CHRGJ Hosts Discussion on Global Health Governance Through the Lens of Human Rights

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On Friday March 25, the Center for Human Rights and Global Justice at NYU School of Law hosted a discussion with Sara L.M. Davis (Meg), as part of its Human Rights in Practice Series, which addresses current issues in human rights practice on the basis of groundbreaking scholarship. The discussion was based on Davis’s most recent research, which focuses on the impact on global health indicators of laws criminalizing certain types of sexual behavior. The discussion drew an audience of  human right practitioners, lawyers and students with an interest in global health aid and in the impact of human rights (measurement) on health.

With 21 million HIV-positive people currently not receiving treatment, the Fast Track approach is often presented as the only viable solution to keep the epidemic under control. It is increasingly acknowledged that even this approach, stands to fail if investments are not considerably scaled up. Meg Davis argued that investments alone cannot curtail the epidemic. Without gaining a better understanding of the target population and who needs treatment, or how we can best reach that group, the impact of investments is bound to be suboptimal. Davis’s research sets out to improve our understanding of this group, and critically examines human rights indicators to shed light on the realities of these rights-holders.

Her research compares data on national laws that criminalize same-sex sexual behavior with reported national UNAIDS HIV indicators for men who have sex with men (MSM), to explore potential correlations. The study utilizes legal mapping by the International Lesbian, Gay, Bisexual, Trans and Intersex Association (ILGA) and HIV data reported by United Nations (UN) member states to UNAIDS between 2005 and 2014. It examines key population size estimates as a percentage of national populations. It also compares distribution of key population size estimates with UN member states’ reported condom use, HIV testing coverage, and HIV prevalence among MSM. Her statistical analysis found correlations between laws criminalizing same-sex sexual behavior and low performance on HIV indicators. The study also found that countries that criminalize same-sex sexual behavior do indeed face challenges in identifying MSM populations and reaching them with HIV prevention services. At the same time, the research points to how the use of quantitative data may fail to measure and assess needs accurately when it does not take into account human rights conditions.

Davis’s research shows that without reliable size estimates of key populations and data on how they are affected by HIV, it is sometimes impossible to persuade health officials to prioritize and fund services to meet those populations’ specific needs. Furthermore, she noted challenges such as ‘denialism’ and ‘state pride’, which make affected populations invisible within their own countries. At the same time, Davis  also warned for the danger of making these populations visible, as their visibility may, in fact, leave them more vulnerable to discrimination or criminalization in those states that have laws criminalizing certain kinds of sexual behavior.

Finally, Davis underlined how the lack of clear global standards and indicators upon which governments can measure actual progress in meeting global targets and goals hampers any meaningful discussion based on quantitative data. Through the discussion, Meg encouraged organizations of civil society and academic institutions to support the collection of reliable data that can be used to pressure governments to adopt policies that are in line with International Human Rights Law, and that do not put rights-holders at risk.