AIDS status & challenges of the epidemic

4. Are human rights and vulnerable populations sufficiently protected?

• 4.1 Is AIDS sufficiently grounded in human rights?
• 4.2 What has been done to reduce vulnerability to HIV infection?

4.1 Is AIDS sufficiently grounded in human rights?

The source document for this Digest states:

People in sub-Saharan Africa on antiretroviral treatment as percentage of those in need, 2002-2005

Despite some improvements between 2003 and 2005, the global AIDS response in many countries is still insufficiently grounded in human rights.

• In 18 of 21 countries surveyed from sub-Saharan Africa, the Asia-Pacific region, eastern and western Europe, and north Africa, national reports cited improvement in policies, laws and regulations to promote and protect human rights.
• Although six out of every 10 countries surveyed report the existence of laws and regulations to protect people living with HIV from discrimination, many indicate that national laws have not been fully implemented or enforced, often due to lack of budget allocations.
• Half of reporting countries also acknowledge the existence of policies that interfere with the accessibility and effectiveness of HIV prevention and care measures, such as laws criminalizing consensual sex between males, prohibiting condom and needle access for prisoners, and using residency status to restrict access to prevention and treatment services.

Source & ©: UNAIDS  Report on the global AIDS epidemic: Executive summary, (2006),
The declaration of commitment on HIV/AIDS: Progress since 2001, Human Rights, p. 13

For more information on this question, see:
 Chapter 03 Progress in countries, HIV and human rights, p.68,
of the full 2006 Report on the global AIDS epidemic  by UNAIDS

4.2 What has been done to reduce vulnerability to HIV infection?

The source document for this Digest states:

While funding for HIV programmes has increased in recent years, many countries fail to direct financial resources towards activities that address the prevention needs of the populations at highest risk, opting instead to prioritize more general prevention efforts that are less cost-effective and less likely to have an impact on the epidemic.

• Evidence from Uganda shows that a child who drops out of school is three times more likely to be HIV-positive in his or her twenties than a child who completes basic education. Three-quarters of responding countries have established structures to coordinate ministry of education responses to the epidemic. Yet, only 59% of these ministries in all countries and 70% in high-prevalence countries have a dedicated budget.
• In sub-Saharan Africa, 21 of 25 countries reported having reduced or eliminated school fees for vulnerable children and having implemented community-based programmes to support orphans and other vulnerable children.
• Some countries are adopting more progressive approaches to reduce vulnerability for injection drug users.
  
  
  • Despite a strong commitment to compulsory treatment for drug dependence and abstinence-based programmes, Malaysia recently decided to introduce harm reduction programmes.
  • In 2005, a judge in the Islamic Republic of Iran ordered that individuals who use illegal drugs no longer be targets of criminal repression but instead be treated as patients by the public health system.
  • In Central Asia, the Kyrgyz Government supports needle and syringe exchange programmes in three cities and in prisons in the country.
  • Overall, however, fewer than 20% of people who inject drugs received HIV prevention services, with coverage of less than 10% reported in eastern Europe and central Asia, where drug use is a major driver of the rapidly expanding epidemic; counterproductive laws and policies in some countries still prohibit substitution therapy with buprenorphine or methadone, which were added in 2005 to the WHO Model List of Essential Medicines.
  • Only 10 of 24 countries that reported data for sex workers achieved at least 50% coverage of prevention services for this population.
  • Public health authorities are devoting fewer resources to men who have sex with men than epidemiological evidence suggests is necessary—a short-sighted policy in light of rising HIV prevalence among this population in many countries.

Source & ©: UNAIDS  Report on the global AIDS epidemic: Executive summary, (2006),
The declaration of commitment on HIV/AIDS: Progress since 2001, Reducing Vulnerability, p. 14

Acknowledging the potential for conflicts and disasters to increase vulnerability and contribute to the spread of HIV, the Declaration of Commitment on HIV/ AIDS calls on countries to integrate HIV activities into programmes and action plans for emergency situations. It also provides for international and nongovernmental organizations to invest in HIV awareness and training for personnel and for HIV to be incorporated into operations of national uniformed services and international peacekeepers.

• According to UNHCR, only 65% of national strategic plans in 2004 mentioned refugees and only 43% articulated specific refugee-related activities. ⁸
• In 2005, 86% of countries had a formal strategy for addressing HIV among uniformed services, compared with 78% in 2003.
• The UNAIDS Secretariat and the UN Department of Peacekeeping Operations have fully integrated HIV awareness programmes into UN-sanctioned peacekeeping operations. Currently, all peacekeeping missions benefit from full - or part- time HIV advisers.

⁸ UNAIDS/UNHCR (2005). Strategies to support the HIV-related needs of refugees and host populations. UNAIDS/ UNHCR, Geneva.

Source & ©: UNAIDS  Report on the global AIDS epidemic: Executive summary, (2006),
The declaration of commitment on HIV/AIDS: AIDS in conflict or disaster regions, p. 16

For more information on this question, see:
 Chapter 03 Progress in countries, Reducing vulnerability among most-at-risk populations, p.69, in conflict and disaster-affected regions, p.72, and
 Chapter 05 At risk and neglected: four key populations, p.104,
of the full 2006 Report on the global AIDS epidemic  by UNAIDS