Parliamentary Strengthening: Parliament & HIV/AIDS

Why Should Parliamentarians Play a Key Role in the Response to HIV/AIDS?

As has been introduced in previous units, strong leadership is required to effectively combat the pandemic. The greatest achievements in preventing the spread of the disease and alleviating the impact of HIV/AIDS has been found in countries where the political leadership has demonstrated strong political will and a firm commitment to prioritize, acknowledge and respond to the crisis openly.

In some countries, the executive branch of government has taken the necessary leadership role to respond to the crisis and ensured that a multisectoral approach was undertaken in the fight against the disease. However, other countries have suffered from the lack of leadership and commitment from political leaders who have largely ignored or avoided the issue, or have not spoken truthfully on the facts about HIV/AIDS. Countries such as Brazil, Cambodia, Senegal, and Uganda are known for their strong political leadership on HIV/AIDS in terms of both treatment and prevention efforts, while other countries such as China and South Africa have demonstrated weak responses to the pandemic (see unit 1 and 2 for more information and examples). Consequently, rates of HIV infection and disease outcomes continue to rise in these countries. Regardless of the level of involvement of the Executive in the fight against HIV/AIDS, parliamentarians have an important leadership role to play in the response to the pandemic.

Parliamentarians are leaders in society and have both the mandate and the public confidence to act in the interests of the community by responding to the HIV crisis. As elected representatives, they have the legitimacy and the duty to make critical decisions about policy issues and legislation that impact on the lives of citizens. As a nation’s legislative body, parliamentarians have the responsibility to enact laws that will protect the rights of those affected by HIV/AIDS such as, people living with HIV/AIDS (PLWHA), orphans, and vulnerable groups. They must also ensure that legislation exists to ensure equal access to healthcare, education and other social services for all citizens. Because parliamentarians also hold the purse strings of government and are mandated to review and approve the national budget, they are the key players in influencing what percentage of the overall budget is allocated to health care and specific programs to fight HIV/AIDS. As representatives of the people, parliamentarians also have a duty to speak out about HIV/AIDS and confront the stigma and taboos in a very public manner.

The global response to HIV/AIDS has intensified in recent years and governments all over the world have committed to several declarations and targets to respond to the pandemic including the Declaration of Commitment on HIV/AIDS, the Abuja Declaration, and the Millennium Development Goals (See Unit 3 – Global Responses to HIV). In this environment, parliamentarians have a critical oversight role to play in order to ensure that the targets outlined in the aforementioned documents are met and that national programs and policies are in place to implement strategies to reduce the spread and impacts of HIV/AIDS.

Although there are significant commitments and pledges to the fight against HIV/AIDS and important progress has been made in several countries to increase the national response to the pandemic, there remain fundamental problems in fulfilling international commitments and implementing policies and programs. Some countries may have achieved great improvements in access to treatment and antiretroviral drugs (ARVs) but may still be lacking in adequate legislation to protect the human rights of people living with HIV/AIDS (PLWHA). Other countries may have developed strong education and prevention programs but not allocated sufficient resources in their health budget to offer equal access to treatment. International funding for AIDS has increased but problems with corruption and misuse of funds have curtailed efforts in certain countries.

Although there have been marked increases in access to ARVs, many people living with HIV in low- and middle-income countries still lack access to these life saving medications. For example, even though 3 million individuals in low- to middle- income had access to ARVs in 2007, this only represents 31% of those in need. In addition, only 33% of HIV-positive pregnant women had access to medicines to prevent mother-to-child transmission globally in 2007, and only 15% of children in need of treatment actually received it;
Evidence still demonstrates that children are significantly less likely than adults to receive treatment. Without treatment half of all children infected with perinatal HIV will die by the age of two, despite this statistic children are only one third as likely to receive treatment as adults;
The number of new HIV infections continues to outstrip the increase each year in the number of people on antiretroviral drugs by 2.5 to 1. Thus, the long-term sustainability of even the current pace of treatment scale-up may be jeopardized;
National health budgets in low-middle income countries in Africa fail to meet the Abuja Declaration 15% target;
Stigma and discrimination against people living with HIV is ubiquitous and there is a lack of protective legislation for such vulnerable groups such as sex-workers, injecting drug users, and men who have sex with men. Weak legislation that addresses these groups have left to the abuse and discrimination of vulnerable groups at high risk to HIV infection;
Countries are struggling to address the growing problem of HIV orphans;
HIV is a social and cultural issue and many governments have failed to promote and encourage dialogue among populations on sensitive issues such as gender equality, sexual and reproductive health or homosexuality;
Countries most affected by HIV will fail to meet other Millennium Development Goals and are already suffering from weakened development and poor economic growth as a result of HIV/AIDS.