TODAY, marks World AIDS Day.
The past four decades have yielded enormous medical and scientific progress – but death and stigma remain. Many elude testing or die in shame, treatment does not reach all who need it, and inequality impedes our global response.
I can write this because life unexpectedly afforded me survival from AIDS.
Around Easter 1985, I became infected with HIV. There was no treatment: HIV meant certain death.
Like many, I kept my HIV status a secret. I hoped to escape death. No. Twelve years later, AIDS felled my body. I became terribly ill.
But my privileges gave me treatment and care. I had loving family and friends, and my job as a judge in South Africa. With early access to life-saving antiretroviral treatment (ARVs), I recovered.
In 1999, I spoke publicly about living with HIV and that ARVs – denied to millions in Africa – had saved me from death.
I remain one of the only public figures in Africa who speaks openly about being gay and living with HIV. I say this because shame, fear and discrimination still silence too many.
As a judge, and from my own deepest life experience, I have witnessed three facts. First, the destructive force of stigma and shame. Second, the damage punitive and discriminatory laws inflict on public health responses. Third, how insufficient legal protections make the cruel load of HIV infinitely worse.
Thus, to overcome AIDS, we must achieve greater equality for all.
It is laudable that UNAIDS’s new strategy highlights how “inequalities fuel the HIV epidemic and block progress towards ending AIDS”, and ending inequality is vital.
Punitive and discriminatory laws target key populations most at risk of HIV. The criminal law clenches the throat of good AIDS work. Stigma sits as a burden on the backs of those living with and at risk of HIV. It intensifies inequalities.
Intersectionality matters as the perils of discrimination mingle. A sex worker, who has a higher risk of contracting HIV, is attacked on numerous discriminatory grounds.
These laws do not merely “leave people behind”. They push those most at risk away from health and social services, increasing HIV infections.
UNAIDS executive director, Winnie Byanyima, recounted how stigma killed her brother, who had HIV “and would be living today but he was afraid to go to the clinic to fetch his ARVs”. Her conclusion? Stigma and discrimination kill.
Discrimination seeps into data and evidence collecting, where key populations are often under-represented. This is profoundly harmful. We do not know whether services are accessible and acceptable.
This reflects an extreme form of stigma – being wiped out.
How do you remove barriers to access services if you do not even see who they are crushing?
We can help by instilling and safeguarding democratic values and enabling legal environments.
The rule of law, freedom of expression, freedom to protest and other human rights matter. It means employing the law to empower rather than oppress. Fostering accountability for human rights violations, scrapping punitive laws, implementing awareness and education campaigns, and supporting civil society.
Through the decades, activists from all over the world secured life-saving gains in treatment for AIDS. The activists’ struggle was about life versus death, health versus sickness, science versus myths, discrimination versus equality – and how fair practices make sound public health sense and save lives. In South Africa, the activists challenged the denialist government in the highest Court – which ordered him to start providing ARVs.
Though there is no cure, AIDS is no longer a death sentence.
Twenty-four years after taking my first ARVs, I am living a vibrant life. Our challenge lies within ourselves, and our societies: to overcome discrimination and stigma and ensure life-saving treatments are equally and equitably accessible.
We can end AIDS by 2030. But to do so, we must respect, protect and fulfil the basic rights of those living with and at risk of HIV. With enough support, science and love, we can end AIDS.
Edwin Cameron is the Inspecting Judge of Correctional Services in South Africa.