Friday, July 1, 2011
Y2N Participates at the 2011 United Nations High Level Meeting on HIV/AIDS at the United Nations Headquaters in New York
Prior to the main event, the Y2N had participated at a youth summit which had in attendance progressive youth activists who work on Sexual health and Rights issues and other development issues that relates to HIV. We analyzed part of the promises that had been made so far with regards HIV, looked for way on how we could advocate for more issues to be brought at the fore-front and then device a strategy on how to hold governments accountable to the promises they have made.
Part of what were discussed at the summit was issues we wanted to be seen addressed and specific messages that we ought to be sharing as young activists working on Sexual health and Rights issues and we pointed out that it was important to highlight the issues of Most at Risk populations, like Men who have sex with Men, Sex Workers, Injecting drug users and so on.
Nonetheless at the main event we were excited to hear presentations from the Executive Director of UNFPA (Babatunde Oshotimehin) who highlighted the importance of involving young people in the HIV/AIDS race and recognizing that they are mostly affected by HIV/AIDS, this point was also reiterated by the head of UNAIDS (Michel Sidibe) and the Crown Princess of Norway who have always been a supporter and a front runner when it comes to working with young people in the area of HIV/AIDS, they also each pointed out the importance of reaching out to most at risk populations like Men who have sex with Men.
Would be good to point out that part of the importance of the High Level Meeting is the outcome document that gets negotiated and for a full analysis of the outcome document at the 2011 High Level Meeting on HIV/AIDS please refer to this analysis below from the RESURJ team.
Analysis of the Outcome Document by the RESURJ Alliance
The 2011 High Level Meeting on HIV/AIDS’ Outcome Document was negotiated over a period of 6 weeks, culminating on June 9. The zero draft of the outcome document was strong, capturing the necessary commitments needed to reach universal access to HIV prevention, treatment, care and support for women, adolescents and young people, men who have sex with men, sex workers, and drug users. The draft provided a strong basis for policies that would invest in prevention programs which included comprehensive sexual and reproductive health services, including male and female condoms, and STI prevention and treatment, ending violence against women, as well as comprehensive education on human sexuality and promotion and protection of human rights in the AIDS response, including reproductive rights.
From the start of the negotiations, the EU led by France and the UK, as well as Norway, Canada, Australia, New Zealand, Mexico, and Brazil (MERCOSUR) were strongly advocating for SRHR. However, the Holy See, the Africa Group, the Arab Group (both led by Egypt), Russia, CARICOM, and Iran consistently negotiated to remove human rights and sexual and reproductive rights language, as well as the listing of “men who have sex with men, sex workers, and intravenous drug users”. They inserted dozens of paragraphs into the document on, family values, cultural relativism, abstinence and fidelity, parental responsibility, and eliminating “unethical and unlawful behavior”. The SRH services and rights protections clauses were traded for targets on treatment, funding, and trade-related intellectual property rights (TRIPS). Thailand, MERCOSUR and the Africa Group negotiated primarily against the EU and US on TRIPS flexibilities and funding.
There is a severe imbalance and profound lack of political will for vital actions needed to turn the tide of HIV and AIDS.
There are 4 paragraphs on prevention, and 29 paragraphs on treatment, TRIPS, and funding. So what about the people? There is one very weak paragraph on mentioning populations at high risk of infection in many countries, such as men who have sex with men, injecting drug users, and sex workers. However, it does not talk about the fact that they are criminalized populations and that this is what makes them less likely to access the HIV prevention and treatment services that they need, for fear of violence, stigma, and discrimination. There is also one mention to migrant populations, four to women and girls, four to young people, and twelve to people living with HIV. But this is not a document that is centered on people’s human rights and the need for governments to commit to the political and financial resources necessary to end HIV and AIDS.
Specific targets were all prefaced by the language “work towards”, which weakens the commitment to achieve universal access to HIV prevention significantly (OP62: reduce sexual transmission by 50%, OP63: reduce intravenous transmission by 50%, and OP64: eliminate vertical transmission by 2015). The goal to achieve universal access to antiretroviral treatment was the only target that was agreed on by “accelerating efforts” and has a number of 15 million on treatment by 2015 (OP 66).
On funding, the Declaration committed to “closing the financial gap” through domestic and international funding to reach between $22 and $24 billion per year on AIDS; strongly urged developed countries to meet the .7% of GNP for ODA and for African countries in particular to meet the Abuja commitment of allocating 15% of national budgets to health; committed to scale up new, voluntary and innovative financing mechanisms, and to provide the “highest level of support” for the Global Fund to Fight AIDS, TB and Malaria. (Paras. 13, 14, 15, 17, 18, 86, 87, 88, 92, 93, 94, 95)
On trade related intellectual property rights, or TRIPS, the Declaration recognizes that countries have access to low cost medicines, and for the first time adopts language on generics, to protect public health and foster access to essential medicines. This includes the commitment to eliminate trade related obstacles that limit developing countries’ capacities to supply diagnosis, care, prevention and treatment supplies as well as medicines for other opportunistic infections. In addition, international organizations such as UNIDO, UNCTAD, WTO and WHO are named to take steps in assisting developing countries to strengthen national capacity in increasing access to medication, including through the adoption and activation of flexibilities existing in TRIPS agreements. (Paras. 12, 35, 71, 72, 87)
Adolescents and Young People
There are four mentions of young people in the document. Thirty years into the AIDS epidemic, nearly half of all new infections a day occur among those ages 15-24, primarily young women in Sub-Saharan Africa. There is no strong recognition of the need for investments in comprehensive sexuality education, access to comprehensive sexual and reproductive health services, and protection of reproductive rights as essential to HIV prevention among women and young people in the Outcome Document.
There is mention of a central role of the family in guiding children to prevent HIV, HIV and AIDS education in curricula, sexual health information and education, and abstinence, fidelity, and condoms to this end.
OP25: Express grave concern that young people aged 15 to 24 account for more than one third of all new HIV infections, with some 3000 young people becoming infected with HIV each day; note that most young people still have limited access to good quality education, decent employment, and recreational facilities, as well as limited access to sexual and reproductive health programmes that provide the information, skills, services and commodities they need to protect themselves; that only 34% of young people possess accurate knowledge of HIV; and that laws and policies in some instances exclude young people from accessing sexual healthcare and HIV-related services such as voluntary and confidential HIV-testing, counselling and age-appropriate sex and HIV prevention education; while also recognizing the importance of reducing risk taking behaviour and encouraging responsible sexual behaviour, including abstinence, fidelity and correct and consistent use of condoms;
OP 56 Commit to encouraging and supporting the active involvement and leadership of young people, including those living with HIV, in the fight against the epidemic at local, national and global levels; and agree to work with these new leaders to help develop specific measures to engage young people about HIV, including in communities, families, schools, tertiary institutions, recreation centres and workplaces;
OP 59 Commit to redouble HIV prevention efforts by taking all measures to implement comprehensive, evidence-based prevention approaches, taking into account local circumstances, ethics and cultural values, including through but not limited to:
a) conducting public awareness campaigns as well as targeted HIV education to raise public
awareness about HIV;
b) harnessing the energy of young people in helping to lead global HIV awareness;
c) reducing risk taking behaviour and encouraging responsible sexual behaviour including
abstinence, fidelity and consistent and correct use of condoms;
d) expanding access to essential commodities, particularly male and female condoms and sterile injecting equipment;
e) ensuring that all people, particularly young people, have the means to exploit the potential of new modes of connection and communication;
OP 68 Commit to develop and implement strategies to improve infant HIV diagnosis, including through access to diagnostics at point-of-care; significantly increase and improve access to treatment for children and adolescents living with HIV, including access to prophylaxis and treatments for opportunistic infections, as well as increased support to children and adolescents through increased financial, social and moral support for their parents, families and legal guardians and promote a smooth transition from paediatric to young adult treatment and related support and services;
OP 83 Commit to promoting laws and policies that ensure the full realization of all human rights and fundamental freedoms for young people, particularly those living with HIV and those at higher risk of HIV infection in order to eliminate the stigma and discrimination they face;
Women and Gender Equality
In every region of the world, HIV infection among women has risen steadily in the past 30 years. However, there is nothing in this document that prioritizes women’s sexual and reproductive rights and health and gender inequality through sound investments as part of the AIDS response. Although paragraph 53 is strong in terms of women’s sexual rights and access to health services, paragraph 81 places women in the context of violence and exploitation “for commercial reasons” which can lead to violence against sex workers and hinder progress in HIV prevention programs. Finally, it is disappointing that the language on women and girls was relegated to the exact same phraseology adopted in 2006 and did not go further, including in recognizing and ensuring women’s reproductive rights as an essential component of HIV responses, including access to contraception, prevention and treatment of reproductive tract infections, and safe pregnancy care. Female-controlled prevention methods are mentioned three times (OP 100); expanding access to female condoms (OP 59 d) and microbicides OP 59 n).
OP 21 Remain deeply concerned that globally women and girls are still the most affected by the epidemic and that they bear a disproportionate share of the care-giving burden and that the ability of women and girls to protect themselves from HIV continues to be compromised by physiological factors, gender inequalities including unequal legal, economic and social status, insufficient access to healthcare and services, including for sexual and reproductive health and all forms of discrimination and violence, including sexual violence and exploitation against them;
OP 53 Pledge to eliminate gender inequalities, gender-based abuse and violence; increase the capacity of women and adolescent girls to protect themselves from the risk of HIV infection, principally through the provision of health care and services, including, inter alia, sexual and reproductive health, and the provision of full access to comprehensive information and education; ensure that women can exercise their right to have control over, and decide freely and responsibly on, matters related to their sexuality in order to increase their ability to protect themselves from HIV infection, including their sexual and reproductive health, free of coercion, discrimination and violence; and take all necessary measures to create an enabling environment for the empowerment of women and strengthen their economic independence;
OP60 Commit to ensure that financial resources for prevention are targeted to evidence-based
prevention measures that reflect the specific nature of each country’s epidemic by focusing on geographic locations, social networks and populations vulnerable to HIV infection, according to the extent to which they account for new infections in each setting, in order to ensure that resources for HIV prevention are spent as cost-effectively as possible; and ensuring particular attention is paid to women and girls, young people, orphans and vulnerable children, migrants and people affected by humanitarian emergencies, prisoners, indigenous people and people with disabilities, depending on local circumstances;
OP81 Commit to ensuring that national responses to HIV and AIDS meet the specific needs of women and girls, including those living with and affected by HIV, across their lifespan through strengthening legal, policy, administrative and other measures for the promotion and protection of women’s full enjoyment of all human rights and the reduction of their vulnerability to HIV through the elimination of all forms of discrimination, as well as all types of sexual exploitation of women, girls and boys, including for commercial reasons, and all forms of violence against women and girls, including harmful traditional and customary practices, abuse, rape and other forms of sexual violence, battering and trafficking in women and girls;
Men who have sex with men, drug users, and sex workers
Although this paragraph for the first time in a high level UN Political Declaration names these groups of people, it does not have human rights protections in the same paragraph. This is not ideal because it leaves these groups vulnerable to be targeted for testing and treatment programs but can also heighten stigma and discrimination and violations of human rights.
OP 26 Note that many national HIV prevention strategies inadequately focus on populations that epidemiological evidence shows are at higher risk, specifically men who have sex with men, people who inject drugs and sex workers, and further note however that each country should define the specific populations that are key to its epidemic and response, based on the epidemiological and national context;
The human rights paragraphs do not include sexual and reproductive rights, which in the context of HIV and AIDS are quite simply the most important to recognize. There is strong language on protecting the human rights of people living with HIV, full respect for privacy and confidentiality in service provision, and to consider reviewing laws and policies that hinder effective AIDS responses (this would have been much stronger if these were named, such as decriminalizing sex work, HIV transmission, and same sex relationships).
The opposition was able to insert a number of clauses and paragraphs with language on “the family”; taking into account local circumstances, ethics and cultural values (which is often rhetoric for not implementing prevention programs that include sexual and reproductive rights and health, human rights prevention programs, and harm reduction programs, for example). However, these paragraphs were in the end limited to a few insertions while at one point there were over 28 paragraphs throughout the document.
OP 38 Reaffirm the commitment to fulfill obligations to promote universal respect for and the
observance and protection of all human rights and fundamental freedoms for all in accordance with the Charter, the Universal Declaration of Human Rights and other instruments relating to human rights and international law; emphasize the importance of cultural, ethical and religious values, the vital role of the family and the community and in particular people living with and affected by HIV, including their families, and the need to take into account the particularities of each country, in sustaining national HIV and AIDS responses, reaching all people living with HIV, delivering HIV prevention, treatment, care and support, and strengthening health systems in particular primary healthcare;
OP 39 Reaffirm that the full realization of all human rights and fundamental freedoms for all is an essential element in the global response to the HIV epidemic, including in the areas of
prevention, treatment, care and support, and recognize that addressing stigma and discrimination against people living with, presumed to be living with or affected by HIV, including their families, is also a critical element in combating the global HIV epidemic; and
recognize the need, as appropriate, to strengthen national policies and legislation to address such stigma and discrimination;
OP 77 Commit to intensify national efforts to create enabling legal, social and policy frameworks in each national context in order to eliminate stigma, discrimination and violence related to HIV and promote access to HIV prevention, treatment, care and support and non-discriminatory access to education, healthcare, employment and social services; provide legal protections for people affected by HIV including inheritance rights and respect for privacy and confidentiality; and promote and protect all human rights and fundamental freedoms with particular attention to all people vulnerable to and affected by HIV;
OP 78 Commit to review, as appropriate, laws and policies which adversely impact on the successful, effective and equitable delivery of HIV prevention, treatment, care and support programmes to people living with and affected by HIV and consider their review in accordance with relevant national review frameworks and timeframes;
OP 79 Encourage Member States to consider identifying and reviewing, in order to eliminate, any remaining HIV-related restrictions on entry, stay and residence;
OP 80 Commit to national HIV and AIDS strategies that promote and protect human rights, including programmes aimed at eliminating stigma and discrimination against people living with and affected by HIV, including their families, including through sensitizing police and judges, training health care workers in non-discrimination, confidentiality and informed consent, supporting national human rights learning campaigns, legal literacy, and legal services, as well as monitoring the impact of the legal environment on HIV prevention, treatment, care and support;
OP 81 Commit to ensuring that national responses to HIV and AIDS meet the specific needs of women and girls, including those living with and affected by HIV, across their lifespan
through strengthening legal, policy, administrative and other measures for the promotion and
protection of women’s full enjoyment of all human rights and the reduction of their vulnerability to HIV through the elimination of all forms of discrimination, as well as all types of sexual exploitation of women, girls and boys, including for commercial reasons, and all forms of violence against women and girls, including harmful traditional and customary practices, abuse, rape and other forms of sexual violence, battering and trafficking in women
OP 84 Commit to address, according to national legislation, the vulnerabilities to HIV experienced by migrant and mobile populations and support their access to HIV prevention, treatment, care and support;
OP 85 Commit to mitigate the impact of the epidemic on workers, their families, their dependants, workplaces and economies, including by taking into account all relevant ILO conventions, as well as the guidance provided by the relevant ILO recommendations, including ILO Recommendation No 200, and call on employers, trade and labour unions, employees and volunteers to eliminate stigma and discrimination, protect human rights and facilitate access to HIV prevention, treatment, care and support;