By Steven LB Jensen
Steven LB Jensen is a senior researcher at the Danish Institute for Human Rights. He is the author of the award-winning book The Making of International Human Rights. The 1960s, Decolonization and Reconstruction of Global Values and co-editor of Histories of Global Inequality: New Perspectives
Editor’s Note: This is an updated version of an article originally carried in the Daily Maverick on January 26,2021. Reprinted with the permission of the author.
Last week, a new global AIDS strategy (End of Inequalities. End of AIDS. Global AIDS Strategy 2021-2026) was adopted in Geneva by UN member states after months of negotiations. This is a landmark achievement and should be groundbreaking news and highly regarded worldwide. Unfortunately, it is not.
“Epidemics are big signposts,” German physician and social medicine founder Rudolf Virchow wrote back in 1848, “[and] forming an indivisible part of the cultural history of mankind. ”However, the international community seems to have lost an understanding of the continuing significance of the global response to the HIV / AIDS epidemic. Nevertheless, the signposts for this are around if we want to look, with one timely example being the question: How were Covid-19 vaccines developed relatively quickly?
As Professor Glenda Gray, president of the South African Medical Research Council, told Daily Maverick on 30 November 2020, it has everything to do with the response to HIV:
“Covid-19, Ebola and Zika [virus] have benefited tremendously from all the work that has gone into developing platforms for HIV vaccines, so if we had not invested all this money in HIV, we would not have solutions for Ebola, Zika and SARS-CoV-2 . Because of those platforms we have been able to move nimbly to the next pathogen. ”
Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases, supported this view in the Wall Street Journal of 24 December 2020: “Everything we do with all other pathogens stems from what we’ve learned with HIV. “
In a world where recovery from the Covid-19 pandemic is at the top of the political agenda and vital for everyone’s future, we would do well to re-learn some essential lessons about the nature and transformative potential that the HIV / AIDS response has demonstrated . This is not only because the AIDS crisis will remain serious for the foreseeable future – it is also because the global response to HIV / AIDS is one of the only successes that the international community has achieved over the last two decades (even if some describe this as a relative success, given the scale of the challenges still before us). We need to learn from and build on success. It is rare these days that we get such an opportunity.
We need examples of how international organizations and their processes are bringing benefits and improvements to people’s lives around the world. It can be done, and the good news is that we have such an example before our eyes. We need to start writing the 21st century story from this perspective. Setting the historical record straight might look something like this:
This century has been a time of protracted and complex crises for the international community to deal with. Peace, security, human rights and development have been under constant threat and international diplomacy has been struggling to cope with the challenges ahead. However, there are other narratives that can inform this overall assessment.
It has become clear that the greatest shapers of international public policy in this century have been representatives of people living with HIV, LGBTQ + people, sex workers and drug users, and their allies. Against the odds, these groups have achieved remarkable achievements not only for their own communities but for wider populations, societies and the international community as a whole. They have fought for human dignity and extended freedom to many – often without recognition and at great personal cost. It is a reality that not enough people are aware of and understand the implications of.
The reason that members of these often humiliated, marginalized and even criminalized communities deserve the above-mentioned label is because of the central role they have played – along with experts and other public health champions – in shaping the global response to HIV / AIDS over the latter. decades. They have implemented international human rights law in innovative ways that break paths. They have expanded democratic culture and practices in countries around the world. Their executive has also brought more political attention and funding to other diseases, such as malaria and tuberculosis, and gradually to issues like strengthening health systems. In the process, they transformed what global health – and to some extent wider social development – means today.
Their long-standing campaign for access to HIV prevention, treatment, care and support – making it a claim for universal attention in the process – as well as increasing social investments, helped change the direction of the global AIDS pandemic. This has helped bring countries back from the brink of social collapse and has done much to save the lives of communities around the world.
The 26 million people worldwide now undergoing HIV treatment has been a much-needed achievement, but it is also shocking, when one remembers the prospects for increasing treatment back in 2000 .This result and much more has only been achieved by continuing. struggle, determination, endurance, innovation, skill, unity and overcoming stigma and grief, and it was also done with a sense of love.
Yes, you are reading correctly. Love is a resource in global politics. Take that in for a moment before we move on.
In this context, it is pertinent to remind ourselves of the political and historical background against which these achievements were made. By this we mean the major global political events that have run parallel since the year 2000 – while the struggles for a more comprehensive HIV / AIDS response have developed – and which have left the international community facing dire and embedded problems or crises systemic.
This list of events includes global terrorism (11 September 2001 and its aftermath), wars (Iraq, Syria, Libya and Yemen), massive displacements and refugee crises (numerous), the global financial crisis ( 2008-), climate change and global increase. inequalities, to mention some. In a fractured world, the United Nations is battling for relevance because of the political effects of these multiple forms of crisis.
Despite its own problems and challenges, including the need to fight for every improvement, the global response to HIV / AIDS has been the single main area where international policy-making and diplomacy have been antidotes to the failures and the above disasters of the last two decades and the subsequent disillusionment with international organizations.
A recent NGO report to the UNAIDS Program Coordination Board (PCB) – the UN governance structure where the global AIDS strategy has just been discussed – can give us more detail on what the communities have done ‘ to contribute through their formal engagement with global health governance over a quarter of a century. It represents a microcosmos of the much larger story of what communities and civil society have brought to the HIV / AIDS response and to wider international politics.
The Engagement, Evidence and Impact report: 25 years of NGO Delegation to UNAIDS PCB documents held:
1) bring the reality of living HIV to the UNAIDS PCB and have continually advocated for priority issues of communities and civil society;
2) bring evidence and passion to contentious and contentious issues before the PCB;
3) brought geographic diversity in highlighting the issues facing communities and civil society;
4) support this intergovernmental forum to link the response to HIV to wider issues and processes;
5) contribute to the effectiveness, efficiency and accountability of UNAIDS governance; a
6) influence governance and partnerships with other global health organizations.
To be even more specific, the NGO delegation has also been instrumental in changing erroneous global policy approaches in the UN relating to HIV and sex work and drug use. The NGO delegation has directed interventions in these areas to more transparent and accountable human rights-based pathways.
Reports of UN board meetings rarely qualify as focal points of excitement. However, in a time of civic space shrinking and persecuting human rights defenders, this example of the impact of NGOs in UNAIDS governance processes deserves attention for the way it identifies civil society achievements during a critical period in history worldwide.
The HIV epidemic remains in a critical state where gains can still be rolled back. Too many have lost their lives in the process and continue to lose their lives. However, we have come a long way from the scenarios of its various and devastating effects presented to us at the turn of the century. Many people are indebted for their survival to the activism and professionalism shown by HIV advocates from the above communities and their allies. There is no doubt that they are the true leaders of the 21st century.
It is important to draw the right lessons from this and to correctly label what this decades-old practice and experience means for today’s international politics: It offers us a grand strategy for dealing with our an unequal world, struggling and suffering.
The historical evidence that the global response to HIV / AIDS presents to us is remarkably clear. Human rights, social justice, welfare and empathy are core elements of what our prestigious strategy must look like in this century.
Our political and intellectual frameworks need to adapt to this way of thinking and do this quickly, because we need this view of a grand strategy to fix the social fabric of our societies and to help the world step back from the brink multiple. crises and disasters.
We need to return to the global HIV / AIDS response and make its various lessons a building block in securing a better trajectory through this century, including in the Covid-19 recovery.
We could start by giving processes such as the adoption and implementation of the new global AIDS strategy and related processes the political significance they deserve. AIDS is not over, but neither is its transformative potential to bring much needed improvements as well as to literally surprise everyone – if we choose to care and commit.