POSITIVE HEALTH, DIGNITY AND PREVENTION Rights Here, Right Now

1. POSITIVE HEALTH, DIGNITY AND PREVENTIONRights Here, Right Now Vuyiseka Dubula TAC, South Africa

2. Presentation outline • DURBAN TO VIENNA • NO TIME TO RE-TREAT • POSITIVE HEALTH, DIGNITY AND PREVENTION • UNIVERSAL ACCESS TO PREVENTION AND TREATMENT • TREATMENT AS PREVENTION • THREATS TO OUR GAINS • HUMAN RIGHTS AND LEGAL FRAMEWORK • WOMEN, GIRLS AND HIV • INEQUALITY • CONCLUSION

3. Durban 2000 to Vienna 2010 • We mark 10 years after Durban Aids conference in South Africa • This conference will remember that there were no people who had access to treatment in the continent. • We can say proudly that we have saved almost 5 million lives but this is only less than 50% of the need • Reduction of prices because of more competition and access to cheap generic drugs.

4. No time to re-treat • Globally we are still faced with 33.4 million people living with HIV • More than 50% are young women. • 40% are young people • Sub-Saharan Africa my region accounting for 1.9 million (35%) of global new HIV infections in 2008. • Carries 67% of global number of people living with HIV • My country South Africa remains the country with largest epidemic also with high HIV new infections of about 1500 daily. • Less than 1% of the world’s population yet we carry 17% of the global HIV burden and have high TB incidences.

5. Positive health, dignity and prevention • Positive prevention started gaining momentum late 2003 looking at the role of people living with HIV in prevention. • Positive prevention has shifted to Positive Health, Dignity and Prevention paradigm designed and led by people living with HIV. • To support people living with HIV with their prevention needs. • Positive Health, Dignity and Prevention focuses on improving and maintaining all aspects of their health and well-being. • At the core of this paradigm, Positive Health, Dignity and Prevention is about policies and programmes that treat the person living with HIV humanely and holistically

6. Universal Access • We know that we committed to treating 10 million people by end 2010, but as its becoming clear that this target will not be met , then we need to re-commit to treat 13- 15 million people by 2015 • Scientist have shown us that starting people living with HIV on treatment early has great benefits and helps to reduce mortality. • Yet very few developing countries have implemented the new WHO treatment guidelines. • South Africa now has about 1 million people on treatment with the newly launched HIV Counselling and Testing aiming to test 15 million people. We have partially implemented the WHO guidelines and that means we are not yet targeting everyone. • But in my region we are only reaching 42% of those in need have access • However... cont.

7. Cont… • Universal access is also a catalyst to support the realisation of a number of other MDGs • We need to address the human and financial resources challenges to meet the unmet targets of treatment and MDG’s. • The current trend of non accountability on meeting Universal Access and the Millennium Development Goals by African Governments and Global Leaders is unacceptable. • We urge all Global leaders to fulfil their commitments by replenishing the Global Fund to fight HIV, TB and Malaria with at least pledging $20 Billion in October this year. • We also demand that African Governments must also honour the commitment they made in Abuja of spending at least 15% of their National budgets on health.

8. Treatment as prevention • Treatment as prevention again provided us with an opportunity to think on how we can scale up access and the preventative effects of antiretrovirals. • However, Communities continue to express caution for the respect for individual human rights in relation to access to treatment; HIV testing, not to impose coerciveness, stigma and discrimination in health facilities.. • While we don’t have enough evidence about how Test and Treat will unfold at which CD4 count threshold?

9. Threats TO our gains • We also need to defend the gains of the past 10 years and struggles against greed and profiteering on life saving medicines. 1. The current EU negotiations on free trade agreements pushing for : • longer patent terms • Harsh intellectual property enforcement measures that violate civil and political rights and threaten the production of cheaper and affordable medicines • Export and import of generic medicines

10. Threats to our gains… cont • New monopolies on medicines threaten feasibility of developing countries to continue to have access to cheap generic affordable medicines. • Secret treaty on anti-counterfeiting supports the drafting of national laws on counterfeiting. • The fundamental problem here is that the term counterfeit has been confused by including generic medicines as counterfeit.

11. 2. Human rights and Legal framework • Modern Law explicitly promotes Human Rights and a gender sensitive approach to HIV related legislation. • This aims to ensure the Human rights of those vulnerable to HIV, people living with HIV and those affected by HIV are respected, protect and realised in the response to AIDS. • 84 out of 136 reporting UNAIDS countries reported having laws and regulations that present obstacles to effective prevention, treatment, care and support for vulnerable populations.

12. Human rights and LEGAL FRAMEWORK ….Cont.. • The African Union and SADC have drafted a number of codes, guidelines and protocols since 1997 that are meant to protect the human rights of people living with HIV. • Concern for legislators in SADC shows a continuing trend to address these concerns in ways that undermine the human rights of people living with HIV. Major issues that are not making progress are: • Criminalisation of HIV • Criminalisation of same sex • Criminalization of sex work

13. 3. Women, girls and HIV • Women in my region constitute more than 50% of those living with HIV, and particularly young women continue to be at risk to HIV. • With very limited to tools to protect them from the risk • Violence against women has reached a human rights crisis of our time. • In Africa we have countries that still forcefully mutilate women.

14. WOMEN,GIRLS and HIV ..Cont… • Violence continues to pose a lifelong threat to young women and exposed them to HIV • This is increasingly alarming and poses a public health crisis. • In Zimbabwe during the political unrest violence against women was used to intimidate women for political reasons and more than 800 women were raped. • We all have a global responsibility to raise our voices to ensure that we as the African and International community can prevent this from reoccurring during next years elections in Zimbabwe.

15. Social inequality • We also have to pay attention to social Inequality that also contributes to the factors that drive the epidemic. • South Africa is regarded as an emerging economy and the only middle income country in Africa in the G20. • South African has the highest number of people living with HIV, with high levels of unemployment and with 20.5 million people living in poverty; facing reduction in life expectancy. • Inequality between the rich and the poor people in the same country has officially led South Africa to be one of the most unequal countries in the world

16. In Closing • Human rights here and now means we cannot go back, hope has just started. However I want to leave all of us with food for thought. • It’s time to support the leadership of people living with HIV and work in partnership with us to address these issues. We must be accepted as leaders and together we must realise positive health, dignity and prevention. • Socio –economic and human rights are non-negotiable and if we don’t protect these rights by holding our governments and global leaders accountable for all our causes, history will judge us. • We must re-energise, recommit to achieve universal access, defend our gains and speak truth to power because health is a global public good.

17. Thank you