2021 Political declaration on HIV and AIDS

75th UNGA
June 2021

Res­o­lu­tion A/RES/75/284

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Offi­cial record A/75/PV.74

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Analysis of precedential value

This dec­la­ra­tion is the prod­uct of the UN High-Level Meet­ing (HLM) on AIDS in June 2021. It was adopted by the UN Gen­eral Assem­bly (UNGA) with 165 votes in favour, 4 against, and 0 absten­tions that same month. The Gen­eral Assem­bly is the pre­em­i­nent gov­ern­ing body of the UN sys­tem and con­sists of all 193 UN Mem­ber States.

The HLM Multi-Stake­hoder Task Force’s state­ment in response to this dec­la­ra­tion notes: “com­mu­ni­ties and civil soci­ety voices call­ing to get back on track to end AIDS by 2030 through sup­port­ing a fully funded, human rights- and evi­dence-based response have been heard by the global com­mu­nity. We affirm the progress rep­re­sented by the Polit­i­cal Dec­la­ra­tion, even as we are dis­ap­pointed by some crit­i­cal omis­sions and weak­nesses. We pledge our action and vig­i­lance to ensure that these are addressed as the work of mov­ing towards an AIDS-free world con­tin­ues.”

Used as precedent

negative legal determinants, stigma and discriminations

• “Com­mit to urgent and trans­for­ma­tive action to end the social, eco­nomic, racial and gen­der inequal­i­ties, restric­tive and dis­crim­i­na­tory laws, poli­cies and prac­tices, stigma and mul­ti­ple and inter­sect­ing forms of dis­crim­i­na­tion, includ­ing based on HIV sta­tus, and human rights vio­la­tions that per­pet­u­ate the global AIDS epi­demic.” (para­graph 1(c))

human rights

• “Reaf­firm the Uni­ver­sal Dec­la­ra­tion of Human Rights 14 and com­mit to respect, pro­mote, pro­tect and ful­fil all human rights, which are uni­ver­sal, indi­vis­i­ble, inter­de­pen­dent and inter­re­lated, includ­ing in the con­text of the HIV response, and urge that all human rights and fun­da­men­tal free­doms, includ­ing the right to devel­op­ment, be inte­grated into all HIV and AIDS poli­cies and pro­grammes.” (para­graph 7)

reproductive rights, sexual rights

• “Reaf­firm the com­mit­ment to sex­ual and repro­duc­tive health and repro­duc­tive rights, in accor­dance with the Pro­gramme of Action of the Inter­na­tional Con­fer­ence on Pop­u­la­tion and Devel­op­ment, the 1995 Beijing Declaration and Platform for Action and the out­come doc­u­ments of their review con­fer­ences, and reaf­firm the right of every human being to the high­est attain­able stan­dard of phys­i­cal and men­tal health, includ­ing sex­ual and repro­duc­tive health.” (para­graph 9)

gender equality

• “Note with con­cern that inequal­i­ties across mul­ti­ple forms and dimen­sions, whilst dif­fer­ent in dif­fer­ent national con­texts, can include those based on HIV sta­tus, gen­der, race, eth­nic­ity, dis­abil­ity, age, income level, edu­ca­tion, occu­pa­tion, geo­graphic dis­par­i­ties, migra­tory sta­tus and incar­cer­a­tion and these often over­lap to com­pound each other, and have con­trib­uted to the fail­ure to reach the 2020 global HIV tar­gets.” (para­graph 22)

• “Com­mit to put gen­der equal­ity and the human rights of all women and girls in diverse sit­u­a­tions and con­di­tions at the fore­front of efforts to mit­i­gate the risk and impact of HIV by:

  (a) Ensur­ing the estab­lish­ment, financ­ing and imple­men­ta­tion of national gen­der equal­ity strate­gies that chal­lenge and address the impact of sex­ual and gen­der-based vio­lence, harm­ful prac­tices such as child, early and forced mar­riage and female gen­i­tal muti­la­tion, neg­a­tive social norms and gen­der stereo­types, and that increase the voice, auton­omy, agency and lead­er­ship of women and girls;
  (b) Ful­fill­ing the right to edu­ca­tion of all girls and young women, eco­nom­i­cally empow­er­ing women by pro­vid­ing them with job skills, employ­ment oppor­tu­ni­ties, finan­cial lit­er­acy and access to finan­cial ser­vices, scal­ing up social pro­tec­tion inter­ven­tions for girls and young women, and engag­ing men and boys as agents of change in inten­si­fied efforts to trans­form neg­a­tive social norms and gen­der stereo­types;
  (d) Elim­i­nat­ing all forms of sex­ual and gen­der-based vio­lence, includ­ing inti­mate part­ner vio­lence, by adopt­ing and enforc­ing laws, chang­ing harm­ful gen­der stereo­types and neg­a­tive social norms, per­cep­tions and prac­tices, and pro­vid­ing tai­lored ser­vices that address mul­ti­ple and inter­sect­ing forms of dis­crim­i­na­tion and vio­lence faced by women liv­ing with, at risk of and affected by HIV;
  (e) Reduc­ing to no more than 10 per cent the num­ber of women, girls and peo­ple liv­ing with, at risk of and affected by HIV who expe­ri­ence gen­der-based inequal­i­ties and sex­ual and gen­der-based vio­lence by 2025;
  (f) Ensur­ing by 2025 that 95 per cent of women and girls of repro­duc­tive age have their HIV and sex­ual and repro­duc­tive health-care ser­vice needs met, includ­ing ante­na­tal and mater­nal care, infor­ma­tion and coun­sell­ing;
  (g) Reduc­ing the num­ber of new HIV infec­tions among ado­les­cent girls and young women to below 50,000 by 2025.

  ” (para­graph 63)

key and vulnerable populations

• “Note that each coun­try should define the spe­cific pop­u­la­tions that are cen­tral to their epi­demic and response, based on the local epi­demi­o­log­i­cal con­text and note with con­cern that global epi­demi­o­log­i­cal evi­dence demon­strates that key pop­u­la­tions are more likely to be exposed to HIV or to trans­mit it, and that these include peo­ple liv­ing with HIV, men who have sex with men who are at 26 times higher risk of HIV acqui­si­tion, peo­ple who inject drugs who are at 29 times higher risk of HIV acqui­si­tion, female sex work­ers who are at 30 times higher risk of HIV acqui­si­tion, trans­gen­der peo­ple who are at 13 times higher risk of HIV acqui­si­tion, and peo­ple in pris­ons and other closed set­tings who have six times higher HIV preva­lence than the gen­eral pop­u­la­tion, and fur­ther note with con­cern that these pop­u­la­tions and their sex­ual part­ners account for 62 per cent of new HIV infec­tions glob­ally” (para­graph 25)

• “Note that, depend­ing on the epi­demi­o­log­i­cal and social con­text of a par­tic­u­lar coun­try, other pop­u­la­tions may be at ele­vated risk of HIV, includ­ing women and ado­les­cent girls and their male part­ners, young peo­ple, chil­dren, per­sons with dis­abil­i­ties, eth­nic and racial minori­ties, indige­nous peo­ples, local com­mu­ni­ties, peo­ple liv­ing in poverty, migrants, refugees, inter­nally dis­placed per­sons, men and women in uni­form and peo­ple in human­i­tar­ian emer­gen­cies and con­flict and post-con­flict sit­u­a­tions.” (para­graph 26)

bodily autonomy and integrity, negative legal determinants, stigma and discrimination

• “Express deep con­cern about stigma, dis­crim­i­na­tion, vio­lence and restric­tive and dis­crim­i­na­tory laws and prac­tices that tar­get peo­ple liv­ing with, at risk of and affected by HIV–includ­ing for non-dis­clo­sure, expo­sure and trans­mis­sion of HIV–and laws that restrict the move­ment or access to ser­vices for peo­ple liv­ing with, at risk of and affected by HIV, includ­ing key pop­u­la­tions, young peo­ple, women and girls in diverse sit­u­a­tions and con­di­tions, and in this regard, deplore acts of vio­lence and dis­crim­i­na­tion in all regions of the world.” (para­graph 28)

gender equality, reproductive rights, sexual rights

• “Rec­og­nize that sex­ual and gen­der-based vio­lence, includ­ing inti­mate part­ner vio­lence, the unequal socioe­co­nomic sta­tus of women, struc­tural bar­ri­ers to women’s eco­nomic empow­er­ment and insuf­fi­cient pro­tec­tion of the sex­ual and repro­duc­tive health and repro­duc­tive rights, in accor­dance with the Pro­gramme of Action of the Inter­na­tional Con­fer­ence on Pop­u­la­tion and Devel­op­ment, the 1995 Beijing Declaration and Platform for Action and the out­come doc­u­ments of their review con­fer­ences, of women and girls com­pro­mise their abil­ity to pro­tect them­selves from HIV infec­tion and aggra­vate the impact of AIDS.” (para­graph 29)

bodily autonomy and integrity, combination prevention, human rights

• “Note with grave con­cern that the holis­tic needs and human rights of peo­ple liv­ing with, at risk of and affected by HIV, and of women and young peo­ple, remain insuf­fi­ciently addressed because of inad­e­quate inte­gra­tion of health ser­vices, includ­ing sex­ual and repro­duc­tive health-care ser­vices and HIV ser­vices, includ­ing for peo­ple who have expe­ri­enced sex­ual or gen­der-based vio­lence, includ­ing post-expo­sure pro­phy­laxis, legal ser­vices and social pro­tec­tion.” (para­graph 30)

combination prevention, harm reduction, reproductive rights, sexual rights, sexuality education

• “Increas­ing national lead­er­ship, resource allo­ca­tion and other evi­dence - based enabling mea­sures for proven HIV com­bi­na­tion pre­ven­tion, includ­ing con­dom pro­mo­tion and dis­tri­bu­tion, pre-expo­sure pro­phy­laxis, post-expo­sure pro­phy­laxis, vol­un­tary male med­ical cir­cum­ci­sion, harm reduc­tion, in accor­dance with national leg­is­la­tion, sex­ual and repro­duc­tive health-care ser­vices, includ­ing screen­ing and treat­ment of sex­u­ally trans­mit­ted infec­tions, enabling legal and pol­icy envi­ron­ments, full access to com­pre­hen­sive infor­ma­tion and edu­ca­tion, in and out of school.” (para­graph 30(a))

harm reduction, intersectionality

• “Note with con­cern that the major­ity of coun­tries and regions have not made sig­nif­i­cant progress in expand­ing harm reduc­tion pro­grammes, in accor­dance with national leg­is­la­tion, as well as anti­retro­vi­ral ther­apy and other rel­e­vant inter­ven­tions that pre­vent the trans­mis­sion of HIV, viral hepati­tis and other blood -borne dis­eases asso­ci­ated with drug use, par­tic­u­larly those who inject drugs, and call urgent atten­tion to the insuf­fi­cient cov­er­age of pro­grammes and sub­stance use treat­ment pro­grammes that improve adher­ence to HIV drug treat­ment ser­vices, the mar­gin­al­iza­tion of and dis­crim­i­na­tion against peo­ple who use drugs, par­tic­u­larly those who inject drugs, through the appli­ca­tion of restric­tive laws, which ham­per access to HIV-related ser­vices, and in that regard, ensure access to and use of the full range of such inter­ven­tions, includ­ing in pre­ven­tion, treat­ment and outre ach ser­vices, pris­ons and other closed set­tings, and pro­mot­ing in that regard the use, as appro­pri­ate, of the tech­ni­cal guid­ance issued by the World Health Orga­ni­za­tion, the United Nations Office on Drugs and Crime and the Joint United Nations Pro­gramme on HIV/AIDS, and note with con­cern that gen­der-based and age-based stigma and dis­crim­i­na­tion often act as addi­tional bar­ri­ers for women and for young peo­ple who use drugs, par­tic­u­larly those who inject drugs, to access and use these ser­vices.” (para­graph 37)

access to health products

• “Reaf­firm that access to safe, effec­tive, equi­table and afford­able med­i­cines and com­modi­ties for all, with­out dis­crim­i­na­tion, is fun­da­men­tal to the full real­iza­tion of the right of every­one to the enjoy­ment of the high­est attain­able stan­dard of phys­i­cal and men­tal health, yet note with grave con­cern the high num­ber of peo­ple with­out access to med­i­cine and that the sus­tain­abil­ity of pro­vid­ing life­long safe, effec­tive and afford­able HIV treat­ment con­tin­ues to be threat­ened by fac­tors such as poverty and under­score that access to med­i­cines would save mil­lions of lives.” (para­graph 42)

combination prevention

• “Com­mit to pri­or­i­tize HIV pre­ven­tion and to ensure by 2025 that 95 per cent of peo­ple at risk of HIV infec­tion, within all epi­demi­o­log­i­cally rel­e­vant groups, age groups and geo­graphic set­tings, have access to and use appro­pri­ate, pri­or­i­tized, per­son-cen­tred and effec­tive com­bi­na­tion pre­ven­tion options.” (para­graph 60)

combination prevention, key and vulnerable populations

• “Tai­lor­ing HIV com­bi­na­tion pre­ven­tion approaches to meet the diverse needs of key pop­u­la­tions, includ­ing among sex work­ers, men who have sex with men, peo­ple who inject drugs, trans­gen­der peo­ple, peo­ple in pris­ons and other closed set­tings and all peo­ple liv­ing with HIV.”” (para­graph 60(b))

combination prevention, comprehensive sexuality education

• “Com­mit­ting to accel­er­at­ing efforts to scale up sci­en­tif­i­cally accu­rate, age- appro­pri­ate com­pre­hen­sive edu­ca­tion, rel­e­vant to cul­tural con­texts, that pro­vides ado­les­cent girls and boys and young women and men, in and out of school, con­sis­tent with their evolv­ing capac­i­ties, with infor­ma­tion on sex­ual and repro­duc­tive health and HIV pre­ven­tion, gen­der equal­ity and women’s empow­er­ment, human rights, phys­i­cal, psy­cho­log­i­cal and puber­tal devel­op­ment and power in rela­tion­ships between women and men, to enable them to build self-esteem and informed deci­sion-mak­ing, com­mu­ni­ca­tion and risk reduc­tion skills and develop respect­ful rela­tion­ships, in full part­ner­ship with young per­sons, par­ents, legal guardians, care­givers, edu­ca­tors and health-care providers, in order to enable them to pro­tect them­selves from HIV infec­tion.” (para­graph 60(g))

key population and community leadership

• “Using dif­fer­en­ti­ated ser­vice deliv­ery mod­els for test­ing and treat­ment, includ­ing dig­i­tal, com­mu­nity-led and com­mu­nity-based ser­vices that over­come chal­lenges such as those cre­ated by the COVID-19 pan­demic by deliv­er­ing treat­ment and related sup­port ser­vices to the peo­ple in great­est need where they are.” (para­graph 61(b))

key population and community leadership, positive legal determinants

• “Com­mit to the Greater Involve­ment of Peo­ple Liv­ing with HIV/AIDS prin­ci­ple and to empower com­mu­ni­ties of peo­ple liv­ing with, at risk of and affected by HIV, includ­ing women, ado­les­cents and young peo­ple, to play their crit­i­cal lead­er­ship roles in the HIV response by:

  (a) Ensur­ing that rel­e­vant global, regional, national and sub­na­tional net­works and other affected com­mu­ni­ties are included in HIV response deci­sion -mak­ing, plan­ning, imple­ment­ing and mon­i­tor­ing and are pro­vided with suf­fi­cient tech­ni­cal and finan­cial sup­port;
  (b) Cre­at­ing and main­tain­ing a safe, open and enabling envi­ron­ment in which civil soci­ety can fully con­trib­ute to the imple­men­ta­tion of the present dec­la­ra­tion and the fight against HIV/AIDS;
  (c) Adopt­ing and imple­ment­ing laws and poli­cies that enable the sus­tain­able financ­ing of peo­ple-cen­tred, inte­grated, com­mu­nity responses, includ­ing peer-led HIV ser­vice deliv­ery, includ­ing through social con­tract­ing and other pub­lic fund­ing mech­a­nisms;
  (d) Sup­port­ing mon­i­tor­ing and research by com­mu­ni­ties, includ­ing the sci­en­tific com­mu­nity, and ensur­ing that com­mu­nity-gen­er­ated data are used to tai­lor HIV responses to pro­tect the rights and meet the needs of peo­ple liv­ing with, at risk of and affected by HIV.

  ” (para­graph 64)

human rights, negative legal determinants

• “Com­mit to elim­i­nat­ing HIV-related stigma and dis­crim­i­na­tion and to respect­ing, pro­tect­ing and ful­fill­ing the human rights of peo­ple liv­ing with, at risk of and affected by HIV, through con­crete resource invest­ment and devel­op­ment of guide­lines and train­ing for health-care providers, by:

  (a) Cre­at­ing an enabling legal envi­ron­ment by review­ing and reform­ing, as needed, restric­tive legal and pol­icy frame­works, includ­ing dis­crim­i­na­tory laws and prac­tices that cre­ate bar­ri­ers or rein­force stigma and dis­crim­i­na­tion such as age of con­sent laws and laws related to HIV non-dis­clo­sure, expo­sure and trans­mis­sion, those that impose HIV-related travel restric­tions and manda­tory test­ing and laws that unfairly tar­get peo­ple liv­ing with, at risk of and affected by HIV, with the aim of ensur­ing that less than 10 per cent of coun­tries have restric­tive legal and pol­icy frame­works that lead to the denial or lim­i­ta­tion of access to ser­vices by 2025;
  (b) Adopt­ing and enforc­ing leg­is­la­tion, poli­cies and prac­tices that pre­vent vio­lence and other rights vio­la­tions against peo­ple liv­ing with, at risk of and affected by HIV and pro­tect their right to the high­est attain­able stan­dard of phys­i­cal and men­tal health, right to edu­ca­tion and right to an ade­quate stan­dard of liv­ing, includ­ing ade­quate food, hous­ing, employ­ment and social pro­tec­tion, and that pre­vent the use of laws that dis­crim­i­nate against them;
  (c) Expand­ing invest­ment in soci­etal enablers—includ­ing pro­tec­tion of human rights, reduc­tion of stigma and dis­crim­i­na­tion and law reform, where appro­pri­ate—in low- and mid­dle-income coun­tries to 3.1 bil­lion United States dol­lars by 2025;
  (d) End­ing impunity for human rights vio­la­tions against peo­ple liv­ing with, at risk of and affected by HIV by mean­ing­fully engag­ing and secur­ing access to jus­tice for them through the estab­lish­ment of legal lit­er­acy pro­grammes, increas­ing their access to legal sup­port and rep­re­sen­ta­tion and expand­ing sen­si­ti­za­tion train­ing for judges, law enforce­ment, health-care work­ers, social work­ers and other duty bear­ers.

  ” (para­graph 65)

gender equality, human rights

• “Request­ing the Joint Pro­gramme to con­tinue to sup­port Mem­ber States, within its man­date, in address­ing the social, eco­nomic, polit­i­cal and struc­tural dri­vers of the AIDS epi­demic, includ­ing through the pro­mo­tion of gen­der equal­ity and the empow­er­ment of women, and human rights, by strength­en­ing the capac­i­ties of national Gov­ern­ments to develop com­pre­hen­sive national strate­gies to end AIDS and by advo­cat­ing for greater global polit­i­cal com­mit­ment in respond­ing to the epi­demic.” (para­graph 70(b))