Let's begin with a story. Once upon a time -- well actually less than two years ago -- in a kingdom not so very far away, there was a man who traveled many miles to come to work at the jewel in the kingdom's crown -- an internationally famous company. Let's call it Island Networks. Now this kingdom had many resources and mighty ambitions, but the one thing it lacked was people. And so it invited workers from around the world to come and help it build the nation. But in order to enter and to stay these migrants had to pass a few tests. And so it was, our man presented himself to authorities in the kingdom, looking forward to settling into his new life.
Hajde da počnemo s jednom pričom. Nekada davno - u stvari, pre manje od dve godine - u kraljevstvu ne tako dalekom, živeo je čovek koji je prešao mnogo kilometara da bi dospeo da radi u dragulju kraljevske krune - međunarodno poznatoj kompaniji. Nazvaćemo je „Island Networks“. To kraljevstvo je imalo mnogo sredstava i velikih ambicija, ali jedna stvar koja joj je manjkala bili su ljudi. I tako je pozvano mnogo radnika iz celog sveta da dođu i pomognu u izgradnji nacije. Ali, da bi došli tamo i ostali doseljenici su morali da prođu nekoliko ispita. I tako je i bilo. Junak naše priče pojavio se pred nadležnima kraljevstva, radujući se svom novom životu.
But then something unexpected happened. The medical personnel who took blood samples from the man never actually told him what they were testing for. He wasn't offered counseling before or after the test, which is best medical practice. He was never informed of the results of the test. And yet, a couple of weeks later, he was picked up and taken to prison where he was subjected to a medical exam, including a full-body search in full view of the others in the cell. He was released, but then a day or two later, he was taken to the airport and he was deported. What on earth did this man do to merit this treatment? What was his terrible crime? He was infected with HIV.
A onda se nešto neočekivano dogodilo. Medicinsko osoblje koje je uzelo uzorak njegove krvi nikada mu nije reklo na šta ga testiraju. Nije mu ponuđeno savetovanje ni pre ni posle testa, što je uobičajena medicinska procedura. Nikada nije obavešten o rezultatima testa. Ipak, par nedelja kasnije, ljudi su došli po njega i odveli ga u pritvor gde je podvrgnut medicinskom ispitivanju, koje je uključilo ispitivanje čitavog tela pred svim prisutnim u ćeliji. Oslobođen je, ali dan ili dva kasnije odveden je na aerodrom i deportovan. Šta je, zaboga, taj čovek uradio da zasluži ovakav tretman? Koji je bio njegov užasni zločin? Bio je zaražen HIVom.
Now the kingdom is one of about 50 countries that imposes restrictions on the entry or stay of people living with HIV. The kingdom argues that its laws allow it to detain or deport foreigners who pose a risk to the economy or the security or the public health or the morals of the state. But these laws, when applied to people living with HIV, are a violation of international human rights agreements to which these countries are signatories. But you know what? Matters of principle aside, practically speaking, these laws drive HIV underground. People are less likely to come forth to be tested or treated or to disclose their condition, none of which helps these individuals or the communities these laws purport to protect.
To kraljevstvo je jedno od pedesetak zemalja koje je postavilo ograničenja na ulazak i boravak osoba koje žive s HIVom. Kraljevstvo tvrdi da mu njegovi zakoni dozvoljavaju da zadrži ili deportuje strance koji predstavljaju rizik po njegovu privredu, bezbednost, javno zdravlje ili moral države. Ali ti zakoni, primenjeni na ljude koji žive s HIVom, jesu kršenje internacionalnog sporazuma o ljudskim pravima koji su te zemlje potpisale. Ali, znate šta? Ako ostavimo principe po strani, realno gledano, ti zakoni teraju HIV u podzemlje. Manje je verovatno da će se osobe odlučiti na to da budu testirane ili lečene, ili da otkriju svoje stanje, a ni jedno ni drugo neće pomoći ni njima kao jedinkama, ni zajednicama koje ti zakoni nazovi štite.
Today we can prevent the transmission of HIV. And with treatment, it is a manageable condition. We are very far from the days when the only practical response to dread disease was to have banished the afflicted -- like this, "The Exile of the Leper." So you tell me why, in our age of science, we still have laws and policies which come from an age of superstition.
Danas se prenošenje HIVa može sprečiti. Uz terapiju, to oboljenje je moguće kontrolisati. Daleko smo od vremena kada je jedini logičan odgovor na ozbiljna oboljenja bio prognati obolele - poput ovoga: „Progon gubavaca“. Recite mi zašto, u našem dobu nauke, još uvek imamo zakone i norme koji potiču iz doba sujeverja.
Time for a quick show of hands. Who here has been touched by HIV -- either because you yourself have the virus or you have a family member or a friend or a colleague who is living with HIV? Hands up. Wow. Wow. That's a significant number of us.
Vreme je za brzo podizanje ruku. Ko je ovde dolazio u kontakt s HIVom - bez obzira na to da li vi lično imate virus ili imate člana porodice, prijatelja ili kolegu koji živi s HIVom? Ruke gore. Opa. Brojni smo.
You know better than anyone that HIV brings out the best and the worst in humanity. And the laws reflect these attitudes. I'm not just talking about laws on the books, but laws as they are enforced on the streets and laws as they are decided in the courts. And I'm not just talking about laws as they relate to people living with HIV, but people who are at greatest risk of infection -- people such as those who inject drugs or sex workers or men who have sex with men or transgendered persons or migrants or prisoners. And in many parts of the world that includes women and children who are especially vulnerable.
Znate bolje od bilo koga da HIV budi ono najbolje i ono najgore u čoveku. Zakoni oslikavaju te stavove. Ne mislim samo na zakone ispisane u knjigama, već na zakone koji važe na ulici i one kojima se odlučuje na sudu. Ne mislim samo na zakone koji se odnose na osobe koje žive s HIVom, već i na osobe koje su pod najvećim rizikom da budu zaražene - osobe poput onih koje ubrizgavaju drogu, ili koje pružaju seksualne usluge, muškarcima koji imaju odnose sa muškarcima, transrodnim osobama, doseljenicima, zatvorenicima. U mnogim delovima sveta to uključuje žene i decu koji su posebno osetljiva grupa.
Now there are laws in many parts of the world which reflect the best of human nature. These laws treat people touched by HIV with compassion and acceptance. These laws respect universal human rights and they are grounded in evidence. These laws ensure that people living with HIV and those at greatest risk are protected from violence and discrimination and that they get access to prevention and to treatment. Unfortunately, these good laws are counter-balanced by a mass of really bad law -- law which is grounded in moral judgement and in fear and in misinformation, laws which specifically punish people living with HIV or those at greatest risk. These laws fly in the face of science, and they are grounded in prejudice and in ignorance and in a rewriting of tradition and a selective reading of religion.
Postoje zakoni u mnogim delovima sveta koji odražavaju ono najbolje u ljudskoj prirodi. Ti zakoni tretiraju osobe pogođene HIVom sa saosećanjem i prihvatanjem. Ti zakoni poštuju univerzalna ljudska prava i utemeljeni su na dokazima. Ti zakoni osiguravaju da osobe koje žive s HIVom i oni koji su izloženi riziku budu zaštićeni od nasilja i diskriminacije i da imaju pristup prevenciji i lečenju. Nažalost, dobri zakoni su suprotstavljeni gomili zaista loših zakona - zakona utemeljenih na moralnoj osudi, strahu i pogrešnoj informisanosti. To su zakoni koji ciljano kažnjavaju ljude koji žive s HIVom ili one koji podležu najvećem riziku. Ti zakoni su sušta suprotnost nauci, zasnovani su na predrasudama, neznanju, prepravljanju tradicije i selektivnom tumačenju religije.
But you know what? You don't have to take my word for it. We're going to hear from two people who are on the sharp end of the law. The first is Nick Rhoades. He's an American. And he was convicted under the U.S. State of Iowa's law on HIV transmission and exposure -- neither of which offense he actually committed.
Znate šta? Ne morate mi verovati na reč. Saslušaćemo dvoje ljudi koji su izvukli deblji kraj tih zakona. Prvi je Nik Rouds. On je Amerikanac. Zakonom Savezne države Ajove osuđen je za izlaganje i širenje HIVa, iako ništa od toga nije počinio.
(Video) Nick Rhoades: If something is against the law then that is telling society that is unacceptable, that's bad behavior. And I think the severity of that punishment tells you how bad you are as a person. You're a class B felon, lifetime sex offender. You are a very, very, very bad person. And you did a very, very, very bad thing. And so that's just programmed into you. And you go through the correctional system and everyone's telling you the same thing. And you're just like, I'm a very bad person.
(Snimak) Nik Rouds: Ako je nešto nezakonito onda to govori društvu da je to neprihvatljivo, da je to loše. I mislim da jačina te kazne govori koliko ste loša osoba. Ti si prestupnik niže klase, doživotni seksualni prestupnik. Ti si veoma, veoma, veoma loša osoba. I učinio si veoma, veoma, veoma lošu stvar. Onda je to prosto programirano u vas. Prolazite kroz popravni sistem u kome vam svi govore istu stvar. Dok i vi ne kažete sebi: „Ja sam veoma loša osoba.“
Shereen El-Feki: It's not just a question of unfair or ineffective laws. Some countries have good laws, laws which could stem the tide of HIV. The problem is that these laws are flouted. Because stigma gives unofficial license to treat people living with HIV or those at greatest risk unlike other citizens. And this is exactly what happened to Helma and Dongo from Namibia.
Šerin El-Feki: To nije samo pitanje nepravednih i beskorisnih zakona. Neke zemlje imaju dobre zakone, zakone koji bi mogli da zaustave talas HIVa. Problem je što se ti zakoni krše. Jer žigosanjem se nezvanično dozvoljava da se osobe koje žive s HIVom ili oni pod najvećim rizikom da ga dobiju, ne tretiraju kao i ostali građani. Upravo to se dogodilo Hilmi Ndongo iz Namibije.
(Video) Hilma: I found out when I went to the hospital for a pregnancy check-up. The nurse announced that every pregnant woman must also be tested for HIV that day. I took the test and the result showed I was positive. That's the day I found out. The nurse said to me, "Why should you people bcome pregnant when you know you are HIV positive? Why are you pregnant when you are living positive?" I am sure now that is the reason they sterilized me. Because I am HIV positive. They didn't give the forms to me or explain what was in the form. The nurse just came with it already marked where I had to sign. And with the labor pain, I didn't have the strength to ask them to read it to me. I just signed.
(Snimak) Hilma: Saznala sam kada sam otišla u bolnicu na pregled zbog trudnoće. Sestra je obznanila da svaka trudnica mora biti testirana i na HIV tog dana. Uradila sam test i rezultati su pokazali da sam pozitivna. Tog dana sam saznala. Medicinska sestra me je upitala zašto sam zatrudnela ako sam znala da sam HIV pozitivna. Zašto sam uopšte trudna ako živim pozitivna. Sada sam sigurna da je to razlog zbog kog su me sterilisali. Jer sam HIV pozitivna. Nisu mi dali formulare, niti mi objasnili šta u njima piše. Sestra ih je samo donela sa već naznačenim mestom na kom treba da potpišem. Zbog porođajnih bolova, nisam imala snage da ih zamolim da mi pročitaju šta tu piše. Samo sam potpisala.
SE: Hilma and Nick and our man in the kingdom are among the 34 million people living with HIV according to recent estimates. They're the lucky ones because they're still alive. According to those same estimates, in 2010 1.8 million people died of AIDS related causes. These are terrible and tragic figures. But if we look a little more broadly into the statistics, we actually see some reason for hope.
Šerin El-Feki: Hilma i Nik i naš čovek iz kraljevstva nalaze se među 34 miliona osoba koje žive s HIVom po najskorijim procenama. Oni imaju sreće jer su još uvek živi. Po istim tim procenama 2010. godine je umrlo 1,8 miliona osoba koje su imale neke veze sa sidom. To su užasne i tragične cifre. Ali ako malo šire sagledamo statistiku, vidimo da zapravo postoji razlog za nadu.
Looking globally, the number of new infections of HIV is declining. And looking globally as well, deaths are also starting to fall. There are many reasons for these positive developments, but one of the most remarkable is in the increase in the number of people around the world on anti-retroviral therapy, the medicines they need to keep their HIV in check.
Globalno, broj novozaraženih HIVom se smanjuje. Takođe gledano globalno, broj smrti se takođe smanjuje. Mnogo je razloga za te pozitivne događaje, a među najneverovatnijima je porast broja ljudi širom sveta koji koriste anti-retroviralnu terapiju, lekove koji su im potrebni da HIV drže pod kontrolom.
Now there are still many problems. Only about half of the people who need treatment are currently receiving it. In some parts of the world -- like here in the Middle East and North Africa -- new infections are rising and so are deaths. And the money, the money we need for the global response to HIV, that is shrinking. But for the first time in three decades into this epidemic we have a real chance to come to grips with HIV. But in order to do that we need to tackle an epidemic of really bad law.
Ali i dalje postoje mnogi problemi. Samo polovina osoba kojima je terapija potrebna trenutno je i prima. U nekim delovima sveta - poput Bliskog Istoka i severne Afrike, broj zaraženih raste, kao i njihova smrtnost. A novac, novac koji nam je potreban da se na svetskom nivou izborimo s HIVom polako nestaje. Ali po prvi put u toku tri decenije ove epidemije imamo realne šanse da se s HIVom izborimo. Da bismo to uradili moramo se izboriti s epidemijom loših zakona.
It's for this reason that the Global Commission on HIV and the Law, of which I'm a member, was established by the agencies of the United Nations -- to look at the ways that legal environments are affecting people living with HIV and those at greatest risk, and to recommend what should be done to make the law an ally, not an enemy, of the global response to HIV.
Iz tog razloga je Globalna komisija za HIV i pravo, čiji sam član osnovana je od strane agencija Ujedinjenih nacija - da sagleda način na koji pravosuđe utiče na ljude s HIVom i one koji su pod najvećim rizikom, i da preporuči šta treba da se uradi da bi zakon bio saveznik, a ne neprijatelj, globalnom suočavanju s HIVom.
Let me give you just one example of the way a legal environment can make a positive difference. People who inject drugs are one of those groups I mentioned. They're at high risk of HIV through contaminated injection equipment and other risk-related behaviors. In fact, one in every 10 new infections of HIV is among people who inject drugs. Now drug use or possession is illegal in almost every country. But some countries take a harder line on this than others.
Daću vam jedan primer kako zakonodavstvo može da napravi pozitivnu razliku. Ljudi koji ubrizgavaju drogu jedna su od grupa koje sam pomenula. Oni su pod visokim rizikom da dobiju HIV preko zaražene opreme za ubrizgavanje i drugih rizičnih aktivnosti koje obavljaju. Zapravo, jedna od deset osoba koje se zaraze HIV dobije preko igle. Korišćenje i posedovanje droge ilegalno je u skoro svim zemljama. Ali neke zemlje imaju čvršći stav o ovome od ostalih.
In Thailand people who use drugs, or are merely suspected of using drugs, are placed in detention centers, like the one you see here, where they are supposed to clean up. There is absolutely no evidence to show that throwing people into detention cures their drug dependence. There is, however, ample evidence to show that incarcerating people increases their risk of HIV and other infections.
Na Tajlandu, ljudi koji koriste drogu, ili su makar osumnjičeni za to, smeštaju se u pritvorne jedinice poput ove koju vidite, gde bi trebalo da se očiste. Nema apsolutno nikakvih dokaza da zatvaranje ljudi leči zavisnost. S druge strane, mnogo je dokaza da zatvaranje ljudi povećava rizik od HIVa i drugih infekcija.
We know how to reduce HIV transmission and other risks in people who inject drugs. It's called harm reduction, and it involves, among other things, providing clean needles and syringes, offering opioid substitution therapy and other evidence-based treatments to reduce drug dependence. It involves providing information and education and condoms to reduce HIV transmission, and also providing HIV testing and counseling and treatment should people become infected. Where the legal environment allows for harm reduction the results are striking.
Znamo kako da smanjimo prenos HIVa i ostale rizike kod ljudi koji ubrizgavaju drogu. To se zove smanjenje štete i uključuje, između ostalog, obezbeđivanje čistih igala i špriceva, nuđenje terapije zamenskim opioidima i druge dokazane tretmane koji smanjuju zavisnost od droga. To uključuje i pružanje informacija, potrebnog znanja i kondoma da bi se smanjilo prenošenje HIVa, ali takođe i obezbeđivanje testiranja na HIV, savetovanje i lečenje ukoliko se ispostavi da je osoba zaražena. Tamo gde pravosuđe dozvoljava ublažavanje štete rezultati su zapanjujući.
Australia and Switzerland were two countries which introduced harm reduction very early on in their HIV epidemics, and they have a very low rate of HIV among injecting drug users. The U.S. and Malaysia came to harm reduction a little later, and they have higher rates of HIV in these populations. Thailand and Russia, however, have resisted harm reduction and have stringent laws which punish drug use. And hey, surprise, very high rates of HIV among people who are injecting drugs.
Australija i Švajcarska su dve zemlje koje su prve uvele tu praksu na samom početku epidemije, i sada imaju jako nizak broj obolelih od HIVa među zavisnicima od igle. SAD i Malezija uvele su tu praksu malo kasnije, i imaju veći broj obolelih među tom populacijom. Tajland i Rusija su se, pak, oglušili o tu praksu i imaju rigorozne zakone koji kažnjavaju upotrebu droge. Zamislite! iznenađenje! Imaju i veoma velik broj osoba s HIVom koje ubrizgavaju drogu.
At the Global Commission we have studied the evidence, and we've heard the experiences of over 700 people from 140 countries. And the trend? Well the trend is clear. Where you criminalize people living with HIV or those at greatest risk, you fuel the epidemic. Now coming up with a vaccine for HIV or a cure for AIDS -- now that's rocket science. But changing the law isn't. And in fact, a number of countries are starting to make progress on a number of points. To begin, countries need to review their legislation as it touches HIV and vulnerable groups. On the back of those reviews, governments should repeal laws that punish or discriminate against people living with HIV or those at greatest risk.
U Globalnoj komisiji smo proučavali dokaze i čuli iskustva preko sedamsto ljudi iz 140 zemalja. I kakva je praksa? Praksa je jasna. Tamo gde se žigošu osobe s HIVom ili one koje su pod većim rizikom epidemija se samo pospešuje. Pronalaženje vakcine protiv HIVa ili leka za sidu - to je jako teško. Ali menjanje zakona nije. Zapravo, priličan broj zemalja počinje da pravi pomak na mnogim poljima. Za početak, države treba da provere zakonodavstvo jer se tiče osoba s HIVom kao i ranjivih grupa. Na osnovu te provere, vlade treba da ukinu zakone koji kažnjavaju ili diskriminišu osobe koje žive s HIVom ili su pod visokim rizikom da ga dobiju.
Repealing a law isn't easy, and it's particularly difficult when it relates to touchy subjects like drugs and sex. But there's plenty you can do while that process is underway. One of the key points is to reform the police so that they have better practices on the ground. So for example, outreach workers who are distributing condoms to vulnerable populations are not themselves subject to police harassment or abuse or arbitrary arrest. We can also train judges so that they find flexibilities in the law and so that they rule on the side of tolerance rather than prejudice. We can retool prisons so that HIV prevention and harm reduction is available to prisoners.
Ukidanje zakona nije lak posao, a posebno je težak tamo gde je povezan sa osetljivim temama, poput droge i seksa. Mnogo se može uraditi dok taj proces traje. Ključna stvar je reforma policije da bi na terenu rezultati bili bolji. Na primer, da terenski radnici koji dele kondome ugroženima ne podlegnu policijskom maltretiranju, zlostavljanju ili nasumičnom hapšenju. Sudije se takođe mogu obučiti da pronalaze fleksibilnosti u zakonu, tako da budu na strani trpeljivosti pre nego predrasuda. Zatvori se mogu snabdeti tako da prevencija HIVa i smanjenje štete budu dostupni i zatvorenicima.
The key to all this is reinforcing civil society. Because civil society is key to raising awareness among vulnerable groups of their legal rights. But awareness needs action. And so we need to ensure that these people who are living with HIV or at greatest risk of HIV have access to legal services and they have equal access to the courts. And also important is talking to communities so that we change interpretations of religious or customary law, which is too often used to justify punishment and fuel stigma.
Ključ svega je podsticanje društva, jer je ono ključ podizanja svesti ranjivih grupa o njihovim zakonskim pravima. Ali svest zahteva delanje. Moramo se osigurati da osobe koje žive s HIVom ili su pod rizikom da ga dobiju imaju pristup zakonskim uslugama i jednak pristup sudu. Važno je i razgovarati sa zajednicama tako da promenimo interpretacije verskog i običajnog prava koja se prečesto koriste kao opravdanje za kaznu i podsticanje žigosanja.
For many of us here HIV is not an abstract threat. It hits very close to home. The law, on the other hand, can seem remote, arcane, the stuff of specialists, but it isn't. Because for those of us who live in democracies, or in aspiring democracies, the law begins with us.
Za mnoge od nas ovde HIV ne predstavlja apstraktnu pretnju. Veoma nam je blisko. Zakon, s druge strane, deluje udaljeno, misteriozno, profesionalno, ali nije. Nama koji živimo u demokratiji, ili težimo istoj, zakon počinje od nas samih.
Laws that treat people living with HIV or those at greatest risk with respect start with the way that we treat them ourselves: as equals. If we are going to stop the spread of HIV in our lifetime, then that is the change we need to spread.
Zakoni koji se s poštovanjem odnose prema osobama s HIVom ili onima pod visokim rizikom, počinju od našeg odnosa prema njima: kao jednakima. Ako planiramo da zaustavimo HIV za našeg života to je promena koju moramo da širimo.
Thank you.
Hvala.
(Applause)
(Aplauz)