The Program on International Health and Human Rights in collaboration with ICASO present HIV/AIDS & Human Rights in a Nutshell A quick and useful guide for action as well as a framework to carry HIV/AIDS and human rights actions forward.
Program's
Mission and Vision
The Program on International Health and Human Rights is housed within the François-Xavier Bagnoud (FXB) Center for Health and Human Rights at Harvard University’s School of Public Health, which is the first academic center to focus exclusively on health and human rights. The Program’s mission is to build the evidence base of the value of attention to human rights in health and to provide the tools and methods for integrating rights into public health policy, program and practice. In addition, the Program seeks to enhance the capacity of intergovernmental agencies, governments, civil society organizations and professionals to develop and support policies and programs consonant with sound public health and human rights principles and practice.
The Program catalyzes thinking and action in health and human rights by working with intergovernmental organizations, governments and non-governmental actors both in countries and through the work of the international organizations. The Program seeks to provide tools to incorporate international human rights norms and standards into health policies and programs and to support international human rights actors to better integrate health issues into their work.
At this juncture in the history of the health and human rights field, the Program believes that there is an urgent need to demonstrate that a human rights approach to health makes a greater positive difference to the lives of individuals than other traditional public health or biomedical approaches. Growing skepticism and backlash among important decision makers is threatening to erode the important gains of the last decade. We have been at the forefront of developing the field of health and human rights research, and we have been leaders in developing health and human rights tools for analysis, evaluation, and programmatic intervention. Building on this important work, in the next five years we will continue to strengthen our ties with a broad network of colleagues, map the field of health and human rights, collect the existing evidence on the efficacy of health and human rights approaches, provide tools and methods for implementing a human rights approach to health, and conduct new research where evidence is lacking, particularly in the areas of HIV/AIDS, sexual and reproductive health, and child and adolescent health.
Guiding Principles
IHHRP's long-term objective is to achieve the highest attainable
standard of health for populations by working through a health
and human rights framework. This is accomplished through three
guiding principles:
Clarifying health and human rights concepts and frameworks
Given the novelty of the health and human rights field, much of the Program 's work is dedicated to clarifying, strengthening and widely disseminating the field's concepts and frameworks. From participating in conferences and consultations to publishing work in a wide range of publications, we accomplish this goal through a variety of approaches. Our work to elucidate the primary ideas and concepts within the field of health and human rights is focused on three areas: HIV/AIDS,Sexual and Reproductive Health, and Child and Adolescent Health.
Incorporating and promoting frameworks and guidelines
Beyond defining and clarifying the field's main concepts and frameworks, the second of the Program's three guiding principles is to expand the field of health and human rights by Collaborating with International Agencies, NGOs, and Multisectoral Initiatives. Through these networks the Program works to increase the use of health and human rights frameworks across a broad range of forums—from international agencies and treaty bodies to NGOs and multisectoral approaches. Our work in this regard has received international recognition and our expertise is sought by a wide variety of global actors.
Training new health and human rights professionals
Our third guiding principle is to expand the field of health and human rights by conducting Research and Training of new professionals. The Program works toward this goal along two central paths: 1) designing and delivering trainings at various forums and 2) designing and teaching academic courses.
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HIV/AIDS
The global HIV/AIDS epidemic played a critical role in the genesis
of the health and human rights movement and continues to be
an important focus of our work. In the area of HIV/AIDS, we
have worked to determine effective methods for implementation
of health and human rights concepts and to enhance the capacity
of institutions to incorporate these concepts into their work.
Highlights from our work in 2002-2003 include:
Professor
Gruskin was appointed Chair and the Program serves as the
Secretariat for the UNAIDS
Global Reference Group on HIV/AIDS and Human Rights.
UNAIDS established this technical group to serve as an independent
advisory body to UNAIDS, including its Secretariat and Cosponsors
and other organizations involved in policy, advocacy, program
development, implementation, monitoring, evaluation, research
and training related to a rights-based approach to HIV/AIDS.
Program
Director, Sofia Gruskin, is one of the Harvard investigators
for the Enhancing
Care Initiative (ECI). Begun in 1998, ECI is jointly
carried out by the Harvard AIDS Institute, the FXB Center,
other entities within Harvard, and counterpart institutions
in Brazil, Puerto Rico, Senegal, Thailand, and South Africa.
ECI has been developing a multisectoral conceptual and practical
framework on how to assess, plan for, and evaluate care
for people living with HIV/AIDS-a framework that includes
human rights and gender-sensitive approaches.
Funded by the Ford Foundation ( India ) the Program has initiated the Gender Based Violence (GBV) project to facilitate an informed exchange of information amongst those working on issues of HIV/AIDS and sexuality at the global and local levels. This project is intended to: set a common human rights and sexuality framework for programs; document “best practices”; put together tools and materials to help integrate HIV and GBV links; and strengthen the skills of practitioners and activists for continued joint efforts. In its initial stage, the project collaborates with partners in China , India , Thailand , and Vietnam to highlight methods by which working together can improve the ability of actors in both areas to accomplish their goals. For more information, click here.
Sexual and Reproductive Health
Included in the study of reproductive and sexual health are the complex biological interactions between the sexes and gender power differentials. Reproductive and sexual health for women goes far beyond having a womb or bearing children; it more broadly encompasses issues such as the consequence of discrimination, the inability to decide with whom to have sexual relations and when to bear children. The Program is dedicated to clarifying the relationship between human rights and reproductive health while also achieving improvements in gender equality. Our work in this area has included:
Program staff are collaborating with WHO’s Department of Reproductive Health and Research on efforts to reduce maternal and neonatal morbidity and mortality. In collaboration with this team, the Program developed “Using Human Rights to Improve Maternal and Newborn Health: A Tool for Strengthening Laws, Policies and Standards of Care”. The purpose of this innovative tool is to help countries use a human
rights framework to identify and address legal, policy and normative barriers to women’s access to quality maternal and newborn health care services. This is the first tool ever to be designed that uses the framework of human rights in a practical manner so as to positively assist governments to understand and fulfill their human rights obligations. The tool is currently being piloted in Mozambique, Brazil and Indonesia.
The Program is involved in various fronts on projects related to sexual and reproductive health and rights of people living with HIV and AIDS. Program staff have collaborated on a UNFPA and EngenderHealth project, putting together a background paper and moderating an e-forum on the human rights and legal issues in providing sexual and reproductive health services for HIV positive women. The Program is also collaborating with WHO on putting together a paper on the reproductive and sexual health needs of HIV positive men and women. The objective of this project is to develop policy and programmatic guidance for health systems on ways to ensure that women and men living with HIV have access to sexual and reproductive health services that help them realize their reproductive goals while ensuring the respect, protection and fulfillment of their human rights. Program staff are co-authoring the overview chapter of this publication which is designed to give a general introduction to the topic and to draw together all of the other chapters.
Over the last two years, the Program worked with Latin American NGOs to shed light on the state of reproductive rights in that region. Ms. Bonnie Shepard published a study entitled: NGO Advocacy Networks in Latin America: Lessons from Experience in Promoting Women's and Reproductive Rights in Latin America. Published in early 2003, numerous networks in Latin America have used this peer-reviewed monograph to avoid common errors in internal governance that create unnecessary conflicts and pose obstacles to advocacy.
The Program
was integral in helping to conduct a midterm evaluation of
the ReproSalud project, an innovative project on reproductive
health and rights-directed by Peruvian NGO Movimiento Manuela
Ramos in alliance with USAID-that works with 2,500 grassroots
women's organizations in Peru.
Child
and Adolescent Health
The Program 's work in child and adolescent health is based on the firm conviction that all children and adolescents should have the opportunity to develop to their full potential. Life, survival, maximum development, access to health, and access to health services are not just basic needs of children and adolescents but are also fundamental human rights. Moreover, the protection and fulfillment of these fundamental rights depends on the realization of other rights including non-discrimination, education, access to appropriate information, and protection of privacy. Our work in this area has included:
Program staff helped draft the General Comment on HIV/AIDS and the Rights of the Child for the Committee on the Rights of the Child. The final document, published in early 2003, is the first ever General Comment on HIV/AIDS issued by a treaty-monitoring mechanism.
Program staff have throughout the years participated in consultations leading up to the UN General Assembly Sessions on Children, and at the sessions themselves. The Program works with UN agencies in preparation and follow up for these sessions and also works with a broad coalition of NGOs to ensure that the health and health-related rights of children are adequately acknowledged and promoted in the governmental agreements.
The Program collaborates with WHO's Department of Child and Adolescent Health and Development. Throughout the years, Program staff have provided technical support and advice to the department on various topics. For example, Professor Gruskin attended a Regional Advisers’ Meeting leading a session on WHO’s strategy for child and adolescent health and development, speaking specifically on "Equity, Gender and Child Rights-Toward a Rights-Oriented Public Health Approach."
Program has also worked with UNICEF on various projects. For example, in 2003, Ms. Shepard served as the team leader of a review of young people's sexual and reproductive health and rights for the HIV/AIDS and Youth Programs of UNICEF in the Middle East North Africa (MENA) Region. Ms. Shepard overviewed the international policy framework and programmatic evidence initiative which informed UNICEF's work with youth in the region. Another colleague was responsible for the needs assessment based in the MENA Region. On the basis of both reports, the co-authors drafted an advocacy report for policymakers in the region and recommendations for programs, research, and policy. Experts in the field and reviewers at UNICEF headquarters praised the final drafts of the reports. UNICEF officials plan to distribute the international policy and program evidence reports to all of their country offices. In 2004, Ms. Shepard continued her technical assistance to UNICEF country offices in the MENA Region on programs for young people.
Collaborating with International
Agencies, NGOs, and Multisectoral Initiatives We believe that international agencies and human rights treaty bodies are critical actors in the health and human rights movement. Therefore we are constantly seeking new ways to incorporate and promote health and human rights frameworks and guidelines into their work . The Program collaborates with the Joint United Nations Program on HIV/AIDS (UNAIDS), the Office of the UN High Commissioner for Human Rights (OHCHR) and with various departments of the World Health Organization (WHO). The Program also worked with NGOs and participated in multisectoral approaches to promote health and human rights. Highlights include:
The Program is involved in various ways in the work of Office of the UN High Commissioner for Human Rights (OHCHR). Program staff provide technical support to the Special Rapporteur on the Right to Health particularly in relation to the development of right to health indicators. In 2005, Professor Gruskin attended a meeting to determine a conceptual approach for human rights indicators to be used in implementing international human rights instruments and identifying ways to firmly establish such indicators at national level. Specifically in relation to HIV/AIDS, Program staff worked with UNAIDS and OHCHR in the drafting of the International Guidelines on HIV/AIDS and Human Rights. These Guidelines—adopted in 1996 at the Second International Consultation on HIV/AIDS and Human Rights—assist States in creating a positive, rights-based response to HIV/AIDS.
The Program worked with WHO to articulate a strategy for working with the United Nations Human Rights Treaty Bodies. This strategy is intended to support WHO in influencing the international human rights agenda from a health perspective. This project intends to bring more consistency to WHO's approach to working with the various Treaty Bodies on matters of reporting, providing information, and establishing indicators.
The Program collaborates with Catholics for a Free Choice (CFFC), an independent not-for-profit organization working on gender equality and reproductive health. Ms. Shepard coordinated the Latin American technical assistance program, providing strategic planning and evaluation training to Católicas por el Derecho a Decidir (CDD) organizations in Latin America, and to other organizations needing support with reproductive health advocacy within a Catholic context.
Program staff play critical roles in expanding the work of Amnesty International USA (AIUSA) towards economic and social rights, and HIV/AIDS more generally, as well as providing technical expertise. Professor Gruskin serves as a member of the HIV/AIDS Task Force.
The Program collaborates with ICASO on a variety of projects and initiatives. This joint effort has recently yielded the publication of a booklet entitled “HIV/AIDS and Human Rights in a Nutshell.”This is a useful and concise guide for clarifying how rights based approaches are key to HIV/AIDS efforts. Plans are currently underway to translate the booklet to several languages.
Research
and Training
The Program carries out research on a number of critical health and human rights issues (see list of publications). In addition, Program staff are sought by international agencies, NGOs, and others to conduct trainings on integrating health and human rights concepts. Educating students in various academic forums is also a fundamental piece of The Program’s work. The Program also designed a number of courses and seminars taught at the Harvard School of Public Health and abroad. Highlights include:
The Program developed Health and Human Rights Training, a training modulerelevant and applicable to all WHO departments. The training is split into two days, the first focusing on basic concepts and the second on applied concepts. The Program staff worked to refine this training through a number of pilot sessions delivered to WHO staff. The training includes sessions on human rights from a personal perspective, human rights and WHO, an introduction and case studies on international human rights in relation to health policies and programs. This training is now being carried out by WHO staff several times a year.
The Program is involved in theHIV/AIDS Public Policy Training Project in Asia. Professor Gruskin serves as one of the key faulty for the project. The project is coordinated by the Center for Business and Government at Harvard’s Kennedy School of Government. The HIV/AIDS Public Policy Training Program is an executive training course for national, provincial and local government officials in the Asian region to promote leadership roles supported by knowledge for an effective response to the HIV/AIDS pandemic. Under this initiative, Professor Gruskin has created a one-day module course on HIV/AIDS, Law, and Rights which she conducted in China. Plans are underway for similar trainings in Vietnam.
The Program also contributes to a four-day Intensive Course on Health and Human Rights at the Harvard School of Public Health. This is a collaborative effort involving the FXB Center, Boston University's Health Law Department, and the Center for Continuing Professional Education at the Harvard School of Public Health.
Program staff are active members of the Working Group on Women, Gender, and Health, which is organized by Harvard School of Public Health faculty members, post-doctoral fellows and students interested in advancing the study of women, gender, and health at the School. The common goal of the Working Group is to improve the health of women-and the population at large-through curriculum development, scientific research, and community outreach.
