Preventing the Further Spread of HIV/AIDS: The Essential Role of Human Rights

In the report, Joseph Amon, director of HIV/AIDS research at Human Right Watch looks at the role of human rights abuses in the spread of HIV/AIDS and "whether [the pandemic is] due to denial of the existence or extent of the epidemic, misappropriation of resources, or hostility to those individuals infected or those populations most at-risk of infection."

The author states that HIV/AIDS is linked to populations marginalised by society because of their gender, race/ethnicity, sexual orientation, or social or economic class. Human rights are central both to understanding the dynamics of the disease and to how to combat it. HIV/AIDS is commonly thought to be related to economic, social, and cultural rights (such as the right to health care), as opposed to civil and political rights, such as freedom of expression and association and due process of law. However, the article proposes that many of the human rights abuses that most increase HIV risk - violence and discrimination against women and marginalised populations as well as people living with HIV/AIDS, harassment and imprisonment without due process of outreach workers and at-risk populations seeking HIV/AIDS information or services, and censorship of health information - are abuses of civil and political rights.

The author explains how focused programmes designed for specific marginalised groups, i.e. drug users, sex workers, men who have sex with men, often initiated by individuals from the most affected communities and supported by local or national governments were based on the dignity and autonomy of each individual, and quickly saw results. Through the mid-1990s emphasis was put on understanding the epidemic as a multi-dimensional problem, requiring a multi-sectoral response. This strategy emerged in part "because HIV/AIDS was expanding unchecked with massive social and economic consequences and in part because of difficulties generating the resources required to fight the epidemic properly. Concerned officials and donors sought to leverage resources simultaneously from multiple sources including ministries of education, agriculture and industry."

The article further explains how there has been increased resources and political will since the year 2000, to create strategies to combat HIV/AIDS. However, at the same time, there has been an increasing trend towards moralising attitudes towards behaviours that are seen to 'contribute' to the epidemic, i.e. drug use and sex work. According to the author this does not recognise the human rights of these communities, and reduced the efficacy of programmes to reach the most marginalised.

The article argues that that programmatic reforms, designed to address human rights violations, should ensure that national HIV/AIDS programmes include measures to combat discrimination and violence against people living with HIV/AIDS, with particular attention to marginalised populations. Efforts should also be made to provide human rights training for judges, police, and other officials; improve data collection relating to police abuse and domestic violence, women’s property rights, and sexual abuse of girls; ensure that anti-retroviral drug distribution systems recognise the challenges marginalised populations face in accessing treatment; and ensure that HIV test results and other patient information is kept confidential. Public education campaigns on the human rights of people living with HIV/AIDS in local languages and using appropriate media should be intensified.

The article concludes that "there is no reason that public health and human rights be considered in opposition to one another. In responding to the global HIV/AIDS epidemic, only programs that start with a basic respect for individuals, and their rights, will be successful. Those programs which adopt strategies in the name of efficiency or ideology and which fail to respect human rights will ultimately fail."