HIV as a human rights issue was the main theme of a high-level meeting co-organized by the European Commission and UNAIDS. The meeting explored the critical human rights issues in Europe that are preventing a more effective AIDS response in Western Europe and are contributing to an increase in new HIV infections and AIDS-related deaths in Eastern Europe.
Held from 27-28 May in Brussels under the overarching theme: right to health, right to life, the event brought together 150 representatives of European Union (EU) Member States and neighbouring countries—including Belarus, Moldova, Russia and Ukraine—civil society activists and representatives from the European Commission and UNAIDS.
Participants discussed ways to promote and protect the rights of people living with or affected by HIV, overcome stigma and discrimination and remove punitive approaches that act as major obstacles to an effective and rights-based response to AIDS.
In his opening statement, the European Commissioner for Health and Consumer Protection, Tonio Borg, committed to ensure continued leadership of the EU in the response to AIDS. For that, he announced the establishment of a new framework for EU action on AIDS before October 2014. "Doing nothing is not an option," said Mr Borg.
Participants reaffirmed the need to strengthen rights-based approaches to HIV and create supportive legal environments throughout Europe for people living with HIV and for key populations at higher risk of infection. It was noted that although Europe provides scientific, technical and human rights leadership in the HIV response across the globe as well as 40% of international AIDS funding, much more needs to be done in the sphere of human rights and HIV in Europe itself.
The legal system should not do more harm than good; it should not stigmatize people or increase their vulnerability to disease.
Luis Mendao from GAT (Grupo Portugues de Activistas sobre Tratamentos de VIH/SIDA
Europe has formally committed to respecting and defending human rights obligations through regional and global declarations. However, for many people living with and affected by HIV, these commitments have yet to make a difference to their lives. Key populations—such as men who have sex with men, transgender individuals, people who use drugs, sex workers, migrants and prisoners—remain marginalized and are still disproportionately affected by the epidemic.
“Europe has not yet been able to develop an approach based on rights and evidence, a legal framework that addresses migration, drug use, sex work, prison and LGBT,” said Luis Mendao from GAT (Grupo Portugues de Activistas sobre Tratamentos de VIH/SIDA). “The legal system should not do more harm than good; it should not stigmatize people or increase their vulnerability to disease,” he added.
HIV prevalence among key populations is well over 5%. In major European capitals, young gay men have a lifetime risk of becoming HIV-positive that matches that of young men in Southern Africa, the area in the world most affected by HIV.
In the past ten years, Europe has seen no reduction in the rate of new HIV infections and in the eastern part of the EU, the number of AIDS-related deaths rose by more than 20% between 2005 and 2011.
Participants recognised that, without properly addressing the human rights of people living with HIV and other key populations, the situation has little chance of improving. Stigma and discrimination remain major barriers to seeking HIV treatment. More than 30% of people living with HIV in Europe are only diagnosed in the advanced stage of infection, suggesting that they are afraid to come forward earlier. This fear may be exacerbated by the fact that a number of European countries still criminalize HIV transmission.
In countries where drug use and sex work are criminalized and law enforcement is harsh, many people are driven underground or imprisoned where they can become even more vulnerable to HIV infection. Although treatment is generally available following an HIV diagnosis, this is often not the case for the many undocumented migrants who are thus denied their right to health.
UNAIDS Deputy Executive Director, Programme, Dr Luiz Loures noted that, as a longer term trend, the global epicentre is moving towards Europe, through a resurgence of HIV in gay men across Europe and the unchecked epidemics among people who use drugs in Eastern Europe. Dr Loures contended that in moving towards the realistic possibility of ending the AIDs epidemic in Europe and beyond, three elements are essential:
“First we need speed: we must accelerate human rights-based programmes that are working, such as harm reduction which offers life to people who inject drugs. Secondly, we need to address the ‘hotspots’, directing vital HIV services to populations who need them most, such as gay men in Europe and other parts of the world where there is high HIV prevalence. Thirdly, we need innovation: in HIV testing, in strengthening community systems, and in building new young leadership in the AIDS response.”
A series of recommendations were made to address the human rights issues in the European AIDS response. Participants focused on the need for sustained and sufficient investment in HIV, including in programmes that challenge stigma, discrimination and punitive legal barriers. A panoply of interventions were identified including stigma reduction programmes, law reform, rights literacy, legal services, sensitization of police and challenging violence against women and harmful gender norms. Improved financing, including the allocation of more domestic resources to the AIDS response and reduced medicine pricing, were highlighted as elements of critical importance.
All agreed that tackling HIV as a human rights issue in the European Union and neighbouring countries is the key to turning the regional epidemic around, setting Europe on the path to ending the epidemic.
