Final Report Independent Evaluation Global Commission HIV and The
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EVALUATION REPORT Project No. 00072811 HIV Global Project for the Evaluation of the Global Commission on HIV and the Law Program on Global Health and Human Rights, Institute on Inequalities in Global Health, University of Southern California February 2021 1 ACRONYMS • ACHPR - African Commission on Human and Peoples’ Rights • AIDS - acquired immunodeficiency syndrome • AMSHeR- African Men for Sexual Health and Rights • ARASA - AIDS and Rights Alliance for Southern Africa • ART- antiretroviral therapy • AU - African Union • AUC- African Union Commission • AWARE - Action for West Africa Region • BRICS - Brazil, Russia, India, China and South Africa • CARICOM - The Caribbean Community • CCM - country coordinating mechanism • CEDEP – Centre for the Development of People • CSDH – The Commission on Social Determinants of Health • CSO- Civil society organization • DANIDA - Danish International Development Agency • DRC - Democratic Republic of the Congo • EAC- East African Community • EALA - East African Legislative Assembly • EATHAN - East Africa Trans Health and Advocacy Network • ECOWAS - Economic Community of West African States • EECA - Eastern Europe and Central Asia • ESCAP – United Nations Economic and Social Commission for Asia and the Pacific • GHHR - Global Health and Human Rights • HEARD - Health Economics and HIV/AIDS Research Division, University of KwaZulu Natal, South Africa • HIV - human immunodeficiency virus • HRDP - International Centre on Human Rights and Drug Policy, University of Essex, United Kingdom • ICASA - Independent Communications Authority of South Africa • ICJ - International Commission of Jurists • IP - Intellectual Property • ISAGS - South American Institute of Government in Health • KELIN - Kenya Legal & Ethical Issues Network on HIV and AIDS • KII - Key informant interview 2 • LEA - Legal Environment Assessment • LGBT - lesbian, gay, bisexual, transgender • LGBTI - lesbian, gay, bisexual, transgender, intersex • LMIC- low and middle-income country • MENAHRA - Middle East and North Africa Harm Reduction Association • MENARosa – Middle East and North Africa Rosa • MERCOSUR - The Southern Common Market • MSM - men who have sex with men • NAC – National AIDS Commission • NGO - non-governmental organization • NHRI - national human rights institutions • NSP - national strategic plan • OHCHR- Office of the High Commissioner for Human Rights • PANCAP - Pan-Caribbean Partnership against HIV and AIDS • PEPFAR – United States President’s Emergency Plan for Aids Relief • PrEP - Pre- exposure prophylaxis • PWUD - people who use drugs • RANAA - Regional Arab Network Against AIDS • REC - Regional Economic Community • RESURJ - Realizing Sexual and Reproductive Justice • SAARC - South Asian Association for Regional Cooperation • SADC- Southern African Development Community • SADC-PF - The SADC Parliamentary Forum • SALC - Southern Africa Litigation Centre • SDG - Sustainable Developmental Goal • SRH- Sexual and Reproductive Health • TAG - Technical Advisory Group • TB- tuberculosis • ToR - The Terms of Reference • TRIPS – The Agreement on Trade-Related Aspects of Intellectual Property Rights • TWG - Technical Working Group • UHC - universal health coverage • UN - United Nations • UNAIDS - Joint United Nations Programme on HIV/AIDS • UNASUR - Union of South American Nations • UNDP - United Nations Development Programme • UNFPA - United Nations Population Fund 3 • UNGA- United Nations General Assembly • USA - United States of America • USAID - United States Agency for International Development • WHO - World Health Organization • WIPO - World Intellectual Property Organization • WTO - World Trade Organization 4 TABLE OF CONTENTS I. Executive summary ...................................................................................................................... 6 II. Overview .................................................................................................................................... 26 III. Introduction .............................................................................................................................. 28 The Evaluation ....................................................................................................................................... 30 Approach ............................................................................................................................................... 33 Structure of the Evaluation Report ........................................................................................................ 35 IV. Methodological approach ........................................................................................................... 36 Introduction ........................................................................................................................................... 36 Evaluation Team Briefing ....................................................................................................................... 36 Data Collection ...................................................................................................................................... 37 Data Analysis ......................................................................................................................................... 41 V. Findings ...................................................................................................................................... 42 Process ................................................................................................................................................... 42 Global Level Impact ............................................................................................................................... 66 Regional Level Impact ............................................................................................................................ 92 National Level Impact .......................................................................................................................... 142 Global Processes and Research Explicitly Influenced by the Global Commission ............................... 151 VI. Conclusions .............................................................................................................................. 154 General Conclusions ............................................................................................................................ 154 Relevance ............................................................................................................................................. 156 Effectiveness ........................................................................................................................................ 158 Sustainability ....................................................................................................................................... 161 Conclusion ........................................................................................................................................... 164 VII. Annexes ................................................................................................................................... 167 Annex 1: List of Participants Interviewed ............................................................................................ 168 Annex 2: Roster of Commissioners and TAG ....................................................................................... 170 Annex 3: Citations in the Peer-Reviewed Literature ............................................................................ 172 Annex 4: Citation Search Results and Abstracts .................................................................................. 191 Annex 5: List of Documents Reviewed ................................................................................................ 209 Annex 6: Key Informant Interview Guide ............................................................................................ 214 Annex 7: References ............................................................................................................................ 217 5 I. EXECUTIVE SUMMARY Introduction In 2010, UNDP, on behalf of the Joint UN Programme on HIV/AIDS (UNAIDS), convened the Global Commission on HIV and the Law (the Global Commission) to examine legal and human rights issues through an HIV lens, increase awareness among key constituencies on issues of rights and law, and engage with and strengthen civil society. The Global Commission spent 18 months on extensive research, consultation, analysis and deliberation so as to inform action- oriented recommendations to strengthen work around HIV and the law. The Commission’s findings and recommendations remain relevant and important to the HIV response, not only historically but moving forward. This independent Global Commission was comprised of fourteen distinguished individuals from diverse disciplines and nationalities, each with extensive experience and expertise on matters of public health, human rights, law or development, and a Technical Advisory Group (TAG). The Global Commission was created at the behest of the UNAIDS Programme Coordinating Board and UNDP served as the Secretariat. This executive summary presents abridged findings from an external evaluation of the impacts and legacy of the Global Commission on HIV and the Law. It explores the fulfilment of the Commission’s objectives, taking into account the perspectives and experiences