Guideline 11: State Monitoring and Enforcement of Human Rights 
41.States should ensure monitoring and enforcement mechanisms to guarantee HIV-related human rights, including those of people living with HIV/AIDS, their families and communities. 

States should collect information on human rights and HIV/AIDS and, using this information as a basis for policy and programme development and reform, report on HIV-related human rights issues to the relevant United Nations treaty bodies as part of their reporting obligations under human rights treaties. 

States should establish HIV/AIDS focal points in relevant government branches, including national AIDS programmes, police and correctional departments, the judiciary, government health and social service providers and the military, for monitoring HIV-related human rights abuses and facilitating access to these branches for disadvantaged and vulnerable groups. Performance indicators or benchmarks showing specific compliance with human rights standards should be developed for relevant policies and programmes. 

States should provide political, material and human resources support to AS0s and CB0s for capacity-building in human rights standards development and monitoring. States should provide human rights NG0s with support for capacity-building in HIV-related human rights standards and monitoring. 

States should support the creation of independent national institutions for the promotion and protection of human rights, including HIV related rights, such as human rights commissions and ombudspersons and/or appoint HIV/AIDS ombudspersons to existing or independent human rights agencies, national legal bodies and law reform commissions. 

States should promote HIV-related human rights in international forums and ensure that they are integrated into the policies and programmes of international organizations, including United Nations human rights bodies, as well as in other agencies of the United Nations system. Furthermore.

States should provide intergovernmental organizations with the material and human resources required to work effectively in this field. 
 
Commentary on Guideline 11 
41.Standard-setting and promotion of HIV-related human rights standards alone are insufficient to address human rights abuses in the context of HIV/AIDS. Effective mechanisms must be established at the national and community levels to monitor and enforce HIV-related human rights. Governments should see this as part of their national responsibility to address HIV/AIDS. The existence of monitoring mechanisms should be publicized, particularly among PLHA networks, in order to maximize their use and impact. Monitoring is necessary to collect information, formulate and revise policy, and establish priorities for change and benchmarks for performance measurement. Monitoring should be both positive and negative, i.e. reporting on good practice to provide models for others to emulate, as well as identifying abuses. The non-governmental sector can provide an important means of monitoring human rights abuses, if resourced to do so, since it frequently has closer contact with the affected communities. Formal grievance bodies may be too bureaucratic and their procedures too time-consuming and stressful to attract a representative sample of complaints. Training is necessary for community participants to develop skills so as to be able
to analyse and report findings at a level of quality which is credible for States and international human rights bodies. 

Guideline 12: International Cooperation 
41.States should cooperate through all relevant programmes and agencies of the United Nations system, including UNAIDS, to share knowledge and experience concerning HIV-related human rights issues, and should ensure effective mechanisms to protect human rights in the context of HIV/AIDS at the international level. 

The Commission on Human Rights should take note of the present Guidelines and of the report on the Second International Consultation on HIV/AIDS and Human Rights and request States to carefully consider and implement the Guidelines in their national, sub national and local responses to HIV/AIDS and human rights. 

The Commission on Human Rights should request human rights treaty bodies, special reporters and representatives and its working groups to take note of the Guidelines and include in their activities and reports all issues arising under the Guidelines relevant to their mandates. 

The Commission on Human Rights should request UNAIDS, its co-sponsors (UNDP, UNESCO, UNFPA, UNICEF, WHO and the World Bank) and other relevant United Nations bodies and agencies to integrate the promotion of the Guidelines throughout their activities. 

The Commission on Human Rights should appoint a special reporter on human rights and HIV/AIDS with the mandate, inter alia, to encourage and monitor implementation of the Guidelines by States, as well as their promotion by the United Nations system, including human rights bodies,where applicable. 

The Commission on Human Rights should encourage the Office of the United Nations High Commissioner for Human Rights to ensure that the Guidelines are disseminated throughout that Office and are incorporated into all its human rights activities and programmes, particularly those involving technical cooperation, monitoring and support to human rights bodies and organs. 

States, in the framework of their periodic reporting obligations to United Nations treaty monitoring bodies and under regional conventions, should report on their implementation of the Guidelines and other relevant HIV/AIDS-related human rights concerns arising under the various treaties. 

States should ensure, at the country level, that their cooperation with UNAIDS Theme Groups includes promotion and implementation of the Guidelines, including the mobilization of sufficient political and financial support for such implementation. 

States should work in collaboration with UNAIDS, the Office of the United Nations High Commissioner for Human Rights and non-governmental and other organizations working in the field of human rights and HIV/AIDS to Support translation of the Guidelines into national and minority languages; Create a widely accessible mechanism for communication and coordination for sharing information on the Guidelines and HIV-related human rights; Support the development of a resource directory on international declarations/treaties, as well as policy statements and reports on HIV/AIDS and human rights, to strengthen support for the implementation of the Guidelines;  Support multicultural education and advocacy projects on HIV/AIDS and human rights, including educating human rights groups with regard to HIV/AIDS and educating HIV/AIDS and vulnerable groups in human rights issues and strategies for monitoring and protecting human rights in the context of HIV/AIDS, using the Guidelines as an educational tool;  Support the creation of a mechanism to allow existing human rights organizations and HIV/AIDS organizations to work together strategically to promote and protect the human rights of people living with HIV/AIDS and those vulnerable to infection, through implementation of the Guidelines; Support the creation of a mechanism to monitor and publicize human rights abuses in the context of HIV/AIDS; Support the development of a mechanism to mobilize grass-roots responses to HIV-related human rights concerns and implementation of the Guidelines, including exchange programmes and training among different communities, both within and across regions; Advocate that religious and traditional leaders take up HIV-related human rights concerns and become part of the implementation of the Guidelines; Support the development of a manual that would assist human rights and AIDS service organizations in advocating the implementation of the Guidelines; Support the identification and funding of NG0s and AS0s at country level to coordinate a national NGO response to promote the Guidelines; Support, through technical and financial assistance, national and regional NGO networking initiatives on ethics, law and human rights to
enable them to disseminate the Guidelines and advocate their
implementation. States, through regional human rights mechanisms, should promote the dissemination and implementation of the Guidelines and their integration  into the work of these bodies. 

Commentary on Guideline 12 
47.The United Nations bodies, agencies and programmes comprise some of the most effective and powerful forums through which States can exchange information and expertise on HIV-related human rights issues and build support among themselves to implement a rights-based response to HIV/AIDS. States, in their work with and governance of these bodies, can use these bodies as tools for promoting the Guidelines. States must, however, both encourage and enable these bodies through political and financial support, to take effective and sustained action in terms of promoting the Guidelines and must respond positively to the work done by these bodies with steps taken at the national level. 
Conclusion 
47.States are urged to implement these Guidelines in order to ensure respect for the human rights of those affected by HIV/AIDS and to ensure an effective and inclusive public health response to HIV/AIDS. These Guidelines are based on experience gained from best practices, which have proven to be effective over the last 15 years. By implementing these Guidelines, States are able to avoid negative and coercive policies and practices, which have had a devastating impact on people's lives and on national HIV/AIDS programmes. 
47.The practical aspects of protecting HIV-related human rights are more likely to be addressed if there is leadership on this issue in the executive and legislative arms of government and if multisectoral structures are established and maintained. Vital to any policy development and implementation is the involvement of affected communities, together with relevant professionals and religious and community leaders, as equal partners in the process. 
47.As national legislation provides a critical framework for the protection of HIV-related human rights, many of the Guidelines relate to the need for law reform. Another major instrument of social change is the provision of a supportive and enabling environment within which to conduct HIV-related prevention, care and support activities. Part of this enabling environment can be obtained by changing attitudes through general and targeted education, public information and education campaigns which deal with HIV-related rights, tolerance and inclusion. Another part of this enabling environment involves the empowerment of
women and vulnerable groups to deal with HIV/AIDS by taking measures to improve their social and legal status and to assist them in mobilizing their communities. 
47.HIV/AIDS continues to challenge our societies in many ways. It is incumbent on States, communities and individuals to address extremely difficult and pervasive societal issues which have always been present in our societies, and to identify solutions thereto. With the advent of HIV/AIDS, we can no longer afford to evade these issues because to do so threatens the lives of millions of men, women and children. These issues relate to the roles of women and men, the
status of marginalized or illegal groups, the obligations of States concerning health expenditure and the role of law in achieving public health goals, the content of privacy between individuals and between individuals and their governments, the responsibility and ability of people to protect themselves and others, as well as the relationship between human rights, health and life. These Guidelines are means for giving guidance on these difficult matters-guidance which has evolved from the international human rights regime and from the courageous and inspiring work of millions the world over who have demonstrated that protecting the human rights of people means protecting their health, lives and happiness in a world with HIV/AIDS. 
 
II. Recommendations for dissemination and implementation of the Guidelines on HIV/AIDS and human rights 
47.At the Second international Consultation on HIV/AIDS and Human Rights, the participants considered strategies for dissemination and implementation of the Guidelines. It was considered that there are three groups of key actors who, jointly and separately, are critical to the implementation of the Guidelines, namely States, the United Nations system, regional intergovernmental organizations and non-governmental and community-based organizations. Recommendations for measures that these actors are encouraged to take in order to ensure that the Guidelines are widely disseminated and effectively implemented are set out below.
 
A. States 
47.States, at the highest level of Government (head of State, Prime Minister and/or relevant ministers), should promulgate the Guidelines and ensure that the political weight of the Government is behind the dissemination and implementation of the Guidelines throughout all branches of the executive, legislature and judiciary. 
47.States, at the highest level of Government, should assign appropriate governmental bodies/staff the responsibility to devise and implement a strategy for dissemination and implementation of the Guidelines and establish periodic monitoring of this strategy through, for example, reports to the Executive Office and public hearings. States should establish within the executive branch a staff member(s) responsible for this strategy. 
47.States should disseminate the Guidelines, endorsed by the executive, to relevant national bodies, such as interministerial and parliamentary committees on HIV/AIDS and national AIDS programmes, as well as to provincial and local-level bodies. 
47.States, through these bodies, should give formal consideration to the Guidelines in order to identify ways to build them into existing activities and prioritize necessary new activities and policy review. States should also organize consensus workshops with the participation of non-governmental organizations, community-based organizations and AIDS service organizations (AS0s), networks of people living with HIV/AIDS (PLHAs), networks on ethics, law, human rights and HIV, United Nations Theme Groups on HIV/AIDS, as well as political and
religious groups: To discuss the relevance of the Guidelines to the local situation, to identify obstacles and needs, to propose interventions and solutions, and to achieve consensus for the adoption of the Guidelines;  To elaborate national, provincial and local plans of action for implementation and monitoring of the Guidelines within the local context; To mobilize and ensure the commitment of relevant governmental officials To apply the Guidelines as a working tool to be integrated into their individual work plans. 
57.States, at national, sub national and local levels, should establish mechanisms to receive, process and refer issues, claims and information in relation to the Guidelines and to the human rights issues raised therein. States should create focal points to monitor the implementation of the Guidelines in relevant government departments. 
57.States,inwaysconsistentwithjudicialindependence,should disseminate the Guidelines widely throughout the judicial system and use them in the development of jurisprudence, conduct of court cases involving HIV related matters and HIV-related training/continuing education of judicial officers. 
57.States should disseminate the Guidelines throughout the legislative branch of Government and particularly to parliamentary committees involved in the formulation of policy and legislation relevant to the issues raised in the Guidelines. Such committees should assess the Guidelines to identify priority areas for action and a longer-term strategy to ensure that relevant policy and law are in conformity with the Guidelines. B. United Nations system and regional intergovernmental bodies 
57.The United Nations Secretary-General should submit the Guidelines to the Commission on Human Rights as part of the report on the Second International Consultation on HIV/AIDS and Human Rights. 
61.The Secretary-General should transmit the Guidelines to heads of State: Recommending that the document be distributed nationally through the appropriate channels; Offering, within the mandates of UNAIDS and the Office of the United Nations High Commissioner for Human Rights, technical cooperation in
facilitating the implementation of the Guidelines; Requesting that compliance with the Guidelines be included in national reports to existing human rights treaty bodies; Reminding Governments of the responsibility to uphold international human rights standards in promoting compliance with the Guidelines. 
62.The Secretary-General should transmit the Guidelines to the heads of all relevant United Nations bodies and agencies, requesting that they be widely disseminated throughout the relevant programmes and activities of the bodies and agencies. The Secretary-General should request that all relevant United Nations bodies and agencies consider their activities and programmes on HIV/AIDS in the light of the provisions of the Guidelines and support the implementation of the Guidelines at national level. 
 62.The Commission on Human Rights and the Sub-Commission on Prevention of Discrimination and Protection of Minorities, as well as all human rights treaty bodies, should consider and discuss the Guidelines with a view to incorporating relevant aspects of the Guidelines into their respective mandates. Human rights treaty bodies, in particular, should integrate the Guidelines, as relevant, in their respective reporting guidelines, questions to States and when developing recommendations and general comments on related subjects. 
62.The Commission on Human Rights should appoint a special reporter on human rights and HIV/AIDS with the mandate, inter alia, to encourage and monitor implementation of the Guidelines by States, as well as their promotion by the United Nations system, including human rights bodies, where applicable. 
62.The Office of the United Nations High Commissioner for Human Rights should ensure that the Guidelines are disseminated throughout that Office and incorporated into its activities and programmes, particularly those involving support for the United Nations human rights bodies, technical assistance and monitoring. This should be coordinated by a staff member with exclusive responsibility for the Guidelines. Similarly, the United Nations Division for the Advancement of Women should ensure the full integration of the Guidelines into the work of the Committee on the Elimination of Discrimination Against Women. 
62.UNAIDS should transmit the Guidelines throughout the system-to co-sponsors of the UNAIDS Programme Coordinating Board, United Nations Theme Groups on HIV/AIDS, UNAIDS staff, including country programme advisers and focal points-and should ensure that the Guidelines become a framework for action for the work of the United Nations Theme Groups on HIV/AIDS and UNAIDS staff;Theme Groups should use the Guidelines to assess the HIV-related human rights,
legal and ethical situation at country level and to elaborate the best means for supporting implementation of the Guidelines at that level. 
62.Regional bodies (such as the Inter-American Commission on Human Rights, the Organization of American States, the African Commission on Human and Peoples' Rights, the Organization of African Unity, the European Commission on Human Rights, the European Commission, the Council of Europe, the Association of South-East Asian Nations, etc.) should receive the Guidelines and make them available to the largest possible number of members and relevant divisions with a view to assessing how their activities might be made consistent with the Guidelines and promote their implementation. 
62.Specialized agencies and other concerned bodies (such as the International Labour Organization, the International Organization for Migration, the Office of the United Nations High Commissioner for Refugees, the United Nations Research Institute for Social Development and the World Trade Organization) should receive the Guidelines and transmit them widely among members and throughout their programmes with a view to assessing how their activities can be made consistent with the Guidelines and promote their implementation. 
 
C. Non-governmental organizations 
62.NG0s should implement the Guidelines within a broad framework of communication in terms of HIV and human rights, including the establishment of ongoing communication between the HIV/AIDS community and the human rights community by: 
Establishing contacts at the international, regional and local levels between networks of AS0s, human rights NG0s, and people living with HIV/AIDS Developing mechanism(s) for ongoing communication and dissemination and implementation of the Guidelines, such as a bulletin board and/or home page on the Internet allowing for input and exchange of information on human rights and HIV and database linkages between groups working on human rights and HIV;  Networking with human rights NG0s at meetings of United Nations human rights bodies; Promoting discussion of the Guidelines in their newsletters and other publications, as well as through other media;  Developing an action-oriented and accessible version(s) of the Guidelines Developing a strategy and process for the dissemination of the Guidelines and seeking funding and technical cooperation in that regard. 
70. Non-governmental organizations at the regional level should: 
Establish or use existing focal points to disseminate the Guide lines, with popularization and/or training; Establish a regional "technical group" to introduce the Guidelines to the region; 
Use the Guidelines as a tool for advocacy, interpretation, monitoring abuse and establishing best practices; Prepare regular reports on the implementation of the Guidelines to human rights bodies (human rights treaty bodies and United Nations
extra-conventional fact-finding mechanisms, such as special reporters and representatives, as well as regional commissions) and other relevant international agencies; Bring cases of HIV/AIDS-related discrimination and other violations of human rights in the context of HIV/AIDS to regional human rights judicial and quasi-judicial mechanisms. 
71.In order to advocate the Guidelines, NG0s at the national level should obtain consensus on their acceptance and establish a joint strategy with governmental and non-governmental partners as a baseline for monitoring the Guidelines, through the following actions: 

Hold national NGO strategy meetings on the Guidelines that include human rights NG0s (including women's organizations and prisoners' rights organization), AS0s, community-based organizations, networks on ethics, law, human rights and HIV and networks of people living with HIV/AIDS; 

Hold meetings with national governmental human rights bodies; 

Hold meetings with national Government (relevant ministries), legislative and the judiciary; 

Establish or use existing national focal points to gather information and develop systems of information exchange on HIV and human rights, including the Guidelines. 

III International human rights obligations and HIV / AIDS Introduction
HIV/AIDS, human rights and public health 72.Several years of experience in addressing the HIV/AIDS epidemic have confirmed that the promotion and protection of human rights constitute an essential component in preventing transmission of HIV and reducing the impact of HIV/AIDS. The protection and promotion of human rights are necessary both to the protection of the inherent dignity of persons affected by HIV/AIDS and to the achievement of the public health goals of reducing vulnerability to HIV infection, lessening the adverse impact of HIV/AIDS on those affected and empowering individuals and communities to respond to HIV/AIDS. 
72.In general, human rights and public health share the common objective to promote and to protect the rights and well-being of all individuals. From the human rights perspective, this can best be accomplished by promoting and protecting the rights and dignity of everyone, with special emphasis on those who are discriminated against or whose rights are otherwise interfered with. Similarly, public health objectives can best be accomplished by promoting health for all, with special emphasis on those who are vulnerable to threats to their physical, mental or social well-being. Thus,health and human rights complement and mutually reinforce each other in any context. They also complement and mutually reinforce each other in the context of HIV/AIDS. 
72.One aspect of the interdependence of human rights and public health is demonstrated by studies showing that HIV prevention and care programmes with coercive or punitive features result in reduced participation and increased alienation of those at risk of infection. In particular, people will not seek HIV-related counselling, testing, treatment and support if this would mean facing discrimination, lack of confidentiality and other negative consequences. Therefore, it is evident that coercive public health measures drive away the people most in need of such services and fail to achieve their public health goals of prevention through behavioural change, care and health support. 
75. Another aspect of the linkage between the protection of human rights and effective HIV/AIDS programmes is apparent in the fact that the incidence or spread of HIV/AIDS is disproportionately high among some populations. Depending on the nature of the epidemic and the legal, social and economic conditions in each country,groups that may be disproportionately affected include women, children, those living in poverty, minorities, indigenous people, migrants, refugees and internally displaced persons, people with disabilities, prisoners, sex workers, men having sex with men and injecting drug users-that is to say groups who already suffer from a lack of human rights protection and from discrimination and/or are marginalized by their legal status. Lack of human rights protection disempowers these groups to avoid infection and to cope with HIV/AIDS, if affected by it. 
76.Furthermore, there is growing international consensus that a broadly based, inclusive response, involving people living with HIV/AIDS in all its aspects, is a main feature of successful HIV/AIDS programmes. Another essential component of comprehensive response is the facilitation and creation of a supportive legal and ethical environment, which is protective of human rights. This requires measures to ensure that Governments, communities and individuals respect human rights and human dignity and act in a spirit of tolerance, compassion and solidarity. 
76.One essential lesson learned from the HIV/AIDS epidemic is that universally recognized human rights standards should guide policy makers in formulating the direction and content of HIV-related policy and form an integral part of all aspects of national and local responses to HIV/AIDS. A. Human rights standards and the nature of State obligations 
76.The Vienna Declaration and Programme of Action, adopted at the World Conference on Human Rights in June 1993 affirmed that all human rights are universal, indivisible, interdependent and interrelated. While the significance of national and regional particularities and various historical, cultural and religious backgrounds must be borne in mind, States have the duty regardless of their political, economic and cultural systems, to promote andprotect universal human rights standards and fundamental freedoms. 
76.A human rights approach to HIV/AIDS is, therefore, based on these State obligations with regard to human rights protection. HIV/AIDS demonstrates the indivisibility of human rights since the realization of economic, social and cultural rights, as well as civil and political rights, is essential to an effective response. Furthermore, a rights-based approach to HIV/AIDS is grounded in concepts of human dignity and equality which can be found in all cultures and traditions. 
76.The key human rights principles, which are essential to effective State responses to HIV/AIDS are to be found in existing international instruments, such as the Universal Declaration of Human Rights, the International Covenants on Economic, Social and Cultural Rights and on Civil and Political Rights, the International Convention on the Elimination of All Forms of Racial Discrimination, the Convention on the Elimination of All Forms of Discrimination against Women, the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment and the Convention on the Rights of the Child. Regional instruments, namely the American Convention on Human Rights, the European Convention for the Protection of Human Rights and Fundamental Freedoms and the African Charter on Human and Peoples' Rights also enshrine State obligations applicable to HIV/AIDS. In addition, a number of conventions and recommendations of the International Labour Organization are particularly relevant to the problem of HIV/AIDS, such as ILO instruments concerning discrimination in employment and occupation, termination of employment, protection of
workers' privacy, and safety and health at work. 
Among the human rights principles relevant to HIV/AIDS are, inter alia: