"Human Rights in the Fourth Decade of the HIV/AIDS Response: An Aspiring Legacy and Urgent Imperative"

More than 35 years since the HIV/AIDS pandemic began, HIV continues to cause almost two million new infections each year, and the “end of AIDS” by 2030 remains elusive.1 Violations of human rights continue to fuel high rates of new infections among key populations and a generalized epidemic in much of sub-Saharan Africa. Meanwhile, as political shifts worldwide threaten not only HIV funding but also progress toward the globalization of human rights, civil society mobilization and advocacy founded firmly on human rights principles have a more vital role to play than ever. Encouragingly, there are numerous examples of successful integration of human rights-based approaches into HIV prevention and treatment initiatives, and evidence increasingly demonstrates that norms enshrining the respect, protection, and fulfillment of human rights can translate into improved public health.2 This essay will succinctly trace the historic emergence of human rights as an issue at the heart of the HIV/ AIDS response; it will then provide examples of progress and setbacks in recent years and consider the potential for rights promotion to address the structural drivers of HIV. Finally, it will consider how the primacy of human rights in HIV/AIDS has affected other fields of global health and will highlight the continuing imperative to work with civil society to protect and promote human rights to reduce the burden of HIV/AIDS.