Abstract Book Vol. 2 [International Conference on AIDS (14th: 2002: Barcelona, Spain)]

650 Abstracts ThPeG8246-ThPeG8250

XIV International AIDS Conference

ThPeG8246I An option for living together
M.R. Jim6nez Cruz, M.S. Galeano Velasco. ASSUR, Bogota D.C., Colombia
Subject: Human Rights and HIV/AIDS.
Descriptions: Training processes in
human and sexual rights, to spread
the Colombian legislation for sexually transmitted diseases (STD),
HIV/AIDS, and therefore endorse
the rights of the people living with
HIV/AIDS, rested on sensitization
processes based on the recognition,
the dignity and the equality of the
people and thus generating spaces
of respect and living together. Addressed to persons that lead prevention programs in STD and AIDS for
the private and public Health Services, teachers, NGO and Self-help
groups.
Lessons learnt:
- The confirmation that the disregard of the rights, duties and protection mechanisms makes the persons more vulnerable to the violation
of their own rights.
- The limited knowledge of the health
professionals about general information of HIV and Health System was
evident.
- It was observed that the discrimination to HIV/AIDS and other STD,
is linked to religious and cultural believes that condemn the free and autonomous sexuality exercise.
- The project opens a meeting place for the human being in which one can recognize the pluralism and diversity, the respect and the acceptance of the fellow in
order to build a world where living with others may be possible.
Results:
- The join of 12 states, 10 more will join during the second phase.
- 420 persons were prepared in human, sexual and reproductive rights, legislation and protection mechanisms.
- 10500 persons benefited by the actions taken for the territorial groups already
trained.
- Creation and distribution of educational material.
Recommendations:
- To carry out processes that beyond information, sensitize and provide persons
with tools that allow them to empower their own rights and know the mechanisms
that let them endorse the exercise of them.
- To develop the project in other regions of the country giving priority to those
where the access to the information is restrained due to the distance and economic conditions.
Presenting author: Edgar Enrique Jim6nez Cruz, Calle 115 No. 41 - 42 Apto.
602 Bogota D.C., Colombia, Tel.: [phone], Fax: [phone], E-mail:
[email protected]
ThPeG8247 Evidence based human rights
C.L. Ward', A.E. Grulich2. 'Australian Federation of AIDS Organisations,
Australian Federation of AIDS Organisations, PO Box 876, Darlinghurst 1300,
Australia; 2National Centre in HIV Epidemiology and Clinical Research, Sydney,
Australia
Issues: How has recent Australian litigation shaped the human rights of people
living with HIV/AIDS (PLWHA) and their associates? How has the evidence of
expert medical witnesses contributed to that process?
Description: Whether enshrined in international human rights instruments or in
anti-discrimination and equal opportunity laws, rights and freedoms enjoyed by
individuals are subject to the rights and freedoms of others. Recent Australian
litigation has involved judicial consideration of the human rights of people living
with HIV/AIDS, and the limits of those rights where they are perceived to clash
with the rights of other people.
A common justification for limiting the rights of PLWHA is that this is required to
protect the health of others. Where it is alleged that exceptions to otherwise legally
protected rights should be permitted, the evidence of expert medical witnesses
has played a central role in shaping judicial decisions, and hence the rights of
PLWHA in Australia.
Recent cases have considered whether PLWHA have the right to play football,
whether a pregnant PLWHA has the right to decide her own medical treatment,

and whether the associates of a person who died of an AIDS related illness are
entitled to have the body reassembled after autopsy, for the purposes of viewing.
In each case, judicial determination of priority as between competing claims of
legal right has depended on the evidence of one or more medical witnesses.
Lessons learned: 1. Expert medical witnesses can play a central role in delineating the human rights of PLWHA.
2. Submission of the best available evidence can be crucial to a fair and proper
determination by courts and tribunals of the extent of the human rights of PLWHA.

Recommendation: Lawyers acting for PLWHA should work closely with medical
experts to ensure that, where relevant, the best available medical evidence as to
the risk of harm to others is submitted for consideration by courts and tribunals.
Presenting author: Christopher Ward, Australian Federation of AIDS Organisations, PO Box 876, Darlinghurst 1300, Australia, Tel.: [phone], Fax: +61
2 9281 1044, E-mail: [email protected]
ThPeG8248 Ethics and the rhetoric of reaction: new pressures
against the 2000 Version of the Declaration of
Helsinki
D.B. Greco. School of Medicine, Post-Graduation Program in Tropical Medicine,
Federal University of Minas Gerais, Rua Goitacazes, 14, 30190-050 Belo
Horizonte, Brazil
Absence of treatment in developing countries has been used to justify pressures
to lower the ethics requirements of the DoH. One fallacious reasoning is that the
volunteers are poor and will not get any worse as result of the trial, as if their
problems were not the researchers' business. The 2000 DoH kept the restrictions
to placebo use, adding: "At the conclusion of the study, every patient... should
be assured of access to the best proven (medical care) identified by the study".
This is progress but access during the trial was not included and misinterpretation
may occur: e.g., volunteers infected in HIV vaccine trials will not get treated, as
sponsors could argue that the needed drugs are not due because were not identified by the study. This can been resolved by substituting for relevant to the study
obligating the provision of the best treatment even if established outside the trial.
Conclusion: DoH establishes adequate ethical standards independent of origin
or economic power. It may also be a spearhead to improve access to health care,
providing everyone with the benefits of research. A Phase III trial should be done
where best proven medical care is available and cost of care should be an integral
part of the budget. If the product is effective it must be made available wherever
needed. In the critical discussions of the DoH, scientists and activists resisted
against lowering the ethical standards - a small step in the much more difficult
battle to ascertain that the status quo of disparity is not immutable. Recently the
rhetoric of reaction is being used, i.e. changes are either futile, perverse or will
jeopardize the hard won reforms: under pressures from drug companies and US
agencies the WMA reinterpreted the DoH allowing the use of placebo for a minor
condition, when there is no additional risk of serious or irreversible harm. This
seemingly innocent change may start the watering down of the gains of 2000
DoH.
Presenting author: Dirceu Greco, Rua Goitacazes, 14, 30190-050 Belo Horizonte, Brazil, Tel.: [phone], Fax: [phone], E-mail: greco
@medicina.ufmg.br
ThPeG8250 Ensuring the optimal legal framework for HIV
vaccine trials in South Africa
T.F. Smit. AIDS Legal Network, South African HIV Vaccine Action Programme,
24 Bowden Road, Observatory, Cape Town, South Africa, South Africa
Issues: Ensuring the optimal legal framework to secure the human rights of HIV
vaccine trial participants and those affected by the upcoming HIV vaccine trials
in South Africa - through scientific review, ethical review, constitutional and other
legal protection.
Descriptions: The paper is based on a survey that has been undertaken of all
the laws in South Africa that affect HIV vaccine development and ultimately ensure the protection of HIV vaccine trial participants and those affected by the
trials. This includes the legal framework for the scientific review process, i.e. the
registration of a candidate vaccine with the regulatory body; the process of ethical review (also the possibility of strengthening this as intended in the National
Health Bill); constitutional provisions, such as the right not to be subjected to
scientific experiments without informed consent, equality and privacy; and other
legal protection through the law of delict and of contract. The aim of the survey is
to establish if there are major gaps in this legal framework and if anything is being
done to address these gaps.
Lessons learnt: The current legal framework for HIV vaccine development in
South Africa can be further improved to ensure the optimal safeguard of human
rights of HIV vaccine trial participants and those affected by the trials.
Recommendations: The recommendations include that the National Health Bill,
which is being delayed and will particularly strenthen the ethical review system,
should be passed and enacted as soon as possible; makes recommendations for
clarity concerning the Acts providing the regulatory framework for scientific review; and further legal finetuning, e.g. changes to the Life Officers Association's
Code of Practice related to HIV testing, and also to Professional Codes.
Presenting author: Thomas Smit, 24 Bowden Road, Observatory, Cape Town,
South Africa, South Africa, Tel.: [phone], Fax: [phone], E-mail:
alncpt @ mweb.co.za