In The Field

A question of rights

Posted on behalf of Roxanne Khamsi, News editor of Nature Medicine

Heavy rain and traffic could not keep thousands of people from attending the opening session of the AIDS 2008 meeting here in Mexico City last night. There, in the massive auditorium, we heard rallying cries against HIV/AIDS from global leaders, including Ban Ki-moon, UN secretary general; Margaret Chan, director general of the World Health Organization (WHO); and Felipe Calderon Hinojosa, president of Mexico. The speakers remained on message, echoing the theme of this year’s conference: a call for broader and more comprehensive treatments and prevention measures under the headline ‘Universal Action Now’.

The crowd was generally responsive to each of the talks; but they saved most of their enthusiasm for one of the lesser-known presenters.

The biggest applause by far came after a speech made by Keren Dunaway-Gonzalez, a 13-year-old young lady from Honduras. Keren has seen first-hand the discrimination and difficulties faced by HIV-positive youngsters and edits a magazine, “Llavecitas”, to raise awareness about the need for a more concentrated effort to support infected children with medications and counseling as they plan for the future. Her talk served as a much-needed reminder that HIV/AIDS is not just a disease that affects individuals and requires individual action: it remains an illness that can impact entire families and therefore requires a family-based approach as well.

For me, the most provocative point in the opening session came during a speech made by Festus Mogae, the former president of Botswana. In his talk, Mogae outlined what he saw as a real and important difference between ‘human rights’ and ‘civil rights’. The first, he said, is sacrosanct and should never be compromised under any circumstances. But then he gave the example of a measles epidemic in which parents objected to vaccines for their children, yet authorities went ahead with the child vaccinations anyway. This, he said, was a rare example of when the need to protect the greater good and prevent the spread of a disease requires action that some might argue compromises civil rights. But he stressed that the vaccination did not violate human rights. The question is, of course, whether it is fair to draw this human/civil rights distinction for measles, HIV/AIDS or other infectious diseases, and if so what good it does to differentiate between the two. The words ‘slippery slope’ come to my mind.


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