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UNAIDS calls for protection of human rights in APAC as path to ensuring health for all

Across Asia Pacific, 38 countries still criminalize some aspect of sex work, 28 criminalize drug possession, 20 criminalize HIV transmission, exposure or non-disclosure, 17 criminalize same sex relations and 14 restrict the entry, stay or residence of people living with HIV.

Photo by Christian Ang from Unsplash.com

Asia and Pacific (APAC) countries should create legal and policy environments that support evidence-informed and rights-based HIV responses for all people. This includes addressing stigma and discrimination in all settings.

This was the call of UNAIDS, as it commemorated on March 1 the Zero Discrimination Day that it established 10 years ago to advance equality and fairness for all regardless of differences including HIV status, age, ethnicity, gender and sexuality. This year’s theme — “to protect everyone’s health, protect everyone’s rights” — stresses the link between human rights and public health.

“The attacks on the rights of marginalized and key populations that we are seeing in many parts of the world are a threat to freedom and democracy and are harmful to health,” said Winnie Byanyima, executive director of UNAIDS. “When laws, policies and practices lead to punishment and discrimination, communities are pushed away from vital health and social services.”

The key populations are men who have sex with men (MSM), people who use drugs, people in detention and other closed settings, sex workers and transgender people.

Ensuring inclusivity

Through the 2021 political declaration on HIV and AIDS, United Nation Member States committed to ensure that:

  • less than 10% of countries have punitive laws and policies;
  • less than 10% of people living with HIV and key populations experience stigma and discrimination; and
  • less than 10% of women and girls and key populations experience gender inequality and violence.

Across APAC, 38 countries still criminalize some aspect of sex work, 28 criminalize drug possession, 20 criminalize HIV transmission, exposure or non-disclosure, 17 criminalize same sex relations and 14 restrict the entry, stay or residence of people living with HIV.

And for UNAIDS, “discriminatory legal environments hinder key populations’ access to HIV prevention services, including harm reduction. Fear of arrest or harassment by law enforcement also negatively impacts the health and well-being of people living with HIV and key populations. These are critical barriers for APAC where four of every five (79%) new infections in 2022 were among key population communities and their sexual partners.”

“Every person has the right to the highest attainable standard of health,” added Eamonn Murphy, UNAIDS regional director for APAC and Eastern Europe Central Asia. “Countries have an obligation to develop and implement laws and policies that guarantee universal access to quality health services and address the source of health disparities.”

Focus on people who use drugs

For UNAIDS, the situation of people who use drugs is especially urgent.

“Many countries in the region operate compulsory detention centers. These facilities are a form of confinement where those thought, or known to be, using drugs are forcibly admitted without due process for ‘treatment’. Conditions have been reported to involve forced labor, lack of adequate nutrition, and denial or limited access to healthcare. Stakeholders continue to advocate for the end of compulsory treatment in the region in the face of evidence that the transition to voluntary, evidence-informed and human-rights-based services has slowed.”

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Additionally, APAC is home to 70% of the people worldwide who require Opioid Agonist Maintenance Treatment (OAMT), which are medicines to prevent withdrawal and reduce cravings. But the regional median for people receiving OAMT is just 6%. And among all key populations, people who inject drugs have the lowest level of access to comprehensive prevention.

For the Network of Asian People who Use Drugs (NAPUD), in the absence of legally conducive environments, people who use drugs cannot tap into appropriate services.

“Healthcare providers lack empathy and have hostile behaviors, while law enforcement personnel apply violence and abuse,” said Francis Joseph, NAPUD Regional Coordinator. “Because they feel unwelcome and dejected in the healthcare facilities, that leads to them going into the shadows and not seeking services”.

To assure the health and rights of people who use drugs, “there must be increased investments in implementing voluntary community-based drug treatment along with complementary health, harm reduction and social support services.”

Progress and the way forward

Throughout the region there are examples of law and policy reforms that bolster human rights while increasing access to health services. India’s HIV and AIDS (Prevention & Control) Act has set up redress mechanisms so people living with HIV can assert their rights in cases of discrimination. The Philippines HIV and AIDS Policy Act allows minors from age 15 to receive HIV tests without parental consent. In Thailand, a new Narcotics Law provides for differentiated sentencing on drug crimes and alternatives to imprisonment for some offenses. And in the Cook Islands, parliament decriminalized same-sex sexual activity.

“Through upholding rights for all, we will be able to achieve the Sustainable Development Goals, and to secure a safer, fairer, kinder, and happier world for everyone,” Byanyima said.

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