People have a fundamental human right to make decisions about their lives and bodies. These rights relate to personal choices on, among other things, health care and treatment. For sexual and reproductive rights, key issues include the right of people to decide when, whether and with whom to have sex, to have children and to get married and their ability to express their gender and sexuality.

Leading legal experts from around the world recently met to lay the foundations for a set of principles to address the misuse and abuse of criminal laws that affect basic human rights and impact on health and equality. The principles will be developed in the coming months and will guide civil society and policy-makers in the development and use of laws that guarantee human rights and protect public health.

Tim Martineau, UNAIDS Deputy Executive Director, Programme, a.i., noted at the outset of the meeting that, “While there is significant progress in HIV prevention, treatment and care, there is a big discrepancy in HIV prevention in relation to key populations, who are more vulnerable to HIV infection in many respects because of a lack of legal protection and the unjust criminalization of their behaviour.”

The legal experts focused on criminalization related to sexuality, reproduction, personal drug use and the overly broad criminalization of HIV nondisclosure, exposure and transmission. Around the world, same-sex sexual practices are criminalized in 73 countries, with 13 states imposing the death penalty. Sex work is criminalized in approximatively 116 countries globally and some 72 countries criminalize HIV non-disclosure, exposure or transmission. Criminal laws often increase stigma against already marginalized and excluded groups and have been linked to discrimination and the denial of critical health services. Criminalization also creates an environment in which people are less likely to seek police assistance when their rights have been violated.

Kate Gilmore, the United Nations Deputy High Commissioner for Human Rights, emphasized that the criminal law plays an essential role in the recognition, protection and enforcement of rights, including by tackling impunity for violations of those rights. “Our purpose here is to raise the shield of criminal law by lowering its sword, ensuring better protection through criminal law by reducing the abuse of it.”

Sam Zarifi, the Secretary General of the International Commission of Jurists, said, “The misuse of the criminal law affects the most marginalized people and, in particular, the dispossessed and disenfranchised.”

The meeting was held on 3 and 4 May and was led by the International Commission of Jurists, in partnership with UNAIDS and the Office of the United Nations High Commissioner for Human Rights.

In 2016, Member States agreed a set of targets at the United Nations High-Level Meeting on Ending AIDS to be met to put the world on course to end the AIDS epidemic by 2030. One of those targets was to strengthen national social and child protection systems to ensure that, by 2020, 75% of people living with, at risk of or affected by HIV benefit from HIV-sensitive social protection. The target is human rights-based. It feeds into and benefits from promoting, protecting and fulfilling all human rights and the dignity of all people living with, at risk of or affected by HIV.

Evidence of how social protection programmes meet the needs of people who are poor and excluded and benefit people living with, at risk of or affected by HIV is increasing. The question is not whether the AIDS response should increase attention to social protection, but how best to leverage resources and partnerships of movements working on ending poverty and inequality to work effectively towards ending AIDS.

Of 127 countries reporting in the UNAIDS National Composite Policy Index in 2017, 109 (86%) stated that they had an approved social protection strategy, policy or framework in 2016, and 99 of those countries (78%) were implementing those programmes. A total of 85 countries stated that their strategies were HIV-sensitive to at least some extent. More than half (47) of the 87 countries with a coordinating mechanism for their social protection strategy have included their national AIDS programme in that structure. However, only 12 countries reported that their social protection strategies were fully HIV-sensitive.

To step up efforts to get social protection on the Fast-Track, UNAIDS recently held a conference at which the participants heard about how to strengthen national social and child protection systems. The conference focused on three objectives: strengthening the links with social and other movements for ending poverty and inequality; intensifying action on social protection; and reinvigorating programming for HIV, food security and nutrition.

“Stronger linkages are required across health, education and community systems to reduce the vulnerability of people living with, at risk of and affected by HIV through social protection services,” said Tim Martineau, UNAIDS Deputy Executive Director, Programme, a.i.

The event also saw the launch of a new UNAIDS report, Social protection: a Fast-Track commitment to end AIDS. The report provides guidance on how to scale up what works in the context of different HIV epidemics and for different populations. It also provides guidance to governments, people living with or affected by HIV, policy-makers and other stakeholders on how to intensify the integration of HIV with social protection and other programmes for ending poverty and inequality towards ending AIDS.

“We must remember that without improving the material and emotional well-being of people, we cannot end the AIDS epidemic,” said Denys Dmytriiev, from the All Ukrainian Network of People Living with HIV.

The International Conference on Fast-Tracking Social Protection to End AIDS was held in Geneva, Switzerland, on 25 and 26 April.

Like many women in sub-Saharan Africa, women in Kenya are disproportionately affected by HIV. In 2016, 34 000 adult women became newly infected with HIV, compared with 22 000 adult men, and adult women accounted for 910 000 of the 1.6 million people living with HIV in the country.

Women also face challenges with sexual and reproductive health issues, such as limited access to family planning, as well as stigma and discrimination when they seek services.

To identify solutions to such challenges facing women in Kenya, the nongovernmental organization Women Fighting AIDS in Kenya (WOFAK) recently held a two-day workshop on 25 and 26 April in Nairobi, Kenya, on advancing the sexual and reproductive health and rights of women living with HIV. More than 30 women living with HIV from across the country met with representatives of the government, civil society and United Nations agencies to take stock and agree a pathway to implement the World Health Organization’s (WHO) Consolidated guideline on sexual and reproductive health and rights of women living with HIV.

“A woman-centered approach must guide a more responsive delivery of services for women living with HIV,” said Dorothy Onyango, co-founder of WOFAK, at the start of the meeting.

To guide effective implementation of the guideline at the country level, the Salamander Trust, with support from WHO, developed a checklist to support women living with HIV to organize and coordinate their own advocacy and ensure their meaningful engagement. The checklist was first used in Kenya and will be rolled out to other countries.

During the meeting, Rukia Ahmed, founder and chairperson of a support network for Kenyan Muslim women living with HIV in north-eastern Kenya, said, “Most women only find out about their HIV status when they are pregnant or very ill. Confidentiality is an issue. When their status is disclosed, some are not accepted by their family afterwards, leading to isolation.”

Ms Ahmed is now going to advocate for discrimination-free health-care settings. “I’m going to visit district hospitals and raise awareness among health-care workers and support groups on the right to stigma-free health care. Change is possible,” she said.

“What stood out for me was the message that as women living with HIV we need to accept ourselves and love ourselves first and as a result we will be able to fight for our rights,” said Joyce Ouma, from Sauti Skika, a network of young people living with HIV.

It is a message Ms Ouma hopes to bring to her peers. “Initially, I did my advocacy out of obligation. Now I want to do it because I have the drive and I know it is important for me first,” she said.

At the conclusion of the meeting, Jantine Jacobi, the UNAIDS Country Director for Kenya, said, “We need to listen to the lived experiences of women living HIV to ensure that services meet their needs.”

Everyone will have experienced stigma and discrimination of some kind during their lives; however, non-discrimination is a human right. As part of UNAIDS' work to achieve zero discrimination, UNAIDS encourages people to speak up and prevent discrimination from standing in the way of achieving ambitions, goals and dreams.

Two UNAIDS ambassadors recently took part in a dialogue with students at Peking University about the need to achieve zero discrimination to end the AIDS epidemic and ensure better health for all.

The First Lady of Panama, Lorena Castillo de Varela, UNAIDS Special Ambassador for AIDS in Latin America, and the famous actor and humanitarian, Huang Xiaoming, UNAIDS Goodwill Ambassador for China, spoke about their commitment to reducing stigma and discrimination at an event on 24 April. The dialogue was opened by the Vice-President of Peking University, Zhan Qimin.

During the lively discussion between the two ambassadors, the First Lady encouraged young people to integrate their antidiscrimination efforts into their everyday actions. “Just that smile, even though it might look very small to you, it can make another humanbeing feel special, not discriminated or different,” said Ms Castillo.

Discrimination has many forms, from racial or religious discrimination to discrimination based on gender, sexual orientation or age, and to bullying at school or at work. In only three out of 10 countries worldwide do equal numbers of girls and boys attend upper secondary school, and people living with disabilities are nearly three times more likely to be denied health care than other people.

Ms Castillo stressed that the important role that the young generation has to play in taking the lead. “I want to use this platform to send messages to all the universities in the world, they should all follow your lead too, and give voices to those who have no voices, be the voice for them, let them know that there’s somebody somewhere sending them love, fighting for them.”

Mr Huang explained what had motivated him to start working on zero discrimination and become a UNAIDS Goodwill Ambassador. “I had seen children who suffered from discrimination related to HIV. Their inner repression, touched me and made me start to think about how I could help them. Of course discrimination is not limited to just children. So when I learned that UNAIDS had the goal of ending AIDS worldwide by 2030, I was very excited and willing to do my best for this goal.”

A piece of advice to young people from Mr Huang moved everyone in the meeting hall: he quoted a line from the film Wonder, "When given the choice of being right and being kind, choose kind—I believe it is important to be kind to everyone, it’s particularly important to keep our minds clear and objective, and to uphold justice and truth".

Ran Wei, a representative of UNAIDS, thanked the two ambassadors for their tireless efforts championing zero discrimination and urged students to follow their lead. “It is not only a responsibility, but also a privilege for youth, to fight for a world that’s healthy, just and free from discrimination,” she said.  

Stigma and discrimination and other human rights violations occur in health-care settings worldwide, barring people from accessing health services or enjoying quality health care. Such stigma and discrimination further increases the vulnerability of people living with and affected by HIV.

To discuss this problem, nearly 300 Egyptian medical students, representing 18 universities across Egypt, met with representatives of academia, civil society, the government and the Egyptian Medical Syndicate. With support from UNAIDS, the Egyptian branch of the International Federation of Medical Students’ Associations held a one-day consultation on HIV-related stigma and discrimination in health-care settings on 21 April in Cairo, Egypt.

“People living with HIV should have equal rights and opportunities. Denial of access to health-care services is unacceptable. Through this consultation, we aim to inform our national strategy with new interventions for addressing stigma and discrimination,” said Walid Kamal, the National AIDS Programme Manager for Egypt.

During the consultation, the participants took stock of the progress made in addressing stigma and discrimination and decided to hold an ongoing dialogue to identify actions to address stigma and discrimination in health-care settings.

“We are witnessing an unprecedented opportunity for addressing discrimination in health-care settings with political support and programmatic vision. While resources are scarce, we count on the support of medical students as leaders of tomorrow and the power of volunteerism to address this issue,” said Ahmed Khamis, the UNAIDS Country Manager for Egypt.

The participants agreed that accountability mechanisms need to be in place to monitor and evaluate interventions, ensuring that proper actions are taken by the relevant authorities to address rights violations in health-care settings.

“Medical ethics is a must among health-care providers. The Egyptian Medical Syndicate is organizing workshops and conferences to enforce ethics among health-care providers. I would like to remind you all of the rights of patients,” said Sherine Ghaleb, representative of the Egyptian Medical Syndicate.

The participants agreed to prioritize launching the Ministry of Health and Population’s stigma-free policy and integrating HIV-related stigma and discrimination in the module on ethics taught to all doctors who graduate in Egypt. They also agreed to give access to the accountability and investigation mechanism of the Egyptian Medical Syndicate to civil society organizations and people living with HIV in order to report violations and to roll out information on post-exposure prophylaxis in the curricula of medical schools.

The recommendations made during the consultation were endorsed by the National AIDS Programme and will be included in Egypt’s road map for addressing HIV stigma and discrimination in health-care settings. Progress of the road map will be monitored by a group that includes a strong representation from people living with HIV.

Russian and international football legends and Russian players living with HIV joined forces on 17 April to play the first football match of the UNAIDS World Cup for Ending AIDS and Discrimination. International and national football stars draw attention to the stigma faced by people living with HIV and demonstrated the value of goodwill, solidarity, and human values towards ending stigma and discrimination.

The match took place in Moscow on the eve of the opening of the Sixth Eastern Europe and Central Asia AIDS Conference. This was the first of a series of matches to be held with support from FIFA in several different countries in the lead up to the 2018 World Cup which will be held in the Russian Federation from 14 June to 15 July 2018. The initiative highlights the need for zero discrimination on the basis of race, nationality or HIV status, both on and off the pitch.  

The Russian FC “Rosich” team was led by its captain, Deputy Prime Minister and Chairman of the Organizing Committee for the FIFA World Cup 2018, Arkady Dvorkovich. Team members included the Minister of Energy, Alexander Novak, the former Russian international and FIFA Anti-Discrimination Officer for the 2018 World Cup, Alexey Smertin, as well as former Russian internationals Dmitry Bulykin, Roman Shirokov, Evgeny Aldonin, Dmitry Sennikov, Oleg Kornaukhov, Marat Makhmutov, Vladimir Leonchenko and Roman Berezovsky.

Michel Sidibe, UNAIDS Executive Director, coached the UNAIDS “Red Ribbon” team, which was captained by former Cameroon international Samuel Eto’o. The Red Ribbon team featured former Senegal international, Abdoulaye Diagne-Faye, former French and Martinique international, Julien Faubert, former French under-21 international, Florent Sinama-Pongolle, former Nigerian international, Peter Odemwingie, former Moroccan international, Jaouad Zairi, Brazilian-born former Bulgarian international, Marcelo da Costa, former Palestinian women international and FIFA official, Hone Thalidjieh, and former Madagascar international, Alister Veerasamy.

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By Tom Rosshirt — Originally published in Creators Syndicate on 20 June 2012

My brother Matt died of AIDS 26 years ago today, passing away in his bed in my parents' home in Houston.

It was a benighted time for people with AIDS. There were no antiretrovirals then. There was nothing much you could do for an AIDS patient but hold his hand. And many people still thought you could get AIDS by touching. My parents knew of individuals who'd been fired from their jobs for volunteering for AIDS organizations. That's how crazy the fear was.

As Matt was dying, we were befriended by a man named Lou Tesconi, a volunteer from the local AIDS organization. Lou came by to visit with Matt and to offer whatever service and kindness he could to my mom and dad.

Shortly after Matt died, Lou began studies to become a Catholic priest. Within the year, he was diagnosed with AIDS and kicked out of the seminary. Lou was a lawyer by training and temperament. He appealed the judgment to a Catholic bishop, who then asked Lou to found and head a ministry for people with AIDS. It was called Damien Ministries and was established in a poor part of Washington, D.C.

In early 1989, when the country was still very ignorant and fearful of AIDS, Lou got a call from the White House. First lady Barbara Bush was planning to visit Grandma's House, a home for infants with AIDS. It was one of the very first outings in her tenure as first lady, and Lou was asked to join a team of people to brief her privately before the event.

During the briefing, Lou told me later, he said: "Mrs Bush, it is a fantastic thing that you are holding these babies with AIDS. But the country sees them as innocent and the rest of us with AIDS as guilty. The whole suffering AIDS community needs a collective embrace from you today."

Lou thought he was speaking metaphorically. Apparently, Mrs Bush doesn't do metaphor. She stood up, walked over to Lou and gave him a big hug.

After the briefing, Mrs Bush took a tour of the facility as she talked to the press. She hugged, kissed and played with three little girls and then nailed the message: "You can hug and pick up babies and people who have ... HIV. ... There is a need for compassion."

At the news conference afterward, Lou stood by his point on Mrs Bush's visit: "I'm afraid that it may send a message that babies are innocent and can be helped," he said, "but that the rest of us aren't." He added: "I told her it would certainly help to get a collective hug from the first lady."

Then, again, this time in front of the cameras, Mrs Bush wrapped Lou up in a big embrace.

Mrs Bush wrote of this visit in her memoirs. She noted that "even then, people still thought that touching a person with the virus was dangerous." But she didn't give herself any credit for dealing a blow against stigma by embracing a gay man with AIDS in 1989.

Lou had a buzz from that hug that never went away.

In the fall of 1991, near Thanksgiving, I got a call from a friend that Lou had gone into the hospital again. He didn't have to tell me that it was for the last time. I called the White House and asked whether I could speak to the first lady's office. I was a nobody press secretary on the Hill. I didn't expect anyone in the White House to talk to me. Suddenly, I was speaking with the first lady's press secretary, Anna Perez, who had accompanied Mrs Bush to Grandma's House that day. I began to recount the events of two years before, and she saved me the time: "I remember Mr Tesconi," she said. I explained Lou's condition and said, "It would be so comforting for him to receive a letter from Mrs Bush."

A few days later, I went to see Lou in the hospital. As soon as he saw me, he reached beside his bed with a slow and shaky hand and pulled out a letter: "Look what I got," he said.

The letter was unflinching and full of love. She didn't duck the issue that Lou was dying. She used it as a pivot to say, "Well-done." At the bottom, in her own hand, she wrote to Lou that his life mattered, that he had made an impact.

That was a long time ago. But some things you don't forget — and shouldn't. In a time of ignorance, her wise touch eased the sting of exclusion for my friend and many others.

Thank you, Mrs Bush.

Tom Rosshirt was a national security speechwriter for President Bill Clinton and a foreign affairs spokesman for Vice President Al Gore.

The United Nations Women for Peace Association (UNWDPA) has honoured Lorena Castillo de Varela, the First Lady of Panama and UNAIDS Special Ambassador for AIDS in Latin America, with its Leadership Award. The award was made in recognition of her work in the response to HIV and the promotion of human rights and women’s empowerment.

Presented at the UNWDPA Annual Award Luncheon, held at United Nations Headquarters in New York, United States of America, on International Women’s Day, the award honours people who have made a difference to the lives of women and girls.

Since her appointment as a UNAIDS Special Ambassador in 2016, Lorena Castillo de Varela has led a zero discrimination campaign that has gone beyond the borders of Panama and become internationally recognized. In her role as Chairwoman of the National AIDS Commission, she catalysed support from 45 governmental institutions to sign an act of commitment to promote HIV prevention and zero discrimination. 

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