Speech from Dutch Minister
Speech by Lilianne Ploumen, Minister for Foreign Trade and Development Cooperation, at the High-Level Meeting on Ending AIDS, New York, 9June 2016
Ladies and gentlemen,
There was a time, decades ago, when we could say that humanity had no control over AIDS. But only last year 1.1 million people died of AIDS-related illnesses, and 2.1 million more became infected with HIV. Currently, an estimated 19.7 million people living with HIV are not receiving anti-retroviral therapy. This isn’t something we have no control over. It’s a manifestation of inequality in all its forms; social, cultural, economic and gender-based. Often, different forms of inequality go hand in hand: victims of rape, for instance, run an extrahigh risk of getting infected with HIV. More often than not they’re poor – and so are their rapists. And once the victims are infected, they are very likely to become ill and die. Because, although there are medical therapies to prevent this, many people don’t have access to them. Either because they have no decent health care,because medication isn’t available or because it’s too expensive. And even when access isn’t a problem, social stigma often is: fear of exclusion and shame mean that even rape victims keep silent about the infection. And die.
This example combines all forms of inequality. And this inequality doesn’t only affect the world’s poorest regions. Fifty-eight per cent of people with HIV currently live in middle-income countries. That figure says a lot. It aptly illustrates an alarming phenomenon: although inequality between countries is fading, inequality within countries is growing. On the one hand, incomes in these countries are rising, a middle class is emerging and health care is improving. On the other hand large groups of people are not benefiting from this progress.People with HIV are a particularly distressingexample. All too often social stigma stops them from seeking help.
There are even cases in which social stigmaprevents help being offered. It’s time that we as governments, together with our civil society partners, tackle the discrimination that prevents those infected with HIV from seeking and finding assistance and treatment.
We know what we have to do. To find solutions we only need to look to each other. Active policy on the sex industry over the past 15 years has reduced the number of HIV infections by three quarters in countries like India and Thailand. Harm reduction programmes among drug users, that provide information and promote needle exchange have had spectacular results in Asia,and similar effects are now being seen in Kenya.
Decriminalising prostitution in New Zealand and drug use in Portugal has also yielded success. In Portugal the number of infections went down by a factor of 14 in as many years. And from El Salvador to the Indian state of Tamil Nadu, governments are pursuing bold policies that save the lives of transgender people every day. In my own country we’re also making progress. People with HIV are now, for example, able to take out life insurance policies. The 2018 International AIDS conference will be held in Amsterdam, with an explicit focus on reaching the most marginalised members of society.
Ladies and gentlemen,
Even though we have made progress, the current situation is still reason for grave concern. As Ihave said, AIDS today is a manifestation of inequality. And that inequality is a result of political choices. In 1990 many obstacles besides inequality prevented us from combating AIDS:there was no effective treatment and there was a serious lack of insight and knowledge on the disease. But now that those barriers have been overcome,the scale of that key remaining problem – inequality – is becoming ever clearer. Girls who are raped or are unaware of HIV, people who are afraid or unable to access condoms, care or treatment, drug users or sex workers who take risks: what they have in common is that they are between a rock and a hard place when it comes to social power relations. The task of giving these people a voice and eradicating AIDS rests largely on the shoulders of governments. That political responsibility should be the decisive factor in all the choices wemake.