Global Commission reiterates need for action on human rights, HIV, TB and SRHR in 2018
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In 2012, the Global Commission on HIV and the Law recommended critical rights-based responses to create enabling environments for HIV, in its report Risks, Rights & Health. In the 2018 Supplement, the Commission highlights ongoing and new priorities for addressing law and human rights for vulnerable and key populations, to end AIDS and TB by 2030.
The Global Commission’s 2018 Risks, Rights & Health Supplement finds HIV and its co-infections continue to disproportionately affect vulnerable, marginalized and criminalized populations. Key populations and their sexual partners account for 47% of new HIV infections in 2017. Adolescent girls and young women aged 15-24 account for 20% of all new HIV infections. In addition, progress to end AIDS is curbed by other epidemics - viral hepatitis and tuberculosis, co-infections that complicate and threaten the lives of people with HIV and vice-versa.
In this changing landscape of advances in medicine, science and technology, yet increasing restrictions on vulnerable and key populations and the organisations that support them, the Global Commission’s 30 new recommendations amplify and extend those of the 2012 report.
The Commission raises several concerns
The 2018 Risks, Rights & Health Supplement reiterates the importance of outlawing discrimination, repealing punitive laws and enacting protective laws to promote public health and human rights for effective responses to HIV and its co-infections, particularly for vulnerable and key populations. While recognising the significant protective steps taken by dozens of jurisdictions over the past 6 years, informed by public health evidence and human rights obligations, the Commission raises several concerns in 2018, including the following:
- As of July 2018, 68 countries continue to criminalize HIV non-disclosure, exposure or transmission or to allow the use of HIV status to enhance charges or sentences on conviction. HIV prosecutions have been reported in 69 countries. This is taking place at a time when scientific evidence now shows a zero risk of HIV transmission from an HIV-positive person with a suppressed viral load.
- The criminalization and imprisonment of people – people who use drugs, TB patients who do not adhere to or complete their treatment – places them at increased risk of exposure and often excludes them from effective treatments for HIV, TB and viral hepatitis.
- Anti-sex work laws remain problematic in several countries, eroding the safety, control and earnings of sex workers.
- Between 2012 and 2015, more than 60 countries drafted or enacted laws, or stepped up enforcement of older ones, to outlaw harass, vilify, attack or bankrupt civil society organisations and international aid groups that support them.
- With 258 million immigrants, including 28,5 million refugees and asylum seekers, countries have adopted restrictive immigration policies, including visa denials, screenings and deportation, based on health status.
- Adolescent girls and young women are being left further behind. Criminalisation, discrimination, violence and legal and human rights barriers continue to undermine women’s and girl’s ability to access sexual and reproductive health care to protect their health and realise their rights.
Recommendations to ensure sustainable health responses
In the 2018 Risks, Rights and Health Supplement, the Commission presents 30 recommendations to ensure effective, sustainable health responses consistent with universal human rights obligations. Some important recommendations include:
- Governments must prohibit in law all forms of discrimination against people living with and vulnerable to HIV, TB or viral hepatitis.
- Governments must ensure that everyone living with or at risk of acquiring HIV, TB or viral hepatitis has affordable access to the most effective, high-quality health technologies, including diagnostics, medicines and vaccines for HIV, TB and viral hepatitis.
- Governments must stop restricting organisations but instead enact laws that provide an enabling environment for civil society organisations to operate, including those providing services to populations living with or affected by HIV, TB or viral hepatitis.
- Governments must not deny entry to, and must provide migrants, including asylum seekers or refugee applicants, access to the full range of health services including for HIV, TB and viral hepatitis regardless of immigration status. Governments must provide this standard of care in detention and confinement settings.
- Governments must require proof, to the applicable criminal law standard and based on the best available scientific evidence, of intent to transmit HIV when adjudicating cases of HIV transmission. They must prohibit the prosecution ¬of women living with HIV for choices they make during and after their pregnancy, including breastfeeding children.
For further details of the findings and recommendations, read the full report here