Four key national commitments to effective action on AIDS
24 May 2006
Universal access in specific countries will not be achieved without national targets that prioritise the most vulnerable and highly affected groups and seek to protect their rights, according to the International HIV/AIDS Alliance.
Speaking at a meeting on universal access at the United Kingdom Parliament, Alliance Policy Advisor Susie McLean urged the British Government to support the inclusion of four new indicators in the list proposed by the UN Secretary General in his note ‘Scaling up HIV prevention, treatment, care and support’.
“The national targets for moving towards universal access are a good starting point but they need to be strengthened with commitments that reflect the importance of meeting the needs of vulnerable and highly affected communities,” said McLean.
Access to prevention for most at risk populations
The Alliance’s first call is for the recommended national indicator – the percentage of populations most at risk reached by prevention programmes – to be made a core indicator.
“The success of our HIV prevention efforts rests on targeting those populations most at risk of HIV,” said Alliance Policy Adviser Joseph O’Reilly.
“HIV risk isn’t equally shared. Some populations are more vulnerable to HIV than others so it is good public health practice to ensure that our investments in prevention are targeted. One of the ways in which the universal access process can promote good practice and ensure that prevention spending goes where it is most necessary and where it will have the biggest impact is by adopting a national indicator that reflects the need for targeted prevention efforts.
“In many developing countries populations that are key to the dynamics of HIV transmission are at the margins of society and have poor access to health and social services. As a result, extra priority needs to be given to ensuring that these groups have access to appropriate services.
“A national target which requires governments to ensure that their populations most at risk have access to prevention services will play an important part in focusing the minds of national decision makers and ultimately represent a sound investment in preventing HIV.”
Involving people living with HIV/AIDS
The Alliance’s second call is for the creation of a new core national indicator on the involvement of people living with HIV in national and local decision making on HIV and AIDS.
“If the rhetoric about the importance of involving people living with HIV in responding to the epidemic is ever going to mean anything then surely that moment has come,” said Anandi Yuvaraj of the India AIDS Alliance and until recently a member of the Communities Delegation to the Global Fund.
“The involvement of positive people, and the communities from which they come, in every stage of the AIDS response is critical and it will be vital if we are going to secure universal access to HIV prevention and treatment.
“National governments have a mixed record on the quality and success of their efforts to work in partnership with positive people. The international community has an obligation to do everything it can to promote the meaningful involvement of positive people in responding to the HIV epidemic at every level. One way that can be achieved is by agreeing on an indicator aimed at securing positive people’s involvement in decision making and service delivery for universal access.”
Linking increased voluntary HIV testing with stigma reduction
The Alliance’s third call is for the creation of a new core national indicator aimed at increasing access to voluntary HIV testing and counseling services together with specific interventions to tackle stigma and discrimination.
“The move to increase HIV testing hasn’t paid sufficient attention to the human rights violations that occur to people, particularly poor women and members of sexual minorities, as a result of an HIV positive diagnosis,” said Javier Hourcade Bellocq of the Alliance.
“Good HIV testing services can play a vital part in reducing stigma and discrimination and protecting the right and interests of people who test positive, but these aspects of testing must be considered essential components of testing programmes.
“A national target that combines increased access to HIV testing with efforts to tackle HIV stigma will help bridge the gap between the public health benefits of increased testing and the human rights concerns that many people have about testing without adequate protection against discrimination.”
Anti-discrimination laws
The Alliance’s fourth call is for the creation of a core national indicator on the development and implementation of anti-discrimination laws to protect the human rights of people living with and affected by HIV.
“Human rights violations fuel the HIV pandemic and follow infection. Protecting people who are vulnerable to or living with HIV from discrimination must be an essential component of national AIDS plans,” said Joseph O’Reilly.
Despite commitments in the 2001 Declaration of Commitment to anti-discrimination measures for positive people, half of all the governments in sub-Saharan Africa have yet to adopt legislation specifically outlawing discrimination against people living with HIV. And only one third of countries worldwide have adopted legal measures specifically outlawing discrimination against populations especially vulnerable to HIV.
“As part of our commitment to making universal access a reality we need to revitalise efforts to advance the rights and interests of people living with and affected by HIV and undertake a global drive for comprehensive national anti-discrimination legislation.
“There is little point in securing access to services for affected communities if discrimination impedes the exercise of their rights or puts them at risk of other human rights violations.”
