HIV Update: Rights in Action

By Kevin Osborne (IPPF)

Since the beginning of the epidemic, HIV has been at the crossroads of science, rights and moral values. All too often human-rights, tolerance, and acceptance are seen as ‘nice-to-haves’ but not ‘must haves’ as part of national and international responses to HIV. Yet studies have shown that failure to respect human rights undermines the return on investment. There is a financial as well as moral imperative to ensure that the efforts, attention and hard-earned currency invested in responding to HIV are as effective as possible.

There is an unconscionable economic, human and social cost of inaction on human rights. In my home country South Africa, a study by the Harvard School of Public Health found that the political inaction during the AIDS denialism of Thabo Mbeki’s government equated to 365,000 premature deaths. This included 330,000 South Africans who died for lack of treatment and the 35,000 babies who perished because of ineffective, incomplete or absent efforts to prevent the transmission of HIV from their mothers. In total, the economists found this was at least 3.8 million years of life, lost.

On a global scale, a recent study has also quantified the cost of inaction. A new investment framework incorporates major efficiency gains through community mobilisation, synergies between programme elements, and benefits of the extension of antiretroviral therapy for the prevention of HIV transmission.  The framework differentiates between (i) basic programme activities that aim to directly reduce HIV transmission, morbidity, and mortality; (ii) activities that are necessary to support the effectiveness and efficiency of these programmes (critical enablers); and (iii) investments in other sectors that can have a positive effect on HIV outcomes (synergies with development sectors). Human rights, tolerance and social inclusion are core principles at the heart of creating such an enabling environment. Scaling up and implementing   the new investment framework, would avert 12.2 million new HIV infections and 7.4 million deaths from AIDS between 2011 and 2020 compared with continuation of present approaches.

The significance of human rights in the response to HIV has been integral from the very beginning. Due to the link between HIV and traditionally sensitive issues, the epidemic has brought into the open differing values and attitudes related to human sexuality and behaviour. As the spotlight shines away from HIV and specific sources of funding are opened up to incorporate other diseases and health systems strengthening, there is a risk that addressing these rights could falter. With an ever-increasing focus on numbers and scales (which are both important) it is imperative that rights – which are often difficult to quantify – are not jeopardized, forgotten, or simply taken for granted.

For IPPF, putting rights into action by upholding the sexual rights of all and addressing HIV-related stigma are key priorities for our work. Practical measures such as ensuring that our workplace is a stigma-free environment and providing stigma-free services in all of our clinics, go a long way in maintaining a rights-based approach in everything we do.

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