Beyond the numbers: using rights-based perspectives to enhance antiretroviral treatment scale-up

Human rights analyses, concepts, and in particular rhetoric have played a consistent role in the global response to HIV for over two decades. Despite the longstanding recognition of human rights as essential to an effective response, recent global guidance, particularly with respect to the implementation of antiretroviral treatment (ART) scale-up efforts, falls short of meaningfully incorporating human rights norms and concepts. Applying human rights to ART scale-up draws attention to who is gaining access to ART, how they are gaining access, and over what period of time, not just how many people gain access. Deliberate consideration of the human rights principles of the interdependence of rights (including attention to the legal and policy environment), participation, non-discrimination, accountability, and key aspects of the right to health can help to identify and overcome some of the challenges to increasing and sustaining access to treatment and needed services, as well as to promote accountability and transparency for what is done and how it is done. Whereas a need remains to document evidence of the ways in which a lack of attention to human rights negatively influences the long-term outcomes of scale-up programmes, this paper focuses on the positive role human rights can play in ART scale-up efforts, and offers suggestions for research and action moving forward.