The UNAIDS negative liberty response to HIV
UNAIDS has made human rights the center of its public policy recommendations and analysis to fight HIV globally (1). This global institution is an UN inter-organizational agency working through a proper secretariat but dependent on nine UN organizations – ILO, UNDP, UNDOC, UNESCO, UNFPA, UNHRC, UNICEF, WFP, WHO –, these nine institutions plus the World Bank are named cosponsors (2). UNAIDS has globally two missions which are taken by its Secretariat. On the one hand, it has to provide a global leadership in response to HIV issues and to find a global consensus among states and non-states actors. On the other hand, it has to improve internal governance of the UN system.
Its twofold mandate allows UNAIDS to have access to any information needed. Firstly, through the coordination it has to implement between its cosponsors that information are flowing between UN agencies and through UNAIDS too. Moreover, UNAIDS is a little institution specialized on HIV issues while its cosponsors treat HIV as one issue among others (3). Secondly, because it works also at the national level, after being briefed on the epidemic situation by the state government, civil society organizations, non governmental organizations and its experts, UNAIDS will identify critical HIV-related human rights (4). Its administration ensures a regular dialogue with all entities linked with HIV issues like ministries of justice, health, employment, education, welfare, interior and finance as well as politicians.
In almost twenty years UNAIDS was able to build one the most specialized data banks on the HIV epidemic. Collecting and banking specific information are a major activity for bureaucratic organizations, because specialized data allows them to shape and disseminate their policy ideas among other administrations as well as societies. Policy entrepreneurs are in other words, those who can make their policy ideas circulate among public or private organizations. As an inter-orgnizational agency dedicated to reinforce the UN system and states HIV response, UNAIDS acts as a policy entrepreneur, disseminating its rights-based public health policy idea among local, national and international public administrations or non-state actors. Although UNAIDS Program’s Workplan for 1996-1998 is already emphasized on rights-oriented HIV responses, this UN institution uses its data to assess the relevance of rights-based HIV prevention and treatment public policies but also to produce norms, fix terminologies, enforce global values and design development policies (5).
For instance, a dozen vulnerable social groups are identified by UNAIDS in its Gap Report. Each of them are analyzed through their social determinants of health but also through their deprivation of fundamental rights. According to this first glance, UNAIDS proposes different specific recommendations to close the gap “between those who can get services and those who can’t and those who are protected and those who are punished” (6). In this report, every social group is treated at the same level, they all have their chapter, their proper analysis and recommendations, without any concern to moral duties. There is no value judgements.
Last week I presented what is political liberty in its positive or negative version. As political project, negative liberty advocates define what they do not desire. On this level, UNAIDS recommends no persecution, no elimination and no domination from state and societies to a person. In promoting such limits, this young institution demands the respect of human rights and links these rights to efficient public health policies. In doing so, it applies two negative principles, the liberty to do what we want to do with our body and to be respected without any moral regard to what we do. UNAIDS does not recommend for instance detoxification and HIV treatment for drug users, but simply ending criminalization of this social group and providing services to them. We can qualify these public policies as collective and individual, facultative but not compulsory.
Finally, prevention and treatment tools designed by the secretariat fall within the scope of a minimalist negative liberty policy project. UNAIDS proposes to look after a permissive space of liberties given to the individual in order to protect them from external interferences. When it talks about closing the gap to win the fight against HIV, UNAIDS does not mean to impose prevention and treatment but to reduce unequal access to HIV medical services. Actually, for this organization, closing gaps means giving to everyone an equitable health care system (7).
Human rights are minimal resources that people can use as an instrument to protect themselves from external interferences to what they want to be. They protect people from states and society domination, persecution and elimination. UNAIDS uses also human rights to develop public policies against HIV issues. Furthermore, this institution separates moral from politic, giving space to people that are punished for what they do. In so doing, UNAIDS is acting as a policy entrepreneur of negative liberty policy project. In fact, even if this inter-organisational agency is classified as a policy entrepreneur specialized in rights-based HIV response, it is better to say that it promotes negative liberty as a response to HIV issues, and on a larger scale, as a response to every factor that makes people ashamed to consult for HIV issues.
Objectively, it is difficult to prove the relationship between human rights and HIV. Following Susan Timberlake in her paper UNAIDS: Human Rights, Ethics, and Law more research needs to be done on this link (8). If I am not mistaken, the link is based on the respect of negative liberty principles. Perhaps studies should focus on what negative liberty can bring to moral issues. As Vladimir Jankélévitch said “moral requirement in itself can be reduced to almost nothing”, but it is this nothing that can be at stake when people need to express their doubts or their pains (9).
Thank you for reading this paper, I hope it has been thoughtful to think HIV issues. Leave a comment to tell me what you think.
I have written it for the Alan R. & Barbara D. Finberg Fellowship application of Human Rights Watch. I would like to thank Martin Graham for his proofread and his advices.
Nowadays, I am working on Michel Foucault’s biopolitics work. For that reason, next week I will publish a paper about biopolitics. It will certainly lead to a study on the new 17 UN Global Goals also called Sustainable Development Goals (SDGs). Concerning the SDGs and sexual minorities, I have launched a discussion on iDeas 4 Minorities LinkedIn Group a few week ago.
- Actually, UNAIDS based its policy project through a report presented by Kofi Annan in 2005 and entitled “In a Larger Freedom: Toward Development, Security and Human Rights for All” (Cf. UNAIDS. (2006). From Advocacy to Action: Progress Report on UNAIDS at Country Level. p. 14.). See also: UNAIDS. (2014). The Gap Report. 2nd ed. pp. 21-22.
- ILO for International Labor Organization, UNDP for United Nations Development Programme, UNDOC for United Nations Office on Drugs and Crime, UNESCO for United Nations Educational, Scientific and Cultural Organization, UNFPA for United Nations Fund for Population Activities, UNHRC for United Nations Human Rights Council, UNICEF for United Nations Children’s Fund, WFP for World Food Programme and WHO for World Health Organization.
- O. Nay. (2012). op. cit. pp. 65-65.
- S. Timberlake. op. cit. p. 95.
- As an example of fixing new norms and terminologies, UNAIDS has just published a new guidelines on what people should avoid or use when they talk about HIV issues (Cf. UNAIDS. (2015). UNAIDS Terminology Guidelines).
- UNAIDS. (2014). op. cit. p. 5 and pp. 119 to 279.
- ibid. pp. 5 and 13.
- S. Timberlake. op. cit. p. 94.
- V. Jankélévitch, & B. Berlowitz. (1978). Quelque part dans l’inachevé. Paris: Gallimard. p. 21.
Jankélévitch, V, & Berlowitz, B. (1978). Quelque part dans l’inachevé. Paris: Gallimard.
Nay, O. (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.
Timberlake, S. (1998). UNAIDS: Human Rights, Ethics, and Law. Health and Human Rights. 3 (1). pp. 87-106.
UNAIDS. (2006). From Advocacy to Action: Progress Report on UNAIDS at Country Level.
UNAIDS. (2014). The Gap Report. 2nd ed.
UNAIDS. (2015). UNAIDS Terminology Guidelines.