Newsletter Issue 7

Welcome to the 2nd ARASA newsletter for 2010. With this issue, the AIDS and Rights


Alliance for Southern Africa (ARASA) is proud to launch its vibrant new electronic, web-


based newsletter! We are proud to bring you a resource that links you directly to our website,


where you can explore the work of ARASA and its partners in further detail. Please send


any feedback you have on this new format to Gillian, the Communications Co-ordinator at


gillian@arasa.info


From 18 to 23 July, staff and partners of ARASA joined 19,000 delegates at the International


AIDS Conference in Vienna, Austria to review progress, challenges and lessons learned in


the global AIDS response.


In this newsletter we focus solely on the International AIDS Conference and bring you stories


and perspectives from ARASA staff and partners on their experience at the conference


as well as reflections on topics, which enjoyed prominence during the conference and


link to advocacy initiatives currently being implemented by ARASA and its partners.


This major gathering for people living with HIV, scientists, community members, lawmakers


and others working in the AIDS response, evaluated recent scientific developments


and lessons learnt, while providing a platform to collectively chart a way forward for the


AIDS response. Read the full article on the significance of the conference theme and key


discussions here


Although this is by no means a conclusive record of the conference proceedings, we


hope you will enjoy reading this issue and we look forward to hearing from you soon!

 

ARASA at the Conference

 


ARASA was represented at the conference by 7 staff members, who participated in X


sessions, x panel discussions and presented 1 poster presentation. In addition, ARASA staff


also participated in side meetings organised by UNAIDS, Global Fund and other agencies,


donors and partners. In total, X amount of materials were distributed and an estimated X


amount of visitors welcomed to the exhibition booth, sponsored by Oxfam Great Britain.


Several ARASA partners also attended the conference and showcased their material at the


booth.


Click here to read the full article, including information on the activities ARASA was directly


involved in as well as presentations, images and videos of the sessions.


No Retreat! Fund AIDS!


On Sunday, 18 July, ARASA joined a few hundred AIDS activists to kick off the conference


with a mass demonstration and ‘die-in’ under the theme ‘No Retreat, Fund AIDS! Broken


Promises Kill! ’


This call propelled the discussion on the impact of the global economic crisis and trends


amongst donors and governments to withdraw funding commitments to HIV, to the centre of


the conference agenda and demonstrated the importance of continued investments in the


AIDS response as crucial to broader health and development goals.


AIDS activists, with placards calling for AIDS funding, were visibly present throughout


the conference to call for urgency and accountability in the AIDS response and to remind


delegates that there is no room for complacency. Paula Akugizibwe, ARASAs Advocacy Co-


ordinator, represented ARASA on several panel discussions on this topis and shares her


experiences here


Criminalisation of HIV Transmission and/ or Exposure: A key barrier to Universal Access


The criminalisation of HIV transmission and / or exposure has become a global phenomenon


with increasing numbers of prosecutions around the world.


Although there is a growing body of evidence that criminalisation is bad public health policy,


criminalisation of HIV transmission or exposure has been touted as a remedy to protect


women and reduce their vulnerability against HIV infection in Africa. AIDS2010 presented


an important platform for people living with HIV, human rights activists and stakeholders in


the AIDS response to dialogue and move towards a common understanding of the harmful


impacts of criminalisation of HIV transmission or exposure.


In addition, UNDP in collaboration with UNAIDS, launched a commission on HIV and the


Law during the conference. To learn more about this commission and get involved, please


visit this link.


You have human rights unless you are gay...


During the conference, delegates were presented with evidence from both public health


and human rights arguments to support the call for legal reform to decriminalise practices


by groups most at risk of HIV such as men who have sex with men, sex workers and


drug users. It was argued that universal access should be universal by definition and that


punitive laws criminalising homosexuality present major challenges to reaching MSM and


other lesbian, gay and transgender (LGBT) groups, thus omitting them from most national


responses in Africa.


Felicita Hikuam presented on the subject of advocacy for decriminalisation of homosexuality


in Africa during several sessions and shares the outcomes of these discussions here.


Close newsletter with a line on what ARASA is; contacts; subscription info etc

 

 

No Retreat! Fund AIDS!

 

No retreat, fund AIDS
Thousands demonstrated for AIDS Funding. 
Photo:  ©IAS/Steve Forrest/Workers' Photos

The anxiety that has been building up over the past year with regards to the future of funding for HIV, particularly funding for HIV treatment, came through strongly at the International AIDS Conference (IAC). This is an issue on which ARASA has been advocating for over a year now, but the conference provided a rare platform for direct interfacing with key government leaders, as well as a wide range of proponents and opponents of HIV funding, so as to gain deeper insight into the challenges that have led to the worrying global decline in political commitment to universal access to HIV prevention, treatment and care.

ARASA contributed to the funding discourse at the IAC through participation in several sessions that explored different angles to the complex funding debate. I began my plenary presentation at the opening ceremony with ARASA’s Lords of the Bling music video, which highlights extravagant expenditure by African heads of state in comparison to the quantities of HIV and TB treatment that could have been purchased at the same cost. The message of the video, which was echoed throughout the presentation – namely that the threat to health in general and universal access in particular is not one of lack of resources, but rather of skewed priorities – appeared to resonate strongly with the audience. It was brought home by the fact that Austria, which expected to make about US$45 million in revenue from the conference, has only ever contributed US$1 million to the Global Fund and recently confirmed that they shall not make any contribution for the next few years as health is not a ‘thematic
priority’ of their development strategy.

In my plenary presentation, entitled “Make or Break” (co-authored by Michaela Clayton, Allan Maleche and Anand Grover) it was stressed that the challenges facing HIV funding are rooted primarily in the lack of recognition of health as a human right in most countries around the world. Recognition of the right to health would entail a governmental obligation to prioritise and sustain resource allocation for it, while approaching public health as a policy prerogative allows for vulnerability to competing political interests – interests that often do not contribute to human development.

Contrary to the misguided statements that have been made by influential figures in the policy arena, such as Roger England who has repeatedly advocated for a massive reduction in global AIDS funding, I re-iterated the message of a statement produced by ARASA last year and endorsed by close to 100 organisations from around the world– namely, that HIV is not over-funded: rather, health is under-funded.

In a panel session entitled “Durban +10: A New Call to Activism” which was organised by the Global Fund to fight AIDS, TB and Malaria and included its executive director Michel Kazatchkine, South African activist Mark Heywood and Lesotho Minister of Health Mphu Ramatlapeng, it was emphasised that over the past decade, rights-based AIDS activism radically altered the landscape of chronic public health neglect, thus driving massive global investment in HIV. In addition to the establishment of the Global Fund in 2002 which was the result of advocacy, the 2001 Abuja Declaration by African heads of state, in which they pledged to contribute at least 15% of their national budgets to health, was stimulated by a summit that had focused on the threat posed by HIV, TB and Malaria in the African region –these infectious diseases were at the time described as the biggest threat to the survival of the African peoples. HIV has thus been precedent-setting with regards to health funding, at the global, regional and national levels. Failure to replenish the Global Fund – which requires pledges from donors amounting to at least US$20 billion in October 2010 – will undo this hard-won precedent and send out a strong political message that we are regressing to the time where the responsibility to provide access to life saving health services was viewed as optional, depending on the price tag.

The impact of backtracking on commitment to universal access goes beyond the far-reaching political implications. Health systems also stand to lose drastically from inadequate investment in HIV treatment. I joined Prof Kazatchkine and Minister Ramatlapeng in another panel discussion on “The Future of Universal Access”, which included Eric Goosby and was chaired by Stephen Lewis. Unsurprisingly, funding dominated this discussion, with Eric Goosby emphasizing the need to get more ‘bang for the buck’ by focusing on identifying cost-saving efficiencies that will reduce the rate of transmission and strengthen the integration of HIV programmes with other disease responses, resulting in overall health systems strengthening. However, I pointed to the findings of MSF’s recently released study in Haiti on the impact of ART scale-up, which showed that scaling up treatment presents some of the most significant cost-saving efficiencies with regards to reduction in the burden of other diseases such as TB.

Additionally, a large body of scientific evidence that was presented at the conference created a strong basis for the “Treatment as Prevention” paradigm that is a cornerstone of UNAIDS’s new “Treatment 2.0” initiative, which recognizes that the most potent biomedical tool we have to prevent HIV transmission is ART, which has been associated with reductions in HIV transmission of up to 90%. At a panel discussion on the implications of ART as prevention that I chaired, which included ARASA staff member Boniswa Seti as well as Reuben Granich from the WHO, author of the Lancet paper that first drove this debate into the limelight, hopes were expressed that the preventive benefit of treatment will provide added impetus to scale up access to ART.

However, as I expressed during the panel discussion on the future of Universal Access as well as in the IAC’s opening press conference, lack of principled commitment to the right to health as well as inadequate civil society involvement in budgeting and expenditure means that governments can make financial decisions that are not ideal within a long-term frame, but serve their interests within the shorter frame of election cycles and immediate popular pressure. As a result, particularly in the context of HIV funding, science and economic rationale for scaling up investment appears to be getting discarded in favour of investments that have more immediate noticeable effects and are therefore politically expedient in the short term.

Within the African region, the situation becomes more complex as one is often attempting to confront these problems in the context of poor governance. Although, in our discussion panels, Health Minister Ramatlapeng from Lesotho repeatedly called on African governments to fulfil their Abuja commitments and drew attention to the importance of activism in ensuring accountability of governments, I pointed out that she has in the past subjected ARASA partners in Lesotho to political intimidation as a result of their efforts to hold government accountable. The ability of civil society to hold governments to account – be it with the amounts of money invested in health or the manner in which available funding is being used – is severely restricted by lack of political space and government intimidation of critics, which is endemic in many countries.

To highlight this point, my plenary presentation included a message from Alfred Maketekete Thotolo – national coordinator of the ADRA treatment literacy and advocacy programme in Lesotho, which is supported by ARASA – who stated that “We see government, through parliament, writing off huge amounts of money that have been spent and unaccounted for. This is a gross violation of tax payers' rights to information… A lot of examples from the [Public Accounts 2006/7] audit report can be cited and yet government does nothing about such irregularities while people are dying due to lack of poor health services and shortage of essential drugs. About 60,000 PLWHIV are still awaiting to be enrolled in ART... Universal Access can be a reality only if our governments stop misusing our taxes and set priorities right. [Our rulers] must be forced to account for all the money entrusted to them! Universal access is only possible through accountability.”

It is therefore clear that the challenge we face is not simply one of money in the bank, but also of repairing the dire lack of transparency and accountability when it comes to usage of both donor and domestic funding earmarked for social development. Unless we create new and effective ways of addressing this overarching and long-standing political disease – including, critically, holding African governments to account on their commitment to increasing domestic investment in health – advocacy for increased resources will be severely compromised.

During the conference I was also involved in several media events, one of which was a BBC panel set up to discuss the human rights issues related to treatment access. One of the women on this panel is from a low-income community in Kenya, and is living with HIV. In Kenya, access to free ARV treatment is government policy – however, she said, although her CD4 count is 71 and her son’s CD4% is less than 10, she has not attempted to initiate treatment because they do not have a regular supply of food. Her concerns about potential interruption of treatment if she cannot tolerate the side effects due to hunger have prevented her from accessing treatment even though it is available free of charge. In an abstract- driven session on Programmatic Management on TB/HIV that I co-chaired, it was interesting to note that the top risk factor for death from TB/HIV co-infection, regardless of CD4 count, is malnutrition. This drew attention to the need for responsible government expenditure not just as it pertains to health services, but across the board, as the success of health interventions depends to a large extent on the fulfillment of other millennium development goals such as food security, eliminating poverty and striving for gender equality.

The last panel in which I was involved, “Political and Economic challenges to achieving Universal Access”, included economists, activists and Anand Grover, the UN Special Rapporteur on the right to health, and explored some of the ways in which advocacy needs to evolve in order to ensure progress towards universal access. I shared an experience from the opening ceremony of the IAC, which began with activists taking over the stage to demand continued political commitment to HIV funding. As time passed, delaying the ceremony from beginning, I witnessed a conference organiser advise the first two
speakers on the compromise that had been reached – namely, that if the speakers began by re-iterating and stating their support for the demand on the banner – “No Retreat: Fund AIDS” – the activists would leave the stage, allowing the ceremony to commence. The speakers complied and opened with the words “We agree: No retreat, fund AIDS”, whereupon the ceremony rolled forward – although it was sporadically interrupted by activists chanting slogans in protest of a comment made on stage, in response to which the speakers repeated this tactic– for example, “We agree – sex work is work.”

It is my feeling that one of the biggest challenges facing HIV advocacy is that political leaders have learnt that instead of resisting activist demands, the best way to quell advocacy is by endorsing these demands in rhetoric and then, through inaction, dismissing them in practice. It is much easier to advocate for leaders to make certain commitments than it is to do the long-term monitoring and advocacy on the implementation of these commitments.

In order for AIDS activism to be impactful and in fact relevant over the next decade, particularly in the light of funding challenges, there is a need to become more analytical, in-depth and focus on long-term strategies that are rooted in a thorough and comprehensive grasp of science as well as politics, and are driven by consistent scrutiny of implementation of commitments. Additionally, we need to find creative ways of conveying our advocacy messages, so as to better mobilize broad-based public support to address the issues of accountability and governance that often undercut health interventions.
Ultimately, the campaign for increased health resources is about social justice and as such requires mass social mobilization in order to be successful.

Over the next two months, in the lead-up to the Global Fund replenishment meeting in October, ARASA’s advocacy will attempt to embrace these principles. Following on from the advocacy roadmap developed at the African Civil Society meeting on resource mobilization for universal access, which was convened by ARASA in May, we have secured a grant to advance hard-hitting and creative advocacy strategies at the regional level as well as in key countries to build up public pressure for the money for health campaign. In Cape Town on 10 August, we launched our song “Make it Count” on the radio, which is a vehicle through which local music celebrities have begun to convey these messages to their fan bases. ARASA is also coordinating content for a special edition of Pambazuka – a pan-African magazine – on health funding, which will attempt to use literary avenues to mobilize further support for advocacy actions on health funding. Additionally, following on from the work done at the conference, ARASA has been invited to the US in September to do media work in an attempt to influence policy decisions in the lead-up to the Millenium Development Goal summit and the Global Fund replenishment meeting, and to address the US Congress on the issue of funding for universal access. We hope for active participation and support of partners as we pursue these various avenues for advocacy. My overwhelming feeling coming out of the conference was that without renewed advocacy energy, focus, and strategic alliance-building, the future of HIV funding – and following on from that, funding for health overall – looks very bleak.

 

Introduction

 

Welcome to the 2nd ARASA newsletter for 2010. With this issue, the AIDS and Rights Alliance for Southern Africa (ARASA) is proud to launch its vibrant new electronic, web-based newsletter! We are proud to bring you a resource that links you directly to our website, where you can explore the work of ARASA and its partners in further detail. Please send any feedback you have on this new format to Gillian, the Communications Co-ordinator at gillian@arasa.info

In this newsletter we focus solely on the International AIDS Conference and bring you stories and perspectives from ARASA staff and partners on their experience at the conference. We also bring you their reflections on topics that enjoyed prominence during the conference and are relevant to advocacy initiatives currently being implemented by ARASA and its partners.

This major gathering for people living with HIV, scientists, community members, lawmakers and others working in the AIDS response, evaluated recent scientific developments and lessons learnt, while providing a platform to collectively chart a way forward for the AIDS response. Read the full article on the significance of the conference theme and key discussions here.

Although this is by no means a conclusive record of the conference proceedings, we hope you will enjoy reading this issue and we look forward to hearing from you soon!

ARASA at the Conference

From 18 to 23 July, staff and partners of ARASA joined 19,000 delegates at the International AIDS Conference in Vienna, Austria to review progress, challenges and lessons learned in the global AIDS response.

Click here to read the  full article, including information on the activities ARASA was directly involved in as well as presentations, images and videos of the sessions.

No Retreat! Fund AIDS!

On Sunday, 18 July, ARASA joined a few hundred AIDS activists to kick off the conference with a mass demonstration and ‘die-in’ at the opening ceremony under the theme ‘No Retreat, Fund AIDS! Broken Promises Kill! ’

This call propelled the discussion on the impact of the global economic crisis and trends amongst donors and governments to renege on funding commitments to HIV, to the centre of the conference agenda and demonstrated the importance of continued investment in the AIDS response as crucial to broader health and development goals.

AIDS activists, with placards calling for AIDS funding, were visibly present throughout the conference to call for urgency and accountability in the AIDS response and to remind delegates that there is no room for complacency. Paula Akugizibwe, ARASAs Advocacy Co-ordinator, represented ARASA on several panel discussions on this topic and shares her experiences here. 

Criminalisation of HIV Transmission and/ or Exposure: A key barrier to Universal Access

The criminalisation of HIV transmission and / or exposure has become a global phenomenon with increasing numbers of prosecutions around the world.

Although there is a growing body of evidence that criminalisation is bad public health policy, criminalisation of HIV transmission or exposure has been touted as a remedy to protect women and reduce their vulnerability against HIV infection in Africa. AIDS2010 presented an important platform for people living with HIV, human rights activists and stakeholders in the AIDS response to dialogue and move towards a common understanding of the harmful impacts of criminalisation of HIV transmission or exposure, particularly on women.

You have human rights unless you are gay...

During the conference, delegates were presented with evidence from both public health and human rights quarters to support the call for legal reform to decriminalise practices by groups most at risk of HIV such as men who have sex with men, sex workers and drug users. It was argued that universal access should be universal by definition and that punitive laws criminalising homosexuality present major challenges to reaching MSM and other lesbian, gay and transgender (LGBT) groups, thus omitting them from most national responses in Africa.

Felicita Hikuam presented on the subject of advocacy for decriminalisation of homosexuality in Africa during several sessions and shares the outcomes of these discussions here. 

The AIDS and Rights Alliance for Southern Africa (ARASA) is a regional partnership of over 50 organisations working together to promote a human rights based approach to HIV/AIDS and TB.

To subscribe to our newsletter, click here.


 
 

You have human rights unless you are gay...

Joel Nana, Executive Director, African Men for Sexual Health and Rights speaking on HIV and homosexuality in Africa
Joel Nana, Executive Director, African Men for Sexual
Health and Rights speaking on HIV and homosexuality in 
Africa. Photo: ©IAS/IAS/Steve Forrest/Workers' Photos

 

“Cultural sensitivity has been the cover under which a lot of repression occurs; under which many atrocities have been perpetrated against homosexuals and under which the genocide of homosexuals continues to happen,” stated Robert Carr, Director of Policy and Advocacy, International Council of AIDS Services Organizations (ICASO), during a session entitled: ‘Know your Epidemic, Know your Response’, which he co-chaired. “Cultural sensitivity has been used as an argument to suppress democratic discussions on issues such as HIV, which affect everyone, including homosexuals and other same-sex couples. Everyone, even those in same sex relationships, has a right to take part in democratic discussions”, he added.

This statement encompassed the sentiments shared by many speakers on the subject of homosexuality in Africa, calling for g rights activists, people living with HIV, AIDS activists and human rights activists to break the silence and denial that surround same sex relationships in Africa.

“The provisions of the penal code are increasingly being used to arrest, detain, blackmail and most importantly silence MSM across Africa,” explained Joel Gustave Nana, Executive Director, African Men for Sexual Health and Right.

Recently, we have witnessed a spate of prosecutions against homosexuals along with propositions for harsher sentences across Africa. Across the continent, 38 countries criminalise same sex relationships and punishment ranges from imprisonment to death. Even in countries that have no specific criminal penalties for same-sex conduct, authorities have detained suspects under a variety of laws including public indecency, vagrancy and debauchery. Popular arguments supporting criminalisation include: ‘homosexuality is unnatural’; ‘un-African’; and against African ‘culture, religion and values’.

Several studies show that same sex sex has been practiced in Africa since pre-colonial days, attesting that the legacy of colonialism was criminal laws against homosexuality and not homosexuality itself.

“We need more conversation on the rights of lesbians, gays and other sexual minorities, including how criminalisation of same sex behaviour affects HIV responses. We need to take these conversations to the community level in a non-confrontational manner to break down the fears and misconceptions that exist and address the rampant homophobia that is behind many of these punitive laws,” explained Felicita Hikuam, ARASA’s Programmes Manager.

Although there is insufficient research regarding HIV prevalence amongst men who have sex with men (MSM) in Africa, several studies have shown that HIV prevalence rates amongst MSM are up to 10 times higher than among the general public. In addition, prevalence rates amongst MSM were highest in countries that ciminalise same sex practices.

Recent studies in Namibia, Malawi and Botswana showed that HIV prevalence among MSM was up to 35% for MSM between the ages of 30 and 49, which is much higher than the general population in that age group.

Across sub-Saharan Africa, high rates of HIV prevalence in MSM directly impact on prevalence rates in the general public, as many men in same sex relationships also have concurrent relationships with women to gender-conform and be socially acceptable. “In a project in Senegal (Dakar), 88% of men who had sex with men also reported vaginal sex, and 20% reported anal sex with a woman,” explained Felicita.

In addition, criminalisation of homosexuality heavily affects HIV responses, as anyone seen to be supporting MSM, including AIDS service organisations implementing HIV prevention activities for MSM, are harassed, side-lined and prosecuted. Recent examples of the effects of criminalisation of homosexuality on the work of non-governmental organisations was highlighted in examples of the arrest and prosecution of staff working for Gays and Lesbians for Zimbabwe as well as of staff of the ARASA partners, Centre for Human Rights and Rehabilitation and Centre for the Rehabilitation of People (CEDEP) in Malawi early in 2010.

Criminalisation of homosexuality drives MSM underground, away from services. It suppresses open discussions and discourages research on prevalence and needs of MSM. This directly contributes to the lack of funding for MSM programmes, thus hampering universal access in many countries. “UNAIDS estimated Africa needed US$353 million for HIV prevention for MSM from 2006 to 2008, while the total amount of funding committed in 2006 was than less US$2 million,” explained Felicita.

However, there is some good news on this front, as the Global Fund for AIDS, Tuberculosis and Malaria recently issued policy guidelines entitled: The Global Fund, HIV and Sexual Orientation / Gender Identities, which recognises the need to strengthen efforts to ensure that most affected populations, including sex workers, MSM, transgender people and other sexual minorities be given appropriate priority in Global Fund policies, processes and funding.

Criminalisation of same-sex relationships increases and legitimises homophobia and prevents redress when acts of violence or discrimination are perpetrated against homosexuals. The lack of protection by the law makes it difficult for sexual minorities to claim the kinds of rights available to heterosexual people.

The conference learned that many African countries have recognised MSM as a most at risk group in their HIV and other health policies but that this has not translated into progressive changes in the legal environment.

The delegates were reminded that all rights of MSM should be protected, not only the right to health, using public health arguments, but for fundamental human rights reasons as well. “The life of men who have sex with men don’t only revolve around health or the lack of health,” explained Joel Nana. “There are other issues such as extortion, harassment, expulsion from schools, unlawful arrest and detention, disownment by families and economic disenfranchisement that deserve equal attention.”

The most progressive move in this area by an inter-governmental body in Africa, is the passing of a resolution by the African Commission on Human and People’s Rights, the foremost protector of human and people's rights on the continent in May 2010 to establish a committee for the protection of the rights of people living with HIV and those most at risk, vulnerable and affected by HIV. The resolution provides the committee with a mandate that includes giving special attention to persons belonging to vulnerable groups, including MSM.

United Nations agencies, particularly the Joint Programme on HIV and AIDS, UNAIDS, has expanded its leadership on and identified its responsibilities towards MSM and other sexual minorities through the new UNAIDS Outcome Framework priority area and decisions taken at the Programme Coordinating Board to support countries to remove punitive laws and find ways of working with most at risk populations to address HIV.

ARASA is currently drafting a policy brief with responses to arguments frequently cited to support anti-homosexuality legislation in Africa. To contribute to this document, contact ARASA’s Advocacy Officer, Lynette Mabote, at lynette@arasa.org

For further resources on advocacy for MSM in Africa please visit:

International HIV/AIDS Alliance resource: Responding to the HIV-related needs of MSM in Africa http://www.aidsalliance.org/includes/Publication/HIV-Related_needs_of_MSM_in_Africa.pdf

The Global Forum on MSM and HIV www.msmandhiv.org

African Men for Sexual Health and Right www.amsher.net

International Gay and Lesbian Human Rights Commission www.iglhrc.org

 

AIDS 2010: "Rights Here, Rights Now"

International AIDS Conference 2010 Banner

 

The 18th International AIDS Conference, AIDS2010, symbolised an important juncture in the AIDS response, coinciding with the deadline for universal access to HIV and AIDS prevention, treatment, care and support, and provided a global platform to reinforce the message that we are still far from achieving universal access to HIV and AIDS prevention, treatment, care and support.

“By working together, we have the power to reverse the tide of this epidemic. Science will one day triumph over AIDS, just as it did over smallpox. Curbing the spread of HIV will be the first step. Until then, reason, solidarity, political will and courage must be our partners.” Durban Declaration, 2000.

 

Paula Akugizibwe during the opening session of the International AIDS Conference 2010
Paula Akugizibwe at the opening press conference. 
Photo: ©IAS/Steve Forrest/Workers' Photos

Quoting the Durban Declaration in her presentation during the opening plenary session, Paula Akugizibwe, ARASA’s Advocacy Co-ordinator argued that now more than ever before, the fields of science and human rights should work together to halt and begin to reverse the spread of HIV.

“We walk into the International AIDS conference together, because for too long we have seen a false divide between human rights and science. We've seen allegations that human rights hold back progress and scientific innovations, but at the end of the day, we're all working towards the same thing, we know what we want to achieve,” she said.

She argued that science is the engine of the HIV response, human rights the vehicle, funding the fuel and accountability the driver. “We all need to get to our final destination –and in a time of crisis, we need to move beyond confrontation to constructive engagement and adaptation,” she added.

The conference examined major barriers to universal access, recognising that stigma, discrimination and the resulting human rights abuses are major obstacles to universal access. AIDS 2010, where human rights was, for the first time, the conference theme, highlighted that the protection of human rights is crucial to an effective response to HIV and illustrated opportunities for synergy and for powerful alliances between the human rights and AIDS movements.

Paula highlighted the need to address criminalisation of HIV transmission or exposure; gender inequality, particularly in the context of women and HIV; punitive laws against sex workers, lesbian, gay, transgender and inter-sex people as well as injecting drug users; policies that challenge access to health care for prisoners and migrants as well as coercive methods to deal with multiple-drug resistant tuberculosis and mandatory testing in the context of prevention of vertical transmission of HIV.

Throughout the week, these human rights challenges were further unpacked in various discussion formats including abstract and non-abstract driven sessions, special sessions, satellite sessions, press conferences, skills building workshops, community discussions in the global village and poster presentations.

The conference also heard strong arguments for why the right to health should be constitutionally guaranteed as an enabler of a rights-based response to HIV and other health challenges. “The absence of legally enforceable provisions at the national level, undermine health systems and the lack of recognition of the right to health allows for hierarchies of access, compounded by discrimination,” Paula explained.

 

Vuyesika Dubula, Secretary General of the Treatment Action Campaign at the ‘die-in’ following the demonstration for AIDS Funding. Credit Health GAP (TakeANumber.org).
Vuyesika Dubula, Secretary General of the
Treatment Action Campaign at the ‘die-in’ 
following the demonstration for AIDS Funding.
Photo: Health GAP (TakeANumber.org).

At the centre of all discussions at the conference was the call for sustainable resources to fund HIV responses, including the replenishment of the Global Fund to fight AIDS, TB and Malaria. “The global economic crisis is not the thing that is threatening the fight against AIDS, it's a global crisis of priorities that is threatening the fight to achieve all millennium development goals,” Paula emphasised in her plenary speech. “The issue is not that HIV is overfunded, the issue is that health is underfunded and it is underfunded because we do not prioritise it. Because we would rather prioritise competing political interests - luxury vehicles, military expenditure, politician's salaries and World Cup Stadiums. And when it comes to health, we have to beg, borrow and steal. There's very little rationality in that”.

The location of the conference in Austria, which is a bridge between western Europe and eastern Europe and central Asia, was also strategic in highlighting how human rights abuses challenge the achievement of universal access in eastern Europe and central Asia. Injecting drug use is a key driver of HIV in the region and the need for evidence-based drug policy was highlighted throughout the conference. The Conference Declaration, also known as the Vienna Declaration called for evidence- based policies and programmes for people who inject drugs, including harm reduction strategies to be expanded.

 

Activists march through the centre of Vienna as part of the Human Rights, now more than ever campaign
Thousands of delegates joined together to call on governments 
to protect the human rights of most at risk populations. 
This event was planned as part of the “Human Rights and 
HIV/AIDS: Now More Than Ever” campaign. 
Photo: ©IAS/Steve Forrest/Workers' Photos

On Tuesday evening, people living with HIV, civil society, AIDS activists, human rights activists, political and community leaders and policymakers joined together for a march through the centre of Vienna and gathered for a rally and performance by legendary performer Annie Lennox. In a show of solidarity the thousands of delegates joined together to call on governments to protect the human rights of most at risk populations including women, sex workers and men who have sex with men. This event was planned as part of the “Human Rights and HIV/AIDS: Now More Than Ever” campaign, which is supported by a statement endorsed by nearly 1,000 organizations
calling for human rights to be at the centre of the AIDS response (the statement is online at www.hivhumanrightsnow.org).

“Science does have the ability to triumph over AIDS – but this will only happen once we adapt the response to realise that we are not dealing with microbes, but with people, people who don’t exist in powerpoints and strategies but in challenging socio-economic realities that make or break our response – and this is why human rights need to be at the centre of the HIV response,” added Paula.

“The AIDS2010 theme is welcome, but I need to emphasise that it is just a significant political gesture that needs to catalyse a much more long-term paradigm shift at the country level”.

Gashiena van der Schaff of the AIDS Legal Network, an ARASA partner, agreed with this sentiment. “After all the song and vuvuzela blowing praises of leaders highlighted at the conference, hard work lies ahead in the continued struggle of promoting and realizing rights of most at risk and marginalised communities everywhere. Women’s issues and the struggle for a supportive and enabling environment require a major response. In addition, we need a commitment to address stigma, discrimination and violation of rights and freedoms, which is prevalent and deny many across the world access and enjoyment of rights. Addressing prejudice, and inequalities between various groups in society, enjoying sexual and reproductive rights and increasing the social and legal status of particularly women and marginalised groups- what is the way forward for these issues?” she queried. “I am disillusioned, as I still do not know what to say to women here (in South Africa)
about why violations of rights, based on stigma, sexual and reproductive choices, occur, and what is  the definite plan (emanating from the conference) to address these issues? What next? What now?
So yes, rights here right now—a cliché—since back in our countries rights are neither here nor there
for many, particularly for women and many marginalised groups.”

Below, ARASA staff and partners share their perspectives of the key outcomes and their experiences at the conference:

“The most important message for me from the conference is that there is need for more political will from our governments especially in Africa. As long as the will is not there, there will not be any meaningful legal and policy reform. Archaic constitutions and other legislation will remain in place that criminalize most at risk populations (MARPS) such as Lesbians, Gays, Bisexuals, Trans-gender and Inter-sex (LGBTI) individuals; men who have sex with men (MSM); women who have sex with women (WSW) and sex workers. These laws are the ones that have institutionalized stigma and discrimination especially towards MARPS. Thus, a conducive legal framework, that upholds human rights will ensure that we indeed achieve universal access to prevention, treatment, care and support for all and that issues of funding for all health-related interventions are prioritized in national budgets. This means that advocacy organizations still have a lot of work to do as clearly law reform remains the key in addressing HIV/AIDS.” Doris Kumbawa, Media and Advocacy Officer, Botswana Network of Ethics, Law and HIV/AIDS

“As it my first time at an International AIDS Society international AIDS conference, it was an eye opener into the latest progress by organizations regarding the AIDS response globally. I had a chance to learn practical experiences of success by organizations that are implementing programmes at the international, regional, national, and even grass roots level. The message I took away from the conference is that with effective coordination and shared learning among organizations, each of our individual contributions to the AIDS response is making a difference, and will continue to do so.” Alan Msosa, Monitoring and Evaluation Co-ordinator, ARASA, Namibia

“As this was my first time at an international AIDS conference, at the initial stage I was sceptical whether a conference of about 19 000 participants can achieve anything because of the sheer numbers. But the Vienna experience proved me wrong as it was a worthwhile meeting. It was an awesome experience for various reasons including the availability of resource materials. The news on the general trend of cutting down on funding for health was not positive, but from that I got the message that since the AIDS Conference in Durban, we have done a lot and we can still do more even though with less money. The message of cautious optimism was clear to me. So we can do more with less money by partnering, collaborate and become innovative.” Tonderai Bhatasara, Project Officer at the AIDS law Unit of the Legal Assistance Centre, Namibia.

“A lack of time available for discussions in most sessions was a problem, as there was a missed opportunity to hear questions and issues raised by advocates from around the world, who most likely work close to communities in their respective countries. In addition, advocates could also not challenge statements or highlight when there were perhaps fabrications of the truth by presenters/representatives of governments. The biggest opportunity lost (during the conference because of a lack of time) was that we all could learn from one another (people working in communities and people working elsewhere).” Gashiena van der Schaff, AIDS Legal Network, South Africa.