The right to health in Peru: Persistent vulnerabilities in the context of HIV/AIDS

Throughout the history of public health in Peru, health policy strategies aimed at communicable diseases have not been guided by human rights considerations. Instead, they have followed compulsory strategies aimed at controlling epidemics and preserving the well-being of the unaffected population. Initial policies and methods to face the emergence of HIV/AIDS were rooted in this tradition of public health, insensitive to the needs, sufferings, and rights of the sick until a new perspective began to surface: the human right to health. This chapter addresses the challenges of implementing human rights-oriented health policies in the context of HIV/AIDS in Peru. Looking at concepts of privacy and nondiscrimination as key components of the human right to health, we explore the ways in which health policies and legislation have succeeded and failed in incorporating the human rights-based approach. This study is based on research conducted in Peru during 2008 as part of a study coordinated by Gayet of the Facultad Latinoamericana de Ciencias Sociales (FLACSO) across eight countries. The research concerned the incorporation of a human rights approach and the evolution of public policy from the first nationally registered case of HIV/AIDS. Policies aimed at prevention and treatment for those living with HIV/AIDS, and the incorporation of the right to health, nondiscrimination, and the right to privacy and confidentiality into policies and programs are examined in light of four populations that meet conditions of vulnerability: sex workers, people with nonheterosexual orientations, pregnant women, and people living with HIV. It surveys existing regulations in the country and secondary sources such as reports from civil society organizations, the Office of the Ombudsman and UN Human Rights Reports to explore law implementation and its implications. Interviews were carried out with representatives of civil society organizations and the Ministry of Health, as well as researchers from academia and other key informants related to sexual health public policies.