Buse Kent, Eba Patrick, Sigurdson Jason, Thomson Kate, Timberlake Susan
UNAIDS.
Health Hum Rights. 2013 Jun 14;15(1):E96-110.
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.
尽管艾滋病仍然是主要死因，尤其在低收入和中等收入国家，但应对艾滋病的行动极大地推动了全球对健康挑战的应对转变。通过将行动主义、政治领导力、国内外投资以及对结果的问责相结合，疫情的发展轨迹已发生根本改变。自应对行动开始的第一天起，艾滋病毒感染者及其他直接受疫情影响的人就发挥了巨大的领导作用：他们努力消除基于血清状态、性别、性取向、残疾、移民身份、吸毒或参与性工作的歧视。这种动员行动有的采取了战略诉讼的形式，将人权诉求转化为具体要求，并确定社会、健康、法律和经济政策。全球艾滋病应对行动表明，健康的核心在于社会正义、人权和问责等考量因素。随着制定《全球健康框架公约》（FCGH）的势头渐强，我们认为有机会总结应对艾滋病毒的经验教训，并确保这些经验在最终的公约中得到推广和制度化。我们认为，艾滋病毒应对行动取得成功的最关键因素是民间社会的领导力和行动主义。公约本身不会带来成果，预计FCGH也不会例外。成功需要积极监测进展和不足，同时进行政治和社会动员，以扩大投资并提供保护和促进健康的服务及基础条件。虽然FCGH必须将民间社会的支持和参与作为一项不可或缺的原则，但艾滋病运动可为其通过贡献实质性内容并进行动员。一个广泛的国际健康法律框架有助于应对一些持续阻碍有效应对艾滋病毒的关键法律、政策、监管和方案挑战。因此，艾滋病应对行动可能会从这样一项公约所产生的规范和体制框架以及对实现健康权的更大承诺中受益匪浅。
