What contribution have human rights approaches made to reducing AIDS-related vulnerability in sub-Saharan Africa? Exploring the case study of access to antiretrovirals

Abstract

Human rights approaches may offer powerful tools to deal with HIV and AIDS-related vulnerabilities experienced throughout the subcontinent's endemic regions. This paper examines how such approaches have contributed to remediating health and dignity violations posed by the inaccessibility of antiretrovirals in the region. Increases in regional access and key changes in the causal chain of drug access are explored. Rights-based social campaigns that produced domestic as well as global shifts in related law and policy are described in the key low-and middle-income countries of South Africa, Brazil and Thailand. Finally, I consider the implications of these shifts in relation to the strengths and weaknesses of rights-based approaches to reducing AIDS-related vulnerability in the region, arguing that these experiences indicate the need for structural fixes that codify the right to health at domestic and international levels, so as to entrench the right to medicines and enable social actors and policy-makers alike to better meet essential health needs. (Global Health Promotion, 2013; 20 Supp. 1: 57-63).

Emergence of Universal Antiretroviral Therapy Coverage in South Africa: Applying the Advocacy Coalition Framework to Refine the Narratives and Inform Epidemic Responses

“…Post-apartheid and for over a decade, high rates of HIV/AIDS and AIDS-related mortality constituted serious public health menaces in South Africa albeit there seemed to be very conducive environment to develop an appropriate HIV/AIDS policy based on the availability of compelling scientific evidence on the pathogenesis of HIV/AIDS and the benefits of ART, availability of funding for national ART roll-out, strong global advocacy to reduce the cost of ART [27], all of these being present in an era when inaction against HIV/AIDS was literally considered a crime [10,[28][29][30]. However, dissidents who constituted the minority coalition, president [31].…”

“…With regards to South Africa, the country with the largest national ART program in the world [3][4][5], the path to national ART roll-out was extremely dramatic and even linked with the death of hundreds of thousands of persons living with HIV/AIDS [6]. Even though the country's pursuit of national ART roll-out post-apartheid has been extensively described using diverse approaches [7,8,17,[9][10][11][12][13][14][15][16], there is scarce literature applying a comprehensive framework to analyse the roles of state and non-state actors who were involved in the process of AIDS policy change. In view of this important gap in the literature and the intense ideological conflicts which characterized the quest for national ART roll-out in South Africa, this paper employs the Advocacy Coalition Framework (ACF) of Sabatier and Jenkins-Smith [18,19] to analyse and summarize interactions among diverse actors, institutions and networks that were associated with AIDS policy change in South Africa.…”

Au-delà des « groupes vulnérables »: contextes et dynamique de la vulnérabilité

“…Par contre, Forman (8) met en évidence la manière dont l’association de l’analyse des droits humains, de l’activisme et des difficultés légales peut transformer à la fois le discours et la réalité pour des millions de gens qui vivent avec le VIH – jusqu’à un certain point. Mohindra et Shrecker (9) nous ramènent à l’extérieur de la sphère « santé », aux déterminants sociaux du logement et de l’urbanisation sous un ordre économique mondial néolibéral, en se penchant sur le pouvoir, les politiques publiques et la résistance publique.…”

Ir más allá de los “grupos vulnerables”: contextos y dinámica de la vulnerabilidad

“…Por el contrario, Forman (8) destaca que la combinación de un análisis desde la perspectiva de los derechos humanos, con activismo y cambios legales puede transformar el discurso y la realidad de millones de personas que viven con el VIH…hasta cierto punto. Mohindra y Shrecker (9) nos sacan de la esfera “sanitaria” y nos devuelven a la de los determinantes sociales de la vivienda y la urbanización bajo el orden económico mundial de tipo neoliberal, centrándose en el poder, las políticas públicas y la resistencia organizada de la población.…”