As part of the main drivers of the BAM Group of Companies, this being the umbrella company within which Informative Newspaper operates, alongside sister brands Finite Magazine, Finite Lifestyle Club, Bam Promotions and Twin Talk, Informative Newspaper takes particular interest in social issues and causes created to advance the development of young girls and women and their participation in the global space.
To advance and cement the organization’s support for women and young girls, the Sexual and Reproductive Health and Rights is today, through this issue introduced. Its purpose is to advance knowledge and create further awareness on developments surrounding the said community sector and to help audiences stay updated on such, further guiding means of both action and reaction to these developments.
This week we discuss Treatment
ART was initially unaffordable for most people living with HIV in Africa, and large numbers of AIDS deaths occurred in the early years of the epidemic. The past decade has seen dramatic increases in the numbers of people who have access to ART: by 2011, the global target of 15 X 15, namely 15 million people on treatment by 2015, was already met and exceeded. UNAIDS reported that by the end of 2016, 19.5 million people were accessing ART.
Despite this important progress, the 2016 UN Political Declaration on HIV and AIDS:
On the FastTrack to Accelerating the Fight against HIV and to Ending the AIDS Epidemic by 2030, cautions against complacency and expresses “grave concern” that 22 million, or three out of five people living with HIV do not have access to ART. The 2017 Global AIDS Epidemic Update indicates that Southern and East Africa has “made huge strides towards meeting the 90-90-90 targets”: 76% of people living with HIV know their status; 79% of people living with HIV who know their status are on treatment and 83% of people on treatment are virally suppressed. Six out of ten people on ART now live in Southern and East Africa and approximately 60% of all people living with HIV in the region are on treatment (this equates to 11.7 million people). In 2016, 67% of women and 51% of men above the age of 15 were accessing treatment. The increase in access to ART has cut AIDS-related deaths by half in the region.
People living with HIV are more vulnerable to Tuberculosis (TB) and hepatitis B and C: people living with HIV account for 13% of all people with TB and TB remains one of the biggest killers of people living with HIV. The 2014 UNAIDS Gap Report indicates that two to four million people living with HIV are co-infected with hepatitis B, while four to five million have hepatitis C. More needs to be done to ensure access, not only to ART, but to TB (including drug resistant TB) and hepatitis medicines.
International and regional human rights obligations
Access to ART, TB and hepatitis medicines is an essential part of every person’s human rights to life and health and, governments have a duty to protect and promote these rights under international and regional human rights treaties. The right to health is enshrined in various international and regional treaties, including the ICESCR, the CEDAW, the CRC, the African Charter on Human and Peoples’ Rights, the Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women (the Maputo Protocol) and the African Charter on the Rights and Welfare of the Child.
The right to health includes states’ obligations to “ensure that medicines are available, financially affordable, and physically accessible on a basis of non-discrimination to everyone”. This means that all governments must take steps, as part of their duty to promote and protect the right to the highest attainable standard of health, to promote broad access to safe, effective and affordable medicines, including ART and treatment for TB and hepatitis.
The UN Human Rights Council adopted a landmark resolution in 2016 reaffirming that the right to health includes access to affordable medicines of good quality in a timely fashion. The resolution was adopted by consensus, although the European Union and other Western countries raised many objections to the language. It calls for international co-operation to assist developing countries to promote the right to health, including through access to medicines, and for innovative funding mechanisms that will contribute to the availability of vaccines and medicines in developing countries.
Access to ART and intellectual property rights
The cost of medicines remains one of the most significant barriers to access to medicines in Africa, where countries still import most of their essential drugs. In order to meet their human rights obligations to protect and promote the right to health, SADC countries must create an enabling legal and policy framework that helps to increase access to medicines. Intellectual property laws and trade rules set out by the World Trade Organization (WTO) and in terms of the Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement have created barriers to affordable medicines in Africa. Intellectual property laws give market exclusivity (through e.g. patents) to companies that develop medicines, allowing them to charge high prices on the basis of their investment in research and development.
In 2001, WTO members adopted the Doha Declaration on the TRIPS Agreement and Public Health, reiterating that least developed countries were able to use the “flexibilities” within TRIPS to increase access to affordable medicines – such as generic medicines – for public health reasons. Since then, WTO members have adopted a number of additional, related decisions to implement the Declaration. Most African countries have incorporated intellectual property protections in their domestic laws, including harmonising their patent laws to protect patents on medicines, but very few countries have become TRIPS compliant or have taken full advantage of TRIPS flexibilities to increase access to affordable medicines.
The 2016 UN resolution on access to medicines emphasises the primacy of human rights over international trade, investment and intellectual property regimes and the obligation of all states to ensure non-discriminatory access to medicines. It urges States to take full advantage of TRIP flexibilities. It promotes the use of affordable medicines, including generics.
Parliamentarians should be familiar with TRIPS flexibilities, such as compulsory licensing and parallel importing, and able to review intellectual property laws to ensure those flexibilities are used.
In addition to their legal obligations under international human rights laws, SADC countries have also committed to achieve the SDGs, also known as the Global Goals. These goals aim to end extreme poverty, eliminate inequality and injustice and address climate change by 2030. Goal 3 deals with health and target 3.3 aims to end the HIV and TB epidemics, by 2030. The indicators for this target include reducing new HIV, TB and hepatitis B infections.
Next we discuss Human rights barriers to ART
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