Civil Society Activists Find Common Ground on ART for Prevention

OSI’s Public Health Program brought together 30 civil society representatives from around the world to find common ground on the many issues and questions raised by the use of a model for HIV prevention that relies on universal testing and immediate antiretroviral treatment (ART) for people living with HIV. 

Since its publication in the January 2009 issue of The Lancet, an article by World Health Organization officials (“Universal Voluntary HIV Testing with Immediate Antiretroviral Therapy as a Strategy for Elimination of HIV Transmission: A Mathematical Model”) has been the subject of much debate among activists and health experts. In particular, the article provided a trigger for people to express deeply held concerns on the lack of attention to human rights issues in the proposed model and, more broadly, in national responses to HIV; the slow pace of efforts to reach universal access to HIV treatment, care, and support; and how and under what conditions can and should ART be promoted for prevention purposes.

The OSI meeting took place on October 14-15, 2009, just ahead of a WHO consultation meeting on ART for prevention. Participants soundly rejected the notion that treatment advocates and human rights advocates are pursuing different agendas in their response to the model published in The Lancet. They agreed that their common agenda is to achieve earlier and successful uptake of HIV testing, counseling, and treatment. Further, they noted that this can only be achieved if human rights concerns are seriously addressed in national and international responses to HIV, including by funding and implementing a series of programs to reduce discrimination and human rights abuses and increase access to justice.

Participants discussed how human rights and treatment advocates can jointly advance the common agenda of universal access and, more specifically, how they can work jointly to advance the ART for HIV prevention agenda. They made a number of recommendations aimed at increasing uptake of HIV testing and counseling; removing barriers to earlier initiation of treatment; and removing barriers to sustaining people on treatment and to sustaining the systems necessary for that.

After the meeting, participants drafted the document, Civil Society Statement on ART as Prevention: Scaling Down HIV Requires Scaling Up Human Rights, Testing and Treatment. The statement was widely endorsed by civil society organizations from countries worldwide and delivered to the participants at the WHO consultation. It is available online at http://www.icaso.org/treatment.html.