“To end AIDS, protect everyone’s human rights”

By Dr Leopold Zekeng

On World AIDS Day (December 1), UNAIDS is highlighting that upholding the human rights of all people living with or at risk of HIV is vital for ending AIDS by 2030

The world has made enormous progress in reducing the impact of HIV over the last 15 years.

Globally, a total of 30.7 million people-77% of those living with HIV were on treatment in 2023, up from just 7.7 million in 2010. This has resulted in a dramatic decline in AIDS-related deaths, down by 51% over the same period.

Similarly, Nigeria has made significant strides in the fight against HIV/AIDS. Currently, approximately 2 million people are living with HIV in the country, with an adult prevalence rate of 1.3% among individuals aged 15–49. In 2023, there were 75,000 new HIV infections, reflecting a decline in new cases over the years. The country has also achieved notable progress in treatment access, with 85% of people living with HIV receiving antiretroviral therapy.

But although a range of effective treatment and prevention tools have been developed, the world is still not on track to end AIDS as a global health threat by 2030. Global progress is too slow. Indeed, in at least 28 countries, new HIV infections are on the rise.

So how do we protect the gains already made against HIV and make further progress towards that vital 2030 goal? A new UNAIDS report released ahead of World AIDS Day, entitled Take the Rights Path, shows that upholding rights is the pathway to an HIV response that is robust and sustainable. The world can end AIDS as a public health threat, if the human rights of all people living with and at risk of HIV are protected.

In Nigeria, 160,000 children are living with HIV, and many more are at risk of infection. With 8 million pregnant women yearly, only about 33% receive anti-retroviral treatment for their own health and to prevent the transmission of HIV to their babies. Regrettably, mother-to-child transmission of HIV rate is 23%. The Convention on the Rights of the Child to which Nigeria is a signatory, obligates all state parties to act in the best interests of the child and to ensure “such protection and care as is necessary for his or her well-being.” These obligations have special importance in the context of HIV.

The denial of education and information puts people at risk. Recent data by UNICEF reveals that 10.2 million children of primary school age and 8.1 million children of secondary school age are out of school in Nigeria. There also remains an urgent need to invest in girls’ education and to provide comprehensive sexuality education -a critical component of HIV prevention.

Upholding the rights of women and girls is central to ending the AIDS pandemic. Gender-based violence increases vulnerability to HIV. Women aged 15 – 49 account for 1,200,000 out of the 2,000,000 people living with HIV in Nigeria. Just like in some other parts of the world, about one in three women have experienced sexual and gender-based violence in Nigeria. Global rankings have consistently placed Nigeria within groups of low performers in terms of gender equality. Societal norms and stereotypes continue to further perpetuate gender inequality.

The social and legal climate faced by people from key populations and women can be lethal. For instance, in August 2024, Christopher Ikbu Terpha, chair of the Nigeria Key Populations Health and Rights Network, and one of his colleagues were brutally murdered. In some instances, key populations in Nigeria have experienced discrimination, violent law enforcement practices, arrests and other forms of human rights violations. These violations and abuses often shove people living with HIV and key populations to the margins of society, denying them access to life-saving health and social services, including HIV services. When marginalized communities are criminalized or stigmatized, their vulnerability to HIV infection increases, and their access to HIV prevention, treatment, care, and support services is obstructed.

In Nigeria, 10.9% of the estimated 446 000 people who inject drugs are living with HIV. Like many countries, Nigeria has punitive laws criminalizing possession of drugs for personal use. A substantial and growing body of evidence reveals that criminalization of drug use worsens HIV prevention and treatment outcomes and triggers a plethora of additional human rights violations.

Countries that are beating the AIDS epidemic are doing so by repealing laws and policies that discriminate, by expanding human rights for all and by allowing marginalized communities to lead the response. The anti-rights backlash which threatens to undo much of the progress made in the global and national AIDS response needs to be challenged head on. To protect everyone’s health we need to protect everyone’s rights.

The Universal Declaration of Human Rights, the International Covenant on Economic, Social and Cultural Rights (ICESCR), and the WHO Constitution recognize the right of all people to the “highest attainable standard of physical and mental health.” Having ratified the ICESCR, Nigeria has an obligation of ensuring the availability, accessibility, acceptability and quality of health services and health promotion efforts and for addressing the underlying determinants of health. In the context of HIV, this requires, among many other things, that all people living with or at risk of HIV have meaningful access to person-centered health services that meet their needs.

Under international human rights law, Nigeria has an immediate obligation to guarantee the enjoyment of the right to health without discrimination. The enactment of the HIV/AIDS Anti-Discrimination Act -a national law on the protection of the rights of people living with or affected by HIV/AIDS from discrimination based on their HIV status, is indeed a right path towards fulfilling this obligation. However, 10 years after its passage, only about 19 states have domesticated the Act.

It has been demonstrated that scientific advances on their own cannot ensure the world will end AIDS as a public health threat by 2030. Indeed, the protection and promotion of human rights has been central to the successes of the global and national HIV response. The World AIDS Day commemoration presents an opportunity for Nigeria to strengthen its commitment towards ensuring that the human rights of all are respected, protected and fulfilled.

UNAIDS’ new report provides a clear roadmap: To end AIDS, take the rights path.

Link to UNAIDS Report – https://www.unaids.org/en/resources/documents/2024/take-the-rights-path-to-end-aids

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination against those living with HIV/AIDS, and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations — UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank — and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals.

Dr Leopold Zekeng, UNAIDS Country Director, Nigeria.

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