At last week’s high-level United Nations AIDS review, world leaders adopted a Political Declaration that indeed included a commitment to having 15 million people on AIDS treatment by 2015, among other targets aimed at real progress. Along with the commitment on AIDS treatment, the other headline from the conference was the commitment to work towards eliminating vertical transmission by 2015.
Importantly, the Declaration also specifically addressed the need for enhanced prevention efforts among marginalized populations, including men who have sex with men and people who inject drugs. This was the first of a high-level UN declaration on HIV/AIDS explicitly mentioned men who have sex with men. The Declaration also set a target of reducing HIV transmission among people who inject drugs by 50% by 2015 — though some advocates were concerned about how the Declaration addressed this population, as UNAIDS has called for the elimination of this mode of transmission. More troubling, the Declaration only weakly called for countries to give “consideration to, as appropriate,” harm reduction programs, despite their proven effectiveness. The science is clear; the Declaration had no reason for being timid.
The Declaration also included other commitments that, if adhered to, will advance human rights of discriminated against groups, including helping to meet the needs of women and girls, and promoting their full enjoyment of human rights. And states committed “to national HIV and AIDS strategies that promote and protect human rights, including programmes aimed at eliminating stigma and discrimination against people living with and affected by HIV, including their families, including through sensitizing the police and judges, training health-care workers in non-discrimination, confidentiality and informed consent, supporting national human rights learning campaigns, legal literacy and legal services, as well as monitoring the impact of the legal environment on HIV prevention, treatment, care and support.” It is critical that these efforts encompass all marginalized populations at heightened risk of HIV infection.
The Declaration committed countries ”to redouble efforts to strengthen health systems, including primary health care.” This is a necessary part of the expanded AIDS response.
The question now is whether the political will and funding will follow these commitments — which included increasing AIDS funding. If so, the world will have made real progress by 2015 in fighting AIDS and advancing human rights. If not, then the failure to keep the promises of 2011 will be another stain on the global conscience.