Last week the UN General Assembly adopted a political declaration aimed at accelerating the world’s response to HIV. The goal was to agree on a set of strategies that would put governments on the path towards ending the AIDS epidemic by 2030, which was agreed to as part of the UN’s Sustainable Development Goals.
The declaration makes bold new commitments to realize human rights, address the drivers of HIV among women and girls, and give young people the information and services they need to better protect themselves from HIV. But it fails to address discrimination against and criminalization of key populations affected by HIV, namely: men who have sex with men, sex workers, people who use drugs, transgender people, and prisoners. This serious shortfall will undermine global efforts at stopping the epidemic.
Every five years, the General Assembly convenes representatives from governments around the world to look at successes, challenges, and lessons learned in curbing HIV and to chart out concrete strategies for the next five years. This year’s high-level meeting was particularly significant as it focused on how to meet the target of ending the AIDS epidemic by 2030. In order to do this, governments need to protect the human rights of people living with and affected by HIV, tackle gender inequality, and step up their investments in HIV prevention and universal access to treatment. This declaration takes us part of the way there.
On women and young people, the declaration makes strong and ambitious commitments to:
- reduce new HIV infections among adolescent girls and young women to below 100,000 annually by 2020;
- address intimate partner violence and ensure access to comprehensive health, social, and legal services for women who have experienced violence;
- end violence against women living with and affected by HIV in health-care settings, such as forced and coerced sterilization;
- ensure universal access to sexual and reproductive health services and eliminate barriers to care, such as age of consent requirements; and
- ensure all adolescents have comprehensive education on sexual and reproductive health and HIV prevention that addresses gender equality and power dynamics in relationships—two critical factors that have been proven to reduce sexually transmitted infections, including HIV.
However, the declaration misses the mark in other ways. It does not go far enough in recognizing the diversity of today’s HIV epidemics, which require varied, rights- and evidence-based responses that meet the needs of key populations affected by HIV. In addition, the document fails to affirm the right of adolescent girls to have control over their sexuality, navigate safer sexual relationships, and refuse unwanted sex.
The lack of progress in these areas is the result of strong opposition from a handful of countries. In the negotiations on the political declaration, some countries—including Saudi Arabia, Qatar, China, Russia, Indonesia, India, Belarus, and the Vatican—blocked commitments to addressing HIV among key populations and the importance of sexual rights to the HIV response. They tried to backtrack on promises they had made in earlier agreements and questioned basic, agreed-upon tenets like the need to invest in proven prevention strategies, such as comprehensive sexuality education for young people and harm reduction services for people who use drugs. Sadly, most countries shied away from supporting the actions that have been proven to make the most difference in reducing new infections among key populations, such as decriminalizing sex work and same-sex sexual activity.
Moving forward, world leaders will need to take action that responds to the lived realities of women, girls, and key populations. Realizing the human rights of all, including their sexual rights, is critical. We won’t get very far in eliminating AIDS until our approaches respond to the diversity of needs of the people living with and affected by HIV.
Over the next five years, IWHC and other civil society organizations will use the declaration to hold governments to the positive actions they have agreed to and will push for a more progressive agenda that fully addresses the needs of key populations and women and girls, and advances human rights for all.