In the course of the 31st regular session of the Human Rights Council, a panel discussion was held on Friday 11 March to address human rights issues in the effort to end the HIV/AIDS epidemic by 2030 – as set in the Sustainable Development Goals (SDG 3). The aim was both to mark the 20-year anniversary of the adoption of the 1996 International Guidelines on HIV and Human Rights and to create momentum for the upcoming high-level meeting on HIV/AIDS at the UN General Assembly from 8 to 10 June 2016.
The key message shared by all the participants was that HIV/AIDS remains a human rights problem, and it, therefore, needs to be addressed through a human rights-based approach if the target of elimination by 2030 is to be achieved. Such an approach entails first and foremost non-discrimination, in particular in terms of access to healthcare. Safe and non-judgmental healthcare systems that respect the privacy and confidentiality of patients and establish grievance mechanisms are crucial. Evidence so far shows that healthcare settings are the most frequent environment where people face stigma and discrimination, especially on the basis of sexual orientation and drug use. Refusals to provide health care, forced abortions and sterilisation, mandatory treatment, or compulsory detention drive people away from health services. In prisons, basic health services are lacking, creating a health emergency that in the most extreme cases could even constitute ill-treatment. In many countries anti-LGBT laws still prohibit access to prevention, treatment, and medication, outlawing HIV/AIDS patients and highlighting the need for inclusive treatment policies. Not least, women and children remain among the most vulnerable groups. HIV/AIDS is still the leading cause of death among adolescents in sub-Saharan Africa, and 22 million people living with HIV/AIDS do not have access to life-saving antiretroviral therapy. New infections continue to rise in populations that are typically excluded or marginalised. The problem of mother-to-child transmission of HIV/AIDS was emphasised by some countries, adding to the list of factors that make sexual education and family planning pertinent also in connection to HIV/AIDS. Empowerment of HIV/AIDS-affected people and their taking part in decision-making processes are, therefore, crucial components of strategies to address discrimination policies.
The second main challenge is access to medicines, not only in terms of affordability, but also with regard to access to new treatments. In 1996, evidence of the effectiveness of a treatment for HIV was announced for the first time, leading to the adoption of the 1996 Guidelines. HIV/AIDS became a manageable health condition, and essentially a public health issue. Although some progress has been made and the TRIPS agreement provides for some flexibility, the recent conclusion of regional Free Trade Agreements (FTAs) that go beyond TRIPS and establish TRIPS+ binding obligations for their signatories, risk posing additional obstacles to access. In December 2015, the United Nations Secretary-General convened a High-Level Panel on Access to Medicines to review and recommend solutions to address the policy incoherence between intellectual property, trade, and public health. HIV/AIDS is also expressly among the SDGs that recognise the interdependence of health and development.
In conclusion, all the participants emphasised that ending HIV/AIDS by 2030 can only be achieved through a human rights-based approach to HIV/AIDS. This means ending discrimination in healthcare settings and ensuring that medical treatment reaches all HIV/AIDS affected people, including drug users and prisoners. Discrimination on the basis of gender and sexual orientation necessitates the establishment of grievance mechanisms, but also education programmes to attenuate societal prejudices. Access to medicines is also crucial. After twenty years, the 1996 Guidelines remain pertinent, but they need to be integrated into wider processes, in particular the implementation of the SDG agenda. It can only be hoped that the panel discussion within the HRC set the stage for far concreter results at the upcoming meeting of the UN General Assembly next June.