PHR-UK and the campaign to prevent and treat HIV/AIDS
During the summer PHR-UK's Chair, Peter Hall, attended two UNAIDS sponsered sessions of the 5 day world conference on AIDS 2002 Barcelona, at the invitation of Ms. Miriam Maluwa, the Human Rights Adviser at UNAIDS. Both meetings dealt with access to healthcare for people living with HIV/AIDS.
As the Director-General of WHO, Dr Gro Brundtland, recently commented, there have been "extraordinary developments in advancing the right to health" since the beginning of the millennium. The two major influences impelling these advances are the development of the General Comment on the Right to Health (in which PHR-UK played a pivotal role) and the work of advocacy activists in promoting access to the prevention and treatment of HIV/AIDS globally. Both were evident in the first of the Barcelona sessions, Putting Third First, the objective of which was to discuss strategies for using the law—as one tool among, and in conjunction with, other tools—to advance access to medicines for people living with HIV/AIDS in developing countries.
Coincidentally, as the session began the South African Constitutional Court made public its determination as to whether or not the government of South Africa should be forced to treat pregnant HIV positive women with an anti-retroviral drug to prevent transmission to the foetus/baby.
One of the organisers of the Barcelona session, a South African advocacy group called Treatment Action Campaign, had led a coalition that took the Government to the Pretoria High Court in August 2001. That Court had ordered the government "to provide pregnant women with access to nevirapine [...] and to plan and progressively implement an effective comprehensive national programme to prevent or reduce mother-to-child HIV transmission." The government appealed the verdict, and it was the Constitutional Court's determination on that appeal that the Barcelona session participants were informed of so dramatically after their coffee break.
Quote:"This appeal is directed at reversing orders made in a high court against government because of perceived shortcomings in its response to an aspect of the HIV/AIDS challenge. The court found that government had not reasonably addressed the need to reduce the risk of HIV-positive mothers transmitting the disease to their babies at birth. More specifically the finding was that government had acted unreasonably in (a) refusing to make an anti-retroviral drug called nevirapine available in the public health sector where the attending doctor considered it medically indicated and (b) not setting out a time frame for a national programme to prevent mother-to-child transmission of HIV."
Unsurprisingly there was a great deal of jubilation at this triumphant conclusion to a 4 year campaign to ensure that babies were protected from being infected with HIV from birth.
[4 months later the South African Government announced it had undertaken steps to distribute nevirapine universally to state hospitals in an attempt to reduce the nation's mother-to-child HIV transmission rate.]
The second session Peter Hall attended was entitled Meeting the Challenge of HIV/AIDS related Stigma and Discrimination:New Paradigms for Civil Society Participants and speakers shared their experiences of existing programmatic interventions aimed at preventing, reducing and eliminating HIV/AIDS-related stigma and discrimination.
Part of the session dealt with discrimination within healthcare settings. There is a widely held perception that a proportion of doctors discriminate against people living with HIV and AIDS, and that was shared by a large number of the Barcelona audience. Research carried out in Uganda and India on behalf of UNAIDS demonstrates discrimination within the health sector. The conclusions of a Dar-es-Salaam consultation meeting in June 2001 stated “[...] experience shows that healthcare institutions and individuals sometimes perpetuate stigma by stigmatising and discriminating people, despite their professional codes.” In the UK, hospital staff, GPs and dentists are identified as some of the most frequent public sector providers to discriminate. It has been shown that even well-meaning doctors who are not overtly biased or prejudiced can demonstrate unconscious negative attitudes that stigmatise.
PHR-UK believes that to definitively expunge stigmatisation from medical practice throughout the international medical community, doctors undertake formal health and human rights education and make a conscious commitment to promoting the international right to the highest attainable standard of physical and mental health as enumerated in the General Comment on Article 12 of the Covenent on Econmic Social and Cutrual Rights.
As opening shots in its global campaign against discrimination within healthcare, which is supported by Mary Robinson - the former High Commissioner for Human Rights - in her letter (see page 6), PHR-UK has organised two conferences to take place in late November and early December, as described on pages 4 and 7. The first deals with discrimination against people living with HIV/AIDS, the second with discrimination against vulnerable groups across the whole of healthcare.
AFTER THE INTERNATIONAL CRIMINAL COURT – THE UN’S NEXT BIG STEP
PHR-UK, along with its colleagues in the International Campaign to End Genocide (ICEG), is gearing up for a major campaign to create an Anti-Genocide Focal Point at the United Nations. This is a natural step to take, now that the International Criminal Court is open for business in The Hague, and the Focal Point will go a long way to bringing about the realisation of the 1948 Convention against Genocide, in which States parties pledged themselves to the prevention, suppression and punishment of the crime of genocide.
In 1994, the U.N. and its members failed to take decisive action on the genocide in Rwanda. In the aftermath of this genocide, many U.N. member nations claimed they were unaware of the gravity of the situation and did not have adequate access to information on the deteriorating conditions. This was an inexcusable justification for the deaths of hundreds of thousands of human beings. The U.N. must act to remedy this informational and political problem and not allow nations to be ignorant of how they can act to prevent future genocides.
PHR-UK, which was in Rwanda at the time of the 1994 genocide, believes that the U.N. should heed numerous recommendations to create a staffed office at U.N. headquarters that would assess and disseminate information on serious risks of genocide and other mass murder. If properly staffed and empowered to issue forceful early warnings and recommendations for prevention, this office could help prevent genocide from secretly unfolding, and reinforce the U.N.’s devotion to the eradication of genocide and other crimes against humanity.
The creation of a focal point for genocide prevention at U.N. headquarters is not a new idea. Such an office was expressly recommended in the 1985 Whittaker Report, the 1999 U.N. Report of an Independent Inquiry into U.N. Actions during the 1994 Genocide in Rwanda, the 2000 Brahimi Report, and the final resolutions of the 2001 World Conference against Racism, Racial Discrimination, Xenophobia and Related Intolerance. PHR-UK believes it is time for the U.N. to act on these recommendations. We believe that the eradication of genocide in the twenty-first century is just as urgent as the abolition of slavery was in the nineteenth century.
PHR-UK is convinced that it is essential for the U.N. to have a funded, full-time staff devoted to genocide early warning and prevention. Due to the urgent nature of these situations, the Focal Point must be located at U.N. headquarters where the Secretary General, Security Council, and General Assembly will have immediate access to the information and options the Focal Point’s staff proposes to the Secretary General and the Presidents of the Security Council and General Assembly. Our aim is to have such an office in place by April 2004, the tenth anniversary of the genocide in Rwanda.
In early September, PHR-UK Chair Peter Hall met with Gerry Caplan of the Remember Rwanda Trust, to discuss the idea. Dr. Hall, who chaired this year’s anniversary seminar on genocide organised by the Rwandan Embassy, said “Governments failed to acknowledge genocide was taking place in Rwanda so as to avoid their obligation under international law to intervene."
PHR-UK was in New York to discuss this initiative with U.N. leaders in October.
The International Campaign to End Genocide is a coalition of seventeen NGO’s in six countries and four continents, which was launched at the Hague Appeal for Peace in May 1999, by Peter Hall and other NGO leaders.
THAT LITTLE BLUE LEAFLET>
This Newsletter contains PHR-UK’s new blue leaflet, which appeals for funds. We hope that you like it and feel that it depicts your organisation. We have selected some pictures for it that indicate areas of our work: investigating torture in Egypt, assessing health education in Palestine, assessing prison medicine in the UK, documenting genocide in Rwanda and examining a victim in Kuwait. These are but a few examples of the huge amount of work PHR-UK has covered over the last 13 years. Because of this work, we are constantly receiving invitations to go to teach, speak or consult from all over the world. Sadly, without more money, we cannot accept more than a very few of these invitations.
We have also assembled a list of Appeal Patrons. These are people who are well known to the health and human rights community, and who represent diverse views. We have discussed our plans with them and they have wholeheartedly endorsed our work, and our efforts to raise further funding for it. A number of them have helped us in other ways in the past, and we are very grateful to be able to have them as Patrons of our Appeal. Human rights knows no boundaries, not national, not ethnic, not religious not linguistic. They are for all people, regardless of age, gender or ability. That is why it is so important to us to get endorsements for our appeal from people who may differ in their politics but are united about our work for human rights.
The leaflet has been sent to eighty foundations, together with a letter from our Chair, Dr. Peter Hall. Long time member Chris Burns-Cox, who has been working on the appeal and the leaflet with us for some time, will be following up with the recipients and others to try to answer their questions and explain how they can assist us to further the responses we are able to make to the many calls on our skills. If you know of anyone who might appreciate a leaflet, please let us know, and we will arrange for them to receive one. It is absolutely vital that more people know about and support our work.
An interesting feature of the leaflet is that it contains a form that solicits donations of any amount. This runs counter to the standard fund-raising advice, which is that if you give folks a choice of boxes to tick, they’ll tick one and you’ll at least get something, however small. We have decided to adopt a different approach. We ask for whatever people can afford. We believe that the choice of how much to give should be left to the donor, and we wouldn’t want them to give any more than they could afford.
Our members do not need us to remind them of what a difficult time it is now for the protection of human rights. Terrorist suspects, refugees, people living with HIV or AIDS, people living in occupied territories, street children, mothers of the disappeared, these are people all of us hear about every day, as we go about our lives. The problem is not overwhelming though. Human rights has made great gains over the years, and PHR-UK is playing a key role by contributing a medical expertise. We ask you to fill in the enclosed form and give us whatever you can afford. Help us to launch PHR-UK’s Appeal for Funds. Help us to protect people… from harm and injustice.