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Reaching zero discrimination in the AIDS response

Claire Gasamagera from Rwanda was five when her parents discovered she had been born with HIV. Her mother died the same year from AIDS-related causes. With no access to treatment at the time, she considers it a miracle that she is alive today. “I was meant to die but God has [kept me alive]… Today is my birthday. I am 28,” she recently told a panel of the UN General Assembly High-Level Meeting on AIDS.

A Bangladeshi woman sits next a red ribbon, a symbol of AIDS awareness © EPA Photo/Abir AbdullahClaire lived long enough to benefit from improved access to antiretroviral treatment. As she pointed out, many others, especially in the poor countries of Sub-Saharan Africa, where the epidemic has been most devastating, were not so lucky.

Countries meeting at a United Nations summit in New York adopted a declaration with ambitious new targets to defeat AIDS, such as the promotion of laws, policies and measures to ensure the full realization of all human rights for people living with HIV, including access to prevention, treatment, care and support, and the elimination of the related discrimination and stigma.

The declaration contains measurable targets, including to halve sexual transmission of HIV by 2015, to reduce HIV transmission among people who inject drugs by 50 per cent by 2015, to ensure that by 2015 no child will be born with HIV, to increase universal access to antiretroviral therapy, to get 15 million people onto life-saving treatment by 2015, and to halve tuberculosis deaths in people living with HIV by 50 per cent by 2015.

According to UNAIDS, the UN agency that leads the global AIDS response, AIDS has claimed about 30 million lives worldwide since it was identified 30 years ago. While access to treatment has increased significantly, new infections, estimated at 7000 daily, far outstrip the capacity to provide universal treatment. More than half – 9 million out of 15 million – of eligible people in low and middle income countries are not getting treatment.

Inadequate funding is not the only obstacle in the way of universal access to prevention, treatment, care and support. Participants in the High Level Meeting cited gender inequality; violence against women and girls; marginalisation and criminalisation of drug users, sex workers and men who have sex with men; and discrimination and stigma against people living with HIV as major obstacles.

“The question is no longer whether we can eliminate AIDS, but whether we have the will to do what it takes: To end discrimination and stigma and to ensure that marginalised populations can enjoy their human rights,” said Assistant Secretary-General for Human Rights, Ivan Simonovic.

Since the early years of the epidemic, people living with HIV and human rights activists around the world have pushed the boundaries of the global AIDS response and elevated the human rights discourse. The lack of respect for human rights has not only fuelled the epidemic, it has brought to the surface pernicious and persistent forms of discrimination and marginalization, in multiple and overlapping manifestations.

Helen Clark, UNDP Administrator, said that leadership at every level of society was required “to bring HIV out of the shadows”. Legal frameworks needed to be conducive to effective AIDS responses.

“If the law is not upholding human rights, effective responses become very difficult,” she said.

In collaboration with UNAIDS, UNDP launched last year the Global Commission on HIV and the Law to assess the impact of laws on national AIDS responses and make recommendations on how the law can advance universal access to HIV prevention, treatment, care and support.

Michael Kirby, co-chair of the Commission and former judge of the High Court in Australia, talked of the need to “name and dignify” the groups most at risk of HIV infection. Calling sex workers “prostitutes” and drug users “junkies” could not help the fight against HIV. “If we are seeking to slow this virus, the way to do it is with human respect and love,” he said.

Anita Krug, who said she started using drugs at the age of 15, spoke of the hurdles that block young people, especially drug users, from getting access to HIV prevention and harm reduction services. She said young people were prevented from accessing such services due to age restrictions, punitive drug laws and requirements of parental consent.

“Denying young people who are drug users access to proven life-saving HIV prevention services contravenes their inalienable human right to the highest attainable standard of health,” she said.

The High Level Meeting that ran from 8-10 June was convened to review progress and adopt a new declaration. This will guide country responses to HIV over the next five years. More than 30 Heads of State and Government, and Vice Presidents attend the meeting which included an official plenary and five panel sessions along with 40 individual side events.

20 June 2011