Human Rights Analysis: North/South Disparity in HIV Treatment Standard of Care Must End
Denying Access to Early/Immediate ART Violates Rights, Opens States and International Organizations to Challenge
A new analysis in the Health & Human Rights Journal by researchers, activists, and clinicians based in the U.S., Southern Africa, and Europe details the new medical evidence that access to antiretrovirals early in the course of HIV clearly improves the health of people living with HIV and enables them to prevent HIV transmission. The evidence was cemented last week with news the START clinical trial was halted because it was so clear that initiating HIV treatment immediately upon detection had strong clinical benefits for patients. Given this reality, the analysis finds that international human rights and many domestic legal standards require access to early ART for all as part of the communal human right to health. Where not long ago it was sufficient to use ARVs to prevent the sick from dying, today new medical evidence makes access to ARVs for all who want it, regardless of their CD4 count, a core human right. Yet there is a stark global disparity—many high income countries in the global North have long enabled immediate initiation of ARVs, but lower income countries, where the majority of people living with live, choose or are forced to ration ARVs to only those significantly immune compromised. This article argues this rationing violates core minimum human rights obligations which require governments to reform policy, donors to fulfill their obligations, and international organizations to facilitate access through rights-based guidance. Today’s human rights standards require not just government funding but increased donor support, reform of intellectual property rules in many countries to enable affordable generic access, and health policy changes to ensure faster access to new medicines and strengthened health systems. Given the current discussions at the World Health Organization and in many countries about HIV treatment guidelines, this analysis calls for a rapid reassessment to bring policy into compliance with core human rights standards.
Matthew M. Kavanagh, Jennifer Cohn, Lynette Mabote, Benjamin Mason Meier, Brian Williams, Asia Russell, Kenly Sikweze, and Brook K. Baker. 2015. “Evolving Human Rights and the Science of Antiretroviral Medicine” Health & Human Rights Journal 17(1), June 2015.
And see the New York Times article on the START Trial.