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[Dear subscribers, a reminder that the UNDP-run e-discussion on "The Global Commission on HIV and the Law - Taking the Commission's Recommendations Forward" continues, with Phase I wrapping up 11 July. Below are three recent contributions to the discussion.]
 

Experiences, good practices and lessons learned in supporting the implementation of the recommendations of the Global Commission on HIV and the Law

[Facilitator’s note: Please find below responses, received with many thanks, from Maung Maung Kyaw, UNDP Myanmar; Ian Milimo, UNDP Zambia; and Claudia Morales, UNDP El Salvador to phase I of the e-discussion on “The Global Commission on HIV and the Law – Taking the Commission’s Recommendations Forward”. We look forward to receiving additional responses to phase I by Thursday 11 July. Responses can be posted online here, or alternatively via email to hivlawdiscussion@unteamworks.org. Kindly note that the discussion platform is publicly accessible. This e-discussion is organized by UNDP’s HIV, Health and Development-Net and the Network for UNDP’s Partnership with the Global Fund, and cross-posted on the UN Human Rights Policy Network – HuriTALK, DGP-Net, Gender-Net, the Asia Pacific Community of Practice on HIV, Gender and Human Rights (HIV-APCoP), the joint United Nations Initiative on Mobility and HIV/AIDS in South East Asia (JUNIMA), the UNICEF HIV/AIDS Community of Practice, the Interagency Task Team HIV and Young People Community of Practice and the Global Commission on HIV and the Law mailing list. Thank you.]


Maung Maung Kyaw, UNDP Myanmar:

Question 1: What actions have been taken in your country to follow-up on the findings and recommendations of the Commission or to promote an enabling legal environment for AIDS responses?

I would like to respond discussing the following for both questions.

UNDP Myanmar’s HIV/AIDS project started its activities in 1992.  As one of a very few agencies having the capacity to readily respond to the threat of AIDS at that time, UNDP incorporated its HIV activities as a major component of its Human Development Initiative (HDI) Programme in Myanmar.

The HDI programme (1992-2012) emphasizes the involvement of communities to address their needs and aspirations formulating their own strategies to resolve their current situation. The same principle is employed by HIV/AIDS component of HDI, addressing HIV and AIDS through civil society organizations, at the same time, implementing target specific HIV prevention interventions to individuals at risk.

Beyond working at the community level, UNDP has also supported successful policy initiatives such as policy and legal reform on HIV/AIDS, impact mitigation strategy. etc. The HIV/AIDS project helped civil society networks to establish strong working relationships with national counterparts on the formulation of HIV/AIDS policy and strategy.

The project addressed the capacity need for enhancement of meaningful participation of people living with HIV (PLHIV) in national response. Civil society organizations, including people living with HIV, faith based and community based organizations, plays a crucial role in the response to HIV in Myanmar. These organizations provide services to key and vulnerable population groups at the field level by outreach activities and facilitate community leadership and guidance, advocate in the interests of affected communities and assist mobilization of human, financial and material resources to support HIV interventions. Furthermore, Myanmar's National Strategic Plan and Operational Plan on HIV and AIDS (2011-2015) has described that legal reform and community systems strengthening are the essential cross cutting interventions for its all strategic priorities.

More importantly, the project supported to conduct the capacity and needs assessment of Myanmar Positive Women Network (MPWN) by using the Network capacity analysis toolkit covers six areas of capacity including involvement and accountability, leadership, knowledge and skills, internal communication, advocacy and external communication as well as the community based organization capacity tool kit includes, inter alia, governance and strategy, project design and management, technical capacity. Follow up trainings were provided as identified by the assessment process to Self Help Groups members of Myanmar Positive Group (MPG), MPWN groups’ leaders, MSM and Sex Workers.

The project also provided the right based programming trainings to networks of key affected populations such as Myanmar MSM network and Sex Workers network in Myanmar (SWIM), which included training on human rights and HIV, legal aid training, training on monitoring and documentation skill for HIV and human rights. Moreover, the project supported to conduct the strategic planning workshop and team building training.  

The project supported to conduct a preliminary study on the socioeconomic impact of HIV at the household level which aimed not only to be a research study but also a learning process for the individuals including infected ones, MSM and sex workers. A participatory enhancement approach was used to involve those individuals from the designing of the research study to the analysis of data to inform an ongoing cycle of participation and reflection. Through these initiatives, the capacities of those individuals are enhanced and empowered. Nowadays, those individuals (people living with HIV, men who have sex with men (MSM) and sex workers) are being engaged in the advocacy and policy initiatives toward legal reform in Myanmar. This is, (these are), the best practice (s) that UNDP HIV/AIDS project has initiated.

The impact of the project's initiatives mentioned-above, many sex workers dare to come to the tables and stages from hidden behind the curtains, expressing their voices for rights and entitlements etc... together with law enforcement officials like representatives from Myanmar Police Force and Judges from the Supreme Court of the Union at the meetings and discussions at the National Working Group of "Sex work and Violence Study - Understanding Factors for Safety and Protection", which is a UNDP led initiative, in collaboration with Myanmar Positive Network, Sex Workers Network in Myanmar (SWIM), Asia Pacific Network of sex workers (APNSW), Department of Health (Ministry of Health), National AIDS Programme, Department of Social Welfare (Ministry of Social Welfare, Relief and Resettlement), Myanmar Police Force (Ministry of Home Affairs), Supreme Court of the Union, UNAIDS, UNFPA and civil societies comprising NGOs. The study was technically and financially supported by the HIV, Health and Development Practice Team at UNDP's Asia Pacific Regional Centre.

The main processes of this study are qualitative interviews with sex workers including female, male and transgender from diverse settings where sex work takes place by trained peer sex worker interviewers and key informant interviews with police, justice, department of social welfare, department of health and clients of sex workers, brothel owners, and entertainment venues. One of the objectives of study is to inform policy and programmes to prevent and respond effectively to violence against female, male and transgender sex workers.

National Dialogues for developing action plans of the study were taken place that would support changing the legal environment. The study also sensitized law enforcement officials on human rights violation and sex work.

Sex Workers of the members of the national working group of the study are the most active ones in leading the processes including training for surveying processes. No discriminatory act was seen along the course of the processes. It was shown "Sex workers are also human beings".

Although the title of the study is culturally sensitive, all the implementing partners including law enforcement officials such as police and judges were well convinced on the processes of the study, which is now on-going. The main challenge of the study is the delayed approval process of government side.

With best regards,
Maung Maung Kyaw

Maung Maung Kyaw (Mr)
Programme Manager
HIV Focal Point for UNDP Myanmar
United Nations Development Programme,  Myanmar
6 Natmauk Road, Tamwe Township
Yangon 11211, Myanmar
maung.maung.kyaw@undp.org
Tel: +95 1 542910 to 542919, Ext:321
Fax: + 95 1 545634 & 544531
www.undp.org  Follow us: cid:image003.png@01CC8762.CBA6C1F0  cid:image004.jpg@01CC8762.CBA6C1F0  cid:image005.png@01CC8762.CBA6C1F0


 Ian Milimo, UNDP Zambia:

Question 1: What actions have been taken in your country to follow-up on the findings and recommendations of the Commission or to promote an enabling legal environment for AIDS responses?

Implementation of the Global Commission on HIV and AIDS and law recommendations in Zambia.

Introduction

Aside from being a chronic health condition, HIV/AIDS has brought critical challenges regarding human rights and the dignity of people infected and affected by the pandemic. This has resulted in heavy social and economic costs to society in Zambia, with the price paid in terms of slowing down human well-being and development. The Constitution recognizes that all Zambians are equal and have the same freedoms, rights and dignities. The 2011–2015 National AIDS Strategic Framework (NASF), recognizes the need for Zambia to include the issues of minorities and key populations and their inherent human rights in the HIV and AIDS response. Despite this national policy direction, Zambia has recorded mixed messages and progress in realizing this goal. Progress in some areas and challenges in others have therefore been encountered in implementing the recommendations contained in the Global Commission on HIV and AIDS and law.

Success

National AIDS Council Leadership: Ever since the Global Commission on HIV and AIDS released its recommendations, the National HIV/AIDS/STI/TB Council (NAC) has committed itself to ensuring that the country is sensitized and that these recommendations are implemented. The consultations held by NAC with multiple stakeholders and the open space and facilitation they have provided has been appreciated by the different stakeholders.  NAC has been generally regarded as accommodating to hear different views and to understand the issues faced by key populations. The role and leadership of NAC is vital to provide the space and support for domesticating the recommendations of the Global Commission on HIV and AIDS. However, other arms of the state have to also be brought on board to agree to take this approach and further dialogue and consultations are needed in this regard. Having a broad based collation of government and civil society organisations engaged and moving closer on to the same page with regards these issues, is needed to further strengthen the response on the ground. NACs continued leadership of this effort will then ensure that the recommendations of the Global Commission are incorporated in the new National AIDS Strategic Framework (NASF) and the subsequent Operational Plan. This way, these recommendations become integral to the Zambian National Aids response.  

Technical Working Group Reinvigorated: As a result of the influence of the Global Commission’s report on HIV and Law, NAC has reinvigorated the National Technical Working Group on Key Populations. This is important as it brings together people with technical and professional expertise and knowledge on issues of key populations and how best to respond to their needs. There is a need to ensure the right data and evidence base upon which to make the right policy decisions. This will also ensure sound technical programming of key issues using a human rights approach.

The Research agenda: This year alone, the Government of the Republic of Zambia has authorized two critical pieces of research that is being conducted by Population Council and Panos Institute Southern Africa. This research is focusing on size estimation, risk of HIV infection using biological and behavioral markers on key populations. The exercises are being undertaken in a phased manner starting with documenting the numbers, needs and experiences of sex workers. This information is important for human rights-based programming as it will not only inform the National AIDS response with the extent but with key interventions that need to be costed and supported. However, this data should not be used to endanger the lives or make more vulnerable the situation of these groups. 

Question 2: What have been the most difficult issues to address in supporting implementation of the Commission’s recommendations?

Challenges

Despite the progress outlined under question 1, there are several challenges and set-backs that have occurred that impede the full realization of Global Commission on HIV and Law’s recommendations.

The law: The current laws of The Republic of Zambia under the Penal Code, states that “any person who has carnal knowledge of any person against the order of nature, or permits a male person to have carnal knowledge of him or her against the order of nature; commits a felony and liable, upon conviction, to imprisonment for a term not less than fifteen years and may be liable to imprisonment for life.” The implication is that key populations are then prohibited from accessing Public Health services for if they are identified to have been practicing the aforementioned they could face a criminal charge accordingly.  Zambia has witnessed in recent times people being arrested and subjected to forced medical examinations to prove they are engaging in anal sex.

Societal norms/expectations: In Zambia, society expects every man to marry a woman or vice versa.  Anything against this expectation is regarded as being against Zambian culture, and against the Christian religion. For example, in recent times, the media has reported that two young men were reported to Police by their own relatives on grounds that they were engaging in homosexual acts. Furthermore, the media has in recent times also reported of a mother who died upon learning that her son was someone’s “wife”. These are a few cases of the strong uncompromising traditional beliefs that have served as bottlenecks in bringing the work of the Commission to the community level. The use of religion and culture as setting these norms are very much in the public domain.

Advocacy: The Civil Society movement faces many challenges in sensitizing and educating the public on issues affecting key populations in Zambia due to the above mentioned pressures, limited funding, legal issues and lack of coordination among CSOs themselves among others. For example, early this year, Zambia witnessed the demise of the Zambia AIDS Law Research and Advocacy Network, an organization that pioneered Zambia’s work on HIV and Law, due to lack of funding. This development will not only affect the ability to take the Global Commission’s recommendation further,  but will also  inhibit Zambia’s capacity to internalize issues articulated in the global report.

Conclusion

Zambia has demonstrated positive strides towards the realization of the recommendations of the Commission.  But this effort is not without limitations.  The overall response is not an aggressive one – neither for nor against. And the key national stakeholders involved, including the key populations, do not seem to wish to engage in a frontal public battle on this score. This space and the local pace for change must be respected. On the policy level, especially in the context of HIV and AIDS, there has been recognition of the need for harm reduction with respect to key populations.  However, aside from these policy reforms that are needed, there are significant ideological challenges fueled by social, religious and cultural norms that fail to respect and embrace difference.  Advances to the full realization of the goals of the Commission will require strong legal reorientation as well as positive advocacy for societal change, in order to fully realize the human rights of marginalized populations.  

Ian Milimo
Assistant Resident Representative/Poverty and MDGs
UN House
P.O.Box 31966
Lusaka, ZAMBIA
Tel: (260-211) 250 800 /251 172
Fax: (260-211) 253 805


Claudia Morales, UNDP El Salvador:

For a translation of this contribution, please click here and select ‘English (or other language of your choice) from the Google Translate button on top of the discussion platform (no log-in required):  

¿Qué medidas se han adoptado en su país para dar continuidad a los hallazgos y las recomendaciones de la Comisión o para promover un entorno jurídico favorable a las respuestas al SIDA? ¿Qué prácticas idóneas o lecciones han surgido de estas actividades?

ANTECEDENTES

El Salvador es un país pequeño (21,000 km2)  que cuenta con 5.9 millones de habitantes distribuidos en 14 departamentos y 262 municipios. A pesar de su reducido tamaño, existen dificultades para que los servicios de prevención y atención  del VIH alcancen las zonas rurales más alejadas del País. Las acciones se concentran en las zonas urbanas en las principales ciudades y zonas más pobladas.

En El Salvador, el VIH SIDA continúa siendo un reto importante a superar en el cumplimiento de los Objetivos de Desarrollo del Milenio. De acuerdo a datos oficiales se reportan 27,700 casos de VIH y SIDA y 1,600 casos nuevos cada año.

La epidemia se concentra en poblaciones con condiciones de mayor riesgo y vulnerabilidad. Las trabajadoras sexuales, los hombres que tienen sexo con hombres y las mujeres trans son las poblaciones con más altos índices de prevalencia del VIH/SIDA (5.7%, 10.8% y 19.7% respectivamente). Las personas entre 15 y 49 años ocupan más del 70% de los nuevos casos.

En materia de derechos humanos, El Salvador ha tenido avances significativos. Existe una Ley de VIH que aborda los principales aspectos, sin embargo aún adolece de algunas debilidades. Existe también un Plan Estratégico Nacional Multisectorial que ha sido construido con la participación de la mayoría de actores relevantes de la respuesta nacional, incluyendo gobierno, sociedad civil y personas afectadas. El Gobierno de El Salvador ha impulsado acciones tendientes a la protección de los Derechos Humanos de las personas afectadas con el VIH y las poblaciones en condiciones vulnerables, tales como: la descentralización de la atención al VIH incluyendo clínicas especializadas para trabajadoras sexuales, hombres que tienen sexo con hombres y mujeres trans; la promulgación de decretos en contra del estigma y la discriminación por orientación sexual; el reconocimiento legal a las organizaciones de la sociedad civil de los grupos más vulnerables y de la diversidad sexual; la creación del Departamento de Diversidad Sexual en la Secretaría de Inclusión Social, entre otros.

Se cuenta con una sociedad civil muy activa y organizada, lo que contribuye a que la respuesta nacional al VIH sea muy efectiva. Las organizaciones de la sociedad civil han sido capacitadas y fortalecidas por organismos de cooperación y el gobierno para actuar a favor de los colectivos que éstas representan. Ejecutan proyectos con financiamiento de diversas fuentes, apoyando la función del gobierno en la atención y prevención del VIH. La sociedad civil ha tenido además, un importante papel en la construcción de las propuestas de país y en la conformación de los planes nacionales en la respuesta al VIH.

El PNUD ha sido Receptor Principal del GFATM desde 2003, y ha tenido una participación relevante en la construcción de las propuestas que han abordado muchos aspectos relativos a la protección de los Derechos Humanos de las personas afectadas con el VIH y poblaciones más vulnerables. Entre las acciones abordadas por las subvenciones del Fondo Mundial se destaca la creación dentro de la Procuraduría para la Defensa de los Derechos Humanos (Oficina del Ombudsman) de un Departamento de Derechos Humanos y VIH, en donde se presentan y resuelven casos de violaciones presentadas por personas con VIH o grupos más vulnerables a la infección. La unidad ha sido asumida por la oficina del Ombudsman con recursos del Estado después de finalizado el proyecto.

Adicionalmente, el PNUD y las organizaciones de la sociedad civil han venido realizando un amplio trabajo en la sensibilización y capacitación sobre no estigma y discriminación hacia funcionarios de las principales instituciones que prestan de servicios a las personas con VIH  (Policía, fiscales,  personal del órgano judicial y personal de salud).

ACCIONES EN RESPUESTA A LAS RECOMENDACIONES DE LA COMISION GLOBAL

En mayo de 2012 con el soporte técnico del equipo del Centro Regional de Panamá, se realizó el Dialogo Nacional sobre VIH y la Ley, impulsado por las conclusiones y recomendaciones del Diálogo Regional que tuvo lugar en Sao Paulo, Brasil en Junio de 2011. El Diálogo de País en El Salvador, fue convocado por el Ombudsman y contó con el apoyo de un grupo de 17 representantes de la Sociedad Civil y de la cooperación internacional quienes tuvieron a su cargo la promoción del evento y la revisión de los casos de buenas prácticas en la aplicación de las leyes y violaciones a Derechos Humanos presentados por las personas afectadas.

Se revisaron 50 casos de violaciones en los temas de: Usuarios de drogas, Trabajo sexua, Relaciones sexuales entre personas del mismo sexo, Privados de Libertad, Niños y niñas, Discriminación contra las mujeres, Acceso al tratamiento y Discriminación laboral

Los casos de violaciones a derechos de privados de libertad, acceso al tratamiento y discriminación laboral destacaron en un mayor número sobre los casos presentados en el resto de temas.

Se examinaron casos de éxito como el apoyo a las mujeres, investigaciones en temas de drogas y asesoramiento en derechos humanos tanto por sociedad civil y el gobierno.

Del Dialogo Nacional se emitió un Informe Final, que fue presentado en la Comisión Nacional contra el Sida, CONASIDA y compartido con los socios relevantes.

ACCIONES DE SEGUIMIENTO

A través de la oficina del Ombudsman, se han revisado los casos presentados en el Diálogo Nacional y se ha dado seguimiento individual para la resolución de aquellos en donde se requiere una acción del estado. Por ejemplo, los casos relativos a niños y niñas con VIH a raíz de la aplicación de una nueva ley de la Niñez han generado reuniones de revisión y un estudio sobre los niños viviendo en orfanatos que han sido devueltos a sus comunidades de origen ha sido ordenado por el Consejo Nacional de la Niñez y Adolescencia. Se espera que del análisis del estudio, se produzcan decisiones respecto a la situación de los niños y las niñas con VIH en general.

En noviembre de 2012, Parlamentarios de los principales partidos, miembros del gobierno y de la oficina del Ombudsman fueron invitados al evento de lanzamiento de las Recomendaciones de la Comisión Global en Panamá. Los asistentes se comprometieron a conformar un plan de trabajo del que emergieron acciones políticas y operativas en relación a las recomendaciones de la Comisión.

El Salvador a través de la Comisión Nacional contra el Sida, ha venido revisando la Ley de VIH en conjunto con la sociedad civil, agencias de cooperación y ONUSIDA. En Abril del presente año, un nuevo borrador fue sometido a consulta nacional. El PNUD ha provisto de apoyo financiero y técnico para realizar la consulta y asegurar que la nueva Ley propuesta no contenga artículos violatorios a los derechos humanos y no se penalice la transmisión del VIH. Las recomendaciones están pendientes de ser incorporadas al nuevo proyecto y se está dando seguimiento.

El PNUD en conjunto con la oficina del Ombudsman y la Red Nacional de Mujeres Trans de El Salvador, REDTRANSAL condujo un estudio sobre el estado de los DDHH de ese colectivo, arrojando importantes aspectos a ser considerados para la protección de sus derechos. Entre ellos se destacó la necesidad de una Ley de Identidad de Género, como inicio al reconocimiento de otros derechos no menos importantes. En esa línea, el PNUD ha iniciado una alianza con la REDTRANSAL para apoyar la redacción y presentación de una Ley de Identidad de Género a la Asamblea Legislativa, lo cual apoya en una de sus partes más importantes, el plan de incidencia formulado por la Red.

LECCIONES APRENDIDAS

El diálogo nacional sobre el VIH y la Ley, así como las acciones de seguimiento a las recomendaciones de la Comisión Global han arrojado importantes lecciones aprendidas para el gobierno y la sociedad civil, entre las que destacan:

  • La necesidad de un diálogo más cercano con las personas afectadas ya que a pesar de la importante colaboración entre el gobierno y la sociedad civil, se requiere mantener un mecanismo de comunicación con las personas afectadas directamente. Los casos vistos develaron con dramatismo algunas situaciones que ameritan la toma de decisiones y sobre todo la investigación por las autoridades de una manera inmediata.
  • Es necesario cubrir vacíos importantes en las leyes existentes y la creación de nuevas leyes para avanzar en la protección de los derechos no solamente de las personas con VIH sino también de los grupos en condiciones de vulnerabilidad. Todavía existen leyes que contienen artículos con consecuencias negativas, vacíos en la legislación y sobre todo casos de no aplicación de leyes, por lo que se hace necesario el involucramiento del sistema judicial en el análisis y propuesta de modificación o creación de leyes que favorezcan un ambiente libre de discriminación y penalización de prácticas que por sí no constituyen ningún delito.
  • A pesar de que El Salvador cuenta con un cuerpo importante de leyes y decretos que protegen los derechos humanos de las personas con VIH y los grupos vulnerables, es la aplicación de dichas leyes lo que reviste de más importancia. En tal caso la capacitación y formación en los prestadores de servicios además de la existencia de mecanismos sancionatorios para asegurar su cumplimiento es lo que propicia un entorno favorable.

¿Cuáles han sido los temas más difíciles de abordar en el apoyo a la implementación de las recomendaciones de la Comisión? ¿Qué enfoques han empleado para encarar estos desafíos?

RETOS

A pesar del liderazgo del Ministerio de Salud en la rectoría de la política nacional de VIH y en la conducción de la CONASIDA, un reto grande para El Salvador en el tema de derechos humanos es el involucramiento del sistema judicial: jueces, fiscales, procuraduría de la república, abogados, entre otros, en la respuesta nacional al VIH.

En El Salvador, a pesar de que no existen leyes que criminalizan algunas prácticas como las relaciones HSH, el consumo de drogas, el trabajo sexual, si existen decretos municipales y prácticas por las autoridades que criminalizan y violan los DDHH de los colectivos de poblaciones vulnerables. Esto hace que vivan marginalizados  y carezcan de acceso a servicios básicos de salud y prevención, lo que incrementa el riesgo de adquirir el VIH.

Es importante el involucramiento de las autoridades locales en la respuesta al VIH, ya que las ordenanzas y decretos de gobiernos locales en muchos casos penalizan algunas prácticas como el trabajo sexual y las relaciones entre personas del mismo sexo. Los cuerpos de policía local están sujetos a hacer cumplir los decretos municipales, lo que favorece conductas violatorias a los derechos humanos y los abusos de autoridad.

Claudia Morales
PNUD El Salvador

https://www.unteamworks.org/sites/all/modules/fileframework/icons/acrobat.gif4Informe Diálogo Nacional 29-11, 12Maquetado.pdf


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