The launch in the UK of the landmark report of the Global Commission on HIV and the Law: Risks, Rights & Health takes place between the observance of World AIDS Day on 1 December and Human Rights Day, on 10 December.
It might be a coincidence, but I can’t think of a better way of illustrating what the report tells us: the enormous impact that the law has on the lives of people affected by and living with HIV.
As noted by Dr Mandeep Dhaliwal, Acting Director of UNDP’s HIV, Health and Development Practice, “The Commission’s report shows that investing in evidence and human rights based legal environments delivers value for money in terms of reducing stigma and violence as well as achieving better HIV and health outcomes that contribute to sustainable development.”
This intrinsic link between human rights and HIV is key to illustrating how the HIV sector revolutionised the way we conceive international development and health. Human rights were at the core of the early activism of people living with HIV, and then the mobilisation of people most at risk of HIV, such as men who have sex with men, sex workers, transgender people and people who use drugs. HIV activism has grown into a successful international movement advocating for universal access to health. Nobody would have predicted just a decade ago that eight million people globally would be on life-saving HIV treatment today.
And in many ways, laws and policies have followed suit. There is no state in the world that is unconcerned about the stigma and discrimination that surrounds HIV. The AIDS paradox that Commissioner Michael Kirby refers to in the Commission report is a reality: for the most part, the world has understood that laws that protect people with HIV are more effective than those that try to “protect the community against people affected”.
But while positive laws can increase access to treatment and facilitate access to prevention services, bad laws which criminalise groups that are already marginalised or impose international trade regulations limiting access to medicines continue to hamper a successful HIV response. Much of the Commission’s report provides evidence of the devastating impact that bad laws can have on the HIV response. The report states that “punitive laws, discriminatory and brutal policing and denial of access to justice for people with and at risk of acquiring HIV are fueling the epidemic”.
In the countries where the Alliance works, we can see firsthand the difference that punitive laws, and law enforcement practices, can make to people who need quick and easy access to HIV and AIDS treatment, prevention and care services. In Uganda and Nigeria, the imminent passing of anti-homosexuality and anti-gay marriage bills are stark reminders of the serious human rights challenges that populations at higher risk of HIV face.
In Latin America, a report we recently produced with our regional partner, the Latin American Network of Transgender People (REDLACTRANS), exposes the violence against transgender human rights defenders and the widespread transphobia at all levels of public office. This is fuelling human rights violations against a community otherwise protected by the law.
And in Ukraine, most at risk communities have to grapple with the state’s own contradictions. State run substitution therapy programmes for people living with HIV are constantly disrupted by laws around drug possession and the resulting police harassment.
But ultimately, for most people affected by HIV, the main threat to the realisation of their human rights is found within the communities where they live. The perception of morality and law, more than the law itself, is at the core of social rejection and discrimination that fuels other violations. In addition to advocating for more enabling legislation, it is at the community level that the human rights-based responses to HIV are needed. When people affected by HIV are empowered to claim their rights, when law enforcement officers, religious leaders, and communities are more aware, law reform actually becomes possible.
This community approach to human rights and HIV-related legal reform is a model for any post-Millennium Development Goal (MDG) framework. It is an approach which respects and promotes human dignity and leads to effective public health programmes.
I would urge those who are involved in developing the successor framework to read and learn from this report. That way, we can collectively start to turn the tide and move towards a more tolerant, pragmatic, and just legal environment for all whose lives are touched by HIV.