Zimbabwe: Punitive laws reverse the gains made in the fight against HIV in Zimbabwe and should be reconsidered

Outdated, punitive laws are encouraging HIV stigma in Zimbabwe

In 2001 Zimbabwe introduced the Sexual Offences Act, which criminalised wilful transmission of HIV. Three years later the law was updated to include those who suspected they could be HIV positive but didn’t inform their sexual partners.

The law allowed people to be criminally charged for deliberately infecting other people with HIV. It came about as a result of activism by women’s rights groups; they sought to empower women who were being recklessly exposed to HIV by rapists and, in some cases, by their partners.

At the time, very few advances had been made in the fight against HIV and AIDS; the epidemic was classed as an international security threat.

But that was 20 years ago. A great deal has changed since then. Most importantly, HIV has become a chronic and manageable condition rather than an automatic death sentence. This is not to say it doesn’t remain a very real public health issue: it’s estimated that about 1.55 million Zimbabweans in a country of 14.2 million people are living with HIV.

And yet Zimbabwe’s punitive law around the transmission of HIV remains on the statute books – and it’s enforced. Today, HIV transmission cases continue to be heard before Zimbabwe’s criminal courts. This is despite the fact that punitive HIV laws are widely acknowledged as undermining a country’s public health policies and strategies.

Laws like this exist in many places, including a number of US states, Russia, the UK and more than 30 sub-Saharan countries.

As I’ve shown in my own research, such laws fuel stigma and discrimnation. They also dissuade HIV testing and adherence to treatment. Unless the legal provision in question is revised, it could reverse the gains made in the fight against HIV and AIDS in Zimbabwe by making it seem as though people living with the disease are criminals.

Proving guilt

In 2016, two women were charged under the law and found guilty of deliberately transmitting HIV. In 2016, two people approached the country’s Constitutional Court to have their sentences overturned and the legal provision declared unconstitutional.

They argued that the wording of that part of the law was too ambiguous and uncertain. This, they said, meant it failed to provide protection to citizens as guaranteed by the Constitution. The ambiguity centred on the “real risk” test, which places an expectation on the accused to recognise the risk or possibility that they are HIV positive and so can transmit the virus to another person.

The applicants argued that this wording was so unreasonably broad that it created a danger of false incrimination. The court disagreed; the applicants lost their legal challenge and their convictions for deliberately infecting partners with HIV were upheld.

One of the problems with the law’s wording is that it’s extremely difficult to prove the causal link between the actions of the accused and the consequences faced by the victim.

And, since the law is worded in such a broad fashion, it leaves room for people to be falsely incriminated when relationships breakdown. This was the case with Samukelisiwe Mlilo – one of the applicants in the 2016 Constitutional Court case – whose husband accused her of infecting him with HIV after she reported him to the police for domestic abuse.

Mlilo was charged under a provision in the criminal code for deliberately transmitting HIV and convicted despite her argument that the state could not prove that she had actually infected him.

Next steps

Zimbabwe needs to reconsider this legislation. If it decides that criminalisation is a necessary tool, the wording of the law must be made more explicit and less open to individual interpretation. Only clear cases of criminality – where there is evidence of foresight, negligence and actual intent – should be tried.

It must also seek to complement public health policies rather than undermining them. The thrust of the law must be to protect all citizens alike rather than encouraging the marginalisation and exclusion of people living with HIV.

Published in The Zimbabwe Mail on August 20, 2018

Russia: Russian Human Rights Council favors criminal punishment over education for HIV denialism, thought to be affecting minors' HIV care

Russian Human Rights Council proposes criminal penalty for HIV denialism

MOSCOW, August 7 (RAPSI) – Russia’s Presidential Council for Human Rights has recommended the government to consider imposition of criminal punishment for propaganda of HIV denialism, a statement released on the advisory body’s website reads.

According to the Human Rights Council, HIV denialism is one of the main problems hindering enhancement of the disease control efficiency and primarily affecting minors.

Other problems in this field include defects in HIV laboratory tests conducted in unspecialized organizations, faults in statistical recording and absence of regulation of a work permit procedure for health care workers in the event of HI virus detection, the statement reads.

Human rights advocates recommended the Health Ministry to adopt corresponding legislation for the solution of these issues.

Published in RAPSI on August

Canada: Speech from Canadian Minister of Health at AIDS2018 welcomes the Expert Consensus Statement on the Science of HIV in the Context of the Criminal Law

Remarks for Ginette Petitpas Taylor, Minister of Health – AIDS 2018 Conference Symposia“Anti-fragile: Strengthening the HIV Response through Addressing Stigma, Prejudice and Discrimination

Speech

Amsterdam, Netherlands

July 26, 2018

Introduction

Good morning.

Hello everyone. I hope everyone is doing well this morning.

I would like to thank the International AIDS Society for inviting me. It is my honour to represent Canada among such a distinguished group.

We have a lot to talk about, and we also have a lot to learn.

Central to this are the perspectives and lived experience of people living with and affected by HIV and AIDS.

To those of you who have chosen to share your stories today — thank you.

You exemplify what it means to be “anti-fragile”.

You turned your challenges into strength.

I am inspired by your determination, courage and resilience.

Over the past 30 years, we have come a long way.

Thanks to the dedication and passion of people like you, we have made once unthinkable progress toward a world without AIDS.

I am proud to say that Canada has been at the forefront of this response, through the work of our civil society as well as such extraordinary champions as Stephen Lewis, Dr. Julio Montaner and, of course, Dr. Mark Wainberg. Sadly, Dr. Wainberg is no longer with us and we keenly feel his loss at this conference.

I also want to acknowledge the invaluable global contribution of people living with HIV.

Together, we have achieved a great deal. But we still have more to do.

Many people still don’t know their status, face barriers to treatment, and lack the support they need to live healthy, active lives.

Despite our efforts, something is getting in the way.

I have spoken with many people living with HIV in my time as Canada’s Minister of Health, including during my time here this week.

And while I have heard of the many struggles faced, one thing I’ve heard repeated is that stigma is holding us back.

Stigma is a significant barrier

Stigma has many faces.

We all know about HIV-related stigma, but it is compounded by other forms of stigma.

Racism. Homophobia. Transphobia.

Stigma about mental illness.

Internalized stigma.

Discrimination against people who inject drugs and those who engage in sex work.

These are just a few of the many different faces of stigma and discrimination, which have devastating effects.

Stigma can isolate people from their intimate partners, families and communities.

Stigma can keep people from getting health care.

Stigma masks HIV …and helps fuel the AIDS epidemic worldwide.

We need to stop stigma in all its forms to ensure that all people living with HIV know their status and get the treatment they need.

A rights-based approach

So, what’s the solution? A key part of the answer lies at the intersection of human rights and public health.

Treatment alone is not enough. Fighting stigma requires an integrated approach — one that puts human rights first.

In Canada, protecting and promoting human rights is part of the social fabric of our country — and it’s essential to the way we govern.

As such, human rights guide our response to HIV in Canada and abroad.

We are working to rebuild trust with marginalized communities.

While this is an ongoing process, we’ve already taken significant steps.

One key priority is renewing our “Nation-to-Nation” relationship with Canada’s Indigenous peoples — a process based on a ‎recognition of rights, cooperation and partnership.

Another priority is LGBTQ2 rights. In November 2017, our Prime Minister formally apologized to the LGBTQ2 community for a history of federal legislation, policies and practices that were oppressive and discriminatory.

Last summer, we passed a law that prohibits discrimination against transgender Canadians and protects them against hate crimes.

We have also made significant changes to Canada’s drug policy to recognize the needs of people who use drugs.

In 2016, we restored harm reduction to the core of public health approach to the opioid crisis.

We also introduced the Good Samaritan Drug Overdose Act to provide some legal protection for individuals who seek emergency help during an overdose.

We hope this Act will help reduce fear of police attending overdose events and encourage people to help save a life.

Recently, we led the charge at the United Nations Commission on Narcotic Drugs to address stigma towards people who use drugs.

Along with nineteen of our allies, we passed a resolution that stresses the importance of fighting stigma and ensuring that no one is denied health care because of it.

Finally, we have taken steps to prevent the criminalization of HIV non-disclosure.

We know that – U=U. Undetectable = Untransmittable. This means that there is effectively no risk of sexual transmission of HIV when an individual is being treated and maintains a suppressed viral load.

Having considered the evidence, the Government of Canada has determined that the criminal law should not apply to individuals engaging in sexual activity without disclosing their HIV status, if they maintain a suppressed viral load.

My colleague, the Minister of Justice, is working with her provincial counterparts towards addressing the criminalization of HIV.

Because we know that HIV criminalization is a manifestation, and driver, of stigma.

As such, the Government of Canada welcomes the work undertaken by experts to develop the Expert Consensus Statement on the Science of HIV in the Context of the Criminal Law which was released yesterday, and supports its conclusions that more caution be exercise when considering criminal prosecution.

The U=U message needs to be heard and has to be shared.

We have a responsibility to do reduce stigma in all its forms.

I challenge my fellow ministers of health to share this message in their respective countries.

STBBI Framework

Canada’s response to HIV takes an integrated approach involving sexually transmitted and blood borne infections, which share common risk factors and transmission routes.

Just last month, Canada launched a new Pan-Canadian Framework for Action on Sexually Transmitted and Blood-Borne Infections.

This Framework will help guide our collective efforts, including our annual investment of more than $87.5 million to reduce these infections.

Meeting our targets

At the heart of this framework are the globally recognized 90-90-90 targets.

I was happy to report on Canada’s progress just last week. Good news – Canada has achieved one of our global targets and are making progress toward the other two.

Based on 2016 data, it was estimated that just over 63,000 people are living with HIV in Canada.

Of these cases, we estimate that 86% have been diagnosed, 81% are being treated and, of these, 91% are achieving viral suppression.

I’m proud of our progress — but I know that we still have work to do to achieve our goals.

We need to get to 90 across the board, and our government supports a number of initiatives to help us get there.

For example, the Know Your Status initiative in Saskatchewan has been successful in promoting HIV testing in Indigenous communities using culturally appropriate models and is showing it is possible to decrease new diagnoses in these communities.

Other important initiatives are supported by our National Microbiology Laboratories, which work with Indigenous partners to make culturally appropriate HIV testing accessible in Canada’s rural and remote communities — which if you know anything about our country’s geography, is no small challenge.

We are also supporting efforts to address stigma and discrimination in the health sector through the development of resources and training for front-line health providers to help them provide safe — non-stigmatizing —services for people living with or at risk for HIV.

International contribution

As we take action at home, we are also looking beyond our borders and supporting the global response to HIV and AIDS.

We have and will continue to support the Global Fund to fight AIDS, Tuberculosis and Malaria.

We have pledged $804 million over three years, which will help ensure people with HIV and AIDS have access to the treatment they need, no matter where they live.

I am proud that our Government supports these and other initiatives— but I also recognize these alone are not enough.

We need to keep sharing knowledge and, most importantly, we need to engage in a meaningful dialogue with people living with HIV and AIDS.

Nothing about us without us

That’s why we support organizations like the Canadian Positive People Network, a group that represents people living with HIV in Canada.

Partnerships like this help facilitate dialogue between policy makers, health care providers and people living with HIV.

As we move forward, we also have to ensure that our work is guided by the voices of youth leaders. I had the great pleasure yesterday of meeting with a group of brilliant, inspired youth from around the world.

Young people: You are the global champions in the fight against stigma, not just for the future, but for today. We need your passion, your engagement and your inspiration… to get to 90 90 90, and then to end this epidemic, for good.

Moving ahead together

We have an opportunity to elevate that conversation — to explore challenges and share solutions.

Everyone has a role to play.

Together, we can build more inclusive societies by ending stigma, prejudice and discrimination.

I wish you fruitful discussions today.

Thank you very much and enjoy the rest of the conference!

From: Public Health Agency of Canada

Bringing Science to Justice: End HIV Criminalisation Now

News Release

Networks of people living with HIV and human rights and legal organisations worldwide welcome the Expert Consensus Statement on the Science of HIV in the Context of Criminal Law

Amsterdam, July 25, 2018 — Today, 20 of the world’s leading HIV scientists released a ground-breaking Expert Consensus Statement providing their conclusive opinion on the low-to-no possibility of a person living with HIV transmitting the virus in various situations, including the per-act transmission likelihood, or lack thereof, for different sexual acts. This Statement was further endorsed by the International AIDS Society (IAS), the International Association of Providers of AIDS Care (IAPAC), the Joint United Nations Programme on HIV/AIDS (UNAIDS) and 70 additional experts from 46 countries around the world.

The Expert Consensus Statement was written to both assist scientific experts considering individual criminal cases, and also to urge governments and criminal justice system actors to ensure that any application of the criminal law in cases related to HIV is informed by scientific evidence rather than stigma and fear. The Statement was published in the peer-reviewed Journal of the International AIDS Society (JIAS) and launched at a critical moment during the 22nd International AIDS Conference, now underway.

“As long-time activists who have been clamouring for a common, expert understanding of the current science around HIV, we are delighted with the content and widespread support for this Statement,” said Edwin J Bernard, Global Co-ordinator of the HIV Justice Network, secretariat to the HIV JUSTICE WORLDWIDE campaign. “Eminent, award-winning scientists from all regions of the world have come together to provide a clarion call for HIV justice, providing us with an important new advocacy tool for an HIV criminalisation-free world.”

The Statement provides the first globally-relevant expert opinion regarding individual HIV transmission dynamics (i.e., the ‘possibility’ of transmission), long-term impact of chronic HIV infection (i.e., the ‘harm’ of HIV), and the application of phylogenetic analysis (i.e., whether or not this can be used as definitive ‘proof’ of who infected whom). Based on a detailed analysis of scientific and medical research, it describes the possibility of HIV transmission related to a specific act during sexual activity, biting or spitting as ranging from low to no possibility. It also clearly states that HIV is a chronic, manageable health condition in the context of access to treatment, and that while phylogenetic results can exonerate a defendant when the results exclude them as the source of a complainant’s HIV infection, they cannot conclusively prove that one person infected another.

“Around the world, we are seeing prosecutions against people living with HIV who had no intent to cause harm. Many did not transmit HIV and indeed posed no actual risk of transmission,” said Cécile Kazatchkine, Senior Policy Analyst with the Canadian HIV/AIDS Legal Network, a member and key partner organisation of the HIV JUSTICE WORLDWIDE campaign. “These prosecutions are unjust, and today’s Expert Consensus Statement confirms that the law is going much too far.”

Countless people living with HIV around the world are currently languishing in prisons having been found guilty of HIV-related ‘crimes’ that, according the Expert Consensus Statement, do not align with current science. One of those is Sero Project Board Member, Kerry Thomas from Idaho, who says: “I practiced all the things I knew to be essential to protect my sexual partner: working closely with my doctor, having an undetectable viral load, and using condoms. But in terms of the law, all that mattered was whether or not I disclosed. I am now serving a 30-year sentence.”

While today’s Statement is extremely important, it is also crucial to recognise that we cannot end HIV criminalisation through science alone. Due to the numerous human rights and public health concerns associated with HIV criminalisation, UNAIDS, the Global Commission on HIV and the Law, the UN Committee on the Elimination of Discrimination against Women, and the UN Special Rapporteur on the Right to Health, among others, have all urged governments worldwide to limit the use of the criminal law to cases of intentional HIV transmission. (These are extremely rare cases wherein a person knows their HIV-positive status, acts with the intention to transmit HIV, and does in fact transmit the virus.)

We must also never lose sight of the intersectional ways that — due to factors such as race, gender, economic or legal residency status, among others — access to HIV treatment and/or viral load testing, and ability to negotiate condom use are more limited for some people than others. These are also the same people who are less likely to encounter fair treatment in court, within the medical system, or in the media.

“Instead of protecting women, HIV criminalisation places women living with HIV at increased risk of violence, abuse and prosecution,” says Michaela Clayton, Executive Director of the AIDS and Rights Alliance for Southern Africa (ARASA). “The scientific community has spoken, and now the criminal justice system, law and policymakers must also consider the impact of prosecutions on the human rights of people living with HIV, including women living with HIV, to prevent miscarriages of justice and positively impact the HIV response.”

HIV criminalisation is a pervasive illustration of systemic discrimination against people living with HIV who continue to be stigmatised and discriminated against on the basis of their status. We applaud this Statement and hope it will help end HIV criminalisation by challenging all-too-common mis-conceptions about the consequences of living with the virus, and how it is and is not transmitted. It is indeed time to bring science to HIV justice.

To read the full Expert Consensus Statement, which is also available in French, Spanish and Russian in the Supplementary Materials, please visit the Journal of the International AIDS Society at https://onlinelibrary.wiley.com/doi/full/10.1002/jia2.25161

VIsit the HIV JUSTICE WORLDWIDE website to read a short summary of the Expert Consensus statement here: http://www.hivjusticeworldwide.org/en/expert-statement/

To understand more about the context of the Expert Consensus Statement go to: http://www.hivjusticeworldwide.org/en/expert-statement-faq/

HIV JUSTICE WORLDWIDE is a growing, global movement to shape the discourse on HIV criminalisation as well as share information and resources, network, build capacity, mobilise advocacy, and cultivate a community of transparency and collaboration. It is run by a Steering Committee of ten partners – AIDS Action Europe, AIDS-Free World, AIDS and Rights Alliance for Southern Africa (ARASA), Canadian HIV/AIDS Legal Network, Global Network of People Living with HIV (GNP+), HIV Justice Network, International Community of Women Living with HIV (ICW), Southern Africa Litigation Centre (SALC), Sero Project, and Positive Women’s Network – USA (PWN-USA) – and currently comprises more than 80 member organisations internationally.

Media session at Beyond Blame preconference outlines stigmatising and harmful media reporting

By Mathew Rodriguez

AMSTERDAM, Netherlands — As a news consumer, how can you tell if a story you’re reading about HIV criminalization is actually fair, or has the interests of people living with HIV in mind? Despite a noticeable shift in better coverage for HIV criminalization cases, activists at the Beyond Blame pre-conference to the International AIDS Conference in Amsterdam reported that too many journalists rely on harmful frameworks when reporting stories about potential HIV exposures and people with HIV whose bodies are criminalized.

Here are a few ways to see whether or not you’re being told a story that is doing way more harm than good for people living with HIV, as outlined by Janet Butler-McPhee, director of communications and advocacy at the Canadian HIV/AIDS Legal Network and Nic Holas, co-founder of Australia’s HIV movement The Institute of Many.

The HIV Monster

Though Butler-McPhee said this narrative is slightly fading, too many journalists still rely on this frame as a way to garner clicks. This narrative paints people with HIV as purposefully hiding their status in order to be deceptive to an HIV-negative person or people. This framework also implies that people with HIV have some innate intent to transmit the virus and that HIV-positive people are all terrifying potential perpetrators of criminal activity.

Aside from othering people with HIV, this narrative also turns HIV-negative people into innocent victims with zero agency in their own lives. These narratives often omit pertinent details about the relationship between the accused and accuser. It turns a complex relationship into victims and villains.

It’s racist AF

HIV criminalization and obvious racism go hand in hand. This is very similar to the HIV monster narrative but also relies on racist tropes to tell its story. For instance, in many countries like Canada and the United States, black men are often painted as vectors of disease who are preying on innocent white women or white gay men. This narrative happens with other marginalized groups, as well.

The story claims HIV criminalization will protect you!

Some stories share the names and information about an HIV-positive person’s HIV criminalization case as a form of “public good” — saying that the public deserves to know someone’s private health information. Butler-McPhee stressed that this is unfortunately rooted in the idea that people with HIV do not have basic rights to privacy and that outing them will do more public good than personal bad — which is wrong . Coverage that relies on outing people with HIV is often inherently racist as well. Their names are published to protect white women.

Stories like this once again put all the onus of public health on HIV-positive people. It also sets HIV apart from every other STI or blood-borne infection, reinforcing the stigmatizing idea that it is somehow scarier or deadlier. Coverage like this also retraumatizes the accused.

Additionally, Holas stressed, local police officers often rely on media to get an accused’s name in headlines and stories to get other potential sex partners to come forward to build a case around them. In cases like this, the media may be unknowingly doing the police force’s work to help criminalize a person with HIV.

The story reports that HIV is easy to transmit and a death sentence.

Any coverage of HIV in 2018 that treats HIV as an automatic death sentence is unscientific and wrong. While it’s true that many people in the global South and even certain regions in the United States might see worse outcomes due to an HIV diagnosis than others, putting the onus on the virus instead of racist socio-economic conditions puts people with HIV at risk. When discussing HIV criminalization, stories too often rely on people’s fear of the virus rather than reality to prove their point.

“It’s easy to disclose your HIV status, so just do it!”

If there’s one thing that HIV criminalization stories prove, it’s that living with HIV in 2018 is a serious risk for personal safety. However, many stories still push the idea that disclosure is the end-all-be-all of living with HIV and that it is the “morally correct” thing to do, even when the story itself is showing the many negative consequences that can come along with HIV disclosure.

These stories also don’t take into the account the pervasive violence and stigma that people living with HIV face daily. As Holas said, these stories revolve around the idea that “if you haven’t done anything wrong, you’ve got nothing to worry about.”

For those in the media interested in improving their coverage or for advocates looking to make sure their messaging on HIV criminalization is media-ready, the HIV Justice Network does have a guide on HIV criminalization and the media.

Published in INTO on July 23, 2018

Beyond Blame symposium highlights intersectionality of issues related to HIV criminalisation at AIDS 2018

Strategies to oppose the unscientific criminalisation of HIV transmission received a high profile at events in advance of the 22nd International AIDS Conference (AIDS 2018) in Amsterdam this week.

These included the launch by the Global Commission on HIV and the Law of a Supplement to its 2012 Report, Risks, Rights & Health, and the HIV Justice Worldwide symposium, Beyond Blame: Challenging HIV Criminalisation.

Livestream: Beyond Blame – Challenging HIV Criminalisation: Rapporteurs and Closing (HJN, 2018)

Welcome to BEYOND BLAME – Challenging HIV Criminalisation, live from De Balie in Amsterdam, 23 July 2018.

15:45 – 16:00 Rapporteur reports from the breakout sessions Lead rapporteur: Sally Cameron (HIV Justice Network)

16:00 – 16:30 Group discussion: Next Steps Facilitators: Naina Khanna (Positive Women’s Network – USA) and Lynette Mabote (ARASA)

Livestream: Beyond Blame – Challenging HIV Criminalisation: Building Bridges Across Movements: Linking HIV Criminalisation With the Criminalisation of Abortion, Drug Use, Gender Expression, Sexuality and Sex Work (HJN, 2018)

Welcome by Luisa Cabal (UNAIDS) Moderator: Susana Fried (CREA and Global Health Justice Partnership) With: Ricki Kgositau (AIDS Accountability International), Oriana López Uribe (BALANCE / RESURJ), Nthabiseng Mokoena (ARASA), Niluka Perera (Youth Voices Count), Jaime Todd-Gher (Amnesty International), Kay Thi Win (Asia Pacific Network of Sex Workers)

Livestream: Beyond Blame – Challenging HIV Criminalisation: Plenary 2 (HJN, 2018)

Welcome to BEYOND BLAME – Challenging HIV Criminalisation, live from De Balie in Amsterdam, 23 July 2018.

11:20 – 12:10 What About Human Rights? The Benefits and Pitfalls of Using Science in Our Advocacy to End HIV Criminalisation Facilitator: Laurel Sprague (UNAIDS) With: Chris Beyrer (John Hopkins Bloomberg School of Public Health), Edwin Cameron (Constitutional Court of South Africa), Richard Elliott (Canadian HIV/AIDS Legal Network), Lynette Mabote (ARASA), Paula Munderi (IAPAC)

12:10 – 13:00 Women and HIV Criminalisation: Feminist Perspectives Facilitator: Naina Khanna (Positive Women’s Network – USA) With: Sarai Chisala-Tempelhoff (Women’s Lawyers Association, Malawi), Michaela Clayton (ARASA), Kristin Dunn (AIDS Saskatoon), Deon Haywood (Women With A Vision)

New report from the Global Commission on HIV and the Law states that discrimination and punitive laws hamper the global HIV response

Bad laws and discrimination undermining AIDS response

AMSTERDAM, July 22 – Discrimination against vulnerable and marginalized communities is seriously hampering the global effort to tackle the HIV epidemic according to a groundbreaking new report by the Global Commission on HIV and the Law. Despite more people than ever before having access to antiretroviral treatment, the new report emphasizes that governments must take urgent action to ensure rights-based responses to HIV and its co-infections (tuberculosis and viral hepatitis). The new report comes on the eve of the biannual global AIDS conference, which is taking place in Amsterdam.

The Global Commission on HIV and the Law – an independent commission convened by UNDP on behalf of UNAIDS – operates with the goal of catalyzing progress around laws and policies that impact people affected by HIV. In 2012, the Commission highlighted how laws stand in the way of progress on AIDS while citing how to institutionalize laws and policies that promote human rights and health. The 2018 supplement to the Commission’s original report assesses new challenges and opportunities for driving progress on HIV, tuberculosis and viral hepatitis through evidence and rights-based laws and policies.

“Progress on tackling the AIDS epidemic shows that when we work together we can save lives and empower those at risk,” said Mandeep Dhaliwal, the Director of Health and HIV at UNDP. “However, the new report is also a warning that unless governments get serious about tackling bad laws, the overall AIDS response will continue to be undermined and we will fail those who are left behind.”

For the past six years, the Global Commission has made clear how marginalized groups are continually left behind in the global HIV response. Men who have sex with men, people who use drugs, transgender people and sex workers face stigma, discrimination and violence that prevents their ability to receive care, and LGBT populations are still under attack in many countries around the world.

Young women and adolescent girls are also uniquely affected by HIV and are not receiving adequate care. In 2015, adolescent girls and young women comprised 60 percent of those aged 15 to 24 years living with HIV and almost the same percentage of new HIV infections were among this cohort. Sexual and reproductive health care, including HIV testing and treatment, have consistently been kept out of the hands of the women and girls who need them.

“Global politics are changing, and repressive laws and policies are on the rise,” said Michael Kirby, former Justice of the High Court of Australia. “In recent years, political trends have negatively impacted the global HIV response: civic space has shrunk, migrants don’t have access to health care, and funding has dropped.”

The report warns that shrinking civil society space due to government crackdowns is hampering the HIV response as marginalized groups are seeing key health services cut off. The fight against HIV, tuberculosis and viral hepatitis will only be won if civil society is empowered and able to provide services, mobilize for justice and hold governments accountable.

“In the wake of the ongoing global refugee crisis, borders have tightened and access to health services has been restricted for millions of migrants – exactly the opposite of what is needed,” said Dr. Shereen El Feki, Vice-Chair of the Commission. “Condemning people who have left their homes to seek safety strips them of their human rights and in the process increases their vulnerability to HIV and its co-infections.”

Refugees and asylum seekers are often at high risk of HIV and overlapping infections like tuberculosis, but harsh laws restrict health care access. Laws must change to ensure that everyone, no matter where they are from, can receive quality health services. The world is also still off track in funding responses to HIV, tuberculosis and viral hepatitis: in 2015 – the same year that countries adopted the 2030 Agenda for Sustainable Development and its pledge to leave no one behind – donor funding for AIDS fell by 13 percent. Sadly the small uptick in donor funding for HIV in 2017 is at best an anomaly.

Despite these challenges, UNDP together with its UN and civil society partners have helped 89 countries revise their laws to protect people’s health and rights since 2012. Successes include:

· HIV criminalization laws have been repealed in Ghana, Greece, Honduras, Kenya, Malawi, Mongolia, Switzerland, Tajikistan, Venezuela, Zimbabwe and at least two US states.

· Leaders are taking steps to address gender inequities to bolster the rights of women and girls who are disproportionately affected by HIV: Tunisia recently passed a law to end violence against women in public and private life, and Jordan and Lebanon have strengthened legislation on marital rape.

· Access to health care is being prioritized with emphasis on emerging illnesses that target people vulnerable to HIV, including Portugal instituting universal access to hepatitis C treatment in 2015, and France following suit in 2016. A court ruling in India led the Government of India to change its policy on who is eligible for tuberculosis treatment.

· Governments are taking steps to protect the rights of vulnerable groups: Canada, Colombia, Jamaica, Norway and Uruguay have decriminalized possession of small amounts of cannabis and Jamaica erased the criminal records of low-level drug offenders.

The success and sustainability of the global HIV response will be determined in large part by urgent action on laws and policies. The Commission calls on governments and leaders around the world to institute effective laws and policies that protect and promote the rights of people affected by HIV and its co-infections. Since 2012, there have been positive changes in transforming laws and policies, and advancements in science that make it possible to further accelerate progress. The future will be determined by legal environments that drive universal health and human dignity.

Media contact:

In Geneva: Sarah Bel, Communications Specialist, sarah.bel@undp.org, Tel: +41 79 934 1117

In New York: Sangita Khadka, Communications Specialist, UNDP Bureau for Policy and Programme Support, sangita.khadka@undp.org; +1 212 906 5043

The Global Commission on HIV and the Law is an independent body, convened by the United Nations Development Programme (UNDP) on behalf of the Programme Coordinating Board of the Joint United Nations Programme on HIV/AIDS (UNAIDS).

Additional information is available at www.hivlawcommission.org.

Published in UNDP website on July 22, 2018