We can end AIDS by ending inequality, we just have to be brave

By Guest blogger

This is guest post by Fionnuala Murphy, a campaigner and advocate for global health and human rights. In her recent role with the Alliance, Fionnuala supported Alliance Linking Organisations that are tackling homophobic legislation.

“Why HIV?” people often ask me, when I tell them that I’m a campaigner with the International HIV/AIDS Alliance. For me the answer’s simple. In my lifetime, AIDS has killed almost 22 million people, and ending it is an imperative in itself. 

Beyond these frightening figures though, there’s something incredibly inspiring about working on HIV. AIDS has a disproportionate impact on the most marginalised people, so if we want to defeat it, we’re compelled to defeat inequality too. I started campaigning a decade ago, when politicians and drug companies still argued that treating HIV in the developing world was impossible. Just 400,000 people in poor countries were on antiretroviral treatment and activists spoke of a global apartheid, that determined who lived and who died. At the end of last year, almost 13 million people were receiving HIV drugs, and the numbers are growing every day. This change has happened because governments, international institutions and we, campaigners, were willing to be brave. We were determined to fight a mindset that was seen as unchangeable. We were bent on doing something even when told that it could not be done.

Today we face a similar challenge, and a new imperative for governments to get braver.  This imperative lies in addressing HIV among marginalised groups, those who are criminalised, stigmatised and feared. Men who have sex with men (MSM) for example are nineteen times more likely to contract HIV than other men, and transgender people are up to 49 times more likely to be HIV positive than the general population. Despite these shocking statistics, more than 70 countries still criminalise LGBT people, with punishments including life imprisonment, flogging and the death penalty. Criminalisation makes it difficult for MSM and trans people to get accurate information about HIV, and means that if they try to access HIV services, they risk being stigmatised, or even reported to the police.

© Nell Freeman for the Alliance

In some countries, the situation facing LGBT people is actually getting worse. This year, while working at the Alliance, I’ve supported partner organisations in Uganda to face down a tough new law banning all public and private expressions of homosexuality. I’ve also worked with Alliance Linking Organisation the Humsafar Trust in India to garner international support for its No to Section 377 campaign. Last December the Indian Supreme Court overturned an earlier High Court ruling that section 377 of the Indian Penal Code, which criminalises “unnatural sex”, did not apply to same sex acts among consenting adults. These developments and other anti gay laws seriously undermine equality and human rights, but they also stand in the way of an effective HIV response.  
People who use drugs are also hard hit by unjust criminal laws. In China and Vietnam, they can be locked up for years in compulsory detox centres, where they face beatings and other human rights violations. In Russia, where HIV infections are soaring, methadone is illegal and in other countries, needle exchange and other harm reduction initiatives face major funding shortages and frequent police crackdowns. 

The next few years are critical to ensuring increased efforts to tackle AIDS and inequality. In 2016 the UN will host a major international summit on drugs, creating a once in a decade opportunity to rethink the war on drugs and to improve access to HIV services for people who use them. 

Before then, world governments will agree the post 2015 development framework, a set of new global priorities to replace the Millennium Development Goals. MDG 6 secured major progress in reducing HIV infections and preventing AIDS related deaths, but if we want to end AIDS, we need to go further. The Alliance has been calling for the post 2015 framework to include a commitment to removing the legal barriers which prevent those most affected by HIV from accessing services. Language supporting access for LGBT people, people who use drugs and sex workers was included in early proposals developed, but has since been removed. We are fighting to have it put back in.

Some tell us to give up – that it will be impossible to persuade governments that people from key populations have human rights, and moreover can play a vital role in ending the global AIDS pandemic. But since I began campaigning on HIV, there have been many impossibles.  Just as we’ve transformed HIV treatment, we can be transformative in ensuring access for people most affected by HIV. Once again, governments simply need to be courageous, to look beyond prejudice and political opportunism and to take the side of science and human rights.  It’s our job to persuade them. We can end AIDS by ending inequality, we just have to be brave.