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Health Hum Rights. 2015 Jun 11;17(1):E76-90.

Evolving Human Rights and the Science of Antiretroviral Medicine.

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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.
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.
Advocacy Team Leader at the AIDS and Rights Alliance of Southern Africa, Cape Town, South Africa.
Associate Professor of Global Health Policy at the University of North Carolina, Chapel Hill, NC, USA.
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.
Executive Director of Health Global Access Project, Philadelphia PA, USA and Kampala, Uganda.
Coordinator of the African Community Advisory Board, Lusaka, Zambia.
Professor of Law at Northeastern University and Senior Policy Analyst at Health Global Access Project, Boston, MA, USA.


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.

[Indexed for MEDLINE]

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