos se venden en el mercado, en las consecuencias que tiene ese precio para los financiadores de la salud, y en la relación costo-oportunidad de tener que pagar por ellos en desmedro de otros recursos considerados esenciales. Por último, se reflexiona sobre los derechos legítimos de cada individuo a reclamar el acceso a medicamentos de alto precio por considerarlos fundamentales para recuperar su salud, y de cómo garantizar esa cobertura puede afectar los derechos colectivos de la población, y se aportan ejemplos concretos que ilustran esta situación.

[ABSTRACT]. Medicines are special goods that cover the health needs of the population. In recent decades, the pharmaceutical industry has changed its research and development strategy, shifting its focus from the exploration of medicines for chronic diseases affecting a large part of the population to the search for drugs for rare diseases that affect a small number of people. This lack of a mass consumer base is reflected in a selective offer of a few very high-cost products aimed at certain diseases, which hinders both patient access and financial coverage. This article reviews the issue of high-cost medicines, including its cultural, legal, political, economic, and health aspects. It emphasizes the differences between various medicines in terms of their efficacy in changing the natural course of diseases, their market price, the consequences of their cost for healthcare funders, and the cost-opportunity ratio of having to pay for them at the expense of other essential resources. Finally, the article reflects on the legitimate rights of each individual to claim access to high-cost medicines when they are considered essential to recover a person’s health, and on how guaranteeing such coverage can affect the collective rights of the population. Concrete examples that illustrate this situation are provided.

[RESUMO]. Medicamentos são bens especiais que atendem às necessidades de saúde da população. Nas últimas décadas, a indústria farmacêutica mudou sua estratégia de pesquisa e desenvolvimento, deixando de explorar medicamentos para doenças crônicas que afetam grande parte da população e passando a buscar medicamentos para poucas pessoas com doenças raras. Esse número limitado de consumidores se reflete em uma oferta seletiva de poucos produtos de preço elevado para determinadas doenças, dificultando o acesso dos pacientes e a obtenção de cobertura dos agentes financiadores da saúde. Neste artigo, analisa-se a questão dos medicamentos de alto custo e incorpora-se ao debate o contexto sanitário, cultural, jurídico, político e econômico. São enfatizados os seguintes aspectos: diferenças entre os diferentes medicamentos em termos da eficácia em mudar o curso natural das doenças para as quais são indicados; determinação do preço pelo qual esses medicamentos são vendidos no mercado; consequências desse preço para os agentes financiadores da saúde; e a relação custo-oportunidade de ter de pagar por esses medicamentos em detrimento de outros recursos considerados essenciais. Por fim, reflete-se sobre os direitos legítimos de cada indivíduo de reivindicar acesso a medicamentos de alto custo, por considerá-los essenciais para recuperar a própria saúde, e como a garantia dessa cobertura pode afetar os direitos coletivos da população; também são fornecidos exemplos concretos que ilustram essa situação.

Health, human rights and freedom at stake? A critical discourse analysis of the Swedish media debate on the national COVID-19 pandemic strategy.

PURPOSE: The aim of this study is to, in the Swedish media debate, explore the discursive constructions of challenges in human rights and freedoms following the national spatial strategy for health and survival during the COVID-19 pandemic. METHODS: The study, inspired by a critical discourse analytic approach, focused particularly on the issues addressed, subject positions, relations and rhetoric. Seventeen opinion articles published in Swedish national newspapers December 2019 - February 2022 were analysed. RESULTS: The main contents were threats to democracy, threats to the freedom and rights of specific groups, and threats to the debate itself. Contents were expressed through three discourse dichotomies: contribution vs interjection, documented vs alarmistic, and active on the stage vs commenting from the balcony. CONCLUSIONS: Striking about the results is the absence of dialogue, the one-way communication, and the absent politicians. It seems that the analysed debate on the challenges of the Swedish COVID-19 pandemic strategy, based on its impact on overall freedoms and rights, has not been the focus of decision-makers during the pandemic. They have neither addressed the threats highlighted in the articles, nor contributed to the discourse. This is worrying for the long-term maintenance and development of a healthy democracy.

[Public policies and right to sexuality of the elderly in Chile]. / Public policies and right to sexuality of the elderly in Chile.

People over 65 years of age will constitute the majority of the world's population in the short term, but in precarious living conditions: more years in a worse condition of vulnerability and fragility. Societies and development models would not be prepared, generating high personal, family and collective costs. In Chile, fragility would be highly prevalent in this population, impacting the full development of their lives; with sexuality as one of the aspects that are invisible and little studied. This work makes a critical approach, based on the review and analysis of context, public policies and legislation in force in Chile, evidencing atomization and biomedical orientation of public policies, collaborating in the understanding of the relationship between fragility and sexuality in old people; and revealing pending training and research tasks for the generation of public policies for an active and healthy life.

Las personas mayores de 65 años constituirán la mayoría de la población mundial en corto plazo, pero en condiciones de vida precarias. Esto quiere decir que vivirán más años en peor condición de vulnerabilidad y fragilidad. Las sociedades y modelos de desarrollo no estarían preparados, generando altos costos personales, familiares y colectivos. En Chile la fragilidad sería altamente prevalente en esta población, impactando el desarrollo pleno de su vida. La sexualidad es uno de los aspectos que son invisibilizados y poco estudiados. Este trabajo realiza una aproximación crítica, a partir de la revisión y análisis de antecedentes de contexto, políticas públicas y legislación vigentes en Chile. En estos aspectos se evidencia atomización y orientación biomédica de las políticas públicas, colaborando en la comprensión de la relación fragilidad y sexualidad en personas mayores. Además, se revelan tareas de formación e investigación pendientes para la generación de políticas públicas para una vida activa y saludable.

The opioid epidemic and accessibility to free Wi-Fi: internet access is a human rights issue.

The opioid epidemic has taken the lives of thousands of people across North America and Europe. Moreover, lack of housing, inflation, and a rapidly changing economy have affected millions of people, and many have become homeless. Many governments, researchers, health agencies, and not-for-profits have offered innovative ways to tackle this crisis, including many harm-reduction technologies that rely on Internet. In the age of the first artificial intelligence (AI) revolution, where reliance and accessibility to Internet have become a necessity for finding jobs, housing, affordable food, social services, social connection, and staying alive, the creation of free Wi-Fi zones around inner city neighborhood by towns and municipalities is not only a cost-effective way to reduce death, social costs, but a human rights issue during the initial stage of first A.I. revolution.

Can trusted authorities change minds on anti-LGBTQ norms: Evidence from an experiment in Ghana.

Across numerous African societies, a prevalent resistance to LGBTQ rights is evident. While prominent strides have been made on LGBTQ rights in various parts of the world, the African context has witnessed limited progress. Public opinion polls indicate that influential figures have succeeded in altering public sentiment towards LGBTQ rights in Western countries, yet such progress remains elusive in the African context. Mechanisms effective in shifting public attitudes toward embracing LGBTQ rights remain largely unexplored, especially in the African context. In this paper, we consider whether endorsement messages conveyed by trusted authorities possess the potential to foster a shift in attitudes towards embracing LGBTQ rights among a nationally representative sample of respondents in Ghana. Through a factorial experiment, we find that there are varying impacts of messaging from distinct trusted authorities in shaping attitudes toward embracing LGBTQ rights. Notably, pro-LGBTQ messaging from traditional and co-partisan leaders yields modest effects, while messaging from religious leaders exhibits no discernible impact. These findings hold significance for determining strategic focal points in potential endeavors to advance LGBTQ rights within the African context.

Ethics in Patients' Health Literacy: a scoping review and a critical discussion.

A growing body of literature has acknowledged that a high number of populations with low Health Literacy (HL) is related to poor health outcomes, inequities in healthcare and high economic costs. Those findings have formulated the research questions of this review: (i) what ethical issues arise within the context of patients' HL and (ii) What is the relationship between HL and quality of life? This review followed the guidelines of Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR) and it was conducted in five databases: PubMed, CINAHL, MEDLINE, Scopus and Science Direct between June 2022 and December 2023. Out of the 3164 titles retrieved, 285 abstracts were eligible to proceed. Following a thorough examination of the full text of 61 papers, 45 sources were identified that met the inclusion criteria. The data analysis process was guided by the research questions, employing a thematic approach. Four themes were identified: the use of language and patient understanding, human rights, the principlism approach (justice, beneficence, non-maleficence and autonomy) and quality of life. The first theme mainly focused on the relation of HL with the notion of consent forms and national action plans. Human rights in relation to HL were discussed as a minor issue. The bioethical framework by Beauchamp and Childress (Principles of Biomedical Ethics, 6th edn. Oxford University Press, New York, NY, 2009), was addressed by several studies, with a particular focus on justice and the loss of autonomy. Quality of life indicated a positive correlation with HL by most of the authors, while few studies revealed a moderate correlation.

Restrictive migration policies and their impact on HIV prevention, care and treatment services.

Migration policies have a significant impact on population health, particularly for individuals living with human immunodeficiency virus (HIV). These policies not only determine who is allowed to enter a country but also influence which immigrants can access services provided by the government. Some countries continue to impose restrictions on HIV-positive individuals, justifying these measures as necessary to protect public health and mitigate healthcare and economic concerns. However, these restrictions lack a valid public health rationale. Due to social, economic and political constraints, restrictive migration laws hinder access to HIV prevention, care and treatment services for immigrants living with HIV. Immigrants face numerous challenges in accessing medication, adhering to treatment regimens and benefitting from HIV preventive efforts. This situation increases the risk of HIV infection and adverse health outcomes due to limited access to preventive programmes, social stigma and engagement in risky behaviours. Additionally, these restrictive migration rules negatively affect immigrants' mental health. To improve the health of both immigrants and host communities, inclusive and evidence-based migration policies that address healthcare through public health and human rights lenses are required.

Palliative care as a Fundamental Human Right: where are we at in Italy?

Abstract: The right to live with dignity during the final stages of existence, enshrined in national and supranational Charters of Rights, represents a significant step towards humanizing medicine and is integral to the right to health. Palliative Care, rooted in health, dignity, and therapeutic self-determination, has emerged as a fundamental human right and a moral imperative within health systems. It seeks to alleviate suffering, emphasizing the holistic well-being of patients with life-limiting illnes-ses. This paper provides an analysis of the current situation of Palliative Care in Italy and examines its critical aspects, also in relation to the issues found in other European and non-European countries. In Italy, although laws have been enacted to ensure the provision of Palliative Care, its availability remains inconsistent across different regions. Financial constraints and insufficient support hinder the comprehensive dissemination of these services. Recognizing the significance of Palliative Care, the Catholic Church also endorses its implementation as a response to human suffering and an approach to end-of-life care. Efforts to strengthen Palliative Care are critical to meeting the rising demand and ensuring access to compassionate and dignified care for all individuals in need. Through legislative advancements and adequate resources, Italy can make significant strides in advancing the provision of Palliative Care.

Enhancing Human Health and Wellbeing through Sustainably and Equitably Unlocking a Healthy Ocean's Potential.

A healthy ocean is essential for human health, and yet the links between the ocean and human health are often overlooked. By providing new medicines, technologies, energy, foods, recreation, and inspiration, the ocean has the potential to enhance human health and wellbeing. However, climate change, pollution, biodiversity loss, and inequity threaten both ocean and human health. Sustainable realisation of the ocean's health benefits will require overcoming these challenges through equitable partnerships, enforcement of laws and treaties, robust monitoring, and use of metrics that assess both the ocean's natural capital and human wellbeing. Achieving this will require an explicit focus on human rights, equity, sustainability, and social justice. In addition to highlighting the potential unique role of the healthcare sector, we offer science-based recommendations to protect both ocean health and human health, and we highlight the unique potential of the healthcare sector tolead this effort.

The "First daughter" effect: Human rights advocacy and attitudes toward gender equality in Taliban-controlled Afghanistan.

International concern for the human rights of Afghan women has spiked since the Taliban consolidated power in Afghanistan in fall 2021. Yet little is known about how to effectively advocate for women's human rights under this new context. We present findings from a random sample of all adult Afghan internet users' attitudes toward peace, security, gender, and human rights and find significant support for women's human rights as a national priority within Afghanistan, even when controlling for other priorities and even among many men and women aligned with the Taliban. Given that men now have much more political power in Afghan society to protect women's rights, we paid particular attention to men's attitudes toward women's human rights. Our evidence from an embedded survey experiment, building on earlier literature from other countries, demonstrates that fathers of eldest daughters are particularly likely to favor prioritizing women's rights when primed to think about the gender of their eldest children. Thus, the human rights and humanitarian community should spend more time and attention engaging with this demographic, and specifically creating marketing and advocacy strategies that encourage men to think about or act on behalf of their eldest daughters.

Being yourself is a defect: analysis of documented rights violations related to sexual orientation, gender identity and HIV in 2022 using the REAct system in six eastern European, Caucasus and Central Asian countries.

INTRODUCTION: Removing legal barriers to HIV services is crucial for the global 2030 goal of ending the HIV and AIDS epidemic, particularly in eastern Europe, the Caucasus and central Asia. Despite state commitments to uphold human rights, gay, bisexual and other men who have sex with men (gbMSM), along with transgender people (TP) still face stigma and discrimination. This article presents an analysis of rights violations based on sexual orientation and gender identity (SOGI) and HIV reported in 2022 across six countries, highlighting features and their links to legislation and law enforcement practices. METHODS: We examined documented cases of rights violations among gbMSM and TP in Armenia, Kazakhstan, Kyrgyzstan, Tajikistan, Uzbekistan and Ukraine in 2022 using the REAct system, a tool for documenting and responding to rights violations against key populations. Initially, we employed directed content analysis based on Yogyakarta Principles to analyse narratives of violations. A codebook was developed through contextual, manifest and latent coding, with themes, categories and codes converted into quantitative variables for statistical analysis. Descriptive statistics were used to identify the characteristics of violations. RESULTS: A total of 456 cases of rights violations related to SOGI and HIV were documented, ranging from 22 cases in Tajikistan to 217 in Ukraine. Most violations concerned gbMSM (76.5%), with one-fifth involving TP, predominantly transgender women. Complex violations with multiple perpetrators or infringements were documented in Armenia and central Asia. Privacy rights were commonly violated, often through outing. Cases of violations of the right to the highest attainable standard of health (13.6%) and protection from medical abuses (2.6%) were also documented. Other rights violations were sporadic, with each country exhibiting distinct patterns of violated rights and types of violations. In Ukraine, the full-scale war in 2022 influenced the nature of documented cases, reflecting the challenges faced by gbMSM and TP. CONCLUSIONS: Monitoring rights violations proved effective for assessing the situation of gbMSM and TP, particularly in the insufficiently studied and diverse eastern Europe, Caucasus and central Asia regions. As rights violations are linked to both legislation and law enforcement practices, comprehensive interventions to minimize structural and interpersonal stigma are essential.

An implementation evaluation of the Breaking Down human rights barriers to HIV services initiative in Ukraine.

INTRODUCTION: Globally, stark inequities exist in access to HIV treatment and prevention. The eastern European and central Asian region is experiencing the sharpest rise in new HIV acquisition and deaths in the world, with low rates of treatment and prevention services, especially for key and vulnerable populations who face a range of human rights-related barriers to HIV prevention and treatment. METHODS: An implementation learning evaluation approach was used to examine the implementation of the Breaking Down Barriers initiative targeting key and vulnerable populations in Ukraine. Between September 2022 and April 2023, researchers conducted 23 key informant interviews with individuals from the Ukrainian government, implementing organizations and human rights experts. Using a concurrent triangulation design, researchers and key informants, in a process of co-creation, sought to describe programme accomplishments, challenges and innovations in implementation, between 2021 and 2023, including periods before and after Russia's February 2022 full-scale invasion. RESULTS: Eight rights-based interventions related to HIV were identified in Global Fund programme documents and key informant interviews as making up the core of the Breaking Down Barriers initiative in Ukraine. These included programmes seeking to: eliminate stigma and discrimination; ensure the non-discriminatory provision of medical care; promote rights-based law enforcement practices; expand legal literacy ("know your rights"); increase access to justice; improve laws, regulations and policies; reduce gender discrimination, harmful gender norms and violence against women and girls; and mobilize communities for advocacy. These programmes received US$5.9 million in funding. Key informants reported that significant progress had been made addressing human rights barriers and scaling up interventions, both before and after Russia's invasion. Programme implementors adopted innovative approaches, including using paralegals, hotlines and other community-led interventions, to ensure that key and vulnerable populations, including displaced individuals, were able to access prevention and care. CONCLUSIONS: An implementation learning evaluation approach examining programmes addressing human rights barriers to HIV services, designed as a process of co-creation between researchers, programme implementors, government officials and human rights experts, can provide a robust assessment of programme outputs, outcomes and evidence of impact, despite a challenging operational environment.