Safety measures during the COVID-19 pandemic shouldn’t come at the expense of human rights or services for other health issues, including HIV, says a new report from UNAIDS.
The report, “Rights in a Pandemic — Lockdowns, Rights and Lessons From HIV in the Early Response to COVID-19,” details human rights violations and interruptions to HIV services in 16 countries during the early response to the pandemic, from February through mid-May. It was released Thursday by UNAIDS, a United Nations agency that manages the global effort against HIV and AIDS.
“As can happen when a significant new infectious disease emerges — and as was the case in the early days of the AIDS epidemic because modes of transmission were unknown — attempts to contain the spread of COVID-19 have resulted in human rights concerns and violations, despite calls for a focus on rights,” the report’s executive summary states. “This has, at least in some cases, had devastating consequences for communities that may be vulnerable to COVID-19, HIV or the broader socioeconomic consequences of the pandemic.”
“Rights in a Pandemic” focuses on two regions with high HIV prevalence — sub-Saharan Africa, and Latin America and the Caribbean. But it notes that human rights have been infringed upon during the pandemic in the rest of the world as well, and that the problem is not necessarily more acute in the regions covered.
The violations detailed include instances of police using rubber bullets, tear gas, and whips to enforce physical distancing, and people being arrested and detained for not wearing masks and being issued fines. Those who could not pay fines remained in jail longer than those who could pay.
Also, doctors were arrested and detained for traveling to and from health facilities. There were reports of pregnant women dying after strict restrictions on movement prevented them from reaching health care services, including some who died while walking to hospitals. The driver of a motorcycle taxi was beaten to death by police after taking a woman in labor to a hospital during curfew hours.
HIV prevention and treatment services were disrupted in 10 of the 16 countries covered. Some countries reported that medicine collections were reduced up to 20 percent in some areas. There were numerous reports of people living with HIV not having enough antiretroviral medicine for a lockdown of more than 60 days as well as reports of people having abandoned their HIV treatment due to a lack of food.
There were lockdown-related consequences for populations particularly vulnerable to HIV, including women and girls, children, sex workers, and LGBTQ+ and intersex people. In some countries, reports of gender-based violence increased by rates of 40 percent to 70 percent. Transgender people were harassed and arrested for leaving their home on the “wrong day” under gendered lockdown policies. Sex workers lost incomes and were largely not eligible for financial support.
UNAIDS recognizes that some restrictions are necessary during a pandemic, but the report points out, “Overly restrictive responses — especially those that do not take the lived realities of communities into account — and violent and coercive enforcement can undermine trust rather than support compliance.” This is a lesson learned from the response to HIV, it notes.
There were many positive findings from the countries covered. In 15 of the 16, governments released people from prisons to reduce overcrowding and stem COVID-19 transmission. Where governments partnered with civil society and the private sector, responses to COVID-19 were more positive and inclusive. In some countries free transportation was provided for emergency medical care during curfews, and in others, police handed out masks rather than fines. Some countries provided temporary homeless shelters and supplies of food to people living in camps for displaced people. Others declared that water supplies could not be suspended for nonpayment of bills and placed a moratorium on evictions or invested heavily in food support. In some countries there was expanded dispensing of HIV medications so that people could receive a three-month or six-month supply, and others made arrangements for delivery of meds.
The report offers recommendations for protecting human rights while maintaining an effective response to the pandemic. These include avoiding disproportionate, discriminatory, or excessive use of criminal law; assuring that restrictions are evidence-based and do not prevent access to food, water, health care, shelter, or other essentials; supporting essential workers; measures to prevent violence against vulnerable populations; and holding governments accountable through the courts and civil society organizations.
“It is a myth that there can be a trade-off between human rights and public health,” Winnie Byanyima, executive director of UNAIDS, said in a press release. “Human rights are not only intrinsic, but they are also the very means by which governments can successfully beat a pandemic.”