The AIDS 2010 conference theme emphasises the central importance of protecting and promoting human rights as a prerequisite to a successful response to HIV. The right to dignity and self-determination for key affected populations, to equal access to health care and life-saving prevention and treatment programmes, and the right to evidence-based interventions based on evidence rather than ideology are all incorporated in this urgent demand for action. Rights Here, Rights Now, a campaign launched by the International Lesbian, Gay, Bisexual, Trans and Intersex Association, emphasises that concrete human rights measures need to be in place to protect those most vulnerable to and affected by HIV, especially women and girls, people who use drugs, migrants, prisoners, sex workers, men who have sex with men and transgender persons.
Values, Policies and Rights
This book is a collection of 16 critical essays by leading scholars and practitioners in the field of sexual and reproductive health and rights. Each author analyses the legacy of the International Conference on Population and Development (ICPD) from a different perspective or focuses on a particular topic. They examine strengths, weaknesses and whether and how the ICPD mandate can still be used to improve sexual and reproductive health. Given the complexities and challenges of implementing and continuing to take forward the ICPD agenda after more than fifteen years, the undertaking in this volume is laudable. The essays all contain some dimension that should be of interest to a variety of readers. Some provide historical background which might otherwise be forgotten. Several other authors point out that the absence of reproductive health in the initial targets for the Millennium Development Goals was a serious setback. While the target of ‘universal access to reproductive health’ has since been added, one of the essays, ‘Mobilising resources for reproductive health’, points out that a strong evidence base is needed to demonstrate that poor reproductive health outcomes do, in fact, undermine the chances of the poor to escape poverty.
The aim of this paper is to examine young women's motivations to exchange sex for gifts or money, the way in which they negotiate transactional sex throughout their relationships, and the implications of these negotiations for the HIV epidemic. An ethnographic research design was used, with information collected primarily using participant observation and in-depth interviews in a rural community in North Western Tanzania. The qualitative approach was complemented by an assisted self-completion questionnaire. The study found that transactional sex underlay most non-marital relationships and was not, per se, perceived as immoral. However, women's motivations varied, for instance: escaping intense poverty, seeking beauty products or accumulating business capital. There was also strong pressure from peers to engage in transactional sex, in particular to consume like others and avoid ridicule for inadequate remuneration. Young women actively used their sexuality as an economic resource, often entering into relationships primarily for economic gain. In conclusion, transactional sex is likely to increase the risk of HIV by providing a dynamic for partner change, making more affluent, higher-risk men more desirable, and creating further barriers to condom use. Behavioural interventions should directly address how embedded transactional sex is in sexual culture.
The United Nations (UN) General Assembly has declared access to safe, clean drinking water and sanitation to be a ‘'human right' in this resolution, which more than 40 countries (including the United States) didn't support. The text is non-binding. The resolution expresses deep concern that, despite the fact that the Millennium Development Goal (MDGs) adopted by world leaders in 2000 call for the proportion of people without access to safe drinking water and basic sanitation to be cut in half by 2015, an estimated 884 million people still lack access to safe drinking water and more than 2.6 billion people do not have access to basic sanitation. In the resolution, the Assembly calls on UN ‘member states and international organisations to offer funding, technology and other resources to help poorer countries scale up their efforts to provide clean, accessible and affordable drinking water and sanitation for everyone’. Additionally, the resolution backs the UN Human Rights Council recommendation that the UN independent expert on the issue of human rights obligations related to access to safe drinking water and sanitation must report annually to the General Assembly. This annual report will focus predominantly on the principle challenges of achieving the right to safe and clean drinking water and sanitation, as well as progress towards the relevant MDGs.
This joint statement from a range of international development organisations argues that regular, predictable social transfers (cash or in kind) from governments to communities can reduce child poverty and vulnerability by helping to ensure children get access to basic social services. Social insurance offers access to health care for children, as well as services to support communities to reach all households and individuals, including children. The statement propose steps that governments and international development partners can take to further social protection in the interests of children, such as ensuring that existing social protection policies and programmes are child-sensitive and setting priorities and sequence policy development and implementation to progressively realise a basic social protection package that is accessible to all those in need. The statement calls for governments and donors to seek to improve fiscal space and increase available resources for child-sensitive social protection programmes, while making broader efforts to build awareness, political will, capacity and intersectoral coordination. Adequate investment is required, and links should be built between transfers and social services to ensure the reach, effectiveness and impact of social protection. At the same time, ongoing research, monitoring and evaluation are needed to better understand effective programme design and implementation, as well as how child-sensitive approaches can benefit the wider community and national development.
For years, there has been silence at the global level about the disproportionate impact that HIV and AIDS have on men who have sex with men (MSM). This silence has led to unabated epidemics and especially weak HIV prevention programming at national levels for MSM across the globe. This policy brief aims to provide universal guidelines for HIV and AIDS services that target MSM. It also discusses the legal context in Africa, where sex between members of the same sex is illegal in most countries, explaining how criminalising homosexuality heightens the risk for HIV transmission and drives those most at need away from prevention, care, treatment, and support services. The brief points to consensus among HIV behavioral researchers and practitioners that combination approaches to prevention, sustained over time and tailored to the specific local needs of MSM, should be adopted to effectively address HIV prevalence and incidence among MSM. These approaches should combine and integrate biomedical and behavioral strategies with community-level and structural approaches. The brief provides some important core principles of practice that can serve as broad guidelines in the design, implementation, and evaluation of targeted HIV prevention programmes and paradigms within MSM communities worldwide.
The Ouagadougou Declaration on Primary Health Care and Health Systems in Africa focuses on nine major priority areas: leadership and governance for health, health services delivery, human resources for health, health financing, health information systems, health technologies, community ownership and participation, partnerships for health development and research for health. This paper describes a framework constructed for implementing the necessary activities in each of these priority areas, and proposes recommendations for consideration by World Health Organization Member States in the development of their own country frameworks. In conclusion, countries are expected to use this Framework, adapted to their own specific situations, by taking into account the progress made and the efforts needed for better and more equitable health outcomes. The Regional Committee is requested to endorse the Framework and urges Member States to put in place monitoring frameworks that feed into the national and regional observatories. Partners are expected to support countries in a harmonised and predictable manner that reduces fragmentation during the implementation of the Ouagadougou Declaration. It is expected that the implementation of the Ouagadougou Declaration by countries will contribute in accelerating progress towards the achievement of the Millennium Development Goals, and reduce the inequities and social injustices that lead to large segments of the population remaining without access to essential health services.
This paper describes the development of a tool that uses human rights concepts and methods to improve relevant laws, regulations and policies related to sexual and reproductive health. This tool aims to improve awareness and understanding of States’ human rights obligations. It includes a method for systematically examining the status of vulnerable groups, involving non-health sectors, fostering a genuine process of civil society participation and developing recommendations to address regulatory and policy barriers to sexual and reproductive health with a clear assignment of responsibility. Strong leadership from the ministry of health, with support from the World Health Organization or other international partners, and the serious engagement of all involved in this process can strengthen the links between human rights and sexual and reproductive health, and contribute to national achievement of the highest attainable standard of health.
Three leading scientific and health policy organisations have launched a global drive for signatories to the Vienna Declaration, a statement seeking to improve community health and safety by calling for the incorporation of scientific evidence into illicit drug policies. Misguided drug policies that criminalise drug abuse are claimed to fuel the AIDS epidemic and result in violence, increased crime rates and destabilisation of entire states, without evidence they have reduced rates of drug use or drug supply. Scientists are calling for evidence-based approaches to illicit drug policy that start by recognising that addiction is a medical condition, not a crime. The Vienna Declaration describes the known harms of conventional ‘war on drugs’ approaches and calls for governments to implement evidence-based approaches that respect, protect and fulfil human rights, as well as reduce harms deriving from current policies. This would allow for the redirection of the vast financial resources towards where they are needed most: implementing and evaluating evidence-based prevention, regulatory, treatment and harm reduction interventions. Legal barriers to scientifically proven prevention services such as needle programmes and opioid substitution therapy (OST) mean hundreds of thousands of people become infected with HIV and Hepatitis C (HCV) every year.
A landmark court case, alleging that HIV-positive women were forcibly sterilised in Namibian state hospitals is taking place in Windhoek, Namibia. Human rights groups claim the practice has continued long after the authorities were notified. Three women's cases will be heard initially. Each woman is demanding the equivalent of US$132,000 in damages. 'The first cases emerged during community meetings in early 2008. In the months that followed we interviewed 230 women, 40 of whom were sterilised against their will,' says Veronica Kalambi of the International Community of Women living with HIV (ICW). 'In August 2008 we formally alerted the Ministry during a meeting with the deputy Minister.' The State will argue that consent forms were signed in all three cases. However, the women’s lawyers maintain the process necessary for 'informed consent' was not followed and the women were coerced, or did not understand the procedure.