An UN response to HIV issues
Since the Second World War, the United Nations (UN) has been missioned to maintain peace and international security. According to its Charter, these twofold mandates need to be achieved through the respect of human rights1. Those rights are minimal resources for people. They are used as an instrument to claim against violences perpetrated by states and societies against fundamental freedoms. With the creation of UNAIDS in 1996, the UN and the World Bank decided to develop a rights-based response to HIV issues. This new institution has however gone beyond human rights. It has shaped policy developments based on policy ideas that brings those rights and the possibility to get medical services without moral regard to what we do with our body.
This paper is a philosophical and sociological study that explains the libertarian characteristics that drive the work of UNAIDS. It argues that this young administration is a policy entrepreneur that disseminates negative liberty through its analysis and recommendations2. Negative liberty may be defined as “the absence of obstacle created by others”3. In its minimalist version, it gives to people a permissive space of liberties without any forms of external domination, persecution, elimination and moral duties4. As Ruwen Ogien tells in his essay L’État nous rend-il meilleurs ? (Does the state make us better?) advocates of this liberty do not look for the excellence of human beings in their political project, they just indicate what they do not desire5. This paper shows that UNAIDS follows this line, it simply tries to make human rights respected through negative perspectives.
Following this perspective this paper draws a particular attention to the legitimation of UNAIDS and dissemination of its policy ideas. It explains how UNAIDS built itself as a policy entrepreneur. It shows how UNAIDS was able to build one of the most important data banks on the epidemic. This facility allows the young institution to produce policy-oriented programs but also to assess the relevance of its work when publishing expertise, guidelines and reports which reinforces the legitimation of its work among actors in the HIV field.
This paper is divided into two parts. After a briefing in the first part on what political liberty is and what are the differences between negative and positive liberty, I discuss the relationship between human rights and negative liberty. That will lead us in the second part to understand the rights-based HIV response that UNAIDS built in order to control the epidemic situation that the world is facing.
The relationship between negative liberty and human rights
Olivier Nay in his analysis How Do Policy Ideas Spread Among International Administrations? classifies UNAIDS work as ideologic. In sociology, an ideology is a coherent and an organized system of ideas, opinions or beliefs leading to a representation or an explanation of the world6. Ideologies are not rationals, neither scientific, they are simply produced in order to reach certain purposes in economic, in religion and in politic7. But Olivier Nay does not give us what is this ideology. He explained in his paper that it is about the fight against discrimination, for the respect of human rights or about caring for certain social groups8. In this paper, I would like to show my understanding of what UNAIDS is doing everyday. Actually, I think this institution always acts through negative liberty principles.
In political philosophy, political liberty is the way citizens can enjoy the use of their civil rights9. Rights define what people are free of – speech, association, circulation, religion, etc. – and free from – hunger, want, disease, fear, etc.10. We are however free when nobody constrains us or prevents us from doing something. Freedom is thus freedom from interferences in what we do and how we do what we do. Rights consequently tell what is “desirable or undesirable in human [or social beings] and what is compulsory, authorized or forbidden”11. If political liberty is delimited by rights, many philosophers try to conceptualize the limits of political liberty. Following Isaiah Berlin in his Two Concepts of Liberty political liberty can be divided in two current thoughts : negative liberty and positive liberty12. This paper will nonetheless use what Ruwen Ogien understands on the twofold meaning of political liberty.
For people who trust in negative liberty, we are free when nobody interferes concretely in our life. They care about those who stop or control our wills or behaviors13. Political liberty is not a metaphysical issue. Whether we are free or not in our actions, whether we are determined or structured to do something, these questions do not matter to the followers of negative liberty. What is at stake is the liberty given by the society or the state where we live. We can say in other words that negative liberty gives to any individual a protected permissive space of liberties where nothing is compulsory or forbidden. In its minimalist version, negative liberty rejects all forms of domination, elimination and persecution from states or societies but also moral duties for oneself14. Finally, it separates in its conception the moral and political in the sense that we do not have moral duties to ourselves as a citizen.
Conversely, positive liberty justifies state and society authorities controlling human beings. It is the position behind the idea that humans must act for a better world, a common good, a virtuous life. It imposes to individuals a way of life and an ideal society. The law should tell us what we have to do or not to do, such as no euthanasia, no same-sex relations, no extramarital sex, no immigration, no prostitution or no drug. Some intellectual currents in positive liberty also justify economic inequalities. For advocates of this liberty, we must obey the law even if we never wanted it. For instance, on the international scene if we are ruled by positive liberty principles we have to accept the UN resolution on “traditional values” presented by the Russian Federation15. This text promotes the “important role of the family” for societies. In other words, the important role of traditional family values can consequently lead gay and lesbian couples being deprived of the possibility to educate their children.
Negative liberty often justifies the negative aspect of human rights, also called individual rights16. They are the first ever fundamental rights written at the dawn of the French Revolution and they protect people in general from arbitrary rules, censorship in speaking or in thinking, etc. After the Second World War, due to the cruelty and madness of the IIIrd Reich, nations decided to include new rights named social rights or second generation. They aim to give education, work, housing or welfare systems to people. Finally, a third generation of rights have appeared more recently. It completes these rights and includes different kinds of rights such as collective rights – protection of minorities – or environmental rights – rights in response to global warming.
At first glance, negative liberty seems useless for rights built after nineteen forty-five such as the access to health. Particularly because it seems that it only interests positive liberty followers to make people healthy through their search of the common goods. Negative liberty wants however, that people are protected from any kind of domination, persecution and elimination committed by states or societies. It is in this sense that negative advocates understand access to health. In its minimalist version, negative liberty advocates for the possibility to harm oneself and because human rights is silent on this topic, it makes it possible. Access to medicine does not mean actually to be treated but solely to have the opportunity to use medical services. In fact negative liberty takes rights as minimal resources that anyone can use as they want. Nobody is forced to use these rights, but everyone must respect them. UNAIDS policy analysis and recommendations are aligned on that conception of human rights.
Want to read the second part of this analysis? Clic here.
I would like to thank Martin Graham for his proofread and advices.
- In 2010, the UN Security Council dedicated for the first time a session on global public health issues and it was about HIV, see : S. Elbe & D. Dominique (2005) and RB. Lillich (1995). ↩
- Which were strictly opposite to what had been done at the turn of the century. Still in the 2000s, an abstinence-response to HIV infections were developed in the South like the Pepfar program (President’s Emergency Plan for AIDS Realief) financed by USAID in Uganda. This especially encouraged the development of homophobia in this country (Cf. E. Demange. (2012). De l’Abstinence à l’homophobie : la “moralisation” de la société ougandaise, use resource politick enter Ouganda et États-Unies. Politique africaine. 2 (126). pp. 25-47). ↩
- R. Ogien. (2013). L’État nous rend-il meilleurs ? Paris: Folio. p. 17. ↩
- This concept of “permissive space of liberties” is interesting in the way that it includes all forms of desires and repulsions that we are not compelled or forbidden to do (Cf. ibid. p. 104.). ↩
- ibid. p. 16. ↩
- O. Nay (2011). Idéologie. In: Nay, O. (Ed.). (2011). Lexique de science politique : vie et institutions politiques. 2nd ed. Paris: Dalloz. p. 128. ↩
- J. Baechler. (1976). Qu’est-ce que l’idéologie ? Paris: Gallimard. p. 103. ↩
- Actually, the purpose of his research was not to understand what are UNAIDS policy ideas, but only how public policy models circulates among administrations (Cf. id. (2012). How Do Policy Ideas Spread Among International Administrations? Policy Entrepreneurs and Bureaucratic in the UN Response to AIDS. Journal of Public Policy. 32 (1). pp. 53-76.). ↩
- J. Russ, & C. Leguil. (2012). Les Chemins de la pensée. Paris: Bordas. p. 243. ↩
- About the differentiation between being free of and free from see GC MacCallum. (1967). Negative and Positive Freedom. The Philosophical Review. 76 (3), pp. 314-319. ↩
- What is in square brackets is added by myself. Ruwen Ogien used otherwise this sentence to tell what political liberty is. As we have seen the relationship between political liberty and rights, it also fits perfectly to define what rights are supposed to rule (Cf. R. Ogien. op. cit. p. 15. ↩
- I. Berlin. (1969). Four Essays on Liberty. New York: Oxford University Press. pp. 121-122. ↩
- R. Ogien. op. cit. p. 16. ↩
- ibid. pp. 103-104. ↩
- S. Timberlake. (1998). UNAIDS: Human Rights, Ethics, and Law. Health and Human Rights. 3 (1). p. 87. ↩
- M. Levinet (2010). Droits et libertés fondamentaux. Paris: Presses Universitaires de France. pp. 33-37. ↩