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Geneva, Switzerland, UNAIDS, 2003. Prepared for the 2nd Meeting of the UNAIDS Global Reference Group on HIV / AIDS and Human Rights, August 25-27, 2003. 3 p.Over 20 years ago, policy and programmatic approaches to HIV testing emerged in a context of great fear about HIV/AIDS and about how to prevent HIV infected individuals from transmitting the virus. As testing methods were developed, HIV testing assumed an important role in epidemiological surveillance, and as treatment became available, on individual testing for clinical purposes. Yet, as national responses to the emerging epidemics unfolded, numerous States argued that the protection of public health warranted compulsory testing requirements of certain populations considered to be “high risk”, mandatory testing for access to certain goods and services, named reporting of those found to be infected and sometimes contact tracing and mandatory notification of partners, family, employers or community members. The realities of stigma, discrimination and the neglect of human rights protections were recognized to keep people away from prevention and care, and creating fertile ground for people not to get tested and, unaware of their HIV status, to further spread the virus. This recognition lead to a bridge between those concerned with human rights protections and those concerned with public health imperatives. Over time, the components of supportive testing became clearer, the concept of voluntary counseling and testing (VCT) was promulgated and policy direction from GPA/WHO centered on making voluntary counseling and testing an important focus of all national responses to the HIV/AIDS epidemics. This policy, further elaborated by WHO and UNAIDS remains in place today. (excerpt)
Ethics and equity in access to HIV treatment. Issue paper: 3rd Meeting, UNAIDS Global Reference Group on HIV / AIDS and Human Rights, 28-30 January 2004.
Geneva, Switzerland, Joint United Nations Programme on HIV / AIDS [UNAIDS], 2004. 6 p.The WHO/UNAIDS 3x5 initiative aims to reach those in need of treatment and to identify those who are hard to reach, especially in populations that have not had access to services. There is a global responsibility to support resource-limited countries to scale up ART in the face of a global public health emergency. In addition, a country-level responsibility exists to ensure treatment is made available as enunciated in human rights guidelines for HIV/AIDS. It will not be possible to reach everyone in need as the 3x5 initiative begins, so it is necessary to work progressively towards universal access. Most countries will use a phased approach and this will necessitate making decisions about priorities in allocating resources. Although adherence to human rights provisions is essential, none of the various human rights treaties or declarations provides criteria for setting priorities or choosing among potentially relevant principles of equity. When not all persons in need of HIV treatment can be served, distribution of HIV treatment services should be guided by principles of equity or fair distribution, and considerations of human rights, including the right to freedom from discrimination and the right to the highest attainable state of health. Policy makers will need to make decisions and various ethical principles will guide these decisions in very different ways. (excerpt)