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