To defeat pandemics, put human rights at the center of global health

This article is written by Steven L.B. Jensen, Senior Researcher, the Danish Institute for Human Rights and Ralf Jürgens, Senior Technical Coordinator, Human Rights and Investment Support, The Global Fund to Fight AIDS, Tuberculosis and Malaria. It was first published in Danish on Globalnyt.dk on 31 July 2020.

In 2020, global health has taken center stage once again as a deadly pandemic rages. We have been here before with the AIDS pandemic which has a critical lesson to teach us and COVID-19: there cannot be health without human rights. Just as with HIV the world must implement a rights-based approach to this coronavirus, one that will involve coming together in international and national efforts to reach all those affected, as well as address the critical and urgent needs of those made more vulnerable to COVID-19 by poverty, inequality and marginalization.  

While human rights are under threat in many places in the world, human rights are championed by those involved in global health governance, including the Global Fund to Fight AIDS, TB and Malaria, UNAIDS, the World Health Organization, and by the Kingdom of Denmark. This is because the global response to HIV has fundamentally redefined an effective health response.  Such a response comprises a rights-based and gender-transformative approach that engages, protects and empowers the people and communities most affected by any health condition. In global health, human rights have earned their place at the table by representing not only the legal obligations of States but also practical and programmatic solutions that lead to reduced infections, lower morbidity and death, and improved outcomes of international and national health spending.  

It became painfully clear in the AIDS pandemic that many factors were undermining, and continue to undermine, the response to HIV.  These were ignorance and confusion about how to protect oneself and others from infection; inadequate, insufficient and unequal distribution of testing, prevention and treatment; and stigma, discrimination and harsh and punitive approaches. The increased vulnerabilities and particular needs of those socially, economically and politically marginalized were also ignored. 

To overcome these challenges, the AIDS response embraced human rights in both principled and pragmatic ways. There was recognition that people have the right to correct health information, effective services and scientifically based leadership; they have the right to non-discriminatory access to prevention and treatment; they have the rights to participation, transparency and accountability in the health measures affecting them.  Further it became apparent that sufficient prevention and treatment would be both delivered and taken up only by engaging communities and empowering them to be health and rights literate and to able to advocate for and act on their health care. Human rights also demand an approach that addresses the particular needs of the groups most affected due to their marginalization.  Finally, an effective response to a pandemic requires international solidarity, coalition-building and burden-sharing across boundaries. Today the fact that 24 million people are on HIV treatment is a result of these aspects of a rights-based approach to HIV. 

The Global Fund to Fight AIDS, TB and Malaria has taken the lessons learned in the AIDS pandemic and applied them to TB and malaria, and in the current crisis, is extending them to COVID-19.  In an effort to make human rights real in the lives of those affected by HIV, TB and malaria, the Global Fund launched an ambitious initiative, Breaking Down Barriers, which supports countries to implement and take to scale for the first time ever concrete programs to remove human rights-related barriers to health services.  Over the last three years the Global Fund has provided approximately 125 million US dollars for these programs.  It is now extending these programs and modifying them as necessary so as to best support the right to health in national COVID responses.  

The goals are once again health and human rights goals: equality in access to medicines and services, non-discrimination, increased efforts to address the need of the most affected and marginalized, attention to gender inequality, and burden-sharing and global solidarity. 

The next months are vital for the future of global health not only due to the COVID-19 pandemic. Two major global health strategies are currently under negotiation. They will define what the international community does up to 2030. UNAIDS is leading consultations for a new Global AIDS Strategy. At the same time, the Global Fund to Fight AIDS, TB and Malaria is preparing its next strategy. 

These strategy processes offer political opportunities in the midst of a global health crisis. We must protect and advance on the gains made. We must protect life and dignity. Human rights must be strengthened in the new strategies for the obvious fact: it works. Denmark has played an important role in securing these gains. It is vital that Denmark, once again, rallies around these processes and pushes for human rights to be central to global health strategies.The world needs this more than ever.