Your search found 289 Results
Reproductive Health Matters. 2009 May; 17(33):91-104.This paper examines why progress towards Millennium Development Goal 5 on maternal health appears to have stagnated in much of the global south. We contend that besides the widely recognised existence of weak health systems, including weak services, low staffing levels, managerial weaknesses, and lack of infrastructure and information, this stagnation relates to the inability of most countries to meet two essential conditions: to develop access to publicly funded, comprehensive health care, and to provide the not-for-profit sector with needed political, technical and financial support. This paper offers a critical perspective on the past 15 years of international health policies as a possible cofactor of high maternal mortality, because of their emphasis on disease control in public health services at the expense of access to comprehensive health care, and failures of contracting out and public–private partnerships in health care. Health care delivery cannot be an issue both of trade and of right. Without policies to make health systems in the global south more publicly-oriented and accountable, the current standards of maternal and child health care are likely to remain poor, and maternal deaths will continue to affect women and their families at an intolerably high level.
Lancet. 2007 Dec 1; 370(9602):1808-1809.Important questions about implementation of the new guidance by WHO and UNAIDS on provider-initiated HIV testing and counselling were raised by Daniel Tarantola and Sofia Gruskin. Their comments and those by other critics centre on individuals' rights to confidentiality, to refuse testing, and to not disclose their status if they fear negative consequences. We are concerned that a singular focus on the individual's rights of refusal overlooks the rights of the individual's sexual partners to protect themselves from HIV. Human rights and public health will be best served by an ethical framework which recognises that both persons in a sexual relationship or exchange have equal rights and responsibilities for their mutual pleasure and protection. Further, these individual rights are meaningless unless each partner respects the rights of the other. Protection of the human rights of both partners needs more commitment from health systems, and from societies, than simply ensuring informed consent and confidentiality. (excerpt)
Lancet. 2007 Oct 27; 370(9597):1471-1474.With the Paul Wolfowitz era behind it and new appointee Robert Zoellick at the helm, it is time for the World Bank to better define its role in an increasingly crowded and complex global health architecture, says Jennifer Prah Ruger, health economist and former World Bank speechwriter. Just 2 years after taking office as president of the World Bank, Paul Wolfowitz resigned amid allegations of favouritism, and is now succeeded by Robert Zoellick. Many shortcomings marked Wolfowitz's presidency, not the least of which were a tumultuous battle over family planning and reproductive health policy, significant reductions in spending and staffing, and poor performance in implementing health, nutrition, and population programmes. Wolfowitz did little to advance the bank's role in the health sector. With the Wolfowitz era behind it and heightened scrutiny in the aftermath, the World Bank needs to better define its role and seize the initiative in health at both the global and country levels. Can the bank have an effect in an increasingly plural and complex global health architecture? What crucial role can the bank play in global health governance in the years ahead? (excerpt)
2004 Nov-Dec; 12(6):847.The Millennium Goals were defined by the United Nations Organization in 2000 and approved by consensus during the Millennium Summit, a meeting that joined 147 heads of State. These goals reflect increasing concerns about the sustainability of the planet and about the serious problems affecting humanity. Constituted by a set of eight goals to be reached by 2015, they refer to the eradication of extreme poverty and hunger, universal access to basic education, gender equality promotion, infant mortality reduction, maternal health improvement, fight against HIV/Aids and other illnesses, guarantee of environmental sustainability and the establishment of a global partnership for development. Sustainability and development are closely linked to health and imply joint actions by States and civil society in the attempt to minimize the influence of the huge gap that exists between countries and persons. Thus, health and particularly nursing professionals' actions are paramount and can lead to local actions with regional, national and international impacts. (excerpt)
Exploring disparities between global HIV / AIDS funding and recent tsunami relief efforts: an ethical analysis.
Developing World Bioethics. 2007; 7(1):1-7.The objective was to contrast relief efforts for the 26 December 2004 tsunami with current global HIV/AIDS relief efforts and analyse possible reasons for the disparity. Methods: Literature review and ethical analysis. Just over 273,000 people died in the tsunami, resulting in relief efforts of more than US$10 bn, which is sufficient to achieve the United Nation's long-term recovery plan for South East Asia. In contrast, 14 times more people died from HIV/AIDS in 2004, with UNAIDS predicting a US$8 bn funding gap for HIV/AIDS in developing nations between now and 2007. This disparity raises two important ethical questions. First, what is it that motivates a more empathic response to the victims of the tsunami than to those affected by HIV/AIDS? Second, is there a morally relevant difference between the two tragedies that justifies the difference in the international response? The principle of justice requires that two cases similarly situated be treated similarly. For the difference in the international response to the tsunami and HIV/AIDS to be justified, the tragedies have to be shown to be dissimilar in some relevant respect. Are the tragedies of the tsunami disaster and the HIV/AIDS pandemic sufficiently different, in relevant respects, to justify the difference in scope of the response by the international community? We detected no morally relevant distinction between the tsunami and the HIV/AIDS pandemic that justifies the disparity. Therefore, we must conclude that the international response to HIV/ AIDS violates the fundamental principles of justice and fairness. (author's)
Oceans of need in the desert: ethical issues identified while researching humanitarian agency response in Afghanistan.
Developing World Bioethics. 2002 Dec; 2(2):109-130.This paper describes the interventions by the International Committee of the Red Cross to support a hospital in Afghanistan during the mid-1990s. We present elements of the interventions introduced in Ghazni, Afghanistan, and consider a number of ethical issues stimulated by this analysis. Ethical challenges arise wherever humanitarian interventions to deal with complex political emergencies are undertaken: among those related to the case study presented are questions concerning: a) whether humanitarian support runs the risk of propping up repressive and irresponsible governments; b) whether humanitarian relief activities can legitimately focus on a narrow range of interventions, or need to broaden to address the range of challenges facing the health system; and c) whether sustainability and quality of care should be routinely considered in such settings. The paper concludes by highlighting the value of case studies, suggesting mechanisms for extending transparency and accountability in humanitarian health interventions, and highlighting the need for contextualising humanitarian work if the interventions are to be successful. (author's)
African Sociological Review. 2003; 7(2): p..This essay seeks to investigate the World Bank's representation of the poor via a close reading of The Bank's Voices of the Poor and a critical comparison between this book and Ashwin Desai's We Are the Poors. The essay argues that The Bank's book is an attempt to represent the majority of humanity as The Poor and that this othering produces The Poor as a category of people who are politically inert, largely responsible for their own circumstances and whose suffering justifies the position and work of The Bank and other social forces with similar agendas. The essay also suggests that there are familial connections between this project and colonial discourses that sought to other people via a process of racialisation. (excerpt)
A report of a theological workshop focusing on HIV- and AIDS-related stigma, 8th-11th December 2003, Windhoek, Namibia. Supported by UNAIDS.
Geneva, Switzerland, UNAIDS, 2005 Feb. 62 p. (UNAIDS/05.01E)Stigma is difficult to define. Generally, though, it implies the branding or labelling of a person or a group of persons as being unworthy of inclusion in human community, resulting in discrimination and ostracization. The branding or labelling is usually related to some perceived physical, psychological or moral condition believed to render the individual unworthy of full inclusion in the community. We may stigmatize those we regard as impure, unclean or dangerous, those who are different from ourselves or live in different ways, or those who are simply strangers. In the process we construct damaging stereotypes and perpetuate injustice and discrimination. Stigma often involves a conscious or unconscious exercise of power over the vulnerable and marginalized. The purpose of this document is to identify those aspects of Christian theology that endorse or foster stigmatizing attitudes and behaviour towards people living with HIV and AIDS and those around them, and to suggest what resources exist within Christian theology that might enable churches to develop more positive and loving approaches. It is not a theological statement, but rather a framework for theological thinking, and an opportunity, for church leaders, to pursue a deeper Christian reflection on the current crisis. (excerpt)
Geneva, Switzerland, UNAIDS, 2000 Jul. 47 p. (UNAIDS Best Practice Collection. Key Material; UNAIDS/00.28E)Surveillance is the radar of public health. Nevertheless, its precise contours and justifications remain a matter of contention. Although the World Health Organization (WHO) Epidemiological Surveillance Unit in the Division of Communicable Diseases has defined disease surveillance quite broadly, most public health authorities, such as the United States Centers for Disease Prevention and Control (CDC) and the World Health Assembly, typically identify three key elements of surveillance. Surveillance involves the ongoing, systematic collection of health data, the evaluation and interpretation of these data for the purpose of shaping public health practice and outcomes, and the prompt dissemination of the results to those responsible for disease prevention and control. Surveillance, then, encompasses more than just disease reporting. "The critical challenge in public health surveillance today," conclude two prominent figures who have helped to define surveillance in the United States, "remains the ensurance of its usefulness." Two issues emerge from this understanding of surveillance. The first entails a question of efficacy. The second involves matters of privacy. Although conceptually distinct, the two are nevertheless intimately related. While the necessities of surveillance may justifiably limit some elements of privacy, such limitations are only justifiable to the extent that they in fact benefit the public's health. (excerpt)
Geneva, Switzerland, UNAIDS, 2000 May. 48 p. (UNAIDS/04.07E)In the present document, UNAIDS seeks to offer guidance emanating from this process. This document does not purport to capture the extensive discussion, debate, consensus, and disagreement which occurred at these meetings. Rather it highlights, from UNAIDS' perspective, some of the critical elements that must be considered in HIV vaccine development activities. Where these are adequately addressed, in UNAIDS' view, by other existing texts, there is no attempt to duplicate or replace these texts, which should be consulted extensively throughout HIV vaccine development activities. Such texts include : the Nuremberg Code (1947); the Declaration of Helsinki, first adopted by the World Medical Association in 1964 and subsequently amended in 1975, 1983, 1989 and 1996; the Belmont Report - Ethical Principles and Guidelines for the Protection of Human Subjects of Research, issued in 1979 by the US National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research; the International Ethical Guidelines for Biomedical Research Involving Human Subjects, issued by the Council for International Organizations of Medical Sciences (CIOMS) in 1993 (and developed in close cooperation with WHO); the World Health Organization's Good Clinical Practice (WHO GCP) Guideline (1995); and the International Conference on Harmonisation's Good Clinical Practice (ICH GCP) Guideline (1996). It is hoped that this document will be of use to potential research participants, investigators, community members, government representatives, pharmaceutical companies, and ethical and scientific review committees involved in HIV preventive vaccine development. It suggests standards, as well as processes for arriving at standards, and can be used as a frame of reference from which to conduct further discussion at the international, national, and local levels. (excerpt)
New England Journal of Medicine. 2006 Jun 8; 354(23):2414-2417.On June 5, 1981, when the Centers for Disease Control reported five cases of Pneumocystis carinii pneumonia in young homosexual men in Los Angeles, few suspected it heralded a pandemic of AIDS. In 1983, a retrovirus (later named the human immunodeficiency virus, or HIV) was isolated from a patient with AIDS. In the 25 years since the first report, more than 65 million persons have been infected with HIV, and more than 25 million have died of AIDS. Worldwide, more than 40 percent of new infections among adults are in young people 15 to 24 years of age. Ninety-five percent of these infections and deaths have occurred in developing countries. Sub-Saharan Africa is home to almost 64 percent of the estimated 38.6 million persons living with HIV infection. In this region, women represent 60 percent of those infected and 77 percent of newly infected persons 15 to 24 years of age. AIDS is now the leading cause of premature death among people 15 to 59 years of age. In the hardest-hit countries, the foundations of society, governance, and national security are eroding, stretching safety nets to the breaking point, with social and economic repercussions that will span generations. (excerpt)
Transactions of the Royal Society of Tropical Medicine and Hygiene. 2006 Jul; 100(7):603-607.The health and human rights communities have much in common. Recently, the international community has begun to devote more attention to the right to the highest attainable standard of health (‘the right to health’). Today, this human right presents health and human rights professionals with a range of new opportunities and challenges. The right to health is enshrined in binding international treaties and constitutions. It has numerous elements, including the right to health care and the underlying determinants of health, such as adequate sanitation and safe water. It empowers disadvantaged individuals and communities. If integrated into national and international policies, it can help to establish policies that are meaningful to those living in poverty. The author introduces his work as the UN Special Rapporteur on the right to health. By way of illustration, he briefly considers his interventions on Niger’s Poverty Reduction Strategy, Uganda’s neglected (or tropical or poverty-related) diseases, and the recent US—Peru trade negotiations. With the maturing of human rights, health professionals have become an indispensable part of the global human rights movement. While human rights do not provide magic solutions, they have a constructive contribution to make. The failure to use them is a missed opportunity of major proportions. (author's)
Journal of Asian and African Studies. 2004; 39(1-2):1-28.This chapter is a contribution to the ongoing debate about Africa and globalization and the interrelated issues of capitalism, marginalization, representation, and political leadership. Problematizing the discourse of Africa as "diseased" and "hapless," the World Bank's structural adjustment "cure-all" is presented as being much worse than the "disease" that preceded it. Proposing a critical ethics of globalization--which highlights the gap between globalization's miraculous, self-reflective images and the miserable conditions it creates--there is an attempt to uncover agents of change on the African continent. Social movements such as those fighting for water and electricity in Soweto, for land in Kenya, or against environmental destruction by oil companies in the Niger delta raise questions about the viability of globalization. Often led by women, these movements not only challenge the "male deal" that defines national governments and multinational corporations, but also call for a revaluation of subsistence economies and local democratic polities as alternatives to globalization. In short, this chapter offers important conceptual, as well as practical, challenges to globalization, indeed to the very nature of politics itself. (author's)
Chimera. 2004 Spring; 2(1):26-30.The need to organize a durable partnership between Africa and its people in the Diaspora is so obvious as to warrant little discussion. However, every partnership, even among blood relations, requires a clear raison d'etre. Why should a Brazilian-African become interested in South Africa's politics or economy? Why should a Nigerian unemployed university graduate believe that it is in his best interest to nurture a relationship with the Diaspora in the Caribbean? Why should a Senegalese-French citizen pay attention to the status of African-Americans in the United States? Why should a recent immigrant in the United States become involved in Africa-Diaspora partnership issues? Why should an inner city Diaspora family in the United States or Britain show interest in the political reforms in Kenya? These questions are neither rhetorical nor amenable to easy responses. At the core of the organizing issue in Africa-Diaspora partnership is the need to define a clear, unambiguous reason for this relationship. (excerpt)
Population 2005. 2002 Sep-Oct; 4(3):8.The HIV/AIDS epidemic shows no sign of leveling off in the hardest hit countries and as much as $10 billion is needed annually to fight it effectively, according to UNAIDS Executive Director Peter Piot. Addressing the 14th international AIDS conference in Barcelona in July, Mr. Piot said that unless the global community provided more assistance to countries with high rates of HIV/AIDS, like debt relief, there could be catastrophic results. “The epidemic hit the world 20 years ago but we failed to contain the increase in HIV cases. The answers point towards politics, power and priorities. $10 billion is needed annually to combat the menace,” he said. Mr. Piot told his audience they must mobilize political support, scale up AIDS prevention and treatment, eliminate stigma, develop a vaccine and arrange funds to fight the disease. (excerpt)
Boston, Massachusetts, Harvard School of Public Health, François-Xavier Bagnoud Center for Health and Human Rights, 2000. 10 p.Before human rights, there was altruism and after human rights there is altruism—the unselfish concern for the welfare of others. Altruism has been and remains an integral part of the beliefs, behaviors and practices of public health practitioners. But altruism means different things to different people. What human rights does for public health is to provide an internationally agreed upon framework for setting out the responsibilities of governments under human rights law as these relate to people’s health and welfare. Human rights as they connect to health should be understood, in the first instance, with reference to the description of health set forth in the preamble of the WHO Constitution, and repeated in many subsequent documents and currently adopted by the 191 WHO Member States: Health is a “state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.” This definition has important conceptual and practical implications, as it illustrates the indivisibility and interdependence of rights as they relate to health. Rights relating to autonomy, information, education, food and nutrition, association, equality, participation and non-discrimination are integral and indivisible parts of the achievement of the highest attainable standard of health, just as the enjoyment of the right to health is inseparable from other rights, whether categorized as civil and political, economic, social or cultural. Thus, the right to the highest attainable standard of health builds on, but is by no means limited to, Article 12 of the International Covenant on Economic, Social and Cultural Rights. It transcends virtually every single other right. This paper highlights the long evolution that has brought health and human rights together in mutually reinforcing ways. It will summarize key dimensions of public health and of human rights and will suggest a manner in which these dimensions intersect in a framework of analysis and action. It will address these issues against the background of the progress being made by the World Health Organization towards defining its roles and functions from a health and human rights perspective. (excerpt)
International responses to drug abuse among young people: assessing the integration of human rights obligations.
Boston, Massachusetts, Harvard School of Public Health, François-Xavier Bagnoud Center for Health and Human Rights, 2000. 15 p.Drug use and abuse among young people is increasing worldwide. Young people are starting to take drugs at younger ages and report use of a wide variety of drugs including heroin, cocaine and amphetamines. It is estimated that the entire illicit drug industry is worth US$500 billion per year, dwarfing the US$62 billion spent on development assistance per year. The health impacts of drug abuse are evident: dependency, addiction, overdose and sometimes death. The goal of this paper is to highlight the intersection of health and human rights with respect to drug abuse among young people. The paper argues two points. The first is that the failure of governments to respect, protect and fulfill human rights leads to less effective prevention drug abuse as well as to less effective treatment of drug abusers. The second point, which comprises the bulk of this paper, is that the international community, and international drug control bodies in particular, because of their focus on drug supply reduction, are in large part responsible for States’ human rights violations against young people who use and abuse drugs, as well those who are vulnerable to drug abuse. The paper is divided into four sections. The first will discuss why drug abuse is a human rights issue. The second will provide readers with some definitions that are central to this topic. The paper will then explore international responses to drug prevention and abuse among young people and suggest how governmental responses are shaped by international responses. The last section will provide the reader with recommendations for how the international response to drug abuse could be more effective in terms of the integration of human rights principles and obligations. (excerpt)
In: Enfoques feministas de las políticas antiviolencia, [compiled by] Centro de Encuentros Cultura y Mujer [CECYM]. Buenos Aires, Argentina, CECYM, . 75-79. (Travesías: Temas del Debate Feminista Contemporáneo 1)I will make another comment on views in the first world of women from the third world. I sometimes believe that the perspectives are very simplistic. From a first world standpoint, it is very easy to say: "we will talk about development and violence, and we will help women from all types of countries who don't have or know anything better." It's not that simple, where you can merely state that a country "is backward as regards women, because it is a backward nation." Backward in the sense that this is a nation whose population is not sufficiently well educated. This is a simplistic notion that contributes to perpetuating many of the feelings of indulgence on the part of aid agencies in diverse donor countries, which encounter a large dose of skepticism and cynicism in the countries receiving that help. In these countries people want to know why they want to help us, what they want to know about our countries to use to their advantage. Then I think that it is necessary to keep in mind that you cannot have a simple notion about complex social problems and a complicated cultural situation about which you know nothing. (excerpt)
Paris, France, UNESCO, 2004. 30 p.This paper uses a framework for quality education developed by UNESCO’s Education Sector, Division for the Promotion of Quality Education (ED/PEQ) to show how education systems can and must change in their analysis and conduct in relation to HIV/AIDS. It summarises the 10 dimensions of the framework, considers how HIV/AIDS manifests itself in relation to these quality dimensions and summarises some practical applications of how education has responded and can respond to the pandemic from a quality perspective. A more detailed annex to the paper provides evidence on the manifestations of the pandemic on education systems, and how systems have responded in practical ways. Some general conclusions are drawn and a final section promotes some practical and strategic actions in support of quality education that reflects and responds to HIV/AIDS. The paper was developed for the UNAIDS Inter-Agency Task Team (IATT) on HIV and Education. The IATT is convened by UNESCO and includes as members the UN co-sponsoring agencies of UNAIDS, bi-lateral and private donors, and NGOs. The IATT focuses on mobilising commitment to prevention education, acting as a catalyst for the exchange of information about what is known, what is available, and what still needs to be known about how education can be most effective in mitigating the effects of the HIV/AIDS crisis. It seeks to examine and strengthen existing tools for monitoring and evaluating education systems’ responses to the crisis, identify weaknesses in these responses and overcome these weaknesses, analyse what is known to strengthen information and materials exchange, and stimulate research and evidence-based policy-making. (excerpt)
Lancet. 2005 Feb 19; 365:723-725.Ensuring environmental sustainability is essential to achieving all the Millennium Development Goals. Longterm solutions to problems of drinking-water shortages, hunger, poverty, gender inequality, emerging and reemerging infectious diseases, maternal and childhood health, extreme local weather and global climate changes, and conflicts over natural resources need systematic strategies to achieve environmental sustainability. For this reason, the UN Millennium Project Task Force on Environmental Sustainability has concluded that protection of the environment is an essential prerequisite and component of human health and well-being. Economic development and good health are not at odds with environmental sustainability: they depend on it. One important dimension of environmental sustainability is the need to maintain ecosystem services critical to the human population. These services include providing food, shelter, and construction materials; regulating the quantity and quality of fresh water; limiting soil erosion and regenerating nutrients; controlling pests and alien invasive species; providing pollination; buffering human, wild plant, and animal populations from interspecific transfer and spread of diseases; and stabilising local weather conditions and sequestering greenhouse gases to contain climate change. A second and equally important dimension of environmental sustainability is the need to control water pollution and air pollution, including the emission of greenhouse gases that drive climate change. These so-called brown issues can have a severe effect on human health and ecosystem function. (excerpt)
Lancet. 2005 Mar 19; 365:1004.An impressive fanfare of melodic African gospel music heralded the long-awaited launch last week of the final report of the Commission for Africa. The 17-strong Commission, chaired by UK Prime Minister Tony Blair, set out to take “a fresh look” at Africa’s past and present, and make realistic recommendations for the continent’s survival. The Commission’s report is a laudable achievement: the hefty volume is a pragmatic and decisive review of Africa’s needs. It is, as promised, unfalteringly honest— and health initiatives are not spared criticism. According to the report, the failings of current health efforts are clear: there are too many initiatives and too little coordination. The Commission’s solution focuses on harmonisation of health policy at a national level and integration of donor-led initiatives into governmental plans. As if in preparation for these recommendations, Luís Sambo, head of the WHO’s African Regional Office, last week concluded a tour of the UK and USA by announcing sweeping reforms of WHO/AFRO. He plans to decentralise activities and give more authority to country representatives “to cope with potential increases in resources”. (excerpt)
Issue paper: Review of the human rights content of frameworks to assess the effectiveness of HIV / AIDS programming.
Geneva, Switzerland, UNAIDS, 2004. Prepared for the 4th Meeting of the UNAIDS Global Reference Group on HIV / AIDS and Human Rights, August 23-25, 2004. 7 p.This paper examines approaches used by some of the primary intergovernmental and governmental agencies in assessing the effectiveness of HIV/AIDS programmes, as they have been reviewed by the UNAIDS Monitoring and Evaluation Reference Group (MERG). This is to attempt to begin to shed light on how the effectiveness of HIV/AIDS programs are currently assessed by UNAIDS, its partners, and other major organizations, and to understand the extent and ways in which human rights considerations form parts of these assessments. (excerpt)
Geneva, Switzerland, UNAIDS, 2004. Prepared for the 4th Meeting of the UNAIDS Global Reference Group on HIV / AIDS and Human Rights, August 23-25, 2004. 7 p.This paper explores issues and approaches relevant to the assessment of the application of a rights based approach to the planning and implementation of HIV/AIDS strategies. It builds on the premise that the Reference Group may wish to recommend to UNAIDS a set of practical steps towards integrating human rights in HIV/AIDS policies and programs and monitoring the compliance of HIV/AIDS policies and programs with international human rights principles and guidelines, in particular those that have been explicitly promoted by UNAIDS in its publications and other work. Some suggested key issues are highlighted and, HIV testing strategies will be used as an example to the extent necessary to clarify concepts. (excerpt)
Issue paper: Review and assessment of HIV / AIDS strategies that explicitly include attention to rights. Impact mitigation.
Geneva, Switzerland, UNAIDS, 2004. Prepared for the 4th Meeting of the UNAIDS Global Reference Group on HIV / AIDS and Human Rights, August 23-25, 2004. 4 p.This issue paper examines human rights based approaches explicitly defined as such by organizations addressing impact mitigation policy and programmatic efforts. Given the diversity of definitions of rights based approaches, consideration is given to how rights are conceptualized, and the explicit attention to rights in these policy and program efforts. Commonalities and differences should be considered between the various approaches to determine the evidence that exists of the value of paying attention to rights in these strategies, as well as how rights based approaches to impact mitigation are articulated. While impact mitigation covers a broad range of areas, given the devastating consequences of the epidemic on the lives of children, most of the examples below will focus on children orphaned by AIDS as an example to illustrate how rights based approaches are applied at policy and programmatic levels. (excerpt)
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)