Health Experts Call for "Major Shift" in Global AIDS Response

New York—More than 30 leading AIDS organizations today called for a major shift in the global response to HIV/AIDS, issuing an unprecedented joint declaration on the need to put legal and human rights protections at the center of HIV efforts.

“It’s plain and simple: without a greater focus on law and human rights, the global response to AIDS will stagger and fail,” said Jonathan Cohen of the Open Society Institute, which sponsored the declaration. “This is widely recognized, yet few governments have ensured human rights protections for people living with or vulnerable to HIV.”

The declaration, “Human Rights and HIV/AIDS: Now More Than Ever,” focuses on populations most vulnerable to HIV: women and girls, young people, injecting drug users, sex workers, gay and bisexual men, and incarcerated people. These groups are the most in need of comprehensive HIV prevention and treatment programs, including access to anti-retroviral drugs, yet they continue to face discrimination and abuse worldwide and are often denied access to life-saving programs. As a result, HIV continues to spread unchecked in communities worldwide.

Up to one-third of HIV infections outside Africa are caused by the sharing of syringes among drug users, according to the United Nations. Yet measures to reduce syringe sharing, such as needle exchange programs and substitution treatment with methadone, are banned or restricted by police practice in many countries. HIV spreads rapidly in post-Soviet prisons, where prisoners are routinely denied access to condoms, sterile syringes, effective drug dependence treatment, voluntary HIV testing, and HIV medications.

The Human Rights Declaration comes at a time when effective HIV-prevention, treatment, and care programs are under threat. Earlier this year, the World Health Organization and UNAIDS released guidelines recommending that in certain situations people should be tested for HIV unless they explicitly decline the test. Many experts worry that making HIV testing more routine without scaling up human rights protections could result in coercive, mass HIV testing programs. Such programs would further stigmatize people living with HIV and deter people from coming forward for needed health services.

“Universal access to HIV testing is critical, but there is no evidence suggesting that human rights need to be relaxed in order to achieve this goal,” said Kevin Moody of the Global Network of People Living with HIV/AIDS, which endorsed the declaration. “Public health and human rights can and should go hand in hand.”

The lack of legal protections for African women, who comprise the majority of infections on the continent worst-affected by HIV, best illustrates the need to combine public health with human rights approaches. Under customary laws throughout Africa, women are denied equal access to divorce, property, and inheritance. In many countries, governments do not aggressively prosecute domestic violence or even recognize the crime of marital rape. This leaves women vulnerable to HIV infection from their spouses and intimate partners. Preventing HIV in these situations is as much a legal challenge as a public health one, experts say.

“Legislation protecting women’s rights languish in African parliaments, while coercive responses to HIV are the order of the day,” said Christine Stegling of the Botswana Network on Ethics, Law and HIV/AIDS. “This is a sad commentary on the current state of the global AIDS response.”

The endorsing organizations called on governments and international donors to take concrete measures to place human rights at the center of their AIDS programs. The groups also called for immediate protection of human rights defenders who are intimidated or detained for their AIDS activism.

“People should not be punished for holding their governments accountable to their HIV/AIDS and human rights commitments,” said Wan Yanhai, who has been detained numerous times by Chinese authorities for his AIDS activism. “Human rights activists simply want to help their governments win the war against AIDS.”

The declaration is available online in English, French, Russian, and Spanish.

It has been endorsed by more than 30 organizations from Botswana, Canada, China, Hungary, India, Kenya, Mexico, Namibia, South Africa, Thailand, Uganda, United Kingdom, United States, and Zambia, as well as numerous international organizations. It has been translated into Albanian, Bulgarian, French, Hungarian, Lithuanian, Mandarin, Portuguese, Romanian, Russian, Spanish, Thai, and a number of African languages. The declaration is being launched locally and nationally at several events planned from December 1-15, 2007. An international endorsement campaign will follow, culminating with a global march for human rights at the 2008 International AIDS Conference in Mexico City.

The Open Society Institute, a private operating and grantmaking foundation established by George Soros, works to build vibrant and tolerant democracies whose governments are accountable to their citizens. To achieve its mission, OSI seeks to shape public policies that assure greater fairness in political, legal, and economic systems and safeguard fundamental rights. OSI works in over 60 countries including the United States, Europe, Asia, Africa, Latin America, and the Middle East. “Human Rights and HIV/AIDS: Now More Than Ever” is a project of the Law and Health Initiative, a division of OSI’s Public Health Program that supports legal and human rights responses to public health worldwide.