November 29th, 2013
08:09 AM ET

Too many being left behind in AIDS fight

By Simon Rushton, Special to CNN

Editor’s note: Simon Rushton is an associate Fellow at Chatham House’s Centre on Global Health Security. The views expressed are the writer’s own.

In his comments in the lead up to World AIDS Day this Sunday, UNAIDS Executive Director Michel Sidibé reiterated the organization’s view that every person counts. “If we are going to keep our pledge of leaving no-one behind we have to make sure HIV services reach everyone in need.” Yet although the updated statistics on HIV and AIDS released this week show remarkable progress in many areas, they also make clear that some are indeed being left behind.

The headline figures are encouraging: a 33 percent decrease in new HIV infections since 2001; a 29 percent decrease in AIDS-related deaths since 2005; a 40-fold increase in access to antiretroviral therapy between 2002 and 2012. But as UNAIDS also admits, global progress in the fight against AIDS is highly uneven. The situation varies widely between countries and regions. In some of the most populous parts of the world – such as the Middle East and East Asia – both new HIV infections and AIDS-related deaths have actually increased over the past decade.

And although the promise of leaving no-one behind sounds uncontroversial, in practice it is highly political. Those “left behind” are not always the victims of a lack of resources (although that remains a problem), and they are not simply forgotten. Instead, in many cases they are deliberately and systematically excluded from accessing prevention, treatment and care services by their governments. Sex workers, men who have sex with men, transgender people and intravenous drug users are in many countries targeted by legislation that restricts their ability to make use of the services they need. In many countries, persistent gender inequalities also make women much more vulnerable to infection, and much less able to access treatment once infected.

Human rights language has long featured prominently in the rhetoric of all the major global AIDS institutions and it is essential that rights remain at the heart of AIDS work, and continue to be respected in AIDS programs at the global, national and local levels.

There have been cases where global AIDS organizations have been successful in persuading countries to change their policies by “shaming” them and publicising the fact that their policies do not accord with their human rights obligations. The International Task Team on HIV-Related Travel Restrictions was one example. Leaders in the AIDS policy community, including Sidibé, have sometimes been highly outspoken about the need for social change and have been clear in calling for an end to discriminatory practices. But are those countries that deliberately practice discrimination really “shame-able” in this way? Are we beginning to reach the limits of what global AIDS institutions can achieve through lecturing governments on respecting the rights of their citizens?

The message, it seems, needs to be amplified – from above and below. We need national governments (including the major donors in the global AIDS effort) to offer more vocal support for the rights of marginalized communities across the world, and to be politically braver in criticising those governments who deny the rights of their citizens to access healthcare.

Equally important, however, is revitalising the grassroots of the AIDS movement. It was civil society that founded the global effort against AIDS in the 1980s and 1990s and that persuaded those governments who were receptive to their message to take it seriously. Ever since, activists and affected communities have continued to play a vital role in defending the rights of those affected by the disease. But in recent years, AIDS activism has become notably less high-profile on the global stage.

Social media gives us a new opportunity to engage with the disenfranchised and a chance to offer them a voice – anonymously where necessary. Pressure from below has been a crucial factor in precipitating social change throughout history, not least around AIDS. We need to hear more from those who are themselves left behind – especially on World AIDS Day – and their voices need to be supported and amplified. It is time for those who claim to have their interests at heart to listen and act. 

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Topics: Governance

soundoff (17 Responses)
  1. Joey Isotta-Fraschini©

    Regarding HIV, any person who allows himself to be intimidated into shame endangers his own life and also others' lives.
    What somebody else thinks of you is not as valuable as your own life.

    November 29, 2013 at 8:43 am | Reply
  2. Joey Isotta-Fraschini©

    No

    November 29, 2013 at 10:28 am | Reply
  3. Joey Isotta-Fraschini©

    No, really–it's all right: I can stand alone here.
    Those intimidated by shame should not expect bigotry based on religion to abate.
    A force that is losing its relevance to modern society will lose its power slowly.

    November 29, 2013 at 10:33 am | Reply
    • banasy©

      Unfortunately, not fast enough to save many victims, whether AIDS related or not.

      November 29, 2013 at 1:54 pm | Reply
  4. chrissy

    Aids affects everyone whether they wish to believe it or not! And only a fool would believe its some disease that suddenly popped up because of gay ppl their nuts! It was man made AND you can bet there IS a cure! But until Big Pharma has milked as much as they out of it at these stages, you can bet your last buck we won't know of it until then! And if they can do this to gays they can do it to anybody!!

    November 29, 2013 at 3:54 pm | Reply
  5. chrissy

    Oops should read "they can"

    November 29, 2013 at 3:56 pm | Reply
  6. ✠RZ✠

    Unlike human stupidity and greed, HIV is not as deadly and might furthermore be cured someday.

    November 29, 2013 at 11:02 pm | Reply
    • banasy©

      I wonder sometimes: when will some people be satisfied? When is enough enough?

      November 30, 2013 at 9:46 pm | Reply
      • ✠RZ✠

        banasy, The ability to reason is in fact a miracle which most of us possess. The problem is that we can only base our reasoning upon what we know and believe to be true, which can often vary drastically from one person to the next. Other than that, we have to trust in others, which should never be done blindly.

        December 1, 2013 at 1:38 am |
      • banasy©

        I agree, RZ. I was mainly referring to the rampant greed of some people at the expense of others.
        Why isn't a multiple-million dollar bank account enough? Why does it gave to be multi-billion?
        I really, really don't get it. Truly.

        December 1, 2013 at 4:43 pm |
      • ✠RZ✠

        @banasy, true character can often be determined by how honestly we manage when poor and how reasonable we might be when rich. Most of us never get to experience the later. But I would recommend that you google the Bill & Melinda Gates Foundation look particularly at the list of annual grants. Then ask yourself, who would you rather have in control of YOUR billions? These guys? Or the clowns in Washington?

        December 1, 2013 at 7:03 pm |
  7. Gilliat Schroeder

    the founding fathers comments on an armed militia are totally out of context today. any defense of gun control is as backwards as flat earth or creationism. we don't defend smoking anymore because it kills so many people. we don't defend drunk drivers because it kills so many people. why guns? gun ownership should be as much a controlled privilege as driving a car!

    November 29, 2013 at 11:43 pm | Reply
  8. rightospeak

    My comments were removed – the Thought Police must be on alert today.

    December 1, 2013 at 10:36 am | Reply
  9. AITEOBHOR JOSEPHINE

    The mass media influences and impacts the society. It is good to know that CNN realizes the fact that she has a great role to play in the fight of Aids. It proves that the media is not only concerned about reporting recent happenings, but also cares and contributes to the well-been of the individuals in their society and beyond. CNN as a media has made a huge impact to the fight for Aids. So many has actually been left behind and their is need for them to be carried along. AITEOBHOR JOSEPHINE OMOMHENE. CALEB UNIVERSITY IMOTA LAGOS.

    December 4, 2013 at 5:26 pm | Reply

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