Leveraging HIV-related human rights achievements through a Framework Convention on Global Health

Abstract

Although AIDS remains a leading cause of death, especially in low- and middle-income countries, the movement to address it has greatly contributed to changing the world's response to health challenges. By fusing activism, political leadership, domestic and international investment, and accountability for results, the course of the epidemic has been radically shifted. People living with HIV and others directly affected by the epidemic have exerted immense leadership since the first days of the response: they have fought to end discrimination on the basis of sero-status, gender, sexual orientation, disability, migration status, drug use, or participation in sex work. Some of this mobilization has taken the form of strategic litigation, drawing human rights down into concrete demands and defining social, health, legal, and economic policy. The global AIDS response has shown that at the core of health lie considerations of social justice, human rights, and accountability. As momentum builds for a Framework Convention on Global Health (FCGH), we believe there is an opportunity to take stock of lessons learned from the response to HIV and ensure that they are replicated and institutionalized in an eventual Convention. We argue that the most critical aspect to the success of the HIV response has been the leadership and activism of civil society. Conventions do not lead to results on their own, and there should be every expectation that the FCGH will be no different. Success requires active monitoring of progress and shortcomings, combined with political and social mobilization to expand investment and access to the services and underlying conditions that protect and advance health. While the FCGH must make civil society support and engagement an indispensable principle, the AIDS movement can contribute substantive content and mobilization for its adoption. A broad international legal framework for health can help address some of the key legal, policy, regulatory, and programmatic challenges that continue to hinder effective responses to HIV. Thus, the AIDS response potentially has much to gain from the normative and institutional framework, and the expanded commitment to realizing the right to health that can be generated under such a Convention.