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2 Acknwlegements We wish t thank Shahira Ahme, Richar Burzynski, Mark Hancck, Je Mahase, Davi Pattersn, Tim Thmas an Mary Ann Trres fr their cntributins t this prject. The Internatinal Cuncil f AIDS Service Organizatins (ICASO) acknwleges the supprt frm the Canaian Internatinal Develpment Agency (CIDA) an GlaxSmithKline's Psitive Actin Prgramme fr making this prject pssible. Written by: Miny Jane Rseman an Sfia Gruskin Prgram n Internatinal Health an Human Rights Françis-Xavier Bagnu Center fr Health an Human Rights Harvar Schl f Public Health an Sumita Banerjee, Internatinal Cuncil f AIDS Service Organizatins Cpyright: This publicatin may be freely repruce an istribute in printe cpy r igital frmat. The Prgram n Internatinal Health an Human Rights, Françis-Xavier Bagnu Center fr Health an Human Rights, Harvar Schl f Public Health an the Internatinal Cuncil f AIDS Service Organizatins shul be acknwlege as the riginal authrs. We wul als appreciate receiving a printe cpy r website aress f any repructins r aaptatins f this publicatin. T cntact us: Internatinal Cuncil f AIDS Service Organizatins 65 Wellesley Street East, Suite 403 Trnt, ON, M4Y 1G7 CANADA Website: Prgram n Internatinal Health an Human Rights Françis-Xavier Bagnu Center fr Health an Human Rights Harvar Schl f Public Health 651 Huntingtn Avenue, 7th Flr Bstn, MA USA Website: Reprinte December 2005

3 1 Intructin 3 HIV/AIDS an Human Rights - Accuntability 9 HIV/AIDS an Human Rights - Avcacy 14 HIV/AIDS an Human Rights - Appraches t Prgramming 17 Key Resurces an Dcuments t G Further HIV/AIDS & Human Rights in a Nutshell

4 I ntructin Human rights are funamental t any respnse t HIV/AIDS.This has been recgnize since the first glbal AIDS strategy was evelpe in Human rights an public health share the cmmn gal f prmting an prtecting the well-being f all iniviuals. The prmtin an prtectin f human rights are necessary t empwer iniviuals an cmmunities t respn t HIV/AIDS, t reuce vulnerability t HIV infectin an t lessen the averse impact f HIV/AIDS n thse affecte. The incience an sprea f HIV/AIDS are isprprtinately high amng grups wh alreay suffer frm a lack f human rights prtectin, an experience iscriminatin. This inclues grups that have been marginalize scially, culturally an ecnmically; fr example, injecting rug users (IDUs), sex wrkers an men wh have sex with men (MSM). Peple living with HIV/AIDS (PLWHA) r thse affecte by it will nt seek cunseling, testing, treatment an supprt if this means facing stigma, iscriminatin, an lack f cnfientiality r ther negative cnsequences. Discriminatry measures an ther cercive actins rive away the peple mst in nee f services. When human rights are prtecte, civil sciety rganizatins wrking n HIV/AIDS are able t respn t the panemic mre effectively, fewer peple becme infecte, an PLWHA an their cmmunities can better cpe with the isease. Human rights encmpass civil, plitical, ecnmic, scial Human Rights are universal legal guarantees prtecting iniviuals an grups against actins that interfere with funamental freems an human ignity. Sme f the mst imprtant characteristics f human rights are that they are: guarantee by internatinal stanars; legally prtecte; fcus n the ignity f the human being; blige states an state actrs; cannt be waive r taken away; are interepenent an interrelate; an are universal. 1 an cultural rights. These are fun in internatinal law, thrugh treaties an eclaratins, such as the Universal Declaratin f Human Rights. In aitin, there are sme ther tls which cntain useful stanars such as the Internatinal Guielines n HIV/AIDS an Human Rights an the Declaratin f Cmmitment n HIV/AIDS, apte at the UN General Assembly Special Sessin n HIV/AIDS (2001). We unerstan human rights an HIV/AIDS t wrk tgether in three separate, but relate ways. These are: Accuntability: Human rights prvie a system fr hling gvernments accuntable fr their actins. 1 HIV/AIDS & Human Rights in a Nutshell

5 Avcacy: Gvernments are respnsible fr what they, nt, an shul fr their ppulatins. This enables activists t engage in a wie range f avcacy actins targete twars securing human rights enjyment an prtectin fr peple living with an affecte by HIV/AIDS an all ther grups vulnerable t HIV infectin. Appraches t Prgramming: Human rights-base appraches t prgramming aim t integrate human rights principles such as nn-iscriminatin, equality an participatin, incluing the greater participatin f PLWHA, int the respnse at lcal, natinal an internatinal levels. This publicatin explains hw HIV/AIDS an human rights are relate an is ivie int three main sectins: Accuntability, Avcacy an Appraches t Prgramming. Each sectin efines the issue an prvies sme examples. A furth Key Resurces sectin prvies a shrt explanatin an an electrnic link (where available) t useful cuments. HIV/AIDS an Human Rights in a Nutshell is intene t prvie a quick an useful guie fr actin, as well as an inspiratinal framewrk t carry HIV/AIDS an human rights actins frwar. HIV/AIDS & Human Rights in a Nutshell 2

6 H IV/AIDS an Human Rights: A c c u n t a b i l i t y Gvernments, by agreeing t the varius internatinal human rights treaties an cnventins, are accuntable fr prmting an prtecting the human rights f their inhabitants. They can s by apting apprpriate legal plicies, natinal laws, institutins an prcesses. Human rights law efines the relatinship between iniviuals an gvernments; it cncerns a gvernment's bligatins t iniviuals an ppulatins. Every persn can make a claim arising as a matter f his r her rights an entitlements, nt as a result f privilege r special favr. The frmally recgnize human rights are fun in the Universal Declaratin f Human Rights (1948) an the tw key internatinal treaties: the Internatinal Cvenant n Ecnmic, Scial an Cultural Rights (1966), an the Internatinal Cvenant n Civil an Plitical Rights (1966). Other imprtant treaties further escribe an elabrate human rights in particular cntexts: Internatinal Cnventin n the Eliminatin f All Frms f Racial Discriminatin (1965), the Internatinal Cnventin n the Eliminatin f All Frms f Discriminatin against Wmen (1979), an the The 1948 Universal Declaratin f Human Rights (UDHR) is nt a legally bining cument. Hwever, it is the funatin fr the mern human rights mvement. All the natins f the wrl have enrse the UDHR an it expresses their cmmn recgnitin abut what rights are, an why they shul exist fr all peple everywhere. Cnventin n the Rights f the Chil (1989) (see Key Resurces). Nne f these treaties expressly ientifies HIV/AIDS, but all human rights elabrate in these treaties can prmte accuntability in HIV/AIDS relate issues. Human rights relevant t HIV/AIDS ientifie in these treaties, an elabrate by ther cuments inclue (but are nt limite t) the right t nn-iscriminatin an equality, t health, t liberty an security f the persn, t privacy, t seek, receive an impart infrmatin, t marry an fun a family, t wrk, an the right t freem f mvement, assciatin, an expressin. All these rights have particular imprtance in the cntext f HIV/AIDS an wul imply that n persn can be iscriminate against n the basis f his/her HIV status. 3 HIV/AIDS & Human Rights in a Nutshell

7 Human rights are enumerate in internatinal UN human rights treaties. 1 Treaties are cntracts between gvernments. When gvernments sign an ratify them, they becme bining, that is, they require gvernments t uphl an implement the rights cntaine in the treaties. Gvernments are als require t reprt t the UN treaty mnitring bies every few years, n the prgress mae, an bstacles encuntere, in fulfilling their bligatins. Treaty mnitring bies review gvernment reprts n their prgress in implementing the treaties an issue cncluing bservatins t them. In aitin, by issuing General Cmments an/r Recmmenatins they help gvernments unerstan their bligatins uner the treaties. Cncluing Observatins an General Cmments nt frce gvernments t act; rather they give guiance t gvernments. Declaratins an Reslutins issue frm ifferent UN bies are nt bining but they shw hw the internatinal cmmunity is thinking abut these issues. Further, they establish stanars fr each gvernment t measure its plicies an actins against. An example inclues the Reslutin passe in April 2004 by the Cmmissin n Human Rights recgnizing that access t HIV treatment is funamental t prgressively achieving the right t health an calls n gvernments an internatinal bies t take specific steps t enable such access. An imprtant set f eclaratins cmes frm a series f UN Cnferences - especially the 2001 UN General Assembly Special Sessin n HIV/AIDS that le t the aptin f the Declaratin f Cmmitment. The Internatinal Guielines n HIV/AIDS an Human Rights ientify actins that gvernments shul take t respn t HIV/AIDS base n their agree t bligatins arising frm internatinal human rights law. The Guielines were evelpe thrugh a cnsultative an participatry prcess invlving gvernment representatives, human rights avcates an PLWHA. Althugh the Guielines nt have the legal status f a treaty, they have legitimacy an gvernments are urge t apt them. Fr example, the right t health inclues nn-iscriminatry access t quality health care services by all, irrespective f gener, age, race, prfessin an sexual rientatin. Gvernments' bligatins twars human rights are unerst in three ways: bligatins t respect rights, prtect rights an fulfill rights. T respect a right means that a gvernment cannt vilate human rights irectly in laws, pli- HIV/AIDS & Human Rights in a Nutshell 4

8 cies, prgrams r practices. Fr example, gvernments cannt arbitrarily eny HIV infecte prisners the same stanar f meical care that is ffere t ther prisners. T prtect a right means that gvernments must prevent vilatins by thers an prvie affrable an accessible reress. Fr example, states must ensure that private emplyers nt iscriminate against HIV infecte emplyees, an prvie avenues fr reress if they are fire because f their HIV status. T fulfill a right means that gvernments must take measures that mve twars the realizatin f rights. These measures shul be legislative, aministrative, bugetary, an cul inclue sme ther types f actin. Fr example, a state may apt a plicy t prvie antiretrviral (ARV) treatment t all iniviuals in nee, yet ue t resurce cnstraints, be able t cver nly a small percentage f the ppulatin. The gvernment shul take measures t prgressively exten cverage i.e., sliciting supprt frm nrs an/r reassessing buget pririties. Gvernments cannt ignre their human rights bligatins. When a gvernment ratifies a treaty, it agrees t ensure that its natinal-level laws, plicies, an actins are cmpatible with the rights efine in that treaty. Gvernments cannt make the excuse that they nt have sufficient resurces t fulfill human rights. They must take sme steps twars the realizatin f the rights thrugh measures such as enacting laws, taking aministrative an bugetary actins, as alreay mentine. This is knwn as prgressive realizatin, an gvernments must mve quickly an effectively twar the realizatin f all human rights. E x a m p l e Inia The Lawyers Cllective, HIV/AIDS Unit, Inia, respns specifically t the legal nees f peple living with HIV/AIDS (PLWHA). It has file a series f petitins befre the curts in Inia n behalf f PLWHA whse rights have been vilate. Fr example, the Lawyer's Cllective file a writ petitin with the Bmbay High Curt n behalf f a persn wh was remve frm emplyment frm a public sectr crpratin because f his HIV status. The High Curt agree with the petitiner an irecte that the iniviual be reinstate an be pai cmpensatin fr the peri f his nn-emplyment with the crpratin. 3 5 HIV/AIDS & Human Rights in a Nutshell

9 E x a m p l e Venezuela In 1999, the Supreme Curt f Venezuela establishe that the Ministry f Health was in vilatin f the right t health, right t life an the right t have access t scientific avances as guarantee by the Venezuelan cnstitutin. The Curt rere the prvisin f antiretrviral meicatins, treatments fr pprtunistic infectins an iagnstic testing - all free f charge - t all PLWHA in Venezuela. 4 Philippines The Natinal AIDS Preventin an Cntrl Act f the Philippines was a result f an extensive campaign by a calitin f Philippine NGOs an human rights lawyers ver several years that hel the State accuntable fr recgnizing the rights f vulnerable grups. This ultimately le t the passage f the Act. Amng ther things the Act requires written infrme cnsent fr HIV testing an prhibits cmpulsry HIV testing. It als guarantees the right t cnfientiality, prhibits iscriminatin n the basis f actual, perceive r suspecte HIV status in emplyment, schls, travel, public service, creit an insurance, health care an burial services. 5 At the internatinal level, treaty mnitring cmmittees, help t hl gvernments accuntable fr nn-cmpliance r failure t implement their human rights bligatins. Gvernments submit reprts t the cmmittees, escribing hw they are uphling the rights in the treaty.a cmmittee thereafter issues a cncluing bservatin - that is, E x a m p l e Glbal (Cmmittee n the Rights f the Chil) In 1996, the Cmmittee n the Rights f the Chil issue a cncluing bservatin t the Gvernment f Argentina, regaring the health f alescents, that it nte[] with cncern the grwing number f cases f HIV/AIDS amng the yuth, ntwithstaning the existing Natinal Plan f Actin fr HIV/AIDS, an recmmene that it shul review an reactivate its prgrams against HIV/AIDS an increase its effrts t prmte alescent health plicies (an seek) technical cperatin frm, amng thers, UNFPA, UNICEF, WHO an UNAIDS. 6 HIV/AIDS & Human Rights in a Nutshell 6

10 what it thinks f the gvernment's actins, an suggests t the gvernment what aitinal measures it shul take. Gvernmental accuntability at the internatinal level is als create thrugh Treaty By General Cmments r Recmmenatins.The General Cmment n the Right t the Highest Attainable Stanar f Health, fr example, spells ut hw health care services, incluing thse fr HIV/AIDS, nee t be accessible t all, incluing the mst marginalize an vulnerable ppulatins (see Key Resurces). Als vital t the accuntability f gvernments in relatin t HIV/AIDS, have been the series f internatinal cnferences hel uner the auspices f the Unite Natins. These cnferences have, t a great egree, helpe t efine the cntent f many f the rights necessary fr preventin, care, treatment, an mitigatin f the impact f HIV/AIDS. Out f each f these cnference prcesses has cme a Declaratin an Prgram f Actin, technically nn-bining, but nevertheless inicating the gvernments' plitical cmmitment. These cmmitments have helpe create new appraches fr cnsiering the extent f gvernment accuntability fr HIV/AIDS. Of special interest is the Declaratin f Cmmitment n HIV/AIDS apte at the UN General Assembly Special Sessin n HIV/AIDS in 2001 (see Key Resurces). The Declaratin f Cmmitment (DC) sets, amng ther things, time bun targets fr preventin an access t essential meicines, as well as fr eliminating iscriminatin. It als hls gvernments accuntable fr their specific cmmitments, particularly n the greater participatin f peple living with HIV/AIDS (PLWHA) an attentin t wmen an ther vulnerable grups. It can be use as a benchmark fr assessing what gvernments have ne (r nt ne) t prmte an prtect human rights in the cntext f HIV/AIDS. E x a m p l e Caribbean Cmmunity The CARICOM (Caribbean Cmmunity) gvernments incrprate sme f the DC's targets int the Caribbean Reginal Strategic Framewrk against HIV/AIDS sn after the UNGASS n HIV/AIDS. This emnstrates CARICOM's recgnitin f its accuntability fr implementing the DC. Further, the Caucus f Ministers fr Health manate the CARICOM secretariat t engage in negtiatins with pharmaceutical cmpanies fr a single reginal price fr antiretrviral (ARV) rugs. Reginal negtiatins le t the signing f an agreement in 2002 fr ARV meicatins. 7 7 HIV/AIDS & Human Rights in a Nutshell

11 E x a m p l e Mexic MEXSIDA, a calitin f HIV/AIDS NGOs in Mexic, aske the Gvernment t prvie funing fr a special ffice t be establishe within MEXSIDA. The ffice wul mnitr the actins f the Natinal AIDS Prgram in implementing the cmmitments cntaine in the DC an wul als prmte the Declaratin thrughut Mexic. This they pinte ut was necessary fr the Gvernment t be accuntable t its peple fr implementing the DC in a transparent manner where an inepenent by cul measure the gvernment's prgress. The gvernment accepte the cncept. 8 The Internatinal Guielines n HIV/AIDS an Human Rights is anther imprtant surce fr helping t hl gvernments accuntable. The 12 guielines take existing human rights nrms an ml them int a series f practical, cncrete measures that states can apt t respn t the HIV/AIDS epiemic. Generally, the guielines attempt t translate internatinal human rights stanars int applicatin at the natinal level by: Prmting refrm f laws an legal supprt services (fcusing n wmen, chilren, an vulnerable grups). Prmting gvernmental respnsibility fr multi-sectral crinatin. Supprting invlvement an participatin f private an cmmunity sectrs in the respnse. E x a m p l e Suth Africa The Suth African Human Rights Cmmissin was the first natinal human rights by in the wrl t publicly enrse an apt the Internatinal Guielines n HIV/AIDS an Human Rights. Further, the Cmmissin aresse HIV/AIDS as a human rights issue at its first natinal cnference. One f the utcmes f the cnference was a reslutin stating that iscriminatin against PLWHA vilate the Suth African cnstitutin. This was mae pssible ue t the effrts f the AIDS Law Prject/AIDS Legal Netwrk, Suth Africa that hel the gvernment accuntable fr uphling its plitical cmmitment in implementing the Guielines. 9 HIV/AIDS & Human Rights in a Nutshell 8

12 H IV/AIDS an Human Rights: Avcacy The relatinship between HIV/AIDS an human rights highlights the ways in which peple vulnerable t human rights vilatins an neglect are mre vulnerable t HIV/AIDS infectin; an if infecte, nt have access t apprpriate quality care an treatment. Vulnerable grups inclue wmen, chilren, refugees, migrants, men wh have sex with men, injecting rug users, sex wrkers an all ther marginalize ppulatins. T raise awareness abut the links between HIV/AIDS an human rights, an t change existing practices, HIV/AIDS an human rights activists turn t avcacy. This is perhaps the mst cmmn use an unerstaning f human rights in the cntext f HIV/AIDS. Avcacy ften epens n researching, cumenting an then enuncing abuses thrugh campaigns an publishe reprts. Human rights grups an HIV/AIDS activists cument human rights abuses relate t HIV/AIDS an call attentin t them. They als wrk t prvie a braer unerstaning f what human rights mean. In ther wrs, avcacy campaigns can take an acknwlege human right, such as the right t the highest attainable stanar f health an buil n its accepte unerstaning t achieve, fr instance, increase access t HIV treatment an ther essential meicatins. Avcacy can happen at the internatinal level, befre the UN treaty mnitring cmmittees. It can als exten acrss the entire range f cuments an reslutins relating t the UN (as iscusse in the Accuntability sectin). Fr example, activists can ask gvernments fr infrmatin n hw they are meeting their targets uner the DC, r hw they are implementing the Internatinal Guielines n HIV/AIDS an Human Rights in their prgrams an plicies. Avcacy is a prcess that is aime at mbilizing cmmunity actin n an issue f cncern t change attitues, actins, plicies an laws fr the betterment f peple affecte by that issue. ICASO has evelpe a framewrk fr avcacy campaigns that invlves eight steps: Select the issue r prblem yu want t aress Analyze an research the issue r prblem Develp specific bjectives fr yur avcacy campaign Ientify yur targets Ientify yur resurces Ientify yur allies Create an actin plan Implement, mnitr an evaluate. 9 HIV/AIDS & Human Rights in a Nutshell

13 E x a m p l e Peru Via Libre, Peru has ae the Declaratin f Cmmitment in all its backgrun cumentatin fr its avcacy campaigns fr better access t treatment an meical care an t ensure the critical imprtance f a multi sectral respnse t the AIDS panemic. The rganizatin als presente a cument t the Ministry f Health highlighting the nee fr multi sectral participatin in the preparatin f a prpsal t the Glbal Fun. As a result, NGOs were inclue in the Cuntry Crinating Mechanism an jintly, with the Gvernment, prepare an submitte a prpsal t the Glbal Fun. 10 Namibia AIDS Law Unit (Legal Assistance Center), Namibia has use the Declaratin t make an argument t the gvernment fr access t treatment in Namibia. The Unit has als use the Declaratin in its infrmatin an strategy meetings n this tpic with ther AIDS service rganizatins an peple living with HIV/AIDS (PLWHA). 11 Venezuela Acción Ciuaana Cntra el SIDA (ACCSI), Venezuela cmpile a list f the cmmitments in the DC an sent this alng with a letter t the Ministry f Health (MH) hling the Gvernment respnsible t evelp a wrk plan t implement the cmmitments in line with its bligatin. Recgnizing that implementatin f the DC is a gvernment-le prcess with active civil sciety participatin, ACCSI ffere t assist the MH t esign strategies t meet the targets cntaine in the DC. As a result, the MH invite the NGO sectr t submit prjects that wul cmplement the existing natinal strategic plan n HIV/AIDS an enable Venezuela t meet at least sme f the cmmitments. 12 Avcacy can ccur at the natinal level thrugh cncrete cases, fr example, by pushing the natinal curts t etermine if uner the cuntry's cnstitutin, there is a right t receive life saving treatment. Avcacy can als be a reminer, fr wealthier cuntries t fulfill their internatin- HIV/AIDS & Human Rights in a Nutshell 10

14 E x a m p l e Israel A cmprehensive avcacy campaign le by the cmmunity sectr eventually cause ne f Israel's fur private sectr health insurance prviers t cver ARV meicatins use by peple living with HIV/AIDS (PLWHA). Part f the avcacy strategy inclue a lawsuit by 10 PLWHA against the gvernment an the health insurance prviers, alleging that they ha faile in their uty t take care f peple's health. The curt issue a temprary rer requiring health insurance prviers t make ARVs available. Tw weeks later the gvernment agree t inclue the seven new rugs in the list f rugs t be subsiize. In 1998, the gvernment ecie t categrize AIDS as a severe isease which meant that all new HIV/AIDS treatment apprve by the gvernment wul be available free f charge. This is an example f hw avcacy can lea t greater accuntability. 13 Canaa The Canaian Gvernment remve a much criticize avantage fr bran name rug firms in a majr change t Bill C-9 t get HIV/AIDS meicatins t pr natins. In the amenment, the gvernment backe away frm the right f refusal prvisin that wul have given the mre expensive, patent rug manufacturers the first right t supply AIDS rugs t evelping cuntries, thereby making it ifficult fr the manufacturers f less expensive, generic rugs t be the suppliers. This actin was ue t a systematic avcacy campaign, spearheae by a number f grups an iniviuals, incluing Stephen Lewis an members f the Glbal Treatment Access Grup (GTAG). 14 al respnsibilities an cmmitments. Avcacy effrts have relie n actin at the cmmunity level, where they can raw n grassrts scial mvements, an have strng public eucatin cmpnents. Cmmunity-base effrts that raise awareness abut the cnnectins between HIV/AIDS an human rights irectly with stakehlers (iniviuals an grups wh wn the human rights, as well as thse with bligatins t respect, prtect, an fulfill thse rights) thrugh wrkshps, publicatins, eucatinal prgrams an ther srts f events can be effective. 11 HIV/AIDS & Human Rights in a Nutshell

15 E x a m p l e Glbal (ICASO) ICASO has evelpe an easy-t-rea versin f the Internatinal Guielines n HIV/AIDS an Human Rights fr NGOs an CBOs. In aitin, ICASO has evelpe an Avcate's Guie cnsisting f a series f articles n hw t use the Internatinal Guielines t avcacy wrk in the area f HIV/AIDS an human rights. This cument has been wiely use in wrkshps an ther frums t buil the capacity f NGOs an CBOs t avcacy. It cntains success stries frm the cmmunity sectr which can help mtivate NGOs an CBOs t cntinue t avcate an pressure their gvernments t fulfill their bligatins. Zambia Zambia AIDS Law Research an Avcacy Netwrk (ZARAN) believe that successful HIV/AIDS interventins are thse that prtect an prmte the rights f peple living with HIV/AIDS (PLWHA). ZARAN has been invlve in a number f avcacy an litigatin activities. In 2000, the Netwrk f Zambian Peple Living with AIDS (NZP+) establishe a Human Rights Referral Center with the bjective f, amng ther things, eucating PLWHA n HIV/AIDS an Human Rights an eucating the public abut the human rights f PLWHA. The center refers cases f HIV/AIDS human rights abuses t apprpriate referral partners wh ffer free legal reress an/r scial services. ZARAN is ne f the center's referral partners that is invlve in avcating fr PLWHA whse rights have been abuse r vilate by emplyers r prspective emplyers. 15 Reginal (Suthern African AIDS Trust) The Suthern African AIDS Trust (SAT) base in Harare, Zimbabwe prmtes an financially assists cmmunity-base preventin, an supprts respnses t the HIV/AIDS panemic in 11 suthern African cuntries in cnjunctin with partner rganizatins. Early iscussins with SAT partners reveale that they ha ifficulty in respning t HIV/AIDS-relate human rights abuses in their wrk. Several partners requeste assistance t buil their skills an capacity in this area. In respnse, SAT evelpe a series f wrkshps that emnstrate the linkage between HIV, gener, human rights an chil rights issues in practical terms. The wrkshps ientify the laws, bth natinal an custmary, that can be applie t enhance the lives f PLWHA thrugh avcacy campaigns fr legal refrms. 16 Meia strategies an campaigns cmplement an are integral t all aspects f human rights avcacy wrk. HIV/AIDS & Human Rights in a Nutshell 12

16 E x a m p l e Ukraine Members f The All-Ukrainian Netwrk f PLWHA have use the meia fr their human rights avcacy wrk. They were the first t speak penly n televisin abut their HIV status, thus giving a human angle t the HIV/AIDS prblem in rer t change steretypes. The All-Ukrainian Netwrk successfully prmte participatin f an HIV psitive wman in a TV prgram, Withut Tabs, n a majr Ukrainian TV channel. Several Netwrk members participate in the prgram, That's My Opinin. Thrugh such avcacy campaigns, the Netwrk is attempting t eucate the general ppulatin an t remve the stigma an steretypes that PLWHA ften face HIV/AIDS & Human Rights in a Nutshell

17 H IV/AIDS an Human Rights: Appraches t Prgramming Human rights-base appraches t HIV/AIDS prgramming help realize human rights themselves as well as imprve access t HIV/AIDS health care infrmatin, services an treatment. Plicies, prgrams an respnses are likely t be effective, sustainable, inclusive an mre meaningful fr peple living with an affecte by HIV/AIDS when they are base n the nrmative frame f internatinal human rights. A rights-base apprach implies being guie by the nees an rights f the cmmunity while simultaneusly empwering thse same cmmunities t braen their participatin an strengthen their relatinships with law, plicy makers an partner rganizatins. 18 There is n single efinitin f a human rights-base apprach t HIV/AIDS prgramming. Hwever, any apprach must inclue the full participatin f peple living with HIV/AIDS an vulnerable grups; an aress factrs such as gener an pwer relatins, religin, sexual rientatin, an race in their effrts. These factrs, iniviually r in cmbinatin, influence the extent t which iniviuals an cmmunities are prtecte frm iscriminatin, inequality, an exclusin, an whether they are able t make an carry-ut free an infrme ecisins abut their lives, incluing their ability t access services. Human rights-base appraches t HIV/AIDS integrate mechanisms fr full participatin an ecisin-making f affecte cmmunities, in rer t prmte the autnmy an empwerment f iniviuals living with an affecte by HIV/AIDS. Human rights can be use t supprt mre effective HIV/AIDS interventins. Central t a human rights-base apprach t HIV/AIDS are the principles f nn-iscriminatin, equality an participatin. Each is relevant t the strategies an appraches t reucing the risk, vulnerability an impact f HIV/AIDS n iniviuals an ppulatins. The first-han experience an knwlege f peple living with HIV/AIDS (PLWHA) prvies the expertise necessary t reuce stigma an iscriminatin in the esign an implementatin, as well as in the versight, f HIV/AIDS prgrams. HIV/AIDS & Human Rights in a Nutshell 14

18 E x a m p l e Glbal (The Prgram n Internatinal Health an Human Rights at the Françis-Xavier Bagnu Center fr Health an Human Rights) The Prgram n Internatinal Health an Human Rights unertakes research in rer t better unerstan an apply human rights-base appraches t HIV/AIDS. Recently, HIV testing has surface as a health an human rights cncern, particularly in the cntext f scaling up the respnse. The Prgram is respning t ensure a cmbine HIV/AIDS an human rights apprach which seeks t evelp an implement plicies, strategies an actins aime at achieving the highest pssible health benefits while uphling the internatinal legal bligatin t respect, prtect, an fulfill human rights. 19 Human rights-base appraches t prgramming are key t the successful scaling up f the respnse t HIV/AIDS. Fr example, the existence f the Glbal Fun t fight against AIDS, Tuberculsis an Malaria, the annuncement f WHO's initiative t prvie ARVs fr 3 millin peple by the year 2005 (3 by 5 Initiative), an the Unite States Gvernment's annuncement t substantially increase its glbal funing fr HIV/AIDS ver the next five years are all welcme evelpments in s far as mre resurces are ptentially available. Hwever, as welcme as accessible antiretrviral meicatin may be fr a cuntry, if the plicy fr ARV prvisin es nt prevent iscriminatin in terms f access, peple wh might benefit may nt cme frwar. E x a m p l e Glbal (UNAIDS) The Unite Natins Jint Prgram n HIV/AIDS (UNAIDS) has ha a lng-term cmmitment t evelping human rights-base appraches in respning t HIV/AIDS. It recgnizes that a rights-base apprach can help mitigate the impact f HIV/AIDS as it allws fr the creatin f a supprtive plicy, legal, scial an cultural envirnment in which peple infecte r affecte by HIV/AIDS are able t participate in, cntribute t an enjy ecnmic, scial, cultural an plitical evelpment espite their HIV status HIV/AIDS & Human Rights in a Nutshell

19 E x a m p l e Glbal (CARE UK) In its prgramming at cuntry level, CARE UK explicitly uses a rights-base apprach, which it efines as prgrams guie by a human rights fcus n respecting human ignity, achieving fairness in pprtunities an equal treatment fr all an strengthening the ability f lcal cmmunities t access resurces an services. CARE prjects aress HIV/AIDS in mre than tw zen high prevalence cuntries, where they wrk with lcal partners t reuce the sprea f HIV/AIDS, prvie care an supprt fr thse affecte, an fin lasting slutins t wier scial an ecnmic prblems that exacerbate the HIV/AIDS crisis. 21 Inia A small interventin prgram fr sex wrkers initiate by a gvernment institutin (All Inia Institute f Hygiene an Public Health) an NGOs in Snagachi (Calcutta, Inia) grew int a pwerful human rights-base prgram. The Snagachi STD/HIV Interventin Prgram (SHIP) was esigne t prevent HIV an STDs amng sex wrkers thrugh clinical services, cnm prmtin an IEC (Infrmatin, Eucatin an Cmmunicatin), an supprt by a team f peer eucatrs. SHIP early n realize that sex wrkers were themselves the best agents f change t fight AIDS by: recgnizing human ignity, nt allwing their ccupatin as sex wrkers t exclue them an equally allwing them t participate in all interventins, incluing ecisin making. 22 HIV/AIDS & Human Rights in a Nutshell 16

20 K ey Resurces an Dcuments t G Further Sme f the cuments liste here can be fun at the websites f ICASO (www.icas.rg) r Françis-Xavier Bagnu Center fr Health an Human Rights (www.hsph.harvar.eu/fxbcenter) In aitin, these cuments can be fun in the many fficial UN repsitry libraries arun the wrl. A CCOUNTABILITY:INTERNATIONAL H UMAN R IGHTS S OURCES Treaties Universal Declaratin f Human Rights, (1948). Internatinal Cvenant n Ecnmic, Scial an Cultural Rights, (1966, entere int frce Jan. 3, 1976). Internatinal Cvenant n Civil an Plitical Rights, (1966, entere int frce Mar. 23, 1976). Cnventin n the Eliminatin f All Frms f Racial Discriminatin, (1965, entere int frce Jan. 4, 1969). Cnventin n the Eliminatin f All Frms f Discriminatin against Wmen, (1979, entere int frce Sept. 3, 1981). Cnventin n the Rights f the Chil, (1989, entere int frce Sept. 2, 1990). General Cmments an Recmmenatins Cmmittee n Ecnmic, Scial, an Cultural Rights: General Cmment 14, The Right t the Highest Attainable Stanar f Health (Twenty-secn sessin, 2000) Cmmittee n the Eliminatin f Discriminatin against Wmen: General Recmmenatin 24, Wmen an Health (Twentieth sessin, 1999). Cmmittee n the Rights f the Chil, General Cmment N. 3 HIV/AIDS an the Right f the Chil, CRC/GC/2003/3 (2003). 17 HIV/AIDS & Human Rights in a Nutshell

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