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It is currently pending adoption by Congress.10 Article 2 of the bill provides for: (a) Developing and implementing a national registry; (b) Developing the range of health-care products and encouraging the practice of self-care; (c) Organizing the flow of health care; (d) Defining the epidemiological profile; (e) Training and building capacity among staff in the Unified Health System so that they can address the various aspects of health care of persons with albinism; (f) Improving integrated health care for persons with albinism. (...) The Ordinance aims at ensuring the universality, completeness and equity of health care for persons with rare diseases in order to reduce morbidity and mortality, to establish care plans at all levels of the health-care system, to ensure comprehensive health care for persons with rare diseases in the health-care network, and to ensure that persons with rare diseases have timely access to diagnostic and therapeutic resources. 23. (...) The Independent Expert was informed that life expectancy among persons with albinism could be as low as 33 years of age owing to an absence of timely and quality preventive and curative care for skin cancer. Based on recent research, the prevalence of skin cancer in patients enrolled in studies of the Pro-Albino Programme was 26 per cent, which is similar to that found in persons with albinism by researchers in Tanzania (25 per cent) and South Africa (23 per cent).26 The same research indicated that persons with albinism in Brazil tend to face similar prejudice and stigma to those experienced by their counterparts in African countries. 60.

Furthermore, the Ministry of Health, Community Development, Gender and Children is in the process of developing the national guidelines on health-care fee waivers for persons with disabilities to facilitate access to health care for such persons, including persons with albinism. 33. (...) One of the main partners of the Centre’s mobile operations is the non-governmental organization (NGO) Standing Voice. Its mobile skin-care clinics bring dermatologists to 33 sites in eight regions of the country every six months. (...) Furthermore, the hypervisibility and colouring of persons with albinism, along with the lesions that skin cancer often leaves on their skin, combined with a lack of general education on albinism, contribute to and strengthen the myths dehumanizing persons with albinism.

Owing to the lack of melanin in persons with albinism, they are particularly vulnerable to skin cancer. In Malawi, skin cancer is a life-threatening condition for persons with albinism as there are few facilities for adequate medical interventions. (...) In addition, free access to dermatological care for persons with albinism is necessary to ensure that skin cancer is detected early and treatment readily provided. 73. (...) The use of mobile clinics to ensure that persons with albinism in remote areas can be screened on a regular basis for skin cancer and vision assessment and care is a best practice established in the region.

This in turn leaves most of them un-skilled and un-equipped for jobs and relegates them to menial work, including jobs that expose them to the sun and subsequently to skin cancer. In other cases, the vision impairment of persons with albinism has led to the assumption that they are all visually impaired. (...) This is highly commendable, given that skin cancer is the number one killer of persons with albinism in Sub Saharan Africa. (...) On the right to the highest attainable standard of health care, the Commission recommends that the government, should establish programmes to support initiatives for producing sun protection cream locally, facilitate free or low cost skin cancer treatment across the country for persons with albinism and provide free or low cost visual aids to enable persons with albinism to participate fully in all spheres of life. 8.

Include colour as a prohibited ground of discrimination. 3 Health Care workers and midwife training State & all stakeholders I to M Train on albinism and early intervention particularly linked to vision impairment and skin cancer (including preventive and curative measures). (...) Include PWA in disability policy and benefits. 3 Skin cancer : access to adequate health care State I to L Provide system wide distribution of sun protection creams and provide cancer, and pre-cancer treatment at no cost. Reimburse cost if distance to care is far from residence. Ensure no standing in the sun for school, work or access to government services.

The other key physiological consequence is vulnerability to skin cancer, which is fatal when left untreated. (...) Entry points include training modules on disabilities, on rare conditions and diseases and on skin conditions, and primary health-care services. (...) At school, poor vision, skin problems, social exclusion and lack of appropriate accommodation impede their progress. 59.

The most common and visible type is oculocutaneous albinism, which affects the skin, hair and eyes. Within this type, subtypes reflect varying degrees of melanin deficiency in an individual. (...) Owing to the lack of melanin in persons with albinism, they are particularly vulnerable to skin cancer. In Mozambique, as in various countries of the region, skin cancer is a life-threatening condition for persons with albinism because there are few facilities for adequate medical interventions. (...) Further, the use of mobile clinics to ensure that persons with albinism in remote areas can be screened on a regular basis for skin cancer is a best practice established in the region. 57.

A/HRC/21/41/Add.1 12 GE.12-14943 (b) Discrimination based on nationality, race or skin colour 71. The Special Rapporteur received reports about the salary discrimination that migrant domestic workers experience because of their ethnicity. (...) It therefore follows that, the lighter the domestic worker’s skin colour, the higher the employer’s prestige: Filipino migrant domestic workers are of a lighter skin colour and are more expensive than Nepalese migrant domestic workers, who are of a darker skin colour. (...) It pays for some meals and medical care if a detainee has to go to hospital. Its social workers work on site and provide recreational activities and a washing machine for the detainees. 103.

Home care accounts for more than 90 per cent of caregiving, while 7 per cent of older persons are accommodated in community-based care centres and less than 1 per cent in care homes.63 By the end of 2019, there were 29,000 registered care homes for older persons with a total of 7.614 million beds. (...) It is essential to improve patient awareness of palliative care and improve accessibility of services and ensure adequate training for health-care professionals. 49. Around 300,000 formal care workers are engaged in old-age care, but less than one third of them have formal qualifications.

These stereotypes also feed the impunity of discrimination based on skin colour for Afro-Peruvians in public spaces outside schools. 51. (...) An administrative directive mandating the registration of ethnicity in the health information system has not yet been implemented, preventing the development of an understanding of the specific challenges that Afro-Peruvians face and the limits in their ability to have access to quality health care. In particular, the lack of updated statistical data has made it difficult to estimate how many Afro-Peruvian children do not have adequate access to health care. (...) In 2014, 13 per cent of Afro-Peruvian children reported discrimination based on their skin colour in schools. Peruvian researchers have confirmed that Afro-Peruvian children suffer more racial discrimination than any other minority group.15 15 Martin Benavides, et al., “Access to higher education of Afro-Peruvians: disentangling the tnfluence of skin color and social origins in the Peruvian stratification system”, Sociology of Race and Ethnicity, vol. 5, No. 3, p. 354, citing Martin Benavides “Situación actual de la población Afrodescendiente en tres localidades del Peru” (unpublished), Lima, GRADE, Fundación Bernard Van Leer.