Splitting the Difference: Partnering with Non-Governmental Organizations to Manage HIV/AIDS Epidemics in Australia and Thailand.

Introduction

The progression of the Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) pandemic since its discovery in the early 1980s has been accompanied by a deepening understanding of the relationship between public health concerns and human rights. In regard to HIV/AIDS, this relationship has been defined through the concept of vulnerability. Vulnerability to HIV/AIDS exists when individuals are unable to make decisions about their health with full freedom and information. [1] When governments, non-governmental organizations (NGOs), and the private sector operate in partnership to safeguard human rights, the opportunity to lessen vulnerability to HIV/AIDS is at its greatest.

This partnership approach to managing the HIV/AIDS pandemic has been promoted by a variety of international governmental organizations (IGOs) through the work of the United Nations Joint Program on HIV/AIDS (UNAIDS), and a plethora of NGOs has prodded nation-states to join in the effort. These organizations have accepted the premise that partnering with governments to safeguard human rights allows HIV/AIDS prevention, education, and care strategies to achieve their maximum potential.

IGO relationships with governments have received much attention regarding human rights strategies for managing the HIV/AIDS pandemic, but the importance of NGOs and the private sector in similar partnership roles has yet to be thoroughly examined. [2] In this paper I will focus on NGOs specifically, defined here as including international non-governmental organizations, national non-governmental organizations, and local community-based organizations, but not including private sector entities. These NGOs may participate in all manner of non-governmental response to HIV/AIDS.

While the roles of governments and IGOs are critical in implementing HIV/ AIDS human rights strategies, NGOs have played a special role by integrating themselves into government policymaking and advocating for human rights-based approaches to HIV/AIDS at all levels of response, supporting the needs of marginalized populations including intravenous drug users, prostitutes, prisoners, gays and bisexuals, people living with HIV/AIDS, children, indigenous people, and women. In this paper, I will first explore the global relationship that has developed over time regarding HIV/AIDS, human rights, and NGOs. Second, I will examine this relationship at the country level by discussing two nation-states in the Pacific Rim, Australia and Thailand. Studying how countries in this region have managed their individual HIV/AIDS epidemics is particularly important. Of the more than 30 million people worldwide who are reported to be living with HIV/ATDS, UNAIDS and the World Health Organization (WHO) paint a particularly distu rbing picture of Asia and the Pacific. [3] In fact, many authorities have projected this part of the globe to exceed HIV/AIDS dissemination in sub-Saharan Africa, the worst-hit region of the world so far, in the years to come.

Australia and Thailand have also been selected for analysis because of their well-documented efforts in HIV/AIDS prevention, education, and care, as well as their varying cultures and political systems. The way that a liberal democratic nation-state (Australia) has responded to the threat of HIV/ATDS, and the manner in which a system in transition from an authoritarian to democratic political structure (Thailand) has acted, hold lessons for how partnerships with NGOs can be used to redress HIV/AIDS human rights abuses in different settings. While it is clear that there is no "one size fits all" answer to creating partnerships that will reduce human rights abuses, Australia and Thailand are examples that can help guide other countries along the road to achieving better results with managing vulnerability to HIV/AIDS.

In these two case studies, I will examine the partnerships constructed to respond to HIV/AIDS and the extent to which NGOs have been integrated into the process of HIV/AIDS-related human rights management. I will assess how effectively the partnership in these two countries has safeguarded these rights in regard to HIV/AIDS. William Korey notes that NGOs working to protect human rights after 1945 began their efforts as standard-setting and fact-finding organizations. From there, human rights organizations broadened their roles to include an "ombudsman" function of advocating on behalf of specific cases. Finally, NGOs in the human rights movement reached the apex of their effectiveness when they became actively involved with creating and influencing various human rights-related agencies and institutions. [4] If the partnership of a country has allowed NGOs to achieve this final level of integration, then it is assumed that the partnership has achieved a level of heightened HIV/AIDS-related human rights protec tion. If this level of integration has not been achieved, then the partnership is likely to still be faltering in providing full protection of HIV/AIDS-related human rights to the country's citizenry, and this increases the vulnerability of the population.