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HEALTH/ HIV-AIDS
NGO Forum Thematic Commission
August 27 through September 1, 2001
Durban, South Africa
On August 30, 2001, the Health/ HIV-AIDS Thematic Commission met from 2:00 pm
through 9:00pm. During that time, the commission spent 150 minutes in oral testimony. More than 50
persons attended the commission, at least 25 persons gave oral testimony and 15 persons gave written
testimony. After the testimony a group of approximately 25 persons continued to work on this
document. The commission identified five (5) themes that must be reflected in the NGO Forum
Declaration and Plan of Action: 1Intersection of Poverty, Racism and Health, 2Health Status, 3Health
Care (Access and Quality) including traditional health, 4Research and Data, and 5HIV/AIDs. Then in
five working groups, the commission developed six key concepts for each theme. After, the
commission came to a consensus on each working groups list of concepts, each working group
developed written statements for the document which the commission adopted by consensus. Ms.
Alta Hooker and Professor Vernellia Randall edited the final document. Below is the recommended
declaration and program of action that resulted from the above process:
[ la Comisión Temática sobre salud / VIH-SIDA ] [ la Commission Thématique Santé /VIH-SIDA ]
Declaration
Recognizing that racism, xenophobia and other intolerance are major physical and mental health
determinates. Historical and current discrimination against racial, ethnic and culturally vulnerable
groups, indigenous peoples, migrants, people discriminated against based on caste, asylum seekers,
refugees and internally displaced people has resulted in members of these groups (especially women,
youth and children) having a lower health status, less access to health care and poorer quality of
health services. Good physical and mental health is a human right and is a precursor to the enjoyment
of all other human rights. Vulnerable groups across the globe are denied access to affordable
prevention and treatment programs undermining their human rights including the rights to health, life,
and dignity.
Acknowledging that poverty is a global phenomenon that is tied to racism, xenophobia and other
intolerances, and that poverty perpetuates lower health status, especially among women, children,
disabled, and other vulnerable groups.
Asserting that health care focuses on not only the body but also the mind and should be protective of
human dignity including the right of participation and informed consent; that health care should be
accessible, comprehensive, culturally sensitive and comprehensible to the recipients. Access to health
care should not be withheld or used as a tool to pressure groups to comply with governmental
policies.
Condemning the unscrupulous practices of the tobacco, alcohol, drug and gun industries in their
targeting of disadvantaged communities (particularly the promoting and encouraging of smoking in
developing countries).
Recognizing that governments and the international community should assure that the health care
system is adequately funded, sustainable and effectively monitored; that the sources of funding for
health care comes not only from the national government but also from the international community
including cancellation of legitimate debt and decreased military spending.
Recognizing the significant lack of evidenced-based research on physical and mental health of
vulnerable groups and access to quality health care for those groups.
Urging governments, nongovernmental organizations and the private sector to address the most
critical manifestation of international racism - the failure to respond aggressively to the AIDS
pandemic. 36 million people globally, of which 25 million (55% women) in Africa are infected with
HIV-AIDS, thus, increasing government and civil society commitment to eradicating gender and
racial inequality is indispensable to fighting HIV/AIDS.
Considering women are at higher risk for HIV infection because of the epidemic of sexual violence
against them.
Program of Action
Health (Generally)
Governments should eliminate disparities in health status experienced by members of vulnerable
groups by the year 2010, including disparities in infant mortality and life expectancy, childhood
immunization, and the incidence of diabetes, mental illnesses, heart disease, HIV/AIDS, cancer,
water-borne illnesses, chronic illnesses, accidents.
Government should adopt measures to ensure that everyone's right to access to education, health
care, social security, clean water and waste disposal, housing and land is protected, promoted and
fulfilled. All such measures should demonstrate respect by being culturally sensitive. Particular
attention should be given to vulnerable groups and victims of discrimination including the
unemployed, rural people, women, children, indigenous people, and people of African descent.
Governments should assure that all people have free or affordable access to effective equitable care,
treatment and medicines, Such health care should include all levels primary (i.e. health promotion,
vaccination, prevention, chronic care), secondary (i.e. hospitalization) and tertiary; it should be
available in different models of health care; it should include both physical and mental health care;
and it should take into consideration the unique issues of women, children and youth. Accessibility to
essential medicines should be facilitated by compulsory licenses; parallel imports and other
internationally recognized means.
Governments, non-governmental organizations, the private sector and the International community
should ensure that health care providers/practitioners are trained to provide culturally appropriate
care; and that members of African and African descendant communities, indigenous communities and
other vulnerable groups are adequately represented as health care providers. In order to assure
cultural appropriate care, governments must permit and promote traditional health practices in
coordination with traditional healers.
Governments, nongovernmental organizations and private sector (particularly medical technology and
pharmaceutical industry) should develop prevention programs and treatment for diseases and
conditions that disproportionately affect vulnerable groups such as sickle cell anemia, diabetes,
hypertension, other chronic diseases and particularly diseases and illnesses in developing countries.
Governments of the developed countries should assure that state of the art medical and health related
technology and knowledge is made accessible to developing countries
Governments should assure equitable health care resources for vulnerable communities including
health care facilities and professionals. Compulsory community service for health care professionals
and the recruitment of trainee health professionals from vulnerable groups are mechanisms for
achieving parity in the health care system. In training health care professionals, governments should
ensure that they receive a human rights and ethics component as part of their educational program
(such program should include a section on racism, xenophobia and related intolerances)
Governments, nongovernmental organizations, the private sector and the international community,
including the World Health Organization, should routinely and systematically collect race, gender and
socioeconomic class data related to health status and health care such data should not be limited to
census and vital statistics but should include data on access and quality particularly service delivery,
diagnosis and treatment, facility availability, provider availability and other related health activities and
services. Special attention should be placed on the impact of racial discrimination and to the
publication of the data, the results and the conclusion.
Governments should set up mechanisms that assure the protection of vulnerable groups who
participate in research . Those mechanisms should include free and informed consent but must also
include other forms that protect vulnerable groups from exploitation. Particular efforts should be
taken to protect vulnerable groups that might arise out of clinical trials, the Human Genome Project,
stem-cell research and other such research.
Governments should develop, improve and apply environmental regulations based on health standards
that are protective of vulnerable populations such as children, elderly and the immuno-compromised.
Governments should monitor and provide an effective mechanism to eliminate racial discrimination
and other forms of discrimination in the health care system (particularly discrimination against persons
affected by HIV/AIDS). The communities and populations affected must be involved in these
mechanisms, with a strong influence over their decision-making processes.
Health (HIV/AIDS)
In order to effectively address HIV-AIDS, governments must implement a comprehensive, multi-sectoral program consisting of the mutually reinforcing components of prevention, treatment, care,
community support and health infrastructure, including culturally sensitive educational programs
which include encouraging citizens to engage in voluntary testing. To overcome racial discrimination
manifested in the response to the HIV-AIDs pandemic, the world must give priority and special
attention to developing countries and vulnerable groups.
In order to reduce women's vulnerability to HIV infection, governments must direct efforts to
eradicate rape and all forms of sexual violence against women.
The Governments of the richest countries of the world should contribute at least $10 billion annually
to the UN Global Health Fund to develop and implement comprehensive programs of prevention,
treatment and community support to fight HIV-AIDS, tuberculosis, malaria and other infectious
disease
Africa's debt should be cancelled. Such debt directly diverts resources from health care and the
struggle against the HIV-AIDS pandemic. African governments who receive debt cancellation should
use those released resources on health and social services.
Governments should develop and implement effective and comprehensive HIV/AIDS Mother-to-Child Transmission programs that is freely accessible to all. Such programs should involve informed
consent, pre and post- test counseling, treatment options, milk formula substitution, and access to
support groups.
Governments should assure that all people have free or affordable access to effective equitable
HIV/AIDS care and medicines. In this regard, we acknowledge the co-operative efforts of the South
African government and civil society in reaching these ends by successfully engaging with the
International Pharmaceutical Industry.
For More Information Contact:
Vernellia R. Randall
Professor of Law
The University of Dayton
School of Law
300 College Park
Dayton, OH 45469-2772
Phone: (937) 229-3378
Fax: (937) 229-2469
randall@udayton.edu
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