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Human rights at the core of AIDS control, conference told

MEXICO CITY -- The AIDS epidemic has been with us for more than 25 years, and it will likely persist for at least 50 more, but by focusing on a "triple combination" of treatment, prevention and human rights, people living with HIV-AIDS will lead relatively normal lives, and health systems around the world will be strengthened, delegates to the International AIDS Conference heard yesterday.
"It is clear that we have moved on from the fruitless debate between prevention and treatment that has plagued us in the past," said Michel Kazatchkine, executive director of the Global Fund to Fight AIDS, TB and Malaria, arguing that they are complementary. But he cautioned that wide-scale prevention, treatment and progress against the disease will not occur unless "human rights remain at the core of everything we do. "Mr. Justice Edwin Cameron of the Supreme Court of Appeal of South Africa told delegates that the growing criminalization of HIV-AIDS is a travesty that risks undermining progress and fuelling the epidemic. "HIV is a virus, not a crime", he said.

 

But he cautioned that wide-scale prevention, treatment and progress against the disease will not occur unless "human rights remain at the core of everything we do."

Judge Cameron, who is HIV-positive himself, said that HIV-AIDS carries a mountainous burden of stigma and that no other illness is viewed with such fear and repugnance.

He noted that consensual same-sex activity is a criminal offence in 86 countries, including seven where it is punishable by death. In addition, a growing number of countries - including a dozen in Africa, the epicentre of the epidemic - have adopted laws making it a crime for the HIV-positive to have sexual relations, or even to be infected with HIV-AIDS.

"These laws are misdirected and bad. They are creating a crisis in HIV management and prevention efforts," Judge Cameron said.

More than 33 million people worldwide are infected with HIV-AIDS, including 2.7 million newly infected last year. Only three million people are being treated in the developing world, and for every two who begin treatment, five people are newly infected.

The conference, which attracted some 22,000 delegates from 175 countries (including 888 from Canada), featured much discussion of how to scale-up access to drugs and on the promise of universal access to antiretroviral drugs by 2010.

Robert Fox, executive director of Oxfam Canada, excoriated United Nations officials for seemingly backing down on the goal of universal access.

"To say we are disappointed is an understatement. Has the AIDS Conference become just another expensive gab-fest?" he asked.

Julio Montaner, the new president of the International AIDS Society, acknowledged that the searches for an AIDS vaccine and for an effective microbicide have both stalled.

"But we must not despair," he said.

This is particularly true because antiretroviral drugs are proving so effective at keeping the disease in check.

But Dr. Montaner, director of the B.C. Centre for Excellence in HIV-AIDS, said it is not acceptable that only rich Westerners are benefiting.

"Let's be perfectly clear: Failure to enact a comprehensive, sustained and multipronged attack on the pandemic represents a crime against those infected, those affected and those susceptible. Indeed, it represents a crime against humanity," Dr. Montaner said.

Mark Harrington, executive director of the New York-based Treatment Action Group, said treating HIV-AIDS is a good investment because it strengthens health systems and improves access to health care.

"We are the vanguard of an unprecedented global citizens' movement for comprehensive universal primary health care for all," he said.

Mr. Harrington also warned that the AIDS fatigue that is setting in among governments, donors and activists could not only lead to a resurgence of the epidemic but to a dramatic worsening of health services across the developing world.