The Social Pact for Non-Discrimination and Equal Treatment associated with HIV is a key tool that can help shed light and reflect the shadows that still persist in the rights-based response in Spain

A few days after the 40th anniversary of the notification of the first case of AIDS in Spain, the Multidisciplinary Journal of AIDS has published in its latest issue a work that analyzes, from a critical perspective, the response to HIV based on rights humans through the Social Pact for Non-Discrimination and Equal Treatment associated with HIV. The Social Pact adopted in November 2018 is the result of a joint, open and participatory work that has been carried out by different health administrations (mainly at the state and regional level), associations that represent the interests and rights of people with HIV and others social agents (unions, universities, scientific societies) and whose general objective is to eliminate the stigma and discrimination associated with HIV.

 

It is true that this tool is not a legal norm and it is not a State Pact that includes legislative reforms, but the Social Pact is the first formal initiative that tries to translate the construction of this response to HIV based on rights and that, in addition, it reflects problems that are common with other chronic diseases.

The necessary reflection on the importance of the publication of the Social Pact lies in the fact that, in Spain, people with HIV, although they are holders of the same rights and freedoms as the rest of the population, cannot enjoy them under equal conditions . This undoubtedly casts a shadow over the achievements made in the medical and scientific fields and prevents the eradication of the pandemic from being achieved, as there are still many areas in which, due to the social stigma surrounding this health condition, people with HIV they are still discriminated against or their rights and freedoms are limited. Complementing the UNAIDS 95-95-95 targets for the year 2025 with a good health-related quality of life would imply greater equality of opportunities and less discrimination and limitation of rights due to HIV.

The authors of the text explain that the Articles of Incorporation, accompanied by other regulatory measures, intends to achieve non-discrimination and equal treatment through a series of specific objectives that are summarized in the following: promote equal treatment and opportunities for people with HIV; work for social acceptance; reduce the impact of stigma on people with HIV; and generate knowledge that guides policies and actions against discrimination. Each of these objectives are developed through lines of action, which, in turn, are specified in a series of actions. It is, therefore, a response that leaves the medical-scientific aspects of HIV in the background and focuses on the social and legal determinants of HIV, that is, those contextual social and economic factors that influence, in a positive or negative way, in the health of people and in their quality of life, and that can be modified through the approval or repeal of legal norms with which in a democratic society an adequate legal ecosystem is created so that all people enjoy, on an equal basis, their right to health protection at the highest possible level.

 

This Social Pact, as a declaration of intentions, includes many of the proposals indicated by the Human Rights Council in Resolution 38/8 and in which the need to carry out structural changes consistent with universal human rights obligations is stated. Thus, for example, States were urged to reform their laws, policies and practices to adapt them to the obligations arising from International Human Rights Law and, if necessary, to repeal those that were discriminatory or negatively affect the people with HIV, suspected of having HIV, or people associated with them. This task is highly complex, but in Spain some reforms have already taken place in the laws that have meant the end, in general terms, of situations of historical discrimination.

Thus, to mention a few examples of these changes, and coinciding with the adoption of the Social Pact, other measures have been adopted to strengthen this rights-based response to HIV. The recovery of universal health care to guarantee that all people living regularly or irregularly in Spain with HIV have free access to antiretroviral treatments has been one of them; the reform of Law 50/1980 to eliminate discrimination against people with HIV in contracting insurance when there are no justified, proportionate and reasonable causes that are previously and objectively documented has been another of the regulatory changes adopted; The reception by the courts of the scientific evidence that supports the preventive effect of antiretroviral treatment - or, in other words, the message of undetectable is equal to untransmittable - has represented a great advance at the level of jurisprudence; o The Agreement of the Council of Ministers to reform the medical criteria for access to the State Security Forces and Corps has put an end to discrimination against people with HIV in this specific workplace.

The text also highlights the problems that continue to persist, despite these regulatory advances and precisely because of the loose ends they have left, for example, by not including migrants with stay visas for tourism or studies as holders of the right to health care financed with public funds, an issue that seriously affects people with HIV who come to our country and do not have sufficient financial resources to pay for treatment.

 

Source: Own elaboration (gTt-VIH)
Referencia: Ramiro Avilés MA, Ramírez Carvajal, P. The social pact and the response to HIV based on human rights. Multidisciplinary AIDS Magazine nº23, May 2021. Available at the following link.

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