International day of zero discrimination against AIDS

International day of zero discrimination against AIDS

By Maeva Giambrone / GICJ

March 1st, 2023 marks the International Day of Zero discrimination against AIDS. A day dedicated to raising awareness about the human immunodeficiency virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS).

UNAIDS launched this campaign on December 1st, 2013, World AIDS Day. The first event in this campaign was the creation of a day focus on Zero discrimination, marked for the first time on March 1st, 2014. The purpose of this day is to celebrate the right of all people to live their lives with dignity and aims to emphasise the need for understanding and inclusion. The objective is to create a movement towards the end of all forms of discrimination against those with HIV and AIDS.

UNAIDS objectives

UNAIDS is the result of a combined action of 11 UN institutions, such as UNHCR, UNICEF, WHO etc. They are working to defeat the AIDS pandemic by 2030 in accordance with the 2030 Sustainable Development Goals (SGC). The 2030 goals include Zero new HIV infections, Zero discrimination, and Zero AIDS-related death. To achieve these targets, UNAIDS initially adopted the 2016-2021 Strategy, which is a call to invest more and to protect the health of the 22 million people living with HIV who still lack access to treatment.

On March 25th, 2021 the UNAIDS Programme Coordinating Board adopted a new global strategy: the “End Inequalities, End AIDS, Global AIDS Strategy 2021-2026”. The chosen approach aimed to use an inequalities lens in order to close the gaps obstructing progress towards ending AIDS. The strategy aims to reduce the inequalities that fuel the AIDS epidemic and to prioritise those who do not so far have access to life-saving HIV services.

Of the 17 SDGs adopted in 2015, 10 of them are particularly relevant to the response to AIDS:

Goal 1, end poverty: Poverty can increase vulnerability to HIV infection. This is why economic empowerment and social protection can reduce poverty and vulnerability to HIV and help people living with HIV to stay healthy.
Goal 2, end hunger: Hunger can heighten vulnerability to HIV by increasing risky behaviours and negatively impacting treatment uptake. Food support can contribute to preventing the transmission of HIV.
Goal 3, ensure healthy lives: Lack of health coverage restricts the accessibility of prevention and treatment. Most people are infected through sexual transmission or from mother to child. Universal health coverage would improve the healthcare situation. This goal includes a specific commitment by Member States to achieve the end of AIDS by 2030.
Goal 4, ensure quality education: The majority of young people do not have accurate and complete knowledge about HIV. Sex education classes enable them to make informed decisions about their health.
Goal 5, achieve gender equality: HIV is the primary cause of death among women of child-bearing age (15-44 years). Women living with HIV often face higher levels of violence. Access to sexual education and to reproductive health services is crucial to support the autonomy of women and girls. When women are involved in decision-making, they are more inclined to practise safer sex and have higher HIV-related knowledge.
Goal 8, promote economic growth: Safe and secure work environments enhance access to HIV-related services. People living with HIV can experience unemployment rates three times higher than national unemployment rates. Addressing HIV in the world of work and protecting workers rights can help ensure that people living with HIV are fully employed.
Goal 10, reduce inequality: Discrimination against vulnerable populations is a major factor leading to high HIV rates among them and is linked to reduced access to health care and housing. Protection from discrimination, as well as legal services, awareness of rights, and access to justice and international protection can lead to people claiming their rights and improving access to HIV services.
Goal 11, make cities safe and resilient: HIV affects cities and urban areas in particular. People living in slums often acquire HIV at higher rates than the rest of the city. City-led local AIDS responses are key to reaching the most excluded people.
Goal 16, promote peaceful and inclusive societies: As already mentioned, infected people are more likely to experience violence. And people who experience violence are more likely to be infected. A peaceful and inclusive society must therefore be promoted in order to reduce these risks.
Goal 17, strengthen means of implementation: To strengthen all the measures implemented, it is necessary to continue to improve access to treatment for all patients. This must include flexible trade legislation.

2023 Theme: “save lives : decriminalise”

The theme for the 2023 International Day of zero discrimination against AIDS is “save lives: decriminalise”. UNAIDS aims to underline how the decriminalisation of people that are living with HIV can save lives and helps to end the AIDS epidemic. Furthermore, this theme is in line with SDG 16 as UNAIDS is committed to removing all laws or policies that punish, stigmatise or discriminate against people affected by HIV.

Further, UNAIDS wants to remind people that laws targeting people living with HIV violate human rights, including the rights to health, privacy, equality, and non-discrimination, and exacerbate the stigma they are facing. Furthermore, it puts them at risk because these laws can deprive them of access to the help or care they need for their health.

The aim of the 2023 theme is to raise awareness of the progress that still needs to be made. According to figures received by UNAIDS, 134 countries in the world still criminalise exposure to AIDS as well as transmission and withholding HIV status. Similarly, 67 countries still criminalise same-sex sexual activity, and 53 require premarital testing. Finally, 17 countries deport individuals once their HIV status is known.

Between 2015 and 2018, there were 913 arrests, prosecutions, appeals and/or acquittals in 49 countries for not disclosing HIV status or for exposing or transmitting the virus. Of these 913 cases, one-third occurred in Russia, at least 250 in Belarus and 158 in the United States.

Although it has been scientifically established that HIV cannot be transmitted through saliva and that the possibility of transmission through biting or oral contact is virtually nil, HIV-positive people have been charged and even convicted for such acts. Criminalisation should only be used in cases of intentional transmission where malicious intent is proven.

All these laws exacerbate discrimination against people with HIV. Moreover, it is also holding back the eradication of the disease. Indeed, it has been shown that countries criminalising these populations have made the least progress towards testing and treatment targets between 2016 and 2021. On the contrary, in countries that are strengthening the protection of their human rights, important progress has been made.

The Oslo declaration on the criminalisation of HIV of February 13th, 2012 is a call from civil society to stop criminalising the disease. The declaration notes that criminalisation has more negative than positive effects. Indeed, the stigma infected people face is a real obstacle to testing and therefore to accessing treatment. The drafters recommend focusing instead on prevention and support for people living with HIV in order to achieve the triple zero objectives.

Current concerns

However, some concerns remain. In the past 20 years the number of people newly infected each year has fallen from 3.1 million to 2 million, however, the epidemic is not yet eradicated. At the end of 2020, there were 12 million people with HIV who were likely to die of lack of treatment. Every week, almost 4,500 young girls acquire the virus and only half of children (0-14 years old) have access to the treatment needed to save them. In 2019, almost 700,000 people died of AIDS-related causes.

Progress varies considerably depending on the population and location. For example, in 2014 about 2 million people became infected with HIV and half of them lived in East and Central Africa. Furthermore, homosexuals, transgender people, sex workers and injecting drug users are the populations most at risk.

Geneva International Centre for Justice (GICJ) condemns all forms of discrimination as a violation of the most fundamental human rights. We call on the international community to abolish all laws criminalising HIV. The use of criminal law by states should be limited to cases of intentional transmission of the disease. People living with the virus must not be denied their rights on the grounds that they are infected with a communicable disease. States have a moral and legal obligation to abolish discriminatory laws and to introduce legislation that protects them from discrimination and unequal treatment.

We urge governments to do their utmost to tackle inequalities in order to achieve the 2030 targets and finally end the HIV epidemic. No one should die from this virus when effective treatments are available. Reducing inequalities is crucial to this, as it is these inequalities that stand in the way of a large proportion of patients from receiving treatment.

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