2009 World AIDS Day- Universal Access and Human Rights

Today, 1st December 2009 marks World AIDS day. Browsing through the 2009 AIDS Epidemic Update , one can see that despite significant efforts towards combating the epidemic, the global HIV/AIDS statics are alarming.

According to the report, an estimated:

  • 33.4 million people are living with HIV worldwide               
  • 2.7 million people were newly infected in 2008
  • 2 million people died of AIDS related illness in 2008

This year’s World AIDS Day theme is “Universal Access and Human Rights”. The challenge therefore for governments and donors, is to translate into real action and results, the knowledge of the interplay of HIV/AIDS and human rights. Notably:

  • The right to share in scientific advancement and its benefits;
  • The right to the highest attainable standard of physical and mental health;
  • The right to non-discrimination, equal protection and equality before the law;
  • The right to life;
  • The right to privacy;
  • The right to be free from torture and cruel, inhuman or degrading treatment or punishment;
  • The right to work;
  • The right to freedom of movement;
  • The right to seek and enjoy asylum;
  • The right to an adequate standard of living;
  • The right to social security, assistance and welfare;
  • The right to equal access to education;
  • The right to participate in public and cultural life;
  • The right to freedom of association;
  • The right to marry and to found a family;
  • The right to freedom of opinion and expression and the right to freely receive and impart information.
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Global Fund faces $5 billion funding gap

global-fund2The Global Fund to Fight AIDS, Tuberculosis and Malaria, which supplies one-quarter of all AIDS funding, two-thirds of tuberculosis funding and three-fourths of malaria funding is facing a $5 billion funding gap for its worldwide programs.Based in Geneva, the Global Fund oversees hundreds of programmes in 136 countries through public-private partnerships that have raised more than 11 billion dollars (8.5 billion euros).

Global Fund Board Chairman Rajat Gupta says the Global Fund’s progress in the fight against AIDS, TB and malaria must be sustained. He says he and other health and business leaders who attended the recent World Economic Forum in Davos, Switzerland were not asking for a bailout but simply calling on donor nations to make good on their pledges to improve the world’s prosperity and its health. Gupta says that the continued support could save nearly two million additional lives in the coming years.

The executive director of the Global Fund, Michel Kazatchkine said he was concerned about the impact of the economic crisis would have on efforts to combat the diseases.

“I’m afraid of the impact the financial crisis will have, first of all on the rich countries which will find it difficult to provide resources but also the impact on poor countries as the crisis will touch them too”.

 

Scholar’s Corner: Recent Scholarly Works in Global Health Law

 President’s Emergency Plan for AIDS Relief: Health Development at the Crossroads

 

Lawrence O. Gostin
Georgetown University Law Center – O’Neill Institute for National and Global Health Law; Georgetown University Law Center

JAMA, Vol. 300, pp. 2046-48, 2008
Georgetown University O’Neill Institute for National & Global Health Law Scholarship Paper No. 18


Abstract:     
The President’s Emergency Plan for AIDS Relief (PEPFAR) was the largest commitment by any nation to combat a single disease in human history, authorizing up to $15 billion over 5 years. On July 30, 2008, President Bush signed into law the historic reauthorization of PEPFAR, dramatically increasing the financial commitment by authorizing up to $48 billion over 5 years, including $5 billion for Malaria and $4 billion for Tuberculosis. PEPFAR’s global targets are inspiring: treat 3 million people; prevent 12 million new HIV infections, and care for 12 million people, including 5 million orphans and vulnerable children. But, PEPFAR has been mired in controversy. To some, it exemplifies America’s extraordinary compassion and generosity, and to others America’s politicization of public health and unilateral approach to international health. The truth lies somewhere in between. American healthassistance to the developing world stands at a crossroad. As PEPFAR is scaled up, will it provide opportunities to fulfill basic human needs, or will its limited focus pull resources from sustainable, capacity-building support in line with poor country priorities?

Available at SSRN.

Indonesia Introduces Legislation to Microchip “Sexually Aggressive” HIV/AIDS Patients

Lawmakers in the Papua province of Indonesia support upcoming legislation that requires “sexually aggressive” HIV/AIDS patients to be implanted with microchips in order to identify, track and ultimately punish those who deliberately infect others with up to six months in jail or a $5,000 fine.

The proposed legislation has received full support from the provincial parliament and, if it passes as expected, the legislation will be enacted next month.  The government has not said how it would determine which patients should be considered “sexually aggressive.” 

Human rights workers are understandably troubled.  “People with AIDS aren’t animals; we have to respect their rights,” said Tahi Ganyang Butarbutar, a prominent Papuan activist.  Local health workers and AIDS activists called the plan “abhorrent.”

Given that much of Indonesia’s HIV/AIDS problem stems from lack of knowledge about how HIV/AIDS is spread, health workers suggest that the best way to tackle the epidemic is through increased spending on sexual education and condom use. Continue reading

More Countries Make Spreading HIV a Crime

According to the report HIV: Verdict on a Virus – Public Health, Human Rights and Criminal Law, put out by the International Planned Parenthood Federation, more countries are criminalizing HIV transmission.  The report analyzes the related health, human rights and legal implications.

According to Planned Parenthood, 58 countries worldwide have laws that criminalize HIV or use existing laws to prosecute people for transmitting the virus. Another 33 countries are considering similar legislation.  According to the report:

“In an increasing number of countries, transmitting or exposing another person to HIV can be an offence under criminal law. Charges are being brought under a variety of laws, either specific to HIV transmission or exposure, or under other laws such as murder, manslaughter, attempted murder, assault, grievous bodily harm (GBH) or poisoning. In some countries a distinction is made between intentional, ‘reckless’, or even negligent transmission of HIV. Exposure laws are primarily concerned with consent whereas transmission laws are concerned with both consent and proof of transmission.

“While some people believe that criminalization can promote public health outcomes and improve HIV prevention efforts, it may also deter people from accessing voluntary counselling and testing (VCT) services, discourage them from knowing their HIV-status and impede people from seeking appropriate care and support.”

Since 2005, seven countries in West Africa have passed HIV laws. In Benin, simply exposing others to HIV is a crime, even if transmission doesn’t occur. In Tanzania, intentional transmission of the virus can lead to life imprisonment. In the U.S., 32 states have laws criminalizing HIV transmission.

As reported: 

“A woman in Canadawas charged with criminal negligence causing bodily harm having chosen not to access PMTCT services. The case is unusual. The charge the woman was convicted of is typically reserved for cases of child neglect. The woman was also charged with criminal negligence causing bodily harm and aggravated assault. However, those charges were withdrawn.

 

“The woman has two children – the first born in 2003, does not have HIV. When she became pregnant the second time, in 2004, she changed her health care provider and did not tell her new doctors that she was HIV-positive. Her second child did not receive essential medication after birth, and tested HIV-positive in 2005. Although the woman did not breastfeed her first baby (under her doctor’s advice) she did breastfeed the second, which may have also facilitated the transmission of HIV. The woman was sentenced to a 6 month conditional sentence followed by 3 years of probation and also burdened with a criminal record, which can have serious implications in terms of future employment, travel, and access to social welfare.”

Read more about the report, after the jump. Continue reading

News Brief: Recent Events in Global Health Law

More than 40 young children have been infected with HIV at a hospital in Uzbekistan.  According to the United Nations, Central Asia has one of the world’s fastest-growing HIV infection rates due, in part, to unsafe blood supplies and contaminated equipment.  BBC

A study published by the Harvard School of Public Health on October 20, 2008, blamed South Africa’s former President Mbeki for the loss of lives from AIDS.  The study found that Mbeki’s decision in 1999 to declare available drugs toxic and dangerous caused almost 330,000 deaths and resulted in nearly 35,000 babies being born HIV+.  Activists are calling for former President Mbeki to be summoned to a judicial inquiry or the Truth and Reconciliation Commission.  BBC

Lancet authors Robert Beaglehole DSc and Prof Ruth Bonita PhD propose a global health scorecard as a means of indentifying progress that has been made and areas in which progress is still needed.  The Lancet (full article available with subscription)

Minority children waiting for a heart transplant have a higher death rate than white youngsters, even accounting for socioeconomic and insurance factors.  The risk of death remained higher for all non-whites — 40 percent higher for blacks and Hispanics and more than 100 percent higher for Asians and others.  Washington Post

Uganda loses $12m in Global Fund AIDS and malaria funding over misuse concerns

 Due to concerns over misamanagement and poor accountability of initial installments, the Global Fund to Fight AIDS, Tuberculosis and Malaria  has refused to release $10m of the $36m that was allocated to Uganda in 2003 for HIV/AIDS activities under Round One. A further $2m has been withheld from the $24m allocated for malaria work under the Global Fund, Round 2 in 2004.

According to Aidspan, an independent watchdog of the Fund, quoted in the New Vision“Uganda failed to satisfy the Global Fund in time that the arrangements put in place after the suspension were good enough to protect their money in Uganda.” 

The organisation noted that the two grants “have become irredeemable” as they are 40months behind schedule and Uganda should have accounted for the first installments.

Back in August 2005, the Global Fund temporarily suspended all of its five grants to Uganda upon evidence of ‘serious mismanagement’ of the funds. The Global Fund requested the country to put in place a new structure that will ensure effective management of the grants.

In October 2005 the Ugandan Government responded by setting up a commission of inquiry into allegations of mismanagement of grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria.  The Global Fund later lifted the suspension of the grants in  November 2005, following the signing of an Aide Memoire setting out action points for restructured management of the grants.  

The commission of Inquiry headed by Justice James Ogoola, issued a damning report in June 2006 but 2 years later the Global Fund board raised concern over Uganda’s delay to act on the Ogoola Commission report.  In August 2008, the Global Fund’s Inspector General visited Uganda to evaluate progress.

 

The Uganda Government, under pressure from donors, begun to prosecute people alleged to have embezzled the money. Among those interrogated were 3 former health ministers.

Continue reading