Human Rights Violations and Remedies in the HIV & AIDS Epidemic

Room XXVII PN
Tuesday 12 April 2004
13.00 – 15.00
1,500 words
Intervention by the High Commissioner

Thank you Mr. Ambassador Rapacki, and let me add my welcome to all of you to today’s event. I would like to express my appreciation to Ambassador Rapacki and to the Permanent Mission of Poland for supporting this event, and for Poland’s leadership in the Commission on the issue of HIV/AIDS and human rights. My appreciation extends to our other co-organizers for this event at UNAIDS and Human Rights Watch.

Distinguished panelists, ladies and gentlemen,
We are here today out of a common concern over the continuing HIV and AIDS epidemic. I have a strong commitment to the role of human rights in supporting efforts to halt and reverse the spread of HIV/AIDS. I would like to briefly share with you some thoughts on how - now more than ever – addressing violations of human rights is key in our fight against HIV and AIDS.

The situation of the HIV and AIDS epidemic today is bleak. The numbing figures are well known and I will defer to our colleagues from UNAIDS to paint the picture in detail. If anything, the unrelenting bad news of HIV and AIDS statistics has rendered trite the catchphrase that ‘HIV/AIDS is one of the greatest human rights and health challenges facing us’. What the figures don't reveal however are the countless individual stories of the many indignities visited upon people whose rights are denied as a result of their HIV status; of women who are ostracized, and of the HIV-positive men and women living in poverty without basic health services or access to adequate prevention, treatment and care services.

Over the past few weeks, the Commission on Human Rights has been discussing the relevance of human rights to the HIV and AIDS epidemic from a number of viewpoints, including health, access to medication, women, children, the MDGs, migrants, criminal justice systems, racial discrimination and so forth. In these, and in the resolutions of the Commission, the General Assembly and other UN bodies, the centrality of human rights in the fight against the epidemic is roundly acknowledged.

But we now need to take an extra step. I have indicated on prior occasions that the human rights movement today is faced with the challenge of more effectively implementing the norms and standards so extensively set out in covenants, conventions and resolutions. HIV/AIDS is no exception. This is not to deny the significant work and achievements in recent years, particularly in areas such as access to medication. We remain, however, faced with situations of widespread and often gross violations of human rights.
At this point where we are challenged to - to borrow an apposite phrase– ‘scale up’ implementation of human rights norms in the context of the epidemic, I think it is worth recalling some of the more challenging aspects of a rights based approach.

Intrinsic –vs.- instrumental

The first point I would like to recall relates to the motivations for adopting a rights based approach to the epidemic. Human rights have both intrinsic and instrumental values. A rights approach may be instrumental in helping us achieve our goals, such as halting the spread of HIV. However, our prime motivation is to respect rights as rights.

I make this seemingly simple point today because arguments are sometimes put forward to the effect that a focus on individual rights in some cases worsens the HIV/AIDS epidemic. Sometimes these arguments place a human rights approach in opposition to a public health approach. There is no need to argue for primacy of one approach over the other. There is no reason to expect that the fight against HIV/AIDS can only be successful if it disregards fundamental rights and freedoms. Any sound policy would strive to halt the spread of the disease without incurring the unacceptable social costs that rights violations inevitably occur.

In what my friend and judicial colleague Michael Kirby has called the ‘AIDS paradox’, it is precisely this focus on individual rights - particularly of those already living with HIV - that will help us overcome the epidemic. Rights may need to be reconciled with other apparently conflicting rights, but human rights remain the framework for the overall policy response to the disease, including significant public health concerns.

Universality

The second point I would like to recall stems from the universality of human rights. Our respect for human rights norms cannot be selective. All are entitled to have their human rights protected. Again, this is a simple - even bland - point. However in the context of HIV and AIDS, it has a peculiarly strong resonance. This is because the spread of the disease is linked very much to situations which cause discomfort, denial and often rejection in many people. I am talking of the spread of HIV through sex, often violent or predatory, sometimes between men, sometimes as a commercial transaction. I am talking of the alarming spread of HIV among injecting drug users, and of infection by what ever means among prisoners or involving children.

These realities cannot prejudice our response to the situation. All individuals have a right
to the highest attainable standard of physical and mental health, including access to prevention, treatment and care. All have a right of access to information to protect themselves. None should be subject to torture, arbitrary detention or execution. And if evidence indicates that individuals are being targeted by reason of their status, governments have an obligation to protect them and, more broadly, to address the situation.

Powershift

My third and final point relates to the importance of human rights in addressing underlying power inequalities. A glaring example of this is that of women and the so-called feminization of the HIV and AIDS epidemic. The most startling statistic is that in sub-Saharan Africa a staggering 76% of people aged 15 to 24 living with HIV are women. Even in regions of the world where transmission has traditionally resulted in male infection, increasing numbers of women are becoming infected. It is difficult to find a clearer illustration of the impact of power relations on the spread of the epidemic. As the Special Rapporteur on Violence Against Women states in her report to this year’s Commission entitled ‘Intersections Of Violence Against Women And HIV/AIDS’:

programmes aimed at the prevention and treatment of HIV/AIDS cannot succeed without challenging the structures of unequal power relations between women and men.

That report sets out in depressing detail the relationship between violence against women and the spread of HIV and AIDS. Addressing the rights of women is now a priority. Indeed, success in this area could turn the tide in the battle against HIV/AIDS. As ever, the basic premise is non-discrimination. Women have equal rights to information, to health care, to property and inheritance and to the equal enjoyment of all internationally protected rights. And they have those rights not as spouses, or mothers, or care-givers, or peace-makers, but as human beings.

Distinguished panelists, ladies and gentlemen,
Conclusion

Before I conclude, let me flag two developments in the year ahead.

This year the international community will look at efforts to achieve the Millennium Development Goals, including Goal 6 which focuses specifically on HIV and AIDS, among other diseases. The MDG initiative has the potential to make enormous strides in realizing the human rights of millions. Human rights provide the only framework – neither time-bound nor quantified - which will support the effective achievement of the MDGs. 2005 is a key opportunity for the human rights aspects of the MDGs to be explicitly acknowledged by the international community. We know that Goal 6 will not be achieved if human rights aspects are ignored, in particular if we are to reach the most marginalized.

2005 is also an important year for the 3 by 5 initiative of the WHO and UNAIDS. Remarkable results have been achieved and the right to health of millions advanced. Much depends on continued access to affordable medicines and the willingness of countries to pursue all means available to them to provide medication to those in need, including by making use of existing flexibilities under international trade agreements. The provision of antiretroviral treatment also relies on the balance between identifying those in need of treatment and respecting individuals’ rights to security of the person and privacy. Rigorous adherence to a policy of voluntary counselling and testing remains our best approach in this situation.

Both 3-by-5 and the MDGs provide important targets for mobilizing resources and action. Respect for human rights will ensure that each initiative will reach those most in need, and will do so without inflicting additional indignities to the most vulnerable.

Finally, I thank you all for attending this event, and encourage you to take part in what I am sure will be a rich discussion. I trust OHCHR can count on your support in the year ahead in working on HIV and AIDS issues and on the human rights challenges that they present.

Thank you.