title: Evolving Human Rights and the Science of Antiretroviral Medicine.
abstract: Recent years have seen significant advances in the science of using antiretroviral medicines (ARVs) to fight HIV. Where not long ago ARVs were used late in disease to prevent sick people from dying, today people living with HIV can use ARVs to achieve viral suppression early in the course of disease. This article reviews the mounting new scientific evidence of major clinical and prevention ARV benefits. This has changed the logic of the AIDS response, eliminating competition between "treatment" and "prevention" and encouraging early initiation of treatment for individual and public health benefit. These breakthroughs have implications for the health-related human rights duties of States. With medical advance, the "highest attainable standard" of health has taken a leap, and with it the rights obligations of States. We argue that access to early treatment for all is now a core State obligation and restricting access to, or failing to provide accurate information about, it violates both individual and collective rights. In a context of real political and technical challenges, however, in this article we review the policy implications of evolving human rights obligations given the new science. National and international legal standards require action on budget, health and intellectual property policy, which we outline.
authors.affiliation: Fellow at the Leonard Davis Institute of Health Economics and Department of Political Science at the University of Pennsylvania, Philadelphia, PA, USA, and Senior Policy Analyst at Health Global Access Project, Philadelphia, PA, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Kavanagh
authors.affiliation: Medical Coordinator of the Médecins Sans Frontières Access Campaign, Geneva, Switzerland, and Assistant Professor of Infectious Disease at the Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cohn
authors.affiliation: Advocacy Team Leader at the AIDS and Rights Alliance of Southern Africa, Cape Town, South Africa.
authors.forename: Lynette
authors.initials: L
authors.lastname: Mabote
authors.affiliation: Associate Professor of Global Health Policy at the University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Benjamin Mason
authors.initials: BM
authors.lastname: Meier
authors.affiliation: Senior Research Fellow at the South African Centre for Epidemiological Modelling and Analysis, University of Stellenbosch, Stellenbosch, South Africa and the Wits HIV and Reproductive Health Institute, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Brian
authors.initials: B
authors.lastname: Williams
authors.affiliation: Executive Director of Health Global Access Project, Philadelphia PA, USA and Kampala, Uganda.
authors.forename: Asia
authors.initials: A
authors.lastname: Russell
authors.affiliation: Coordinator of the African Community Advisory Board, Lusaka, Zambia.
authors.forename: Kenly
authors.initials: K
authors.lastname: Sikwese
authors.affiliation: Professor of Law at Northeastern University and Senior Policy Analyst at Health Global Access Project, Boston, MA, USA.
authors.forename: Brook
authors.initials: B
authors.lastname: Baker
mesh_terms: D044966:Anti-Retroviral Agents / Q000494:pharmacology / Q000627:therapeutic use*; D015658:HIV Infections / Q000188:drug therapy* / Q000517:prevention & control; D006297:Health Services Accessibility; D006806:Human Rights; D006801:Humans; D061665:Time-to-Treatment / Q000941:ethics*
chemical_list: D044966:Anti-Retroviral Agents