High Commissioner for Human Rights Michelle Bachelet

AT

50th session of the Human Rights Council

Excellencies, colleagues and friends:

I am very pleased to participate in this dialogue. The HIV movement is a dynamic and far-sighted initiative, which can legitimately take much of the credit for the change in direction we have witnessed over the last four decades, in which HIV prognosis has gone from being a sure warning from death to being the announcement of a more or less normal life.

You were pioneers in demanding that human rights be at the forefront of the health response and in calling for people to be treated with dignity, whatever their state of health.

The progress made since HIV was first identified is truly amazing.

Today we have treatments that were almost unimaginable then. Antiretroviral therapies continue to improve and now we even have pre-exposure prophylaxis (PfEP) and post-exposure prophylaxis (PEP) and drugs that prevent vertical transmission of the virus.

This situation is very positive. But many challenges remain.

Progress has slowed considerably in recent years and we have lost even more ground during the COVID-19 pandemic, highlighting and worsening the multiple inequalities that have helped fuel the AIDS epidemic. Without a significant increase in current momentum, we risk missing the goal of eradicating AIDS by 2030.

But this matter is not a simple matter of adding numbers.

Prevalence patterns point to the role of inequality, discrimination, and stigma in determining who is at risk of contracting HIV and what health outcomes they can expect. For example, some key population groups remain at much higher risk than the general population: rates are 34 times higher for transgender women, 26 times higher for sex workers, and 25 times higher for men and women. homosexual men and those who have sexual relations with other men.

(1) Access to retroviral therapies points to another story about inequalities: About 1.8 million children between the ages of birth and 14 were living with HIV at the end of 2019.

Just under half of these children have access to the drugs that can save them from the virus.

(2) AIDS remains the leading cause of death among women aged 15-49, and the Global Fund estimates that 5,000 young people and adolescents are newly infected with HIV each week in Eastern and Southern Africa, (See: Global Fund, Outcomes Report 2021, p. 21).

Motivated by the urgent need to address this situation, in December 2021 the Member States of the United Nations General Assembly committed to achieving, by 2025, the following objectives:

(a) less than 10% of countries with restrictive legal and policy frameworks;

(b) less than 10% of people living with and suffering from HIV, victims of stigma and discrimination; and

(c) no more than 10% of women, girls and people living with, living with, or at risk of HIV, subject to gender inequalities or gender-based or sexual violence.

My Office has submitted a report to the current session of the Council, with a view to contributing to the debate around these goals. I would like to thank UNAIDS for its active engagement and support, and also many of you for your contributions.

The OHCHR report examines two aspects: the measures needed to meet these “social promotion” goals specified in the Political Declaration on HIV and AIDS, and other gaps in the response to HIV.

I will highlight four areas on which my Office has made recommendations:

(1) Laws and policies largely determine the extent to which we can enjoy our rights. Our recommendations in this regard essentially call for the implementation or strengthening of laws and policies that are conducive to the enjoyment of human rights in the context of HIV. The elimination of stigma and discrimination and of the barriers that hinder access to health services would be especially decisive in this regard.

(2) It is essential to develop plans and strategies to address HIV-related stigma, discrimination and marginalization affecting various population groups and to ensure that such activities receive adequate funding. Where special measures are needed to promote equality, such measures must be adopted.

Plans, activities and strategies should specifically address multiple and intersecting forms of discrimination.

(3) States should develop national strategies and plans to address discrimination against girls and women, in all their diversity, in access to health care, including sexual and reproductive health services. These plans and strategies should be implemented in conjunction with measures to protect girls and women from gender-based violence, given their links to HIV and AIDS.

(4) A human rights-based approach is needed to ensure that all policies relevant to the response to HIV respect, protect and fulfill human rights, ensuring that major population groups and other marginalized sectors are empowered to claim their rights.

From here we ask that the availability and access to good quality health services be promoted, including sexual and reproductive health services, for all, in an equal manner. The main and most vulnerable population groups, such as people with disabilities, refugees and prisoners, should receive priority attention in these policies.

Given that stigma, discrimination and other human rights violations against people living with HIV occur in the context of health services as well as in society in general, medical personnel should receive training and awareness courses on how to respect and protect the health and related rights of people living with HIV.

In this regard, my Office coordinated, in December 2021, a training course for health workers with a view to facilitating the implementation of a human rights-based strategy for the provision of sexual and reproductive health services and care for patients with HIV, aimed at women living with HIV, in close collaboration with UNAIDS and the Ugandan Ministry of Health.

Excellencies, colleagues and friends:

The views of people who have accumulated empirical experience in responding to HIV should be like a common thread that runs through all our plans and programs. Similarly, the participation of all other stakeholders, especially grassroots community organizations, is a critical element. Civic space must be opened up and those concerned must be given financial and other support so that they can participate in the response to HIV.

Finally, we need to allocate resources in such a way that the activities needed, both to regain lost momentum and to go further, are properly funded and therefore effective. Innovative financing methods, such as the Global Fund's “Debt2Health” mechanism, are inspiring examples of what is possible when we are determined to deliver on our political commitments.

I hope that the recommendations in this report will help catalyze further efforts to reach the 2025 targets and to protect the rights of people living with HIV.

Thank you very much.

Source: UN Office of the High Commissioner for Human Rights