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.
讓我來講個故事, 很久很久以前-- 其實是少於兩年前, 在一個不是很遙遠的國度, 有一個人 走遍千山萬里 到鑽石般閃耀的王國求職。 那是一間享譽國際的公司, 讓我們稱其為《網路島》。 這王國現在有很多資源 和強大的野心, 但它缺乏人手。 所以,它邀請來自世界各地的工作者 來幫助它壯大國家。 但是,若新移民要入境和留在這個國家, 他們不得不通過幾個測試。 就在這時,這個人 向王國自薦, 期待開展他的新生活。
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.
但是,意想不到的事發生了。 幫這個人抽血的醫務人員 從沒有告訴他有關的測試內容; 也從未在測試之前或之後心理輔導他; 這是最有效率的測試方式。 從來沒有人告知過他的測試結果。 然而數周之後, 他被抓起來並關進監獄。 他被迫進行了一系列醫療測試, 包括全身掃描, 其他人可以在外面完全看到他。 他後來被釋放了,但在一至兩天內, 他被帶到機場,驅逐出境。 這個人到底因為犯了什麼罪 而受到這般不人道的待遇? 他的罪行是什麼? 他感染了愛滋病。
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.
像這樣的王國世界上約有五十個, 對愛滋病毒感染者的入境或逗留 設有嚴格限制。 王國認為 法律允許他們扣留或驅逐 可能對經濟,安全 公共衛生,或社會道德 帶來風險的外國人。 但這些法律若用在愛滋病患身上, 便違背了國際人權協定, 而這些國家都是簽署國。 但你知道嗎? 把原則問題放一邊, 事實上,這些法律導致愛滋病地下蔓延。 人們很少願意表露身分, 接受測試,治療或揭露自己的狀況, 這樣不只無法保護這些人, 也危害法律宣稱要保護的社區。
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.
今天我們可以防止愛滋病毒傳播。 這疾病是可以被藥物控制管理的。 我們早已不用像遠古時代 必須要將帶病者 驅逐出境-- 像這畫"麻瘋病患的流亡"。 所以你告訴我,為什麼在我們這麼科學的時代, 仍有法律和政策 來自迷信的時代?
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.
舉手的時間到了, 在場各位,誰接觸過愛滋病毒-- 無論是你自己感染了, 或你的家人,朋友,同事 是愛滋病毒帶原人? 請舉起手來。 哇,哇, 看來不是小數目。
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.
你們定比任何人都更明白, 愛滋病毒,同時引發了 人性最光輝也殘酷的一面。 而法律正好反映出這點。 我指的不是只有書上的法律, 而是街道巷弄裡的不成文法, 和法院實際判決的法案。 我說的這些法律, 不只牽涉到感染愛滋病的人, 也涵蓋了處在高風險狀態的人們-- 注射毒品者,性工作者, 男同性戀者, 變性人, 外來移民,或監獄的囚犯。 在世界許多地方,婦女和兒童 更是身處劣勢容易受到傷害。
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.
現今,有許多地區的法律 反映出人性最良善的一面, 同情並且接納 這些與愛滋病為伍的人們。 這些法律尊重全體人權, 並且以科學證據為根基。 這些法律確保感染愛滋病毒的人們 與那些高風險族群 不受暴力和歧視迫害, 並且有管道獲得防治與治療。 不幸的是, 這些良好法律的功用 被一些建立在道德批判, 恐懼,誤傳等的不良法律 給銷抵掉了。 這些不良法律,專門懲治 愛滋病毒感染者與那些高風險者。 這些有害法律,公然違抗現有科學, 把根基建在偏見,無知 重蹈覆轍的傳統迷信, 和斷章取義的宗教典籍上。
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.
但你知道嗎?你不必相信我的話。 我們來聽另外兩個人的心聲, 他們都直接被這些法律影響。 第一個是美國人,Nick Rhoades。 根據美國愛荷華州法律,他被定罪了-- 罪行: 蓄意散播愛滋病毒-- 然而他根本沒有這個意圖。
(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.
(視頻)Nick Rhoades: 被宣判違反法律條文, 就像是在告訴社會大眾 這是不可接受的不良行為。 我認為這種懲罰的嚴重性在於 告訴你你是一個多麼糟糕的人。 你是個 B 類重罪犯, 一生都是個性犯罪者。 你是一個非常,非常,非常不好的人。 你做了一件非常,非常,非常不好的事情。 這就像是精神制約, 你必須接受行為治療, 且你身邊所有人都像是在說: 你是個很不好的人。
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.
Shereen El-Fek:這問題的嚴重性 不只是法律的不公正或無效力。 一些國家有良好的法律 可以阻止愛滋病毒的蔓延。 問題是這些法律被藐視了。 愛滋病毒感染者或高風險者 被社會大眾 貼上了恥辱的標籤, 他們不配當一般公民。 而這正是住在納米比亞的 Helma和Dongo所親身經歷的事情。
(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.
(視頻)Helma: 那天我去醫院 去做妊娠的例行體檢。 護士公布每個懷孕的女人 都必須接受愛滋病感染測試。 我做了測試,結果表明我被感染了。 這天,我得知我是愛滋病患者。 那護士對我說:"為什麼你們這種人 明明感染愛滋病還要懷孕? 你們幹嘛要懷孕?" 我敢肯定,這是他們消毒我的原因。 因為我是愛滋病毒陽性。 他們拿給我一些表格, 沒有做任何解釋, 那護士在表格上 標記我要簽名的欄位, 我正經歷分娩的痛楚, 無力要求他們對我解釋那些表格, 我就乖乖的簽名了。
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.
SE:Helma,Nick和那個故事中的主角, 根據統計,是世界上3千4百萬愛滋病感染者 其中的一員。 他們是幸運的, 因為他們還活著。 根據相關估計, 2010年有1百80萬人 死於愛滋病。 這些數字令人驚恐。 但如果我們更詳細的看這些統計, 我們可以找到一絲希望的曙光。
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.
綜觀全球,新的愛滋病感染人數, 與愛滋病死亡人數, 都正在下降。 有很多原因促進這個發展, 其中一個最引人注目的 是越來越多人開始接受 抗轉錄病毒療法, 這療法可以有效抑制愛滋病毒發作。
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.
現在,仍有許多問題待解。 只有約一半需要治療的人 得到該治療。 在世界上有些地方-- 像在中東和北非-- 新感染病例與死亡人數正在攀升。 而我們需要的經費, 對抗全球愛滋病毒的經費, 卻在萎縮。 但,這是第一次, 從這流行病蔓延的三十年來, 我們真正有機會來對付愛滋病毒。 為了做到這一點, 我們需要對抗這些普遍存在的壞法律。
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.
正是出於這個原因 聯合國簽署建立了:全球愛滋病法 監督委員會, 我正是其中的一員, 去監督響愛滋病毒感染者 和那些高風險族群 所處在的法律環境。 並且建議如何 使法律不是敵人,是盟友, 共同對抗全球愛滋病毒。
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.
讓我給你舉個例子 正確的法律環境, 可以帶來積極的改變。 注射毒品的人 是的我提到的族群之一。 他們是感染愛滋病的高危險群, 經由受污染的注射設備 和其他危險行為而感染。 事實上,每10個感染人之中, 就有一個是毒品注射者。 現在毒品濫用或持有 幾乎在每個國家都是違法的。 但一些國家對此採取更強硬的手段。
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.
在泰國,使用毒品, 或只是受到懷疑有在用毒, 就會被關在羈留中心, 如同您看到的, 他們被迫在此斷毒癮。 世上絕對沒有任何證據 指出只要把人關在拘留所 就可以治療毒品依賴。 反而,有充分的證據顯示, 把人當囚犯監禁, 會增加愛滋病毒和其他感染的風險。
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.
我們知道如何減少毒品注射者感染愛滋病 與其他疾病的風險。 這是藉由提供 清潔針頭,注射器, 提供毒品替代療法, 和其他經過驗證 有療效的治療法, 來減少藥物依賴性。 另外包括衛生教育, 保險套的使用宣導, 提供愛滋病毒檢測, 提供諮詢, 都可保護人們 降低感染機率。 這種減低傷害的法律環境 帶來驚人的成效。
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.
澳大利亞和瑞士 這兩個國家在愛滋病毒傳播的初期, 就推出減低傷害的法律環境, 它們的毒品注射者感染愛滋病 的機率非常低。 而美國和馬來西亞 較慢推行減低傷害法律環境, 它們在此有較高的愛滋病毒感染率。 至於泰國和俄羅斯, 拒絕推行減低傷害, 並用嚴酷的刑法, 來懲治毒品濫用。 所以,嘿, 毒品注射者很多都感染了愛滋病毒。
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.
我們的委員會已研究證據, 聆聽親身經歷者 7百多人,涵蓋140 個國家。 這個趨勢是很明顯的。 只要感染者或高風險族群被當成罪犯, 無論何處, 是對這流行病火上加油。 現在愛滋病毒疫苗,或甚至解藥 已經快要問世了, 這門科學非常複雜。 但改變法律不複雜。 事實上,許多國家正如火如荼的 展開改革。 首先,國家需要審查其立法, 因為它涉及到愛滋病與弱勢群體。 審查之餘, 各國政府應廢除那些 懲罰或歧視愛滋病毒感染,與高風險者 的不良法律。
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.
廢除法律並非易事, 且變得格外困難 當它涉及毒品和性別等敏感話題。 但,在這進程中,我們能做很多事。 其中一個關鍵點,是警方的改良。 使他們在法律改革中有更好表現。 例如那些分發保險套 到弱勢族群的外展工作人員, 不會自己受到員警騷擾, 謾罵或任意逮捕。 我們還可以訓練法官, 讓他們在法律中找到彈性, 用寬容來裁定 而不是偏見。 我們可以整備監獄, 預防,與減少愛滋病毒危害 監獄裡的囚犯。
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.
最為關鍵的,是加強民間團體的力量。 因為,民間團體 可以幫助弱勢族群意識到 他們擁有的法律權利。 但只有意識是不夠的。 我們需要採取行動, 確保這些愛滋病患者 或高風險族群 能有管道獲得法律服務, 且確保他們平等出庭的機會。 另外,與社區對話也極為重要。 這樣,我們能對宗教與習俗法條 從新詮釋, 讓它們不再助長 不合理的懲罰和歧視。
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.
對很多在場的人來說, 愛滋病毒不是個抽象的威脅, 它的影響伸手可處。 另一方面,法律, 看似艱澀,遙遠而神秘,只有專家才懂, 但這不是事實。 因為對於我們這些生活在有抱負有理想 的民主國家的人民, 法律起始於我們。
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.
法律必須起始於平等, 無論是對待愛滋病族群 或是對待我們,皆須平等。 如果我們要愛滋病毒在我們這一代停止蔓延, 公平法律,就是我們必須發揚的觀念。
Thank you.
謝謝。
(Applause)
(掌聲)