HUMAN RIGHTS COUNCIL HOLDS PANEL DISCUSSION ON HUMAN RIGHTS AND HIV/AIDS
The Human Rights Council this morning held a panel discussion on the progress in and challenges of addressing human rights issues in the context of efforts to end the HIV/AIDS epidemic by 2030.
Kate Gilmore, United Nations Deputy High Commissioner for Human Rights, said that the international community had travelled a long journey from the fear and panic that had characterized responses to HIV/AIDS in the early days. An HIV diagnosis could be less perilous today, but the stigma and discrimination remained. From a human rights perspective, it was key to provide universal health coverage to all HIV/AIDS affected persons based on the principle of non-discrimination, and to address barriers to public health due to intellectual property rights.
Luiz Loures, Deputy Executive Director, Joint United Nations Programme on HIV/AIDS (UNAIDS), said that this was a historic opportunity to bring AIDS down. Geography could not be a justification for people to die or to live – if there was a medicine it had to be shared by everyone. The Council had to help bring human rights and the AIDS epidemic to the centre of the negotiations in New York. The historic opportunity to bring AIDS down would start at the General Assembly High-level Meeting on HIV/AIDS in New York.
Pedro Alfonso Comissario, Permanent Representative of Mozambique to the United Nations Office at Geneva and moderator of the panel, said that the vision was the elimination of HIV/AIDS by 2030. Discussions today would be an exercise in the context of preparations for the high-level meeting which would take place in New York in June this year.
Ayu Oktariani, Public Campaign Officer, Indonesia AIDS Coalition, said that women, young people and children were always those left behind; this was an unjust situation which had to be rectified with programmes addressing their specific vulnerabilities. The lesbian, bisexual, gay and transgender community was still living in fear, and the criminalisation of drug users needed to be eliminated. Access to affordable medicines was a human right; people had to be put ahead of profits.
Nana Oye Lithur, Minister for Gender, Children and Social Protection of Ghana, presented some of her experiences in the context of HIV/AIDS from Ghana, which she had handled as a human rights lawyer and the people she had dealt with personally at her human rights clinic. She underlined the importance of advocacy, research, direct interventions at all levels, and using international, regional and national laws and conventions in order to improve access to services to persons living with HIV/AIDS.
Jorge Bermudez, Vice President of Health Production and Innovation and Member of the United Nations Secretary-General’s High-Level Panel on Access to Medicines, said barriers to access included intellectual property, monopolies, oligopolies and unaffordability. The world had been struggling fiercely during the past 20 years, seeking a balance between trade and health, or between innovation and health, and it had failed. It needed to be bold and face those barriers in line with the ambitious agenda pointed out in the Sustainable Development Goals.
Mark Dybul, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, said the Global Fund disbursed nearly four billion dollars to support local programmes that prevented the premature deaths of millions of people from HIV, tuberculosis and malaria. There had been great progress, with almost every country today implementing prevention and treatment programmes. HIV did not affect people equally, and the international community had to move toward being more inclusive.
Dainius Puras, Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, underlined the role of healthcare settings given their position as spaces where key populations could access the services and information they needed. All over the world people faced various forms of discrimination in relation to health care, linked to race, gender, socio-economic status or sexual orientation, among others.
In the ensuing discussion, speakers underlined the importance of combatting HIV/AIDS through a multi-sectoral and human-rights based approach, tackling discrimination and stigmatization of the most vulnerable communities, including women, girls, lesbian, gay, bisexual and transgender persons, as well as drug users and prison inmates. Speakers also stressed the importance of international cooperation in combatting HIV/AIDS, and presented their national, regional and international efforts in that regard. A number of speakers said the 2011 Political Declaration remained the internationally agreed framework for HIV/AIDS as it reaffirmed the sovereign rights of Member States and the need for all countries to implement the commitment and pledges consistent with national laws.
Speaking in the panel discussion were Brazil on behalf of a group of countries, Pakistan on behalf of the Organization of Islamic Cooperation, Dominican Republic on behalf of the Community of Latin American and Caribbean Countries, Kuwait on behalf of the Arab Group, European Union, Portugal, Saint Vincent and the Grenadines, Egypt, Poland, Colombia, Morocco, India, United States, Chile, Denmark, Paraguay, Estonia, Saint Kitts and Nevis, Namibia, El Salvador, Switzerland, Monaco, Iran, Malawi, Panama, Australia, Austria, Ecuador, Uruguay and Cuba. World Food Programme and the International Labour Organization also took the floor.
The following civil society organizations also took the floor: Elisabeth Glaser Paediatric AIDS Foundation in a joint statement, Centre for Reproductive Rights in a joint statement, National Harm Reduction Association, International HIV/AIDS Alliance, World Young Women’s Christian Association, and Action Canada for Population and Development.
At the end of the meeting, the Council heard right of reply statements in relation to the interactive dialogue with the High Commissioner on his annual report that was held on Thursday, 10 March (summary is available here). Speaking in right of reply were Armenia, Burundi, China, Russian Federation, Syria, Malaysia, Morocco, Myanmar, Republic of Korea, Azerbaijan, Georgia, Qatar, Algeria, and Democratic People’s Republic of Korea.
The Council is having a full day of meetings today. At 1:15 p.m., it will hear the presentation of the report of the Intergovernmental Working Group on transnational corporations, as well as the presentation of a number of thematic reports by the United Nations Secretary-General, the High Commissioner for Human Rights and his Office, followed by a general debate on its agenda item on the promotion and protection of all human rights, civil, political, economic, social and cultural rights, including the right to development.
Opening Statements
BERTRAND DE CROMBRUGGHE, Vice-President of the Human Rights Council, reminded that in its resolution 30/8 adopted on 1 October 2015 the Human Rights Council had decided to convene a panel discussion on the progress and challenges of addressing human rights issues in the context of efforts to end the HIV/AIDS epidemic by 2030. Since 2016 would mark the twentieth anniversary of the International Guidelines on HIV/AIDS and Human Rights, the Human Rights Council would take that opportunity to review and reflect on successes, best practices and lessons learned over the past two decades. A summary report of today’s panel discussion would be brought to the attention of the General Assembly as the Council’s contribution to the high-level meeting on HIV/AIDS to take place in New York from 8 to 10 June 2016.
KATE GILMORE, United Nations Deputy High Commissioner for Human Rights, said that as the international community celebrated the twentieth anniversary of the International Guidelines on HIV/AIDS and Human Rights, it had travelled a long journey from the fear and panic that had characterised responses to HIV/AIDS in the early days. Today HIV/AIDS could be treated as a chronic condition or infection, and quality health care and services could be accessible and acceptable. Today an HIV positive diagnosis no longer meant death. The trajectory of the AIDS pandemic was also a story of the crucial role that human rights played in the effective public health response. There was ample evidence that human rights approaches increased the effectiveness, efficiency and sustainability of the public health response. Poverty, inequality and discrimination were intimately linked to the spread of HIV/AIDS. An HIV diagnosis could be less perilous today, but the stigma and discrimination remained. The fear of stigma deterred people from diagnosis, treatment and from disclosing an HIV positive status. Globally, adolescents were the only age group for whom deaths due to AIDS had increased over the course of the Millennium Development Goals, an increase of about 50 per cent while all other groups had enjoyed a 32 per cent decrease during the same period. Adolescents were also the group with the least access to information, education, services and support. Guaranteeing all populations participation in the design and implementation of policies to address HIV/AIDS advanced rights, prompted better responses and ensured that interventions reached those at risk of being left behind.
That was why alongside non-discrimination, human rights principles such as access to information, privacy and confidentiality offered so much. From a human rights perspective, universal health coverage required the creation of conditions in which every person had access to appropriate medical attention and service in the event of need. Access to medicines was the product of scientific freedom that had allowed medical researchers to radically advance health technologies and develop new products. But that came with an associated right – the right of everyone to enjoy the benefits of scientific progress and its applications. The fact that intellectual property rights had been allowed to take precedence over the protection of public health had severely limited access to life-saving and health-preserving medicines for persons living with HIV/AIDS, with the poor being effectively priced out of the market. On the recommendation of the Global Commission on HIV and the Law, the Secretary-General had established a High-Level Panel in November 2015 to consider and propose solutions to remedy policy incoherence in that area, with a strong role envisaged for human rights.
The Human Rights Council then watched a UNAIDS video on the 15 Years of the AIDS Response 2000 – 2015.
Luiz Loures, Deputy Executive Director, Joint United Nations Programme on HIV/AIDS (UNAIDS), said that this was a historic opportunity to bring AIDS down. Up until today, AIDS had killed 35 million people. In the 1990s, the AIDS pandemic had been in full force, making the funeral industry the fastest growing industry at that the time in Southern Africa, with 5 million people dead. It had taken 15 years to tackle that challenge with a global effort. In 1996 the first studies had shown that AIDS could be treated. Until that time, the world had been living in a pre-treatment era. The International Guidelines on HIV/AIDS and Human Rights had been a major movement forward. Nelson Mandela had shifted the silence, and African people had come out in the streets of Durban. Geography could not be a justification for people to die or to live – if there was a medicine it had to be shared by everyone. This was the shift in the movement. It was in that context that the Human Rights Council joined the efforts. Today 60 million people were under treatment. The world was living a science momentum that it had never seen before. Even if there was no vaccine there were the tools to bring down this epidemic. However the AIDS paradox was more global than ever. Geography was less important now. What defined it was who you were, what were your options, where you lived, your gender, and your sexual orientation. The impact affected women, not because of biology but due to gender inequality. This could be fixed. If you were gay, a prisoner, or a sex worker, you were more affected. Among sex workers in Africa, rates of infection were approximately 75 per cent. There was no justification for this. A looming treatment crisis was beginning, and major challenges were faced in terms of costs and systems that were conducive. Children had much less access to treatment than adults.
The history of the AIDS epidemic showed uneven progress that happened to some but not to others. Progress needed to be accessible by all, and the world needed to deal with the factors that were making this progress inaccessible by all. Lack of access was more and more the reason for life or death. The centrality of human rights was much greater today than twenty years ago. Experience was extremely important, and the challenge today was human rights for all. Discrimination was unacceptable. AIDS was the first challenge to humanity, followed by Ebola, and now Zika seemed to be the next. When the centrality of people affected by HIV was starting to affect progress, that was when the AIDS epidemic was brought to the fore. In the Ebola response, the lack of community assistance was the challenge. In Zika, the success to rights of reproductive health by women was crucial. Killing the mosquito only would not kill the Zika virus. A fundamental shift was needed in the way public health was seen. This Human Rights Council had to help bring human rights and the AIDS epidemic to the centre of the negotiations in New York. This was an opportunity not to be missed. The historic opportunity to bring AIDS down would start at the United Nations General Assembly High-Level Meeting on HIV/AIDS in New York, three months from today.
Statements by the Moderator and Panellists
PEDRO ALFONSO COMISSÁRIO, Permanent Representative of Mozambique to the United Nations Office at Geneva and moderator of the panel, said that they were commemorating the twentieth anniversary of International Guidelines on HIV/AIDS and Human Rights. Progress made so far would be presented, as would challenges still faced, and the centrality of human rights in the effectiveness of that response would be underlined. The vision was the elimination of HIV/AIDS by 2030. Discussions today would be an exercise in the context of preparations for the high-level meeting which would take place in New York in June this year. The composition of the panel reflected efforts undertaken by civil society, experts, concerned United Nations entities, governments and activists on the ground.
AYU OKTARIANI, Public Campaign Officer, Indonesia AIDS Coalition, said she still recalled the moment seven years ago when she found out she was infected with HIV without knowing why. She had not known how to keep moving forward with her life. But now she was involved in empowering her community and speaking for the voiceless. Efforts to tackle the HIV and AIDS epidemic could not be separated from the fulfilment of the human rights of people who were affected. Women, young people and children were always those left behind, an unjust situation which had to be rectified with programmes addressing their specific vulnerabilities. The “90:90:90” Joint United Nations Programme on HIV/AIDS (UNAIDS) treatment target which aimed for the goal that by 2020, 90 per cent of all people living with HIV would know their HIV status, receive sustained antiretroviral therapy, and have viral suppression, was “nothing” without the full recognition of human rights in AIDS programmes and policies. The lesbian, bisexual, gay, and transgender community was still living in fear, and the criminalisation of drug users needed to be eliminated. Access to affordable medicines was a human right; people had to be put ahead of profits, and trade agreements such as the Trans Pacific Partnership could endanger access to such life-saving commodities.
PEDRO ALFONSO COMISSÁRIO, Permanent Representative of Mozambique to the United Nations Office at Geneva, moderating the discussion, noted that the Sustainable Development Goals had emphasized the rule of law and inclusion to advance inclusive societies. He underlined the importance of starting at the grass-roots level for improving access to justice for women. He asked the next panellist to elaborate on the approaches that had proved to be most effective from her experience in Ghana in order to advance access to justice in the context of HIV/AIDS.
NANA OYE LITHUR, Minister for Gender, Children and Social Protection of Ghana, presented some of her experience in the context of HIV/AIDS from Ghana, which she had handled as a human rights lawyer and the people she had dealt with personally at her human rights clinic. Those were people who failed to get access to justice, remedies for human rights violations or legal redress. They faced increased vulnerabilities and human rights violations were committed against those key populations. Prevalence of gender based violence was high, such as assault, beating, discrimination, disgrace and poverty. Some police officers who were supposed to be enforcing the law and protecting citizens had been found defiling young sex workers. Service providers in healthcare, social services and law enforcement were unable to assist. Speaking of the most effective strategies, Ms. Lithur underlined advocacy, research, direct interventions at all levels, and using international, regional and national laws and conventions. She used those strategies to strengthen the legal and policy framework, namely she had conducted a comprehensive legislative audit in Ghana to identify gaps and initiate action to repeal, amend and review laws in order to create a more conducive legal environment. The Audit Report had informed the creation of the National HIV Policy in Ghana in 2011, and an HIV Law that was being considered by the Cabinet. Ms. Lithur had also been supported by the United Nations Population Fund to research human rights violations by police officers of female sex workers. That had led to the development of curricula and training of police officers and key populations on HIV/AIDS. She had also conducted the first ever training for service providers, the Department of Social Welfare, the Police Domestic Violence and Victim Support Unit, and the Commission on Human Rights and Administrative Justice on key populations and human rights. A human rights clinic was created in 2008 and it had dealt with 1,568 persons until the end of 2015. There was also a pro bono lawyers network, with 100 lawyers registered to deal with cases.
PEDRO AFONSO COMISSARIO, Permanent Representative of Mozambique to the United Nations Office at Geneva and moderator of the panel, paid tribute to Brazil for its very important role in the fight against HIV/AIDS, through ensuring access to medicines, vital to both prevention and treatment of HIV/AIDS, including in the face of intellectual property acts which sometimes acted as a barrier. He asked Dr. Bermudez what approaches had emerged as the most promising to overcome this challenge and what would be the contributions of the Secretary-General’s newly-appointed High-Level Panel on Access to Medicines in this regard?
JORGE BERMUDEZ, Vice President of Health Production and Innovation, Fiocruz, Ministry of Health of Brazil and Member of the United Nations Secretary-General’s High-Level Panel on Access to Medicines, said barriers to access included intellectual property, monopolies, oligopolies and unaffordability. The world had been struggling fiercely during the past 20 years, seeking a balance between trade and health, or between innovation and health, and it had failed. Brazil had pioneered the response to HIV/AIDS since the first cases had been detected, and was one of the first countries in the world to establish a national programme in 1985. The Brazilian response was based on a human rights approach, with no discrimination and universal access to prevention and treatment, as well as civil society participation. A comprehensive approach, with prevention and care being addressed, local public production, public-public and public-private partnerships were currently at stake. The appointment of sixteen members to the United Nation Secretary-General’s High-Level Panel on Access to Medicines in December 2015, with two former Presidents as Co-Chairs, gave an idea of the relevance that the Secretary-General attributed to the issue of access to medicines, who had recognized that in spite of all the progress made in health, millions had been left behind. The scope of the Panel, which resulted from several previous initiatives, was to remedy or correct the misalignment and policy incoherence between individual rights of inventors and human rights, discussing trade and public health in the context of health technologies. Today, the world was facing innovation which was restricted to the rich, health systems about to collapse, not only in the South, with high and unjustifiable prices of new products and unaffordability of new technologies. The world needed to be bold and face the barriers, including regulatory, intellectual property, strengthening health systems and ensuring better health and life conditions to all mankind, in line with the ambitious agenda pointed out in the Sustainable Development Goals. There was no unique or simple solution.
PEDRO ALFONSO COMISSÁRIO, Permanent Representative of Mozambique to the United Nations Office at Geneva and moderator of the panel, asked why it was important to invest in human rights programmes in the context of HIV/AIDS, and also what the Global Fund was doing to ensure greater investment in human rights programmes in the context of its 2017-2022 strategy, also asking how the Fund’s partners could assist those efforts?
MARK DYBUL, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, said the Global Fund disbursed nearly 4 billion dollars to support local programmes that prevented the premature deaths of millions of people from HIV, tuberculosis and malaria. There had been great progress, he said, with almost every country today implementing prevention and treatment programmes. HIV did not affect people equally, and the international community had to move toward being more inclusive. The Global Fund had had a human rights objective in its Strategy since 2011. In many settings, the impact of the Fund’s grants was greatly reduced because of human rights-related barriers to services, such as women and girls not having access to testing and treatment. UNAIDS, which was a close partner of the Fund, had defined seven key programmes that reduced human rights-related barriers to services, including programmes for legal literacy, also known as “know your rights” programmes. But investment in those programmes remained minimal. The Fund’s new Strategic Framework for 2017-2022 had as one of its main objectives to introduce and scale up programmes that removed human rights barriers to accessing services. Efforts would be concentrated on 15 to 20 countries with particular needs and opportunities for the introduction and scale-up of programmes. The target was increased uptake of and retention in services through decreased stigma and discrimination.
PEDRO ALFONSO COMISSÁRIO, Permanent Representative of Mozambique to the United Nations Office at Geneva, asked the Special Rapporteur about the HIV/AIDS related stigma and its various forms in many settings. Efforts to address that stigma had been ongoing for the past 30 years. In his view why was it crucial to focus on addressing discrimination in health care settings, and what interventions could do so effectively?
DAINIUS PŪRAS, Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, underlined the role of healthcare settings given their position as spaces where key populations could access the services and information they needed. All over the world people faced various forms of discrimination in relation to health care. Evidence showed that health care settings were among the most frequent environments where people experienced HIV-related stigma and discrimination. Such discrimination was often linked to race, socio-economic status and age of service users, or because they were women and due to their sexual orientation or gender identity and expression, because they lived with HIV/AIDS and disability, sold sex, used drugs, or because they lived in prisons. Some of the most common manifestations of discrimination in health care included denial of health care and unjust barriers in service provision, inferior quality of care, disrespect, abuse and other forms of mistreatment, and extreme violations of autonomy and bodily integrity. Evidence showed that interventions that worked best were those with a strong human rights-based approach. Health care had to be provided in a timely and quality manner regardless of gender, nationality, age, disability, ethnic origin, sexual orientation or gender identity, religion, socio-economic status, or health status.
Discussion
Brazil, speaking on behalf of a group of countries, noted that 2016 marked the twentieth anniversary of the International Guidelines on HIV/AIDS and Human Rights and also set the beginning of the implementation of the 2030 Agenda for Sustainable Development, expressing hope that the Human Rights Council would send a strong message to New York. The response to HIV/AIDS needed to be grounded in a human rights-based approach, consistent with international human rights obligations, promoting access to treatment, especially to women and young girls, and combatting prejudice and inequalities. Pakistan, speaking on behalf of the Organization of Islamic Cooperation, stated that in most developing countries it was the lack of resources and capacity that had caused the spread of HIV/AIDS. Antiretroviral medicines, diagnostics and supportive treatment remained too expensive for the majority of patients. It expressed hope that the 2011 Political Declaration remained the internationally agreed framework as it reaffirmed the sovereign rights of Member States and the need for all countries to implement the commitment and pledges consistent with national laws. Dominican Republic, speaking on behalf of the Community of Latin American and Caribbean Countries, highlighted its efforts to provide integral care to people living with HIV/AIDS, notably the safe blood strategy in hospitals. But, there were still major challenges and some 900,000 people in Latin America and 157,000 in the Caribbean still did not have access to treatment. Prevention was another important challenge as between 2005 and 2013 there had been only a 3 per cent decrease in new infections.
Kuwait, speaking on behalf of the Arab Group, said the Political Declaration on HIV and AIDS reaffirmed the obligations of States to fulfil their obligations and rights in this respect, and the important role of the family and cultural and moral aspects of the fight against HIV/AIDS. This Declaration had international consensus. European Union said adopting a human rights based approach to HIV/AIDS was vital. Such an approach encompassed fulfilling everyone's right without discrimination, ensuring free testing and access to antiretroviral medicines, promoting gender equality and empowerment of children, and access to sexual and reproductive rights. The European Union asked what were the main human rights challenges on a daily basis when providing technical assistance. Portugal hoped that the Human Rights Council would send a key message to the forthcoming meeting of the Secretary-General’s High-Level Panel on HIV/AIDS meeting in New York, underlining the key aspect of human rights to the fight against HIV/AIDS. The aim was to eliminate all forms of discrimination, stigma and violence associated with the disease. Universal access to antiretroviral treatment and medicines had to be ensured. How could one ensure that young women and girls had combined access to health services to ensure prevention?
Saint Vincent and the Grenadines detailed national initiatives taken to combat the HIV/AIDS epidemic, which included establishing partnerships with the Pan American Health Organization, establishing partnerships with the private sector and community groups, and expanding access to HIV support and treatment. Egypt said the 2011 Political Declaration remained the internationally agreed framework on addressing the subject matter. Abusing efforts to eradicate HIV/AIDS to promote “controversial social norms” such as sexual orientation and decriminalisation of drug abuse could weaken the global partnership to accomplish its common objective. Poland shared national experiences in combatting the epidemic, which included providing all HIV-positive patients, including marginalised groups, with free, highly effective antiretroviral therapy. That had increased those patients’ life expectancy and Poland had achieved a significant decrease in the number of AIDS cases.
Colombia reiterated its commitment to providing universal access to healthcare and prevention for persons living with HIV/AIDS. It combatted the pandemic with its sexual and reproductive healthcare policy adopted in 2014. Morocco said the national strategy for the period 2012-2016 had adopted the goal of zero new infections, zero discrimination and zero deaths due to HIV/AIDS. The national strategy was grounded in human rights principles. India noted that the international community needed to redouble its efforts to ensure that no one was left behind. It was committed to ending the pandemic and it was mainstreaming its AIDS response through service integration and adopting a human rights approach. But it warned that more than 60 per cent of people affected by HIV/AIDS still lacked access to affordable antiretroviral drugs.
Elizabeth Glaser Pediatric AIDS Foundation, in a joint statement with Caritas Internationalis (International Confederation of Catholic Charities), highlighted that States must uphold the rights of children to health and life, through tackling the mother to children transfer rate, combatting gender-based discrimination, and providing stronger legislation to fight child exploitation. There was direct link between child sexual, psychological and physical abuse and HIV/AIDS infection. Centre for Reproductive Rights, in a joint statement, said barriers for women and girls were rooted in stereotypes related to sex and sexuality, and were the cause and effect of laws, policies and practices that failed to recognize adolescent and women’s autonomy over their own bodies. The criminalisation of autonomous decision-making over one’s body, such as the criminalization of abortion, were key drivers of the HIV epidemic. National Harm Reduction Association said any discussion on HIV/AIDS and human rights had to consider the current international system for drug control. It could no longer be ignored that punitive approaches to drugs were seriously impending global efforts to end the HIV/AIDS epidemic by wasting finite resources on enforcement and the incarceration of people who used drugs.
United States said that if efforts were accelerated now, the 90-90-90 targets could be achieved by 2020, and UNAIDS had shown the international community exactly what needed to be done to achieve those critical targets and ultimately end the epidemic by 2030. World Food Programme said one of the most heavily affected population groups was adolescent girls and young women, who faced gender-based violence, hunger and limited access to health care and education. Ending AIDS would not be achieved without taking it out of isolation and making the right linkages, including the fundamental right of everyone to be free of hunger. International Labour Organization said that the protection of human rights at work was fundamental. ILO standards provided protections against workplace discrimination, prohibiting mandatory HIV testing or screening for employment, among other protections.
Chile noted that the reinforcement of political and social actions, and international and multi-sector cooperation was key in the fight against the pandemic. Denmark noted that the international response to HIV/AIDS had made tremendous progress and could report many positive results. Yet, infections continued to rise, predominately due to discrimination. Paraguay stated that HIV/AIDS was still a problem in the country, despite the adoption of relevant legislation and the implementation of transversal policies in the framework of the public health care system.
Estonia said that the situation of vulnerable groups, such as lesbian, gay, bisexual and transgender persons, had worsened in Russian-occupied Ukraine, especially in Crimea, leading to restricted access to HIV treatment and sexual and reproductive rights. Saint Kitts and Nevis said that it had forged a strategic partnership with regional, local and private organizations, leading to the adoption of a plan for the national response to HIV/AIDS, and presented regional efforts in the Caribbean region. Namibia noted with concern that women and young girls continued to experience higher rates of infection, and therefore underlined the importance for States to expand preventive programmes to encompass this vulnerable group. El Salvador said efforts to combat HIV/AIDS had to include measures targeting vulnerable groups and addressing stigmatization and discrimination. Switzerland underlined the importance of a human rights based, non-discriminatory and multi sectorial approach to combat HIV/AIDS, with collaboration between all stakeholders. Monaco said that, while scientific research was paramount, its effect would be limited without a human rights based approach to treatment and prevention, with a focus on the most marginalized groups.
International HIV/AIDS Alliance , on behalf of severals NGOs1, said that 52 HIV and human rights organizations supported the statement he was making, calling on States to adopt four commitments which included eliminating legislation that criminalised people living with or affected by HIV. World Young Women’s Christian Association said that women’s empowerment and gender equality were critical for ensuring that young women and girls could claim their reproductive health rights, and listed seven key actions to advance gender equality which included promoting zero stigma. Action Canada for Population and Development, in a joint statement with Sexual Rights Initiative, said that governments had to refrain from enacting harmful laws which criminalized HIV non-disclosure, among other acts.
Iran said that its national response had reduced stigma and discrimination, and had demonstrated that a community-based approach could attract national and international resources to facilitate the achievement of prevention, treatment, care and support objectives. Malawi said that for the response to be effective, everyone had to be involved, and that it was equally important to ensure how victims were handled. Discrimination against some groups, such as migrants and refugees, increased the chances of infection and spread of the epidemic. Panama asked how countries could address existing challenges of the price and shortages of antiretroviral medicines, and also how to tackle the issue of intellectual property rights?
Australia had recognized since the early days of the HIV/AIDS outbreak that meaningful cooperation and consultation between healthcare professionals, policy makers, researchers and affected or at risk communities was essential in the response to HIV. Access was integral to ensuring the right of everyone to the enjoyment of the highest attainable standard of health. Austria welcomed the new UNAIDS Strategy 2016-2021 and said a human rights based approach needed to look well beyond the concept of the inalienable right to health to take into account human rights in their entirety. The topic of non-discrimination had to be particularly stressed, as had the focus on prison inmates. Ecuador said that a high percentage of children lived with HIV/AIDS, and since 2006, Ecuador had a programme to prevent mother-to-child transmission. In 98 per cent of the cases, they had been able to cut the transmission. The Government provided 85 per cent of the resources needed to prevent the disease. Uruguay said the importance of working together to find effective responses was crucial. Discrimination had to be dealt with, and women, children, and lesbian, gay, bisexual and transsexual persons had to be prioritised. Cuba said the country’s response had focused on three main fronts, namely political leadership, reformulating policies, and promoting people-centred approaches. The people who were affected by HIV/AIDS should not be seen as problems but rather as part of the solution.
Concluding Remarks
LUIZ LOURES, Deputy Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS), said that what was needed was a pragmatic approach, combining for example the elimination of punitive laws with other measures. As had been mentioned by Egypt and other States, democratic access to science and technology needed to be global. To make the 90:90:90 goal “alive”, the international community needed to work on access to new technologies. He noted that there was a generation gap which was a fundamental challenge today.
DAINIUS PŪRAS, Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, said that many fundamental changes had been brought to the field of public health by the AIDS response, adding that the AIDS response could provide many examples in other fields. The international community had ambitious goals now which included universal health coverage. The Sustainable Development Goals emphasized a more integrated and holistic approach. It was known that health delivery models were too disease-oriented. The current crisis was an opportunity for the AIDS response to be strengthened through universal health coverage.
MARK DYBUL, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, said that the Sustainable Development Goals could not be achieved unless gender equality was achieved. Discrimination existed at all levels. The second challenge faced was the tension between immediate action and long-term action, and the international community needed a human rights push. Health was an excellent entry point. Progress could happen, he said, adding that the relevant situations in Mozambique and Ghana were great examples of that. A pragmatic long-term approach could advance the human rights agenda in a rapid way.
JORGE BERMUDEZ, Vice-President of Health Production and Innovation, Fiocruz, Ministry of Health of Brazil, noted that all countries had highlighted that a human rights approach to HIV/AIDS was at the core of the strategy to fight the disease. He assured that this would also be the focus of the June 2016 meeting of the Secretary-General’s High-Level Panel on Access to Medicines. Millions had been left behind. The issues surrounding the new medicines for Hepatitis C had raised new concerns about affordability and access which affected not just low-income, but high-income countries as well. In relation to this, Mr. Bermudez urged countries to be bold and use the Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement flexibilities. It was mandatory that TRIPS+ agreements were stopped, as they hampered access to medicines. The work of the Secretary-General’s High-Level Panel on Access to Medicines included ongoing public hearings and a call for contributions. Over 170 such contributions had been received and would be digested in the Panel’s Report.
NANA OYE LITHUR, Minister for Gender, Children and Social Protection of Ghana, quoting from the African Human Rights Commission, said that most vulnerable groups were denied the protection they required. Due to the Government of Ghana’s consistency in placing human rights at the centre of the HIV/AIDS response, there was a positive response. This was a message for Africa, as it was most affected by HIV. What defined the disease was gender inequality, stigma, discrimination, and sexual orientation. The African region had to address these issues by tackling gender, population and other key issues when there were traditional dimensions. The imperative was saving human lives.
AYU OKTARIANI, Public Campaign Officer, Indonesia AIDS Coalition, urged all nations to ensure the implementation of human rights with real action, including actions aimed at key affected populations, and helping communities realise their goals in this respect. States had to take a stand against economic and political pressure and put people first. This was her message, as a person affected by HIV/AIDS, as a woman, and as a mother.
PEDRO AFONSO COMISSARIO, Permanent Representative of Mozambique to the United Nations Office at Geneva and moderator of the panel, said the statements had reminded that HIV/AIDS was one of the greatest challenges of all times, and called upon all to remember that what was at stake was human beings with aspirations, dreams and hopes. The respect for their dignity meant they had to promote high quality care and health delivery, and the elimination of stigma and discrimination. In this context, a human rights based approach was crucial to ending the HIV/AIDS epidemic. The International Guidelines on HIV/AIDS and Human Rights approved 20 years ago emphasized the role of States in collaboration with communities. The Human Rights Council panel discussion had highlighted that a strong message to New York must be sent on the importance of the full realization of all human rights and fundamental freedoms in response to HIV/AIDS. Another important aspect had been that the leadership and ownership of countries was important in the effort to combat HIV/AIDS. The discussion had highlighted a number of successful approaches, and shown that efforts to eliminate HIV/AIDS were most effective when they were rights based. The international community as a whole had been making progress but recognized that much more needed to be done, both individually and collectively. This had to be the message of the Human Rights Council to the High-Level Panel.
Right of Reply
Armenia, speaking in a right of reply in response to the statement made by Azerbaijan during the interactive dialogue on cultural rights, said Azerbaijan’s allegations concealed its systematic destruction of Armenian cultural heritage, and it had become habitual for Azerbaijan to distort the findings of international organizations. What about numerous eyewitness reports? Azerbaijan refused the creation of any monitoring mechanisms with respect to the preservation and protection of cultural rights, while it tried to present itself as a religiously tolerant country.
Burundi, speaking in a right of reply in response to the statements made by the European Union, United States, Switzerland and United Kingdom regarding the human rights situation in Burundi, said the Government of Burundi had spared no effort to improve its human rights situation. It had opened private media which had been closed during the crisis and many arrested persons had been released. The establishment of the national reconciliation commission was a sign of progress in the country, and the reconciliation dialogue would involve all relevant stakeholders.
China, speaking in a right of reply in response to statements made by the delegations of Switzerland and the United States, which aired groundless accusations, said democracy and the rule of law had made steady progress in China and the policy of “one country” had been implemented earnestly, with the rights for all guaranteed by law. Switzerland always made allegations whereas it itself had human rights problems, such as the protracted detention of migrants and the mistreatment of the Roma people. China admonished Switzerland and the United States to carefully scrutinize their own problems instead of making allegations against other countries.
Russian Federation, speaking in a right of reply, recommended that Georgia discuss its problems with South Ossetia and Abkhazia directly, adding that the international obligations of the Russian Federation covered all its subjects, including in Crimea and Sebastopol. Ukrainian authorities were urged to correct the human rights violations referred to in the report of the United Nations Observer Mission for human rights in Ukraine, especially the thirteenth report.
Syria, speaking in a right of reply, said that the “schizophrenia” Qatar suffered from was revealed every time they took the floor, adding that if they lived in dreams that was their own problem, and that they could not silence all voices. The Qatari regime had to convince the world that the regime was not violating the rights of migrants, as it was repatriating migrant workers after exploiting them. Qatar thought it could buy revolutions with money.
Malaysia, speaking in a right of reply, said in response to comments made by the United States and Germany regarding the trial of Anwar Ibrahim that it had undergone exhaustive due process. He had been sentenced by the highest court after a series of appeals in a process which had spanned seven years. He had been accorded every opportunity to exercise his constitutional rights and he did so, exhausting every opportunity to appeal given to him. The democratic space in Malaysia was not restricted but had actually increased, and new legislation has been undertaken through a democratic parliamentary process.
Morocco, speaking in a right of reply, regretted the statement by Algeria and regretfully rejected its allegations. It reiterated the commitment of Morocco to achieve a just solution to the dispute, and to propose an autonomy initiative for Western Sahara. With regards to human rights, Morocco said that its level of openness and development, including in Western Sahara, had been recognized by United Nations human rights mechanisms. Human rights violations continued, however, in the Tindouf Camp.
Myanmar, speaking in a right of reply, regretted that some delegations had used the term “Burma” to refer to it. Myanmar had made good progress for the protection of human rights, and would continue on that path.
Republic of Korea, speaking in a right of reply, regretted that the Democratic People’s Republic of Korea refused to recognize the mandate of the Office of the High Commissioner for Human Rights’ office in Seoul, and urged the country to collaborate with the international community on human rights issues.
Azerbaijan, speaking in a right of reply in response to Armenia, said that the protection of cultural heritage was a critical issue for Azerbaijan in light of ethnic and cultural cleansing perpetrated in occupied regions of Azerbaijan by Armenia. Armenia had conducted its policies in these regions in a violent manner, including the destruction and looting of cultural monuments with a view to re-write the history of the occupied regions. For its part, Azerbaijan ensured that Armenian culture was respected and protected.
Georgia, speaking in a right of reply, noted that the Russian Federation had committed aggression against Georgia and that it now occupied 20 per cent of Georgia’s territory. Russia continued its policy of violating the territorial integrity of Georgia and had violated all Security Council resolutions in that respect. The Russian Federation had failed to meet its obligations under the cease fire agreement. It had never pulled back and showed no intention of withdrawing its troops from the Georgian territory, which made it an occupying power.
Qatar, speaking in a right of reply, said that the representative of the Syrian regime had attempted to raise unfounded allegations against Qatar. That bloody regime had no right to speak of human rights violations. The Assad regime had killed more than 400,000 innocent Syrians and had forced millions to flee, and it had been destroying Syria with all kinds of weapons. Qatar cared about the fate of Syria more than the Syrian regime.
Algeria, speaking in a right of reply, responded to Morocco by reminding it that the question of Western Sahara was on the agenda of the Security Council. Morocco had been blocking the political solution because it had refused access to the Secretary-General to inspect the situation on the ground. During his visit to the occupied territory of Western Sahara, the Secretary-General had said that the situation amounted to occupation. The issue was one of decolonisation which needed a political solution.
Democratic People’s Republic of Korea, speaking in a right of reply, said that the country did not feel the need to respond to unacceptable things, and took the opportunity to urge hostile forces to put an end to the futile campaign against his country under the pretext of human rights.
Armenia, speaking in a second right of reply, said cultural rights were interdependent, and that the overall human rights situation in Azerbaijan had deteriorated continuously over the past two years. The Government of Nagorno-Karabakh had directed funds for the restoration of mosques and initiated studies on Muslim culture.
Syria, speaking in a second right of reply, said that there was another who was victimised by Qatar and that was the Arabic language, adding that the regime was funding terrorist organizations including Al Nusra Front in the political and media field, and that regarding civil society organizations, the regulations by the Security Council regarding terrorist organizations should be read, and founders of such civil organizations in Qatar were part of the Security Council’s terrorist list. It was shameful that a capital city like Doha hosted humanitarian organizations while terrorists lived peacefully there.
Morocco, speaking in a second right of reply, said that it had never refused access to the Secretary-General and would always allow him to visit all parts of the country. Morocco was pursuing a very cooperative approach with all United Nations agencies. It was an open country with good faith, and would continue to try to find a peaceful political solution.
Republic of Korea, speaking in a second right of reply, highlighted that the international community had adopted United Nations resolutions on the situation of human rights in the Democratic People’s Republic of Korea for a long time, and that it was time for that country to implement international recommendations.
Azerbaijan, speaking in a second right of reply, recalled brutal massacres by Armenian troops invading Azerbaijan. No State in the international community had recognized the occupied territories as independent. In 1993, the United Nations Security Council had adopted resolutions condemning Armenia’s occupation of Azerbaijan and reaffirming its territorial integrity.
Qatar, speaking in a second right of reply, responded to the representative of Syria, noting that she had used inadequate language, a street language that was used by Assad representatives. The Assad representative had once again tried to serve up lies that rested on the Syrians’ blood. That regime was carrying out ethnic cleansing and had caused displacement of so many people. It spoke about terrorism and funding of terrorism, whereas it was the greatest contributor to Da’esh.
Algeria, speaking in a second right of reply, wished to clarify the planned visit of the Secretary-General to Western Sahara. That visit could not take place because Morocco had tried to impose conditions that could not have been accepted by the Secretary-General. Algeria was not talking about a bilateral visit, but about a visit by the United Nations Secretary-General, noting that its purpose was to decolonise.
__________
1Joint statement: International HIV/AIDS Alliance; International Lesbian and Gay Association; International Council of AIDS Service Organizations; Canadian HIV/AIDS Legal Network; Global Network of People Living with HIV; International Planned Parenthood Federation; International AIDS Society; Grandmothers Advocacy Network; and Humanist Institute for Co-operation with Developing Countries.
For use of the information media; not an official record
HRC16/026E