A/HRC/17/25 has highlighted the importance of domestic legislation enshrining the right to health, and recognition of the rights of citizens to participate in public policy and budgeting,43 which has the potential to strengthen health systems. C. Use of the right to health framework in HIV/AIDS programmes 36. Successful examples of the use of the right to health in programming and the evidence of its value-added to health-related development can be found in the context of HIV. The public health response to HIV was possibly the first instance in which the relationships between health and human rights became overwhelmingly apparent, and observations can be drawn from this that may be useful to further strengthen the integration of human rights and development. 37. Around 33.3 million people worldwide44 are currently living with the human immunodeficiency virus (HIV), a retrovirus which causes acquired immunodeficiency syndrome (AIDS), a universally fatal syndrome causing failure of the human immune system. One of the most pressing health and human rights conundrums of modern life, it has been described as a “health threat of massive proportions”45 and an “extraordinary challenge”46, and represents the first illness that has essentially required the introduction of a public health response that gave heed to human rights. The relationship between HIV and development has also been clearly recognized over time. The pernicious effect of HIV on human development is being tackled through its prioritization as one of the eight Millennium Development Goals, and UNDP has noted that “mainstreaming” HIV into development processes is effective.47 The connections between HIV/AIDS and human rights were articulated by the International Guidelines on HIV/AIDS and Human Rights (“Guidelines”), which recognize the central role played by human rights in addressing, limiting and attempting to eradicate HIV/AIDS. 38. The historical evolution of the response to HIV/AIDS is a good example of a health problem with strong implications for human development contained most effectively by protecting and promoting human rights. Jonathan Mann described three clearly defined phases in the response to the epidemic: the first period concerned discovery of the illness and corresponding uncertainty surrounding its containment, while the second period largely focused on individual risk reduction and behavioural change, accompanied by the use of discriminatory prevention measures justified under a “public health rationale”. It was not until the third period, in the late 1980s, that a societal dimension was included in the approach to the disease, and the concept of “vulnerability” arose in identifying barriers to individual control over health. The “traditional” public health approaches initially applied to HIV/AIDS, consisting of information, education and services targeted at changing individuals’ behaviour and reducing risk, were effective but ultimately insufficient to 43 44 45 46 47 12 Commission on Social Determinants of Health, Closing the gap in a generation: health equity through action on the social determinants of health (Geneva, WHO, 2008), p. 97. WHO/UNAIDS, Global summary of the AIDS epidemic: 2009 (Geneva, 2009), p 1. Available from: http://www.who.int/hiv/data/2009_global_summary.png Jonathan Mann, Daniel Tarantola and Thomas Netter, eds., AIDS in the World, vol. 1, (Cambridge, Massachusetts, Harvard University Press, 1992), p. 1. Michael Kirby, “AIDS and the Law” South African Journal of Human Rights, vol. 9, No. 1 (1993), p. 2. UNDP, “HIV, the Millennium Development Goals and development planning”. Available from: http://www.undp.org/hiv/focus_dev_planning_mainstreaming.shtml