As the globe marks World Aids Day on December 1, the truth behind Nelson Mandela’s words that Aids is “a human rights issue” is becoming ever apparent.

Twenty-five leading AIDS organisations from around the world have called for a major shift in the global response to HIV/AIDS, issuing an unprecedented joint declaration on the need to put legal and human rights protections at the center of HIV efforts.

“It’s very simple: human rights must take centre stage, otherwise our national, regional and global responses to AIDS will not succeed,” said Michaela Clayton of the AIDS and Rights Alliance for Southern Africa (ARASA), one of the regional organizations which issued the declaration. “This is widely recognised, yet few governments have ensured human rights protections for people living with or vulnerable to HIV.”

The declaration, Human Rights and HIV/AIDS: Now More Than Ever, sponsored by the Open Society Initiative, focuses on populations most vulnerable to HIV: women and girls, young people, injecting drug users, sex workers, gay and bisexual men, and prisoners.

These groups are the most in need of comprehensive HIV prevention and treatment programs, including access to anti-retroviral drugs, yet they continue to face discrimination and abuse worldwide and are often denied access to life-saving programs. As a result, HIV continues to spread unchecked in many communities.

Earlier this year, the World Health Organisation and UNAIDS released guidance recommending that in certain situations people should be tested for HIV unless they explicitly decline the test. Many experts worry that making HIV testing more routine without scaling up human rights protections could result in coercive, mass HIV testing programs. Such programs would further stigmatize people living with HIV and deter people from coming forward for needed health services.

“Universal access to HIV testing is critical, but there is no evidence suggesting that human rights need to be relaxed in order to achieve this goal,” said Kevin Moody of the Global Network of People Living with HIV/AIDS, which endorsed the declaration. “Public health and human rights can and should go hand in hand.”

The lack of legal protections for African women, who make up a majority of infections on the continent worst-affected by HIV, best illustrates the need to combine public health with human rights approaches, according to the AIDS organisations. Under customary law systems throughout Africa, women are denied equal access to divorce, property, and inheritance. This leaves them trapped in marriages that are often violent and polygamous. The problem is compounded by the failure of governments to prosecute domestic violence or even recognise the crime of marital rape. Preventing HIV in these situations is as much a legal challenge as a public health one, experts say.

“Politicians in many countries pander to antigay prejudice rather than demonstrating the political will needed to combat HIV…”

“Bills protecting women’s rights languish in African parliaments, while coercive responses to HIV are the order of the day,” said Christine Stegling of the Botswana Network on Ethics, Law and HIV/AIDS. “This is a sad commentary on the current state of the global AIDS response.”

Men who have sex with men also continue to face widespread violence and discrimination around the world, as well as continued criminalization of sodomy in many countries.

“The continued stereotype of AIDS as a “gay disease” fuels social exclusion against gay men and people living with HIV alike, often driving both populations from mainstream health services. In many jurisdictions, police officers are more likely to ridicule or compound violence against gay men and transgender persons rather than investigate these crimes properly. Politicians in many countries pander to antigay prejudice rather than demonstrating the political will needed to combat HIV among vulnerable groups,” says the declaration.

Up to one-third of HIV infections outside Africa are caused by the sharing of syringes among drug users, according to the United Nations. Yet methadone, an orally administered treatment for heroin addiction, is banned in Russia. HIV spreads rapidly in post-Soviet prisons, where prisoners are routinely denied access to condoms, sterile syringes, effective drug dependence treatment, voluntary HIV testing, and HIV medications.

“Distributing clean syringes is one of the cheapest and most effective tools to prevent the spread of HIV among drug users, but such efforts are useless if the police harass and arrest people at needle exchange sites,” said Raminta Stiuykite of the Eurasian Harm Reduction Network. “Denying access to effective HIV prevention and treatment services for people who use drugs puts the entire population at risk.”

The endorsing organisations have called on governments and international donors to take concrete measures to place human rights at the centre of their AIDS programs. The groups also called for immediate protection of human rights defenders who are intimidated or detained for their AIDS activism.

“People should not be punished for holding their governments accountable to their HIV/AIDS and human rights commitments,” said Wan Yanhai, who has been detained numerous times by Chinese authorities for his AIDS activism. “Human rights activists simply want to help their governments win the war against AIDS.”

The declaration has been jointly developed and endorsed by 25 organizations from Botswana, Canada, China, Hungary, India, Kenya, Mexico, Namibia, South Africa, Thailand, Uganda, United Kingdom, United States, and Zambia, as well as numerous regional and international organisations.

The declaration is being launched regionally and nationally at several events planned from December 1-15, 2007. An international endorsement campaign will follow, culminating with a global march for human rights at the 2008 International AIDS Conference in Mexico City.

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