The Human Right to Health - A Study of HIV/AIDS in Vietnam
Abstract: Although infectious diseases kill around 17 million people a year, some states spend less then one percent of their budget on health. The promotion and protection of health is a fundamental condition for well being and the possibility to leave a life in dignity. The world has now for 20 years been facing an extremely dangerous epidemic. In Vietnam the first HIV infection was reported in 1990 and today it is estimated that 292 930 persons are infected with HIV. The disease continues to spread with up to a 100 new people infected each day. Experience in the fight against the HIV epidemic has showed that promotion and protection of human rights is of utmost importance in prevention the disease and reducing the impact of HIV. The human right to health is protected in a number of international legal instruments, including the ICCPR, the ICESCR, the CEDAW and the CRC. With a progressive interpretation as done by for example the ICESCR Committee in its general comments a rather good base for combating the disease could be found. Some obligations have an immediate character whereas others impose an obligation to take steps to the maximum of state parties' available resources. Vietnam is a state party to the above mentioned treaties. Although international legal instruments can assist in the combat against HIV the ultimate effectiveness is dependent on measures taken by Governments to give effect to their international legal obligations. It took many years since the first reported disease in 1990 before Vietnam adopted any real substantial legal measures to combat HIV. A new National HIV Strategy was adopted in 2004 and later backed up by a new law on HIV in June 2006.The law on the Prevention and fight against HIV was a significant improvement and a piece of legislation compared to existing legislation in neighboring countries. Nevertheless in terms of health programmes to aid PLHIV, as well as the actual implementation of the laws on a practical level, a great deal of work remains. The law still does not provide free treatment to large groups of the population and only around 20 percent of the population is covered by insurance. Most children above the age of 6 years stand without any protection. There is also a lack of provisions to address the prevention of sexual transmissions of HIV and the vulnerability of women and girls. In addition, more could be accomplished in order to address the stigma and discrimination against people living with HIV. The most obvious shortcomings are to be found when looking at existing practices. The Vietnamese health care system is hierarchal and the lower district and commune levels don't have the capacity to provide high quality services. The salaries are low and as a result qualified doctors work in the higher sectors. People tend to avoid district and commune level health care facilities which make the central hospitals overcrowded. Private expenditure now accounts for 72 percent of all health spending in Vietnam. The 2006 world health report places Vietnam among the countries in the world with the highest out-of pocket spending on health in the world. The government of Vietnam has chosen to focus on high risk populations in order to combat the disease. In doing so other groups has been left out, mainly women. There is a great threat that the disease will continue to spread in large numbers from high risk populations to the general public.
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