Helen Clark: Remarks at Inaugural meeting of HIV Global Commission

06 Oct 2010

Talking Points by Helen Clark, UNDP Administrator 
On the Occasion of the Inaugural Meeting of the
Global Commission on HIV and the Law

Wednesday, 6 October 2010,     
via videoconference from New York to Sao Paolo, Brazil

First of all, a very warm welcome from me to all Commissioners who have been able to attend this inaugural meeting of the Global Commission on HIV and the Law.

I would like to express my gratitude to President Fernando Henrique Cardoso for hosting the meeting at his institute in Brazil – a nation which has long been a leader in the global AIDS response.

I also thank Michel Sidibé for his commitment to and support of this Commission’s work. Michel unfortunately could not join us today, but he has sent a statement which is included in your docket.

While my schedule did not allow for me to join you in person, I am delighted to be able to join you via videoconference today as you set out on your very important work.

UNDP is pleased to have led the formation of this global Commission on behalf of the Joint UN Programme on HIV/AIDS (UNAIDS) and to be supporting your work as an independent body of experts.

The law has many important functions in our society. It defines the basic rights and obligations of citizens and governments. It establishes rules and enforcement mechanisms. It can be a tool for social change and the pursuit and achievement of justice.

Where the legal environment protects and promotes human rights, it benefits the health and well being of individuals, families, communities and nations.

Decades into the HIV/AIDS epidemic, the language of human rights and HIV now features prominently in international declarations and commitments, as it does in national laws guaranteeing equality for people living with and vulnerable to HIV, and in judicial decisions establishing the rights of people living with HIV, including the right to access HIV treatment, care, and support. 

The law has the power either to facilitate or to impede effective HIV prevention, treatment, care, and support.

The world’s HIV response to date suggests that upholding human rights is critical in addressing the causes and the consequences of the spread of the disease. Legal environments based on human rights frameworks help create enabling environments for effective HIV responses to flourish. Some of the most successful responses to HIV have occurred precisely where the rights of those most vulnerable to and living with the disease have been upheld.

Laws which facilitate targeting prevention services to the marginalized and most vulnerable segments of society, including men who have sex with men and drug users, have helped bring HIV out of the shadows. Laws which protect the rights of sex workers to access condoms and be free from a punitive legal environment have helped to reduce health risks for sex workers and clients alike.

Confidentiality laws which allow people living with HIV to keep their status private and anti-discrimination laws have made it possible for those living with HIV to keep their jobs and housing and to access treatment and prevention services.

Conversely, where laws and law enforcement practices either oppress or fail to protect human rights, the spread of the disease and its effects are exacerbated. 

When the Technical Advisory Group for this Commission met in June, it proposed three areas on which the Commission should focus :

  • laws and practices which in effect criminalise people living with HIV and vulnerable to HIV;
  • laws and practices which mitigate or sustain the violence and discrimination as experienced by women; and 
  • laws and practices which facilitate or impede HIV-related treatment access. 

Many countries use the law to punish behaviour associated with HIV transmission. The measures used may include drug control laws; laws affecting sex workers; prohibitions of same-sex sexual behaviour; and the inappropriate criminalisation of HIV transmission and exposure.

In recent years we have witnessed a spate of punitive laws and practices specifically enacted in response to HIV.  More than thirty countries have enacted such laws, inappropriately criminalising HIV transmission and/or exposure. Over two dozen countries have used non-HIV-specific laws to prosecute individuals on similar grounds.  

We are now seeing a rise of compulsory detention centres for drug users in East and Southeast Asia, despite evidence that these result in greater risk of HIV infection, increased stigma and prejudice, and human rights violations.

Laws which fail to empower women and which perpetuate discrimination against them are entrenching the gender inequalities which characterise the HIV epidemic in some parts of the world. According to the latest data from UNAIDS, for example, while women account for half of the estimated 33.4 million people living with HIV worldwide, they make up more than sixty per cent of people living with HIV in sub-Saharan Africa.

Over the past ten years, the HIV response has used new approaches to reduce the cost of HIV medicines and increase access to HIV-related treatment. Yet, two out of three people in need of treatment still do not have access to it. Treatment costs, especially those of second-generation medicines, remain exorbitantly high.

Despite the significant progress which has been made on halting the spread of HIV, huge challenges remain.

The HIV response is now at a crossroads. We are challenged with achieving more progress at a time of fiscal constraint in many countries, and in times of multiple crises. We should not therefore turn a blind eye to the cultural, moral, social, and legal complexities which continue to impede our efforts to halt and reverse the spread of HIV.

The establishment of this Global Commission on HIV and the Law stands firmly in the center of this crossroads. It is an opportunity to improve the world’s response to HIV. Over the next eighteen months, the Commission will look at the diverse ways in which the law has both helped and hindered the effectiveness of efforts to provide HIV prevention, treatment, care, and support.

The recommendations which you will issue at the end of this process, together with an action plan, should help countries craft HIV responses which go beyond setting prevention and treatment targets to confronting the inequalities, prejudices, and stigma which have driven the AIDS epidemic. This meeting is a key step in that process, and will help establish the scope of the Commission’s work.

Overall, your work can help catalyze the next generation of the global HIV response - one in which equality, dignity, and justice are not the exclusive domain of a privileged few.  Your task is complex and difficult, and inevitably there will be those who push back against changes you advocate.

I have every confidence in the ability and integrity of members of this Commission. I hope your findings will help improve the lives of those at risk from or already affected by HIV. 

In the coming years, will the world allow HIV and development responses to bypass and exclude those most vulnerable and marginalized, or will it help ensure equitable and inclusive HIV, health, and development responses for all ? I hope that this Commission will help steer our responses in the latter direction.

Please use the opportunity afforded by this Commission to push for change which does addresses the needs of those we seek to help.