Vienna 2010: Rights-centred responses to HIV

When social worker Meena Seshu first entered a brothel in rural India, she was expecting a melodramatic scene in which poor helpless women were being victimized by brutal, aggressive men. It did not take long for her to find out that the reality was rather different. These women were, for the most part, in control of their lives but through a combination of prejudice and fear were being mistreated by every section of society.

Seshu runs Sampada Grameen Mahila Sanstha (SANGRAM), an Indian non-governmental organization that works with sex workers to stop the spread of HIV/AIDS. SANGRAM, based in rural Maharashtra, seeks to empower the women to form collectives and fight for their human rights.

Delivering the Jonathan Mann Memorial Lecture at the plenary session on Thursday 22nd July at the XVIII International AIDS Conference in Vienna, Seshu argued: “Too often, programmes that claim to be committed to rights-centred responses do not reflect that commitment”.

She presented examples of rights-centred responses to the HIV epidemic using real-life stories of programmes in western India shaped by the participation of sex workers, men who have sex with men (MSM), rural women living in poverty and young people.

Seshu said: “Sex workers’ involvement in shaping HIV education and health services helped them go from social pariahs to leaders in the HIV response while gaining community respect”.

Through this evolution, the community found the strength to challenge generations of entrenched discrimination and abuse against MSM, overturn social norms that impeded young people’s access to comprehensive sexuality education, and bring to the centre of its collective consciousness the hidden problem of violence against women. She noted that while the stories she presented arose from the Indian perspective, the challenges to be overcome and rights-centred language, tools and strategies are similar to those in many parts of the world.

Through SANGRAM she has worked for the empowerment of people in sex work, including mobilization for HIV related peer education, since1991. In 1996 this work broadened into the organization of a collective of women in prostitution called VAMP (Veshya Anyay Mukti Parishad). Seshu has worked with marginalized populations, particularly rural women, adolescents, people in sex work and MSM, on HIV and AIDS, sexual and reproductive health, violence against women, and gender and sexual minority rights through grassroots, rights-based organizations in the Indian states of Karnataka and Maharashtra.

One of the SANGRAM's most successful projects is building the capacity of sex workers to organize in collectives, negotiate condom use with their clients, and assert and defend their rights.

The Jonathan Mann Memorial Lecture was inaugurated at the XIII International AIDS Conference in Durban, South Africa. The lecture is sponsored and supported by the Global Health Council and honours the memory and legacy of one of the key figures of the 20th century in the fight against global poverty and illness.

Mann (1947 - 1998) is best remembered for his extraordinary contributions as the visionary physician and public health official who clearly articulated the connection between poverty and ill-health. A crusader against AIDS and a champion for human rights, Mann played a major role in focusing public attention on the fact that prejudice and discrimination were helping to drive and spread the epidemic.

Founder and the first head of the World Health Organization's Global Programme on AIDS, and the first director of Harvard's Francois-Xavier Bagnoud Center for Health and Human Rights, Mann believed that improved health couldn't be achieved without basic human rights.

Jonathan Mann and his wife Mary Lou Clements-Mann, herself a world-renowned immunologist, were killed in the fatal crash of Swissair Flight 111 in September 1998.

Ishdeep Kohli-CNS

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