In 2006, world leaders committed “to pursuing all necessary effort towards the goal of universal access to comprehensive prevention programs, treatment, care and support by 2010.” Yet many of those most in need of HIV services are still the least likely to receive them:
- Women and girls face widespread discrimination and gender-based violence, including within marriage, that fuel their HIV risk and impede their access to information and services.
- Children and youth lack unfettered access to HIV information, sexual and life-skills education, and pediatric formulations of HIV medicines.
- Criminalized populations, such as men who have sex with men, people who use drugs, and sex workers, are driven from HIV services by discrimination and violence, often at the hands of police officers and judges charged with enforcing sodomy, narcotics, and prostitution laws.
In every regional and country consultation on universal access, obstacles such as these have been cited as major barriers to achieving the goal of universal access.Yet in national responses to HIV and AIDS, hardly any political commitment, funding, or programming is dedicated to overcoming them.
The French have a simple term that says it all: HIV has become a problem mainly for les exclus, or “the excluded ones,” living at the margin of society.
—Jonathan Mann, 1998