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GLOBAL COMMISSION on HIV and the AW GLOBAL COMMISSION ON HIV and the AW Risks, Rights & Health JULY 2012 The content, analysis, opinions and policy recommendations contained in this publication do not necessarily refl ect the views of the United Nations Development Programme. SECRETARIAT, GLOBAL COMMISSION ON HIV AND THE LAW UNDP, HIV/AIDS Group, Bureau for Development Policy, 304 East 45th Street, New York, NY 10017 Email: [email protected] Tel: (212) 906 6590 Fax: (212) 906 5023 Web: www.hivlawcommission.org Copyright © UNDP 2012 Images used with permission. Graphics Createch & Myriad Editions Design & Printer Consolidated Graphics TABLE OF CONTENTS ABOUT THE GLOBAL COMMISSION ON HIV AND THE LAW ..................................................................................................................................................3 PREFACE ................................................................................................................................................................................................................................................................4 Acknowledgments .........................................................................................................................................................................................................................................5 Abbreviations .....................................................................................................................................................................................................................................................6 EXECUTIVE SUMMARY ..................................................................................................................................................................................................................................7 INTRODUCTION: CAN LAWS SAVE LIVES? ...................................................................................................................................................................................... 11 CHAPTER 1: AGAINST DISCRIMINATION: HEALTH AND DIGNITY THROUGH LAW ................................................................................................ 15 CHAPTER 2: PUNISHING VULNERABILITY: CRIMINALISATION OF HIV TRANSMISSION, EXPOSURE AND NON-DISCLOSURE ...................................................................................................................................................................... 20 CHAPTER 3: RISK + STIGMA: KEY POPULATIONS ........................................................................................................................................................................ 26 3.1 PEOPLE WHO USE DRUGS ........................................................................................................................................................................................... 29 3.2 SEX WORKERS ..................................................................................................................................................................................................................... 36 3.3 MEN WHO HAVE SEX WITH MEN ............................................................................................................................................................................. 44 3.4 TRANSGENDER PERSONS ............................................................................................................................................................................................. 51 3.5 PRISONERS ............................................................................................................................................................................................................................ 55 3.6 MIGRANTS ............................................................................................................................................................................................................................. 59 CHAPTER 4: GENDER AND DISEMPOWERMENT: WOMEN ................................................................................................................................................... 62 CHAPTER 5: THEIR WHOLE LIVES TO LIVE: CHILDREN AND YOUTH ................................................................................................................................ 70 CHAPTER 6: MEDICINES FOR WHOM? INTELLECTUAL PROPERTY LAW AND THE GLOBAL FIGHT FOR TREATMENT ................................................................................................................................................................... 76 CONCLUSION .................................................................................................................................................................................................................................................. 88 Annex I: Commission Terms of Reference ..................................................................................................................................................................................... 90 Annex II: Commissioner Biographies ................................................................................................................................................................................................ 92 Annex III: Technical Advisory Group Biographies ..................................................................................................................................................................... 94 Annex IV: Summary of Recommendations .................................................................................................................................................................................. 97 ENDNOTES ......................................................................................................................................................................................................................................................106 Table of Contents : I 1 GRAPHICS 1. Why the Law Matters ---------------------------------------------------------------------------------------------------------------------11 2. Written Submissions Received by the Commission ------------------------------------------------------------------------------14 3. Legal Shelter --------------------------------------------------------------------------------------------------------------------------------16 4. Criminalising a Virus ----------------------------------------------------------------------------------------------------------------------21 5. Mitigating the Harm ----------------------------------------------------------------------------------------------------------------------33 6. Sex Work & Law ----------------------------------------------------------------------------------------------------------------------------37 7. Men Who Have Sex with Men, Law & HIV -------------------------------------------------------------------------------------------46 8. LGBT Rights & HIV Transmission Risk -------------------------------------------------------------------------------------------------47 9. Unprotected Sex Behind Bars ----------------------------------------------------------------------------------------------------------57 10. HIV Travel Restrictions ------------------------------------------------------------------------------------------------------------------60 11. Rape within Marriage -------------------------------------------------------------------------------------------------------------------64 12. Growing Contradictions ---------------------------------------------------------------------------------------------------------------72 13. Generic Competition: Making ARVs Aff ordable ----------------------------------------------------------------------------------77 14. The Treatment Gap ----------------------------------------------------------------------------------------------------------------------78 15. Free Trade Mounting Constraints ----------------------------------------------------------------------------------------------------83 16. Boosting Innovation? -------------------------------------------------------------------------------------------------------------------84 2 I HIV and the Law: Risks, Rights & Health ABOUT THE GLOBAL COMMISSION ON HIV AND THE LAW The Global Commission on HIV and the Law consisted of fourteen distinguished individuals who advocate on issues of HIV, public health, law and development. Fernando Henrique Cardoso, former president of Brazil, chaired the Commission. The Commission’s unique convening power allowed it to focus on high-impact issues of HIV and the law, which have important rami- fi cations for global health and development. The Commission advocated for evidence and human rights based legal environments for eff ective and effi cient HIV responses. The life experiences of the Commissioners gave them a formidable ability to access a wide cross-section of society. This means they are well placed to infl uence change on complex issues that require the engagement of multiple stakeholders across a range of sectors. Fernando Henrique Cardoso Ana Helena Chacón-Echeverria Charles Chauvel Shereen El Feki Bience Gawanas (Brazil) (Costa-Rica) (New Zealand) (Egypt) (Namibia) Dame Carol Kidu Michael Kirby Barbara Lee Stephen Lewis Festus Gontebanye Mogae (Papua New Guinea) (Australia) (United States) (Canada) (Botswana)
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