A/HRC/59/62/Add.1 accessing decent work opportunities and any manifestations of racial discrimination within the labour market. 35. The Special Rapporteur received reports, including in Rio de Janeiro and São Paulo, of pervasive spatial segregation along racial and ethnic lines, with people of African descent disproportionately living in favelas in urban periphery areas. Favelas provide for inadequate, environmentally exposed and dangerous housing conditions, with poor access to essential infrastructure, such as shops and public transport. The Special Rapporteur also heard testimonies of the high and rising levels of homelessness experienced predominantly by those from marginalized racial and ethnic groups in urban areas. She was concerned to hear about the disproportionate impact of rising homelessness on women of African descent. 36. The Special Rapporteur welcomes the fact that health is established as a universal right by the Constitution of 1988 and that the unified healthcare system offers publicly funded healthcare. She was nevertheless concerned by reports that significant racial disparities persist in the provision of healthcare and in health outcomes. The Special Rapporteur was also concerned by reports of limited or no access to basic healthcare for the lesbian, gay, bisexual, transgender and intersex community and of racism and phobia against that community among medical professionals within the healthcare system. A lack of understanding of the specific health concerns of people of African descent and Indigenous women by healthcare workers was also brought to her attention. The Special Rapporteur welcomes the reinforcement of the national health policy on people of African descent but stresses the need for its effective implementation. She also notes with concern the absence of similar health policies for other marginalized racial and ethnic groups, including Roma persons and Indigenous Peoples. 37. The lack of access to mental health services, despite the constant anguish caused by systemic racism, was a common theme shared by many of those with whom the Special Rapporteur met. She notes information provided by the Ministry of Health on initiatives to ensure access to mental health services for persons from marginalized racial and ethnic groups. The Special Rapporteur also welcomes the fact that the state government in Bahia has been working to overcome accessibility issues through mobile units offering mental health services. She encourages federal and state government entities to analyse the reach and effectiveness of current initiatives. 38. The Special Rapporteur heard about racial disparities in access to educational institutions at all ages and about how children of African descent and Quilombola and Indigenous children suffer racist bullying in schools. These phenomena are interrelated, as children who are subjected to racist bullying are reportedly more likely to drop out of school. The Special Rapporteur welcomes the National Policy on Equity, Education for Ethnic-Racial Relations, and Quilombola School Education and the measures taken to implement Law No. 10.639/2003 concerning the teaching of African and Afro-Brazilian history in schools. She also welcomes the measures taken in Maranhão to develop curriculum guidelines on Quilombola education and noted measures at the federal and state levels, including in Rio de Janeiro, to address racist bullying. She stresses the importance of ensuring the effective implementation and universal reach of these policies in view of the lasting impact that bullying and the lack of access to education have on the life trajectories of children from marginalized racial and ethnic groups. G. Affirmative action 39. The Special Rapporteur received information from a range of different stakeholders on the design and implementation of an affirmative action programme in Brazil. The programme, started in 2001, initially created quotas for certain marginalized racial and ethnic groups in some public higher educational institutions. It was subsequently expanded to include more higher education institutions and some public sector employers. The programme has reportedly been successful in raising higher education enrolment rates among students from certain marginalized racial and ethnic groups and improving racial representation in parts of the public sector. She therefore commends Brazil for its affirmative action programme, which is an important step forward. The Special Rapporteur also 10 GE.25-06011