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.     

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.     

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.     

Australia: court orders doctors to pay damages to woman who contracted HIV from her husband

IN a case that received extensive media coverage, the New South Wales Supreme Court has found two doctors negligent for failing to take steps to make a bride aware that she was at risk as a result of her prospective husband's HIV infection. The court awarded the woman AUD$727,437 in damages. The couple had attended the physicians together to be tested for HIV and other sexually transmitted infections, but had received their test results separately. She subsequently contracted HIV as a result fo unprotected sexual intercourse with him.     

South Africa: highest court orders government to provide antiretrovirals to prevent mother-to-child transmission

On 5 July 2002, South African treatment activists won a significant victory when the Constitutional Court ordered the South African government to make the antiretroviral drug nevirapine available in public hospitals and clinics for the purposes of preventing mother-to-child transmission of HIV. The Court also ruled the government has a constitutional obligation to implement a program to realize the right of pregnant women and their newborn children to access health services to prevent transmission.     

Barcelona 2002: law, ethics, and human rights. Advancing research and access to HIV vaccines: a framework for action

In light of the continuing spread of HIV infection and the devastating impact of the disease on lives, communities, and economies, particularly in the developing world, the investment in new treatments, vaccines, and microbicides has clearly been inadequate. Efforts must be intensified to develop effective HIV vaccines and to ensure that they are accessible to people in all parts of the world. This article is a summary of a paper by Sam Avrett presented at "Putting Third First: Vaccines, Access to Treatments and the Law," a satellite meeting held at Barcelona on 5 July 2002 and organized by the Canadian HIV/AIDS Legal Network, the AIDS Law Project, South Africa, and the Lawyers Collective HIV/AIDS Unit, India. In the article, Avrett calls for immediate action to increase commitment and funding for HIV vaccines, enhance public support and involvement, accelerate vaccine development, and plan for the eventual delivery of the vaccines. The article briefly outlines steps that governments need to take to implement each of these objectives. The article also provides a menu of potential actions for vaccine advocates to consider as they lobby governments.     

Access to Medicines and the Transformation of the South African State: Exploring the Interactions of Legal and Policy Changes in Health,Intellectual Property,Trade, and Competition Law in the Context of South Africa's HIV/AIDS Pandemic

Access to essential medicines remains highly contested around the globe and a vital issue in South Africa. At the same time, the HIV/AIDS pandemic and the demand for medical services are having important political and social consequences in a society heavily impacted by the pandemic. Legal and institutional changes within the postapartheid state in South Africa are in part a reflection of the interaction of opportunities and constraints both within and across the country's geographical boundaries. The transformation of state institutions in this context has been set in motion and shaped by different policy imperatives: from demands for medical care to the promotion of economic competition and the need to implement international trade commitments, including specific levels of intellectual property protection. Despite a strong commitment to social change, to address the legacies of apartheid, as well as the relative strength and political will of the dominant political party, the African National Congress, the transformation of a number of state institutions was significantly framed by the global environment in which the country found itself. In the context of South Africa's democratic transition and the devastating HIV/AIDS pandemic, the state responded to a range of shifting opportunities and constraints, whether real or perceived. As a result, impetus was given to different policies and competing political and economic factions, enabling particular institutions and rules to be embraced, created, reshaped, or simply foregone.     

Barcelona 2002: law, ethics, and human rights. Using the law to improve access to treatments

The XIII International AIDS Conference in Durban, South Africa in July 2000 focused worldwide attention on the problem of accessing treatments in developing countries. In the interim, thanks to the work of activists - from demonstrations to court cases, and from acts of public courage by people living with HIV/AIDS to ongoing lobbying of politicians and trade negotiators - some very significant developments have occurred. But the reality is that the vast majority of people living with HIV/AIDS still lack access to affordable, quality medicines. This article, a summary of a paper presented at "Putting Third First: Vaccines, Access to Treatments and the Law," a satellite meeting held at Barcelona on 5 July 2002 and organized by the Canadian HIV/AIDS Legal Network, the AIDS Law Project, South Africa, and the Lawyers Collective HIV/AIDS Unit, India, explores three approaches for improving access. In the first part, Richard Elliott provides an overview of the state of the right to health as embodied in international human rights law; comments on the experience to date in litigating claims to the right to health; and identifies potential strategies activists can adopt to advance recognition of the right to health. In the second part, Sharan Parmar and Vivek Divan describe price-control and drug-financing mechanisms used by industrialized countries to increase the affordability of medicines; and discuss how some of these mechanisms could be adapted for use in developing countries. Finally, Jonathan Berger describes the use of litigation in the courts by the Treatment Action Campaign in South Africa.     

South Africa: damages awarded to woman infected by husband

In mid-2001, the High Court of South Africa issued its judgment in Patricio v Patricio, a civil case in which a woman sued her HIV-positive husband for infecting her with HIV.     

The UNGASS Declaration of Commitment on HIV/AIDS: a review of legislation in six Southern African countries

This article reviews legislation of six Southern African countries to determine what progress has been made after the UNGASS Declaration of Commitment on HIV/AIDS, particularly with regard to paragraph 58 on human rights and paragraph 69 on rights in the workplace. The article notes the complexities introduced by the coexistence of customary laws and practices and codified law. It describes certain features of specific codified and customized laws. It concludes that, with the possible exception of South Africa, the countries under review have not responded to the challenges the HIV/AIDS epidemic have confronted their legal systems with. They have resorted in the first instance to criminal law, and have allowed discriminatory customary laws and practices, which propel the epidemic, to continue to operate.     

South Africa: Treatment Action Campaign steps up pressure

In December 2002, in its ongoing efforts to secure access to affordable HIV/AIDS treatment for all South Africans, the grassroots organization Treatment Action Campaign (TAC) initiated two new proceedings over governmental failure to act to prevent mother-to-child transmission of HIV. In March 2003, it launched a national civil disobedience campaign to pressure government into implementing a national treatment and prevention plan, including taking measures to ensure access to affordable medicines.     

South Africa: TAC, COSATU and allies file complaint of excessive pricing

On 19 September 2002, the Treatment Action Campaign (TAC), the Council of South African Trade Unions (COSATU), the Chemical, Energy, Paper, Printing, Wood and Allied Workers' Union (CEPPWA), and eight individuals (health-care workers and people living with HIV/AIDS) launched a complaint with the country's Competition Commission against two major transnational pharmaceutical companies. TAC and its allies allege that GlaxoSmithKline (GSK) has engaged in excessive pricing for its antiretroviral drugs Retrovir (zidovudine or AZT), 3TC (lamivudine), and Combivir (AZT/lamivudine), and that Boeringer Ingelheim (BI) has engaged in excessive pricing of its antiretroviral drug Viramune (nevirapine).     

Health, Social Movements, and Rights-based Litigation in South Africa

This article investigates the impact of rights-based litigation on social struggles in the South African health sector. It considers the manner in which individuals and social movements have utilized rights and the legal process in their efforts to dismantle the ill-health/poverty cycle, in the particular context of the struggle for universal access to treatment for HIV/AIDS. Relying on literature concerning the transformative potential of socio-economic rights litigation and on examples from South African case law, the article critically evaluates the gains that have been made and the obstacles that have been encountered in this context. It argues that rights-based litigation presents a powerful tool in the struggle against poverty, but also elaborates on structural and institutional hurdles that continue to inhibit the effectiveness of rights-based strategies in this regard.     

Associations between intimate partner violence and emotional distress among pregnant women in Durban, South Africa

Intimate partner violence (IPV) during pregnancy has been associated with multiple negative health outcomes including emotional distress during pregnancy. However, little is known about IPV during pregnancy and its association with emotional distress among South African women. The objectives of this study were to determine the prevalence of both emotional distress and IPV during pregnancy, to identify whether different exposures of violence were associated with emotional distress and to assess whether social support attenuated the relationship between IPV and emotional distress. Pregnant women enrolled in the South Africa HIV Antenatal and Posttest Support Study (SAHAPS) who completed the baseline survey were included in this cross sectional analysis. We used logistic regression models to explore bivariate and multivariate relationships between the proposed covariates and emotional distress. Nearly a quarter of women experienced some type of IPV during the current pregnancy, with psychological violence being the most prevalent. The odds of emotional distress was 1.41 times (95% CI: [1.26, 1.57]) higher for each additional episode of psychological violence and 2.01 times (95% CI: [1.16, 3.77]) higher for each additional episode of sexual violence during pregnancy, adjusting for other covariates. Physical violence was only marginally associated with increased odds of emotional distress. Finally, social support was marginally significant as a main effect but did not attenuate the relationship between IPV and emotional distress. The high prevalence of IPV among South African women and its association with emotional distress during pregnancy suggest that interventions that reduce violence during or prior to pregnancy are needed.     

Preventing mother-to-child transmission: landmark decision by South African court

On 14 December 2001, the High Court of South Africa delivered its judgment in Treatment Action Campaign et al v Minister of Health et al, ruling that the government was in breach of its constitutional obligations and must promptly develop and implement a comprehensive national program to prevent mother-to-child transmission of HIV, including making antiretroviral drugs available for this purpose. This article summarizes the legal arguments and the outcome of a case that is of global significance in holding governments accountable for their obligations to progressively realize the human right to health.     

Heterodoxy, iconoclasm and spuriousness: the limits of novel expert evidence

A difficult issue arises for courts' decision-making at common law and under statutory evidentiary regimes when expert opinions are significantly unorthodox, iconoclastic or methodologically flawed. This editorial analyses the relevant evidentiary principles and the Australian jurisprudence on the subject, giving particular attention to the decisions of the South Australian Supreme Court in R v Parenzee [2007] SASC 143 and R v Parenzee [2007] SASC 316 in which expert opinions about the existence, identifiability and transmissibility of HIV and its relationship to AIDS adduced on behalf of the defence in a criminal trial were found to be seriously wanting. A variety of factors indicative of low probative value in expert opinions are distilled.     

Rural HIV: Brief interventions for felony probationers

HIV/AIDS in Southern rural America has been described as an epidemic. Furthermore, the HIV prevalence rate among criminal justice populations is higher than the general population in both rural and urban areas. One segment of the criminal justice population, felony probationers, has not been targeted for HIV/AIDS interventions and little is known about rural HIV risk behaviors. Probation is an appropriate setting for examining HIV interventions because rural participants can be easily identified and contacted. Thus, the purpose of this paper is to describe an HIV intervention for Southern rural probationers and to profile participants (N=800) on their demographics and risk behaviors by degree of criminality. Results suggest that HIV interventions are needed to target rural probationers, especially those with extensive arrest histories since they engage in high-risk behaviors, including illicit substance use and unprotected sex. This project is supported by grant #R01DA11580 from the National Institute on Drug Abuse. The opinions expressed are those of the authors.     

News from Venezuela

A Venezuelan court has ordered a university to stop requiring HIV testing for admission, while shortly thereafter the Venezuelan Ministry of Health and Social Development authorized obligatory HIV screening of pregnant women.     

相互依赖理论与全球化时代的南北关系

在经济全球化条件下，南北国家之间的相互依赖，尤其是经济上的相互依赖日益加深，但两之间的相互依赖又是不对称，不平衡的，更多地表现为南方国家对北方国家单方面的依赖。这就使得南北关系不仅没 随着冷战的结束以后全球化的深入发展而有所改善，而且南北差距还进一步扩大，南北之间的等级结构进一步凸显。南北矛盾也随着南方国家的日益贫困化和边缘化而有所激化。南北关系不容乐观。