0:00:00.310,0:00:04.326 Let's begin with a story. 0:00:04.326,0:00:06.277 Once upon a time -- 0:00:06.277,0:00:09.343 well actually less than two years ago -- 0:00:09.343,0:00:12.376 in a kingdom not so very far away, 0:00:12.376,0:00:14.127 there was a man 0:00:14.127,0:00:15.994 who traveled many miles 0:00:15.994,0:00:19.576 to come to work at the jewel in the kingdom's crown -- 0:00:19.576,0:00:22.160 an internationally famous company. 0:00:22.160,0:00:25.278 Let's call it Island Networks. 0:00:25.278,0:00:28.126 Now this kingdom had many resources 0:00:28.126,0:00:30.343 and mighty ambitions, 0:00:30.343,0:00:32.910 but the one thing it lacked was people. 0:00:32.910,0:00:36.343 And so it invited workers from around the world 0:00:36.343,0:00:38.993 to come and help it build the nation. 0:00:38.993,0:00:41.960 But in order to enter and to stay 0:00:41.960,0:00:45.495 these migrants had to pass a few tests. 0:00:45.495,0:00:47.978 And so it was, our man presented himself 0:00:47.978,0:00:49.747 to authorities in the kingdom, 0:00:49.747,0:00:52.945 looking forward to settling into his new life. 0:00:52.945,0:00:56.195 But then something unexpected happened. 0:00:56.195,0:00:59.795 The medical personnel who took blood samples from the man 0:00:59.795,0:01:03.478 never actually told him what they were testing for. 0:01:03.478,0:01:07.747 He wasn't offered counseling before or after the test, 0:01:07.747,0:01:10.078 which is best medical practice. 0:01:10.078,0:01:13.079 He was never informed of the results of the test. 0:01:13.079,0:01:15.195 And yet, a couple of weeks later, 0:01:15.195,0:01:18.229 he was picked up and taken to prison 0:01:18.229,0:01:20.763 where he was subjected to a medical exam, 0:01:20.763,0:01:23.514 including a full-body search 0:01:23.514,0:01:27.112 in full view of the others in the cell. 0:01:27.112,0:01:30.879 He was released, but then a day or two later, 0:01:30.879,0:01:35.848 he was taken to the airport and he was deported. 0:01:35.848,0:01:39.113 What on earth did this man do 0:01:39.113,0:01:41.263 to merit this treatment? 0:01:41.263,0:01:43.865 What was his terrible crime? 0:01:43.865,0:01:47.513 He was infected with HIV. 0:01:47.513,0:01:50.644 Now the kingdom is one of about 50 countries 0:01:50.644,0:01:54.916 that imposes restrictions on the entry or stay 0:01:54.916,0:01:57.516 of people living with HIV. 0:01:57.516,0:01:59.117 The kingdom argues 0:01:59.117,0:02:04.317 that its laws allow it to detain or deport foreigners 0:02:04.317,0:02:07.016 who pose a risk to the economy 0:02:07.016,0:02:10.516 or the security or the public health 0:02:10.516,0:02:12.633 or the morals of the state. 0:02:12.633,0:02:16.466 But these laws, when applied to people living with HIV, 0:02:16.466,0:02:19.848 are a violation of international human rights agreements 0:02:19.848,0:02:23.068 to which these countries are signatories. 0:02:23.068,0:02:24.316 But you know what? 0:02:24.316,0:02:25.799 Matters of principle aside, 0:02:25.799,0:02:30.784 practically speaking, these laws drive HIV underground. 0:02:30.784,0:02:33.382 People are less likely to come forth 0:02:33.382,0:02:37.416 to be tested or treated or to disclose their condition, 0:02:37.416,0:02:40.248 none of which helps these individuals 0:02:40.248,0:02:44.417 or the communities these laws purport to protect. 0:02:44.417,0:02:48.482 Today we can prevent the transmission of HIV. 0:02:48.482,0:02:51.901 And with treatment, it is a manageable condition. 0:02:51.901,0:02:54.732 We are very far from the days 0:02:54.732,0:02:57.918 when the only practical response to dread disease 0:02:57.918,0:03:00.498 was to have banished the afflicted -- 0:03:00.498,0:03:03.400 like this, "The Exile of the Leper." 0:03:03.400,0:03:06.617 So you tell me why, in our age of science, 0:03:06.617,0:03:09.183 we still have laws and policies 0:03:09.183,0:03:12.466 which come from an age of superstition. 0:03:12.466,0:03:15.733 Time for a quick show of hands. 0:03:15.733,0:03:18.998 Who here has been touched by HIV -- 0:03:18.998,0:03:22.082 either because you yourself have the virus 0:03:22.082,0:03:25.567 or you have a family member or a friend or a colleague 0:03:25.567,0:03:27.600 who is living with HIV? 0:03:27.600,0:03:28.700 Hands up. 0:03:28.700,0:03:30.681 Wow. Wow. 0:03:30.681,0:03:33.600 That's a significant number of us. 0:03:33.600,0:03:36.132 You know better than anyone 0:03:36.132,0:03:38.399 that HIV brings out 0:03:38.399,0:03:41.982 the best and the worst in humanity. 0:03:41.982,0:03:44.702 And the laws reflect these attitudes. 0:03:44.702,0:03:47.382 I'm not just talking about laws on the books, 0:03:47.382,0:03:50.749 but laws as they are enforced on the streets 0:03:50.749,0:03:53.682 and laws as they are decided in the courts. 0:03:53.682,0:03:56.232 And I'm not just talking about laws 0:03:56.232,0:03:58.601 as they relate to people living with HIV, 0:03:58.601,0:04:01.832 but people who are at greatest risk of infection -- 0:04:01.832,0:04:05.600 people such as those who inject drugs or sex workers 0:04:05.600,0:04:07.749 or men who have sex with men 0:04:07.749,0:04:09.632 or transgendered persons 0:04:09.632,0:04:12.100 or migrants or prisoners. 0:04:12.100,0:04:15.650 And in many parts of the world that includes women and children 0:04:15.650,0:04:17.681 who are especially vulnerable. 0:04:17.681,0:04:20.483 Now there are laws in many parts of the world 0:04:20.483,0:04:23.915 which reflect the best of human nature. 0:04:23.915,0:04:27.201 These laws treat people touched by HIV 0:04:27.201,0:04:30.100 with compassion and acceptance. 0:04:30.100,0:04:33.499 These laws respect universal human rights 0:04:33.499,0:04:36.183 and they are grounded in evidence. 0:04:36.183,0:04:39.316 These laws ensure that people living with HIV 0:04:39.316,0:04:41.432 and those at greatest risk 0:04:41.432,0:04:45.016 are protected from violence and discrimination 0:04:45.016,0:04:49.232 and that they get access to prevention and to treatment. 0:04:49.232,0:04:52.028 Unfortunately, these good laws 0:04:52.028,0:04:54.164 are counter-balanced by a mass 0:04:54.164,0:04:57.165 of really bad law -- 0:04:57.165,0:05:01.614 law which is grounded in moral judgement 0:05:01.614,0:05:04.467 and in fear and in misinformation, 0:05:04.467,0:05:08.566 laws which specifically punish people living with HIV 0:05:08.566,0:05:10.198 or those at greatest risk. 0:05:10.198,0:05:12.965 These laws fly in the face of science, 0:05:12.965,0:05:16.248 and they are grounded in prejudice 0:05:16.248,0:05:20.066 and in ignorance and in a rewriting of tradition 0:05:20.066,0:05:23.348 and a selective reading of religion. 0:05:23.348,0:05:25.965 But you know what? You don't have to take my word for it. 0:05:25.965,0:05:27.849 We're going to hear from two people 0:05:27.849,0:05:30.382 who are on the sharp end of the law. 0:05:30.382,0:05:32.583 The first is Nick Rhoades. He's an American. 0:05:32.583,0:05:36.581 And he was convicted under the U.S. State of Iowa's law 0:05:36.581,0:05:39.466 on HIV transmission and exposure -- 0:05:39.466,0:05:42.918 neither of which offense he actually committed. 0:05:42.918,0:05:46.116 (Video) Nick Rhoades: If something is against the law 0:05:46.116,0:05:47.315 then that is telling society 0:05:47.315,0:05:49.916 that is unacceptable, that's bad behavior. 0:05:49.916,0:05:52.486 And I think the severity of that punishment 0:05:52.486,0:05:56.175 tells you how bad you are as a person. 0:05:56.175,0:05:58.665 You're a class B felon, 0:05:58.665,0:06:01.449 lifetime sex offender. 0:06:01.449,0:06:05.482 You are a very, very, very bad person. 0:06:05.482,0:06:08.869 And you did a very, very, very bad thing. 0:06:08.869,0:06:11.424 And so that's just programmed into you. 0:06:11.424,0:06:14.657 And you go through the correctional system 0:06:14.657,0:06:16.458 and everyone's telling you the same thing. 0:06:16.458,0:06:21.422 And you're just like, I'm a very bad person. 0:06:21.422,0:06:23.387 Shereen El-Feki: It's not just a question 0:06:23.387,0:06:26.486 of unfair or ineffective laws. 0:06:26.486,0:06:28.587 Some countries have good laws, 0:06:28.587,0:06:31.237 laws which could stem the tide of HIV. 0:06:31.237,0:06:34.337 The problem is that these laws are flouted. 0:06:34.337,0:06:37.304 Because stigma gives unofficial license 0:06:37.304,0:06:39.621 to treat people living with HIV 0:06:39.621,0:06:40.937 or those at greatest risk 0:06:40.937,0:06:43.271 unlike other citizens. 0:06:43.271,0:06:44.970 And this is exactly what happened 0:06:44.970,0:06:48.184 to Helma and Dongo from Namibia. 0:06:48.184,0:06:49.911 (Video) Hilma: I found out 0:06:49.911,0:06:52.825 when I went to the hospital for a pregnancy check-up. 0:06:52.856,0:06:56.508 The nurse announced that every pregnant woman 0:06:56.508,0:06:58.603 must also be tested for HIV that day. 0:06:58.603,0:07:01.652 I took the test and the result showed I was positive. 0:07:01.652,0:07:04.248 That's the day I found out. 0:07:04.248,0:07:06.860 The nurse said to me, "Why should you people bcome pregnant 0:07:06.860,0:07:08.388 when you know you are HIV positive? 0:07:08.388,0:07:10.783 Why are you pregnant when you are living positive?" 0:07:10.783,0:07:13.772 I am sure now that is the reason they sterilized me. 0:07:13.772,0:07:18.904 Because I am HIV positive. 0:07:18.904,0:07:21.935 They didn't give the forms to me 0:07:21.950,0:07:25.672 or explain what was in the form. 0:07:25.672,0:07:28.072 The nurse just came with it 0:07:28.072,0:07:30.154 already marked where I had to sign. 0:07:30.154,0:07:32.098 And with the labor pain, 0:07:32.098,0:07:39.168 I didn't have the strength to ask them to read it to me. 0:07:39.168,0:07:41.697 I just signed. 0:07:41.712,0:07:44.850 SE: Hilma and Nick and our man in the kingdom 0:07:44.850,0:07:49.201 are among the 34 million people living with HIV 0:07:49.201,0:07:51.317 according to recent estimates. 0:07:51.317,0:07:53.185 They're the lucky ones 0:07:53.185,0:07:54.869 because they're still alive. 0:07:54.869,0:07:56.734 According to those same estimates, 0:07:56.734,0:08:00.718 in 2010 1.8 million people died 0:08:00.718,0:08:03.117 of AIDS related causes. 0:08:03.117,0:08:06.620 These are terrible and tragic figures. 0:08:06.620,0:08:11.051 But if we look a little more broadly into the statistics, 0:08:11.051,0:08:14.252 we actually see some reason for hope. 0:08:14.252,0:08:19.652 Looking globally, the number of new infections of HIV is declining. 0:08:19.652,0:08:22.103 And looking globally as well, 0:08:22.103,0:08:25.469 deaths are also starting to fall. 0:08:25.469,0:08:27.502 There are many reasons for these positive developments, 0:08:27.502,0:08:29.635 but one of the most remarkable 0:08:29.635,0:08:32.802 is in the increase in the number of people around the world 0:08:32.802,0:08:34.985 on anti-retroviral therapy, 0:08:34.985,0:08:39.118 the medicines they need to keep their HIV in check. 0:08:39.118,0:08:41.151 Now there are still many problems. 0:08:41.151,0:08:44.501 Only about half of the people who need treatment 0:08:44.501,0:08:46.734 are currently receiving it. 0:08:46.734,0:08:48.586 In some parts of the world -- 0:08:48.586,0:08:50.935 like here in the Middle East and North Africa -- 0:08:50.935,0:08:54.318 new infections are rising and so are deaths. 0:08:54.318,0:08:57.469 And the money, the money we need 0:08:57.469,0:08:59.402 for the global response to HIV, 0:08:59.402,0:09:02.398 that is shrinking. 0:09:02.398,0:09:04.687 But for the first time 0:09:04.687,0:09:07.905 in three decades into this epidemic 0:09:07.905,0:09:12.022 we have a real chance to come to grips with HIV. 0:09:12.022,0:09:13.988 But in order to do that 0:09:13.988,0:09:17.887 we need to tackle an epidemic of really bad law. 0:09:17.887,0:09:19.505 It's for this reason 0:09:19.505,0:09:21.635 that the Global Commission on HIV and the Law, 0:09:21.635,0:09:22.934 of which I'm a member, 0:09:22.934,0:09:26.000 was established by the agencies of the United Nations -- 0:09:26.000,0:09:28.650 to look at the ways that legal environments 0:09:28.650,0:09:30.667 are affecting people living with HIV 0:09:30.667,0:09:32.801 and those at greatest risk, 0:09:32.801,0:09:34.551 and to recommend what should be done 0:09:34.551,0:09:37.787 to make the law an ally, not an enemy, 0:09:37.787,0:09:40.519 of the global response to HIV. 0:09:40.519,0:09:42.868 Let me give you just one example 0:09:42.868,0:09:45.518 of the way a legal environment 0:09:45.518,0:09:48.084 can make a positive difference. 0:09:48.084,0:09:50.899 People who inject drugs 0:09:50.899,0:09:52.714 are one of those groups I mentioned. 0:09:52.714,0:09:54.835 They're at high risk of HIV 0:09:54.835,0:09:56.700 through contaminated injection equipment 0:09:56.700,0:09:59.382 and other risk-related behaviors. 0:09:59.382,0:10:03.064 In fact, one in every 10 new infections of HIV 0:10:03.064,0:10:05.798 is among people who inject drugs. 0:10:05.798,0:10:08.399 Now drug use or possession 0:10:08.399,0:10:10.548 is illegal in almost every country. 0:10:10.548,0:10:14.798 But some countries take a harder line on this than others. 0:10:14.798,0:10:17.482 In Thailand people who use drugs, 0:10:17.482,0:10:20.333 or are merely suspected of using drugs, 0:10:20.333,0:10:22.199 are placed in detention centers, 0:10:22.199,0:10:24.116 like the one you see here, 0:10:24.116,0:10:26.199 where they are supposed to clean up. 0:10:26.199,0:10:29.131 There is absolutely no evidence 0:10:29.131,0:10:31.982 to show that throwing people into detention 0:10:31.982,0:10:34.315 cures their drug dependence. 0:10:34.315,0:10:36.482 There is, however, ample evidence 0:10:36.482,0:10:38.482 to show that incarcerating people 0:10:38.482,0:10:43.700 increases their risk of HIV and other infections. 0:10:43.700,0:10:49.350 We know how to reduce HIV transmission and other risks 0:10:49.350,0:10:51.115 in people who inject drugs. 0:10:51.115,0:10:53.246 It's called harm reduction, 0:10:53.246,0:10:55.030 and it involves, among other things, 0:10:55.030,0:10:58.161 providing clean needles and syringes, 0:10:58.161,0:11:00.996 offering opioid substitution therapy 0:11:00.996,0:11:03.262 and other evidence-based treatments 0:11:03.262,0:11:05.512 to reduce drug dependence. 0:11:05.512,0:11:08.029 It involves providing information 0:11:08.029,0:11:10.047 and education and condoms 0:11:10.047,0:11:13.178 to reduce HIV transmission, 0:11:13.178,0:11:15.695 and also providing HIV testing 0:11:15.695,0:11:17.528 and counseling and treatment 0:11:17.528,0:11:19.346 should people become infected. 0:11:19.346,0:11:22.879 Where the legal environment allows for harm reduction 0:11:22.879,0:11:25.133 the results are striking. 0:11:25.133,0:11:26.963 Australia and Switzerland 0:11:26.963,0:11:29.564 were two countries which introduced harm reduction 0:11:29.564,0:11:32.264 very early on in their HIV epidemics, 0:11:32.264,0:11:35.283 and they have a very low rate of HIV 0:11:35.283,0:11:37.446 among injecting drug users. 0:11:37.446,0:11:39.797 The U.S. and Malaysia 0:11:39.797,0:11:42.347 came to harm reduction a little later, 0:11:42.347,0:11:46.314 and they have higher rates of HIV in these populations. 0:11:46.314,0:11:47.997 Thailand and Russia, however, 0:11:47.997,0:11:49.899 have resisted harm reduction 0:11:49.899,0:11:51.631 and have stringent laws 0:11:51.631,0:11:53.197 which punish drug use. 0:11:53.197,0:11:54.697 And hey, surprise, 0:11:54.697,0:12:00.064 very high rates of HIV among people who are injecting drugs. 0:12:00.064,0:12:02.930 At the Global Commission we have studied the evidence, 0:12:02.930,0:12:04.681 and we've heard the experiences 0:12:04.681,0:12:09.014 of over 700 people from 140 countries. 0:12:09.014,0:12:11.272 And the trend? Well the trend is clear. 0:12:11.272,0:12:14.597 Where you criminalize people living with HIV 0:12:14.597,0:12:15.963 or those at greatest risk, 0:12:15.963,0:12:18.712 you fuel the epidemic. 0:12:18.712,0:12:22.981 Now coming up with a vaccine for HIV 0:12:22.981,0:12:24.182 or a cure for AIDS -- 0:12:24.182,0:12:26.680 now that's rocket science. 0:12:26.680,0:12:28.463 But changing the law isn't. 0:12:28.463,0:12:31.176 And in fact, a number of countries are starting to make progress 0:12:31.176,0:12:32.759 on a number of points. 0:12:32.759,0:12:36.797 To begin, countries need to review their legislation 0:12:36.797,0:12:40.329 as it touches HIV and vulnerable groups. 0:12:40.329,0:12:42.446 On the back of those reviews, 0:12:42.446,0:12:44.412 governments should repeal laws 0:12:44.412,0:12:47.580 that punish or discriminate against people living with HIV 0:12:47.580,0:12:49.797 or those at greatest risk. 0:12:49.797,0:12:52.313 Repealing a law isn't easy, 0:12:52.313,0:12:54.097 and it's particularly difficult 0:12:54.097,0:12:58.380 when it relates to touchy subjects like drugs and sex. 0:12:58.380,0:13:01.947 But there's plenty you can do while that process is underway. 0:13:01.947,0:13:06.246 One of the key points is to reform the police 0:13:06.246,0:13:09.063 so that they have better practices on the ground. 0:13:09.063,0:13:10.818 So for example, outreach workers 0:13:10.818,0:13:13.818 who are distributing condoms to vulnerable populations 0:13:13.818,0:13:16.934 are not themselves subject to police harassment 0:13:16.934,0:13:19.884 or abuse or arbitrary arrest. 0:13:19.884,0:13:21.385 We can also train judges 0:13:21.385,0:13:24.552 so that they find flexibilities in the law 0:13:24.552,0:13:27.702 and so that they rule on the side of tolerance 0:13:27.702,0:13:29.601 rather than prejudice. 0:13:29.601,0:13:31.119 We can retool prisons 0:13:31.119,0:13:34.484 so that HIV prevention and harm reduction 0:13:34.484,0:13:36.704 is available to prisoners. 0:13:36.704,0:13:41.219 The key to all this is reinforcing civil society. 0:13:41.219,0:13:42.902 Because civil society is key 0:13:42.902,0:13:45.768 to raising awareness among vulnerable groups 0:13:45.768,0:13:47.552 of their legal rights. 0:13:47.552,0:13:49.169 But awareness needs action. 0:13:49.169,0:13:50.635 And so we need to ensure 0:13:50.635,0:13:52.968 that these people who are living with HIV 0:13:52.968,0:13:54.635 or at greatest risk of HIV 0:13:54.635,0:13:57.369 have access to legal services 0:13:57.369,0:14:00.285 and they have equal access to the courts. 0:14:00.285,0:14:02.986 And also important is talking to communities 0:14:02.986,0:14:05.135 so that we change interpretations 0:14:05.135,0:14:07.635 of religious or customary law, 0:14:07.635,0:14:09.453 which is too often used 0:14:09.453,0:14:12.936 to justify punishment and fuel stigma. 0:14:12.936,0:14:14.184 For many of us here 0:14:14.184,0:14:17.703 HIV is not an abstract threat. 0:14:17.703,0:14:20.202 It hits very close to home. 0:14:20.202,0:14:22.719 The law, on the other hand, 0:14:22.719,0:14:27.152 can seem remote, arcane, the stuff of specialists, 0:14:27.152,0:14:29.234 but it isn't. 0:14:29.234,0:14:32.119 Because for those of us who live in democracies, 0:14:32.119,0:14:34.435 or in aspiring democracies, 0:14:34.435,0:14:37.452 the law begins with us. 0:14:37.452,0:14:40.385 Laws that treat people living with HIV 0:14:40.385,0:14:43.053 or those at greatest risk with respect 0:14:43.053,0:14:47.901 start with the way that we treat them ourselves: as equals. 0:14:47.901,0:14:52.535 If we are going to stop the spread of HIV in our lifetime, 0:14:52.535,0:14:56.202 then that is the change we need to spread. 0:14:56.202,0:14:57.601 Thank you. 0:14:57.601,0:15:05.435 (Applause)