On World AIDS Day 2010, the global community focused
attention on protecting human rights of all people affected by HIV.
Health, HIV and human rights are inextricably linked.
HIV responses need to ensure that human rights are protected and
promoted. At the same time, the promotion and protection of human rights
reduces HIV risk and vulnerability and makes HIV programs more
effective. Those populations most vulnerable and at risk of HIV are
often the same populations prone to human rights violations. HIV
policies and programs in the health sector must promote human rights and
empower individuals to exercise their rights.
The right to health is central to the HIV response.
While we are encouraged by news that HIV epidemics are stabilizing in
most regions of the world, it is clear that too many people still do not
have access to essential HIV services that can prevent HIV infections
and save lives. Antiretroviral treatment is still only available to one
third of people in need. Even with the expansion of programs to prevent
mother-to-child transmission of HIV, in 2009 only 53% of pregnant women
living with HIV were able to access treatment to prevent their infants
from becoming infected.
Populations most at risk of HIV infection, including
injecting drug users, sex workers, men who have sex with men and
transgender people are also those populations who have the least access
to much needed HIV prevention, treatment and care services. For example,
coverage of harm reduction programs remained limited in 2009. Among 92
countries that reported, 36 had needle and syringe programs and 33
offered opioid substitution therapy.
People living with HIV should not only enjoy their
right to health but also their right to access crucial social services
such as education, employment, housing, social security and even asylum
in some cases. Ensuring the rights of people living with HIV is good
public health practice, by improving the health and well-being of those
affected and by making prevention efforts more effective. A wide range
of countries have enacted legislation to prevent discrimination against
people living with HIV. However, in many cases, there is poor
enforcements of such laws and stigmatization of people living with HIV
and most-at-risk populations persist.
HIV-related stigma and discrimination continue to
undermine HIV responses. The fear of being shunned by their families and
friends, marginalized in their communities or denied employment and
other services is often the reason why people do not present for HIV
testing or attend HIV services. All too often it is the negative
attitudes and behaviors of health workers that make health services
inaccessible and unacceptable to those people at greatest risk of HIV
infection and in greatest need of prevention, treatment and care
services. People living with HIV, drug users, sex workers and men who
have sex with men should be able to attend health services where they
feel safe and are ensured the best possible and non-judgmental care.
The failure to promote and protect human rights
increases vulnerability and can drive HIV epidemics. In sub-Saharan
Africa, women and girls are particularly vulnerable to HIV; 80% of all
women living with HIV are in this region. In Eastern Europe, over 50% of
HIV cases are among people who inject drugs. In France, Netherlands and
Spain, between 1/3 and 3/4 of new HIV infections are concentrated among
migrants.
On the eve of a new decade, we need to address laws,
policies, and regulations that increase HIV vulnerability and risk,
impede access to health services or infringe on human rights,
particularly for vulnerable and most-at-risk populations. In nearly 80
countries, same-sex sexual relations are criminalized, with 6 countries
applying the death penalty. In over 50 countries and territories, there
are restrictions on travel and residence for people living with HIV. In
many countries drug users are sent to prison or compulsory
rehabilitation programs rather than being provided with effective
treatment. The health sector has a critical role to play in promoting
public health approaches and arguments when laws are made and strategies
developed by other sectors.
Today, I call on all sectors to protect human rights,
including the right to health, and to combat discrimination. Working
with people living with HIV is critical for an effective HIV response
and Member States need to be mindful of the commitments made in the 2006
Political Declaration on HIV/AIDS to promote better legal and social
environments for people to access HIV testing, prevention and treatment.
WHO is firmly committed to the goal of achieving
universal access to key HIV services. However, this will not be possible
unless we make sure that the human rights of everyone, everywhere, are
protected and promoted.
Dr Margaret Chan,
Director-General, World Health Organization