July 23, 2014

Full speed ahead, but leaving nobody behind

Written by Alvaro Bermejo, Executive Director, International HIV/AIDS Alliance

This post originally appeared on the AIDS 2014 conference blog here. Reposted with permission.

It’s just two years since the bright lights of the 19th International AIDS Conference in Washington but how the world has changed in that time. From Nigeria to India, Ukraine to Uganda, the human rights of key affected populations have come under attack, particularly in recent months. We watched in horror as earlier this year Uganda – hot on the heels of Nigeria – adopted harsh new laws that further criminalize homosexuality, while last December India recriminalized gay sex, reversing a 2009 Delhi High Court decision. Consequently, both nations have witnessed a significant rise in acts of violence and discrimination against the LGBT community, driving an already marginalized community further underground and making the uptake of HIV services all the more difficult.

Creating an enabling social and legal environment for HIV prevention, care and treatment is essential if we are to bring about an end to AIDS. This means defending the rights of people living with HIV, sexual minorities, people who use drugs and sex workers among others. It also means addressing HIV-related stigma and discrimination, and advocating for laws and policies that promote and support evidence-based programming.

The relationship between HIV and human rights has never been so evident. This was comprehensively documented in the report produced in 2012 by the Global Commission on HIV and the Law and today we are seeing clearly how ‘bad laws’ and policies are hindering HIV responses and wasting resources across the world. Human rights-based responses to the epidemic are more critical than ever to improving access to services. Civil society remains at the centre of the HIV epidemic and it is only through that leadership that we will achieve a sustainable response to HIV and AIDS. Strengthening civil society and increasing participation in decision making among key populations are paramount.

And with HIV now thought to be the number two cause of death among adolescents globally, and the number one in Africa, we simply can’t – at this point in the epidemic – forget young people, particularly those from key populations. They need universal access to tailored, rights-based comprehensive HIV and sexual and reproductive health (SRH) services that incorporate sexuality education, including family planning, HIV prevention, gender identity and sexual orientation.

We also need to recognise that for most at risk children and adolescents under 18 years old the categorization of their risk may not be easily assigned to commonly used key population groups, and that the overlapping vulnerabilities in this period of their lives mean that we are looking at behaviours and risks and identities that are often fluid and overlapping. This requires a different approach from our existing adult key population programmes.

In order to ensure continued strong political and financial support for the global AIDS response in the post 2015 era, it is crucial to advocate for the inclusion of strong targets and indicators related to AIDS, sexual and reproductive health and rights and human rights goals in the new post 2015 Development Framework. As the new goals will be universal goals, applicable to all countries, both developed and developing countries alike, it is more important than ever that the new overarching health goal which will replace Millennium Development Goals 4, 5 and 6, as well as the other new goals, have a cross cutting focus on equity and in particular on reaching marginalized and excluded populations. Without addressing human rights violations and the persistent stigma and discrimination all at risk groups face, we will not achieve sustainable development and the new post-2015 framework will be a failure.

Addressing these challenges is difficult work and requires sustained engagement from affected communities themselves. As the theme of this year’s conference encapsulates, we do indeed need to step up the pace but let’s be sure not to leave anybody behind as we go full throttle in our quest to end AIDS.

Download the new Good Practice Guide on HIV and Human Rights produced by the International HIV/AIDS Alliance and the AIDS & Rights Alliance for Southern Africa (ARASA).

Find out more about Link Up, an ambitious, five country project which aims to improve the sexual and reproductive health and rights (SRHR) of more than one million young people living with and affected by HIV in Bangladesh, Burundi, Ethiopia, Myanmar and Uganda.

Read the joint briefing paper on Health In The Post 2015 Development Framework.