Putting third first: critical legal issues and HIV/AIDS

On 7 July 2000, before the XIII International AIDS Conference, the Canadian HIV/AIDS Legal Network and the AIDS Law Project, South Africa held a one-day satellite meeting on legal, ethical, and human rights issues in Durban, South Africa. Entitled Putting Third First--Critical Legal Issues and HIV/AIDS, the satellite focused on legal strategies to advance the human rights of those most vulnerable to HIV/AIDS and to discrimination: people in the developing world, and people who, although they live in the industrialized world, suffer from poverty and marginalization and are at high risk of contracting HIV. The satellite grew out of the ongoing partnership between the Canadian HIV/AIDS Legal Network and the AIDS Law Project, South Africa, and was co-hosted by UNAIDS.     

Survey reveals knowledge and attitudes of Canadians regarding HIV/AIDS

According to a national survey, almost two out of every three Canadians think the federal government should be spending more to fight HIV/AIDS. The survey also found that: (a) although most Canadians know a lot about HIV/AIDS, there are some significant gaps in their knowledge; and (b) although most Canadians think HIV/AIDS is a serious problem, the vast majority do not consider themselves to be at risk for HIV infection. Few Canadians blame people for contracting HIV through sex or drug use, but many Canadians are still uncomfortable associating with people with HIV/AIDS in certain settings.     

Access to treatment as a right to life and health

In some countries in Latin America, in the absence of leadership from governments, activists have had to resort to the courts to obtain access to HIV/AIDS treatments for people with HIV/AIDS. In his presentation to the XIII International AIDS Conference (abstract TuOrE458), Edgar Carrasco, of Acción Ciudadana Contra el Sida (ACCSI), discusses the process that was followed in Venezuela. The presentation describes the very limited access people with HIV/AIDS had to antiretroviral therapies and treatments for opportunistic infections under Venezuela's health and social security systems. It provides details of lawsuits that were launched on behalf of several individuals living with HIV/AIDS, and that resulted in the courts ordering the government to provide treatments for these individuals and, eventually, for all people with HIV/AIDS in Venezuela. The presentation concludes that recourse to the courts is a useful tool for activists and that civil actions launched on behalf of people with HIV/AIDS can serve as an example for people with other chronic diseases.     

输血后艾滋病的司法鉴定

本文综述了近年来输血后艾滋病病毒感染、艾滋病发病情况及其影响因素,强调了按照国家法律,法规,严格控制血液制品进口,采血部门严格筛查,供血单位规范生产,用血医院严把指征,以及受血病人知情理解是避免输血后艾滋病病毒感染和艾滋病法律纠纷的关键。阐述了输血后艾滋病病毒感染及艾滋病发病的司法鉴定工作要点。     

Québec: an outbreak of HIV/AIDS-related stigma and discrimination

In the space of a few weeks in January 2004, actions by three different institutions in Québec combined to threaten the human rights of people living with HIV/AIDS, raise the spectre of mandatory HIV testing, and create unnecessary public fears about the spread of HIV infection. In response to what they called "the worst weeks in recent history for people living with HIV/AIDS in Québec," the Canadian HIV/AIDS Legal Network and COCQ-Sida (the Québec coalition of community-based organizations fighting AIDS) called for a province-wide campaign against HIV/AIDS-related stigma and discrimination. A victory was achieved when a Montréal catholic seminary announced that it had backed down from its initial proposal to mandatorily test all applicants for priesthood for HIV, but much more is needed to fight the rapid outbreak of mandatory-testing proposals.     

Chinese scholars call for AIDS rules based on respect for individual rights

In June 2002, the UN Theme Group on HIV/AIDS in China published a comprehensive situation analysis and needs assessment of the HIV/AIDS epidemic in the People's Republic of China (PRC). The report, entitled "HIV/AIDS: China's Titanic Peril", also describes and analyzes current HIV/AIDS legislation and policies. It notes that "laws and regulations that are based on fear and prejudice have contributed to fuelling the epidemic instead of curbing it." The report observes that the targets and goals established in China's five-year Plan of Action (2001-2005) are not consistent with the commitments endorsed in June 2001 at the United Nations General Assembly Special Session on HIV/AIDS. It states that the Plan "continues to present HIV/AIDS as a medical problem, and fails to understand the epidemic as a broader development issue." Even where laws could assist, enforcement remains a huge challenge. For example, in 1998 the National People's Congress passed a law prohibiting commercial blood donations for medical purposes. Nonetheless, the illicit and unregulated blood trade, which has rapidly accelerated the spread of HIV infection in China, has continued. When the alarm was sounded by Dr. Wan Yanhai, coordinator of the AIZHI (AIDS) Action Project, the government response was to arrest him. In the following article, Nick Young, editor of China Development Brief, reviews the findings of three studies commissioned by the United Nations Development Programme (UNDP) on the role of the law in response to HIV/AIDS.     

A human rights critique of the United Kingdom's HIV response

The National AIDS Trust (NAT) is the United Kingdom's leading HIV policy and advocacy NGO. NAT is committed to promoting a human rights framework for HIV responses through work with communities, governments, professionals, and the private sector, both within the UK and internationally. In this presentation to the XIII International AIDS Conference (abstract WeOrE524), John Godwin and Saul Walker discuss current human rights issues related to HIV/AIDS in the UK, and NAT's perspective on the International Guidelines on HIV/AIDS and Human Rights as an advocacy tool.     

AIDS Law Project receives AIDS and human rights award

The AIDS Law Project, the recipient of the 2nd Annual International Award for Action on HIV/AIDS and Human Rights, has been at the forefront of the struggle for human rights for people living with HIV/AIDS in South Africa. It has played a major role in convincing the South African government to implement a national HIV treatment plan.     

United Nations Declaration of Commitment on HIV/AIDS

The United Nations General Assembly Declaration of Commitment on HIV/AIDS calls for a fundamental shift in the response to HIV/AIDS.     

Developments in South African law on HIV/AIDS

South Africa has a powerful legal framework that offers high levels of protection to people living with HIV/AIDS, yet discrimination against people living with HIV/AIDS continues to be widespread in South African society. Court cases decided in 2003 regarding children's issues and health care testify to this ongoing discrimination, and to the potential of the South African legal system to uphold the rights of people living with HIV/AIDS.     

Report on complementary/alternative health care and HIV/AIDS

In 2001, the Canadian HIV/AIDS Legal Network published a lengthy report on Complementary/Alternative Health Care and HIV/AIDS: Legal, Ethical & Policy Issues in Regulation. The document is the first in a series of papers to be produced by the Legal Network on priority legal and ethical issues related to HIV/AIDS care, treatment, and support. The article below summarizes the contents of the report.     

艾滋病立法与国际人权保障

国际社会已经达成共识,认为有效地控制艾滋病与人权保障之间存在着密切关系,而法律则是实现防治艾滋病的一个重要手段。因此,现实和未来都要求各国通过以保障人权为核心的相关立法,充分保护艾滋病病人和艾滋病病毒感染者的各项基本权利,切实调动社会各方面的积极因素来战胜艾滋病,最终维护人类的共同利益,实现社会的可持续发展。对此,在国际人权法的框架下,结合艾滋病的流行特点,国际社会和许多国家近年来制订了不少准则和法律,以阻止艾滋病的进一步传播。     

Mandatory HIV testing used to bar potential immigrants

Last year Canada turned away 75 people with HIV/AIDS because the federal government said that they would place excessive demands on publically funded services. Another 207 people with HIV/AIDS were allowed to enter Canada, mainly because of exemptions to the excessive-demand provisions. HIV/AIDS organizations have objected to the government's policy of mandatory HIV-antibody testing of potential immigrants and have expressed concerns about the way in which excessive demand is calculated.     

Caribbean: Regional support for HIV/AIDS law and policy reform

In this article, David Patterson describes the second regional training workshop on HIV/AIDS, law, ethics, and human rights, which took place in Georgetown, Guyana in November 2003; and a grant from the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria (the Global Fund) to the Pan Caribbean Partnership against HIV/AIDS (PANCAP). The grant focuses on human rights, prevention, and care and support.     

HIV/AIDS and human rights revisited

In their article, Sofia Gruskin and Daniel Tarantola demonstrate how, as the number of people living with HIV and with AIDS continues to grow in nations with different economies, social structures, and legal systems, HIV/AIDS-related human rights issues are not only becoming more apparent, but also increasingly diverse. In the 1980s, the relationship of HIV/AIDS to human rights was only understood as it involved people with HIV or AIDS and the discrimination to which they were subjected. The concerns included mandatory HIV testing; restrictions on international travel; barriers to employment and housing, access to education, medical care, or health insurance; and the many issues raised by named reporting, partner notification, and confidentiality. Almost 20 years into the epidemic, these issues remain serious and most often have not been resolved. In the 1990s, however, there was increased understanding of the importance of human rights as a factor in determining people's vulnerability to HIV infection and their consequent risk of acquiring HIV infection and their chances of accessing appropriate care and support. And most recently, human rights have also come to be understood to be directly relevant to every element of the risk/vulnerability paradigm. Gruskin and Tarantola identify three situations and three levels of governmental obligations that should be considered when identifying the specific needs and related rights of individuals in the context of HIV/AIDS. They conclude that policymakers, program managers, and service providers must become more comfortable using human rights norms and standards to guide and limit government action in all matters affecting the response to HIV/AIDS; and that those involved in HIV/AIDS advocacy must become more familiar with the practicalities of using international human rights law when they strive to hold governments accountable.     

Draft discussion paper on HIV/AIDS and immigration released

In October 2000, the Canadian HIV/AIDS Legal Network released a 57-page draft discussion paper on HIV/AIDS and immigration, reacting to the announcement that HIV testing may become mandatory for all prospective immigrants to Canada. A final version of the paper will be released in early 2001.     

Barcelona 2002: law, ethics, and human rights. Introducing ARVs in resource-poor settings: challenges and consequences

In most industrialized countries, AIDS mortality has plunged sharply with the advent of antiretroviral therapy. Yet the majority of people living with HIV/AIDS do not have access to modern HIV care, and some experts have argued that introducing such therapy is not a ranking priority. In this article, which is based on a plenary presentation at the XIV International AIDS Conference, Paul Farmer presents the experience of an integrated HIV prevention and care project in rural Haiti, and explores the challenges to national AIDS programs and other bodies in the "least developed" countries as more resources are made available for HIV prevention and care.     

Canada: new report on HIV,HCV, and women prisoners

In March, 2003, the Prisoners' HIV/AIDS Support Action Network (PASAN) released Unlocking Our Futures: A National Study on Women, Prisons, HIV and Hepatitis C, a qualitative, evaluative study investigating the perceptions and lived experiences of federally incarcerated women regarding HIV/AIDS and hepatitis C (HCV).     

Global access to treatment: achievements and challenges

As mentioned in the previous issue, this section of the Review addresses issues related to improving access to adequate and affordable care, treatment, and support everywhere. It replaces the section previously called "Patents and Prices." In this issue, we feature a review of achievements and challenges in recent years in opening global access to HIV/AIDS treatments. The article - one of a series commissioned to mark the tenth anniversary of the Canadian HIV/AIDS Legal Network, discussing past developments and future directions in areas of policy and law related to HIV/AIDS - describes the developments that recast the debate about access to treatment from one focused on patent entitlements to one focused on the right to health and treatment. It analyzes the role of national and international activism, strategically constructed alliances, and principled leadership in achieving this change. And it discusses continuing obstacles to equitable access to HIV/AIDS treatments for the world's population.     

Criminal law and HIV/AIDS: strategic considerations

Richard Elliott's paper on criminal law and HIV/AIDS, an edited and updated version of his presentation at "Putting Third First," sets out five guiding principles for criminal law policy and HIV/AIDS; briefly outlines the rationales for criminalization; discusses three strategic legal questions regarding the criminalization of HIV transmission/exposure; and offers a number of recommendations for consideration of those needing to articulate a well-considered perspective on the ethical, legal, human rights, and public health dimensions of the criminalization of HIV transmission/exposure.