Shereen El-Feki: How to fight an epidemic of bad laws

43,806 views ・ 2012-05-24

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00:00
Translator: Timothy Covell Reviewer: Jenny Zurawell
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譯者: Yuning912 陳又寧 審譯者: Yuguo Zhang
00:15
Let's begin with a story.
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讓我來講個故事,
00:19
Once upon a time --
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很久很久以前--
00:21
well actually less than two years ago --
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其實是少於兩年前,
00:24
in a kingdom not so very far away,
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在一個不是很遙遠的國度,
00:27
there was a man
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有一個人
00:29
who traveled many miles
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走遍千山萬里
00:31
to come to work at the jewel in the kingdom's crown --
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到鑽石般閃耀的王國求職。
00:34
an internationally famous company.
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那是一間享譽國際的公司,
00:37
Let's call it Island Networks.
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讓我們稱其為《網路島》。
00:40
Now this kingdom had many resources
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這王國現在有很多資源
00:43
and mighty ambitions,
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和強大的野心,
00:45
but the one thing it lacked was people.
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但它缺乏人手。
00:48
And so it invited workers from around the world
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所以,它邀請來自世界各地的工作者
00:51
to come and help it build the nation.
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來幫助它壯大國家。
00:54
But in order to enter and to stay
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但是,若新移民要入境和留在這個國家,
00:57
these migrants had to pass a few tests.
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他們不得不通過幾個測試。
01:00
And so it was, our man presented himself
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就在這時,這個人
01:03
to authorities in the kingdom,
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向王國自薦,
01:05
looking forward to settling into his new life.
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期待開展他的新生活。
01:08
But then something unexpected happened.
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但是,意想不到的事發生了。
01:11
The medical personnel who took blood samples from the man
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幫這個人抽血的醫務人員
01:15
never actually told him what they were testing for.
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從沒有告訴他有關的測試內容;
01:18
He wasn't offered counseling before or after the test,
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也從未在測試之前或之後心理輔導他;
01:23
which is best medical practice.
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這是最有效率的測試方式。
01:25
He was never informed of the results of the test.
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從來沒有人告知過他的測試結果。
01:28
And yet, a couple of weeks later,
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然而數周之後,
01:30
he was picked up and taken to prison
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他被抓起來並關進監獄。
01:33
where he was subjected to a medical exam,
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他被迫進行了一系列醫療測試,
01:36
including a full-body search
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包括全身掃描,
01:38
in full view of the others in the cell.
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其他人可以在外面完全看到他。
01:42
He was released, but then a day or two later,
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他後來被釋放了,但在一至兩天內,
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he was taken to the airport and he was deported.
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他被帶到機場,驅逐出境。
01:51
What on earth did this man do
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這個人到底因為犯了什麼罪
01:54
to merit this treatment?
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而受到這般不人道的待遇?
01:56
What was his terrible crime?
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他的罪行是什麼?
01:59
He was infected with HIV.
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他感染了愛滋病。
02:02
Now the kingdom is one of about 50 countries
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像這樣的王國世界上約有五十個,
02:05
that imposes restrictions on the entry or stay
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對愛滋病毒感染者的入境或逗留
02:10
of people living with HIV.
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設有嚴格限制。
02:12
The kingdom argues
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王國認為
02:14
that its laws allow it to detain or deport foreigners
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法律允許他們扣留或驅逐
02:19
who pose a risk to the economy
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可能對經濟,安全
02:22
or the security or the public health
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公共衛生,或社會道德
02:25
or the morals of the state.
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帶來風險的外國人。
02:27
But these laws, when applied to people living with HIV,
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但這些法律若用在愛滋病患身上,
02:31
are a violation of international human rights agreements
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便違背了國際人權協定,
02:35
to which these countries are signatories.
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而這些國家都是簽署國。
02:38
But you know what?
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但你知道嗎?
02:39
Matters of principle aside,
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把原則問題放一邊,
02:41
practically speaking, these laws drive HIV underground.
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事實上,這些法律導致愛滋病地下蔓延。
02:46
People are less likely to come forth
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人們很少願意表露身分,
02:48
to be tested or treated or to disclose their condition,
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接受測試,治療或揭露自己的狀況,
02:52
none of which helps these individuals
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這樣不只無法保護這些人,
02:55
or the communities these laws purport to protect.
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也危害法律宣稱要保護的社區。
02:59
Today we can prevent the transmission of HIV.
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今天我們可以防止愛滋病毒傳播。
03:03
And with treatment, it is a manageable condition.
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這疾病是可以被藥物控制管理的。
03:07
We are very far from the days
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我們早已不用像遠古時代
03:09
when the only practical response to dread disease
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必須要將帶病者
03:13
was to have banished the afflicted --
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驅逐出境--
03:15
like this, "The Exile of the Leper."
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像這畫"麻瘋病患的流亡"。
03:18
So you tell me why, in our age of science,
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所以你告訴我,為什麼在我們這麼科學的時代,
03:21
we still have laws and policies
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仍有法律和政策
03:24
which come from an age of superstition.
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來自迷信的時代?
03:27
Time for a quick show of hands.
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舉手的時間到了,
03:30
Who here has been touched by HIV --
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在場各位,誰接觸過愛滋病毒--
03:34
either because you yourself have the virus
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無論是你自己感染了,
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or you have a family member or a friend or a colleague
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或你的家人,朋友,同事
03:40
who is living with HIV?
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是愛滋病毒帶原人?
03:42
Hands up.
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請舉起手來。
03:43
Wow. Wow.
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哇,哇,
03:45
That's a significant number of us.
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看來不是小數目。
03:48
You know better than anyone
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你們定比任何人都更明白,
03:51
that HIV brings out
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愛滋病毒,同時引發了
03:53
the best and the worst in humanity.
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人性最光輝也殘酷的一面。
03:57
And the laws reflect these attitudes.
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而法律正好反映出這點。
03:59
I'm not just talking about laws on the books,
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我指的不是只有書上的法律,
04:02
but laws as they are enforced on the streets
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而是街道巷弄裡的不成文法,
04:06
and laws as they are decided in the courts.
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和法院實際判決的法案。
04:08
And I'm not just talking about laws
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我說的這些法律,
04:11
as they relate to people living with HIV,
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不只牽涉到感染愛滋病的人,
04:13
but people who are at greatest risk of infection --
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也涵蓋了處在高風險狀態的人們--
04:17
people such as those who inject drugs or sex workers
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注射毒品者,性工作者,
04:20
or men who have sex with men
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男同性戀者,
04:23
or transgendered persons
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變性人,
04:24
or migrants or prisoners.
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外來移民,或監獄的囚犯。
04:27
And in many parts of the world that includes women and children
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在世界許多地方,婦女和兒童
04:30
who are especially vulnerable.
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更是身處劣勢容易受到傷害。
04:32
Now there are laws in many parts of the world
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現今,有許多地區的法律
04:35
which reflect the best of human nature.
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反映出人性最良善的一面,
04:39
These laws treat people touched by HIV
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同情並且接納
04:42
with compassion and acceptance.
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這些與愛滋病為伍的人們。
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These laws respect universal human rights
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這些法律尊重全體人權,
04:48
and they are grounded in evidence.
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並且以科學證據為根基。
04:51
These laws ensure that people living with HIV
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這些法律確保感染愛滋病毒的人們
04:54
and those at greatest risk
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與那些高風險族群
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are protected from violence and discrimination
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不受暴力和歧視迫害,
05:00
and that they get access to prevention and to treatment.
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並且有管道獲得防治與治療。
05:04
Unfortunately, these good laws
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不幸的是,
05:07
are counter-balanced by a mass
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這些良好法律的功用
05:09
of really bad law --
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被一些建立在道德批判,
05:12
law which is grounded in moral judgement
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恐懼,誤傳等的不良法律
05:16
and in fear and in misinformation,
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給銷抵掉了。
05:19
laws which specifically punish people living with HIV
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這些不良法律,專門懲治
05:23
or those at greatest risk.
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愛滋病毒感染者與那些高風險者。
05:25
These laws fly in the face of science,
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這些有害法律,公然違抗現有科學,
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and they are grounded in prejudice
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把根基建在偏見,無知
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and in ignorance and in a rewriting of tradition
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重蹈覆轍的傳統迷信,
05:35
and a selective reading of religion.
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和斷章取義的宗教典籍上。
05:38
But you know what? You don't have to take my word for it.
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但你知道嗎?你不必相信我的話。
05:41
We're going to hear from two people
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我們來聽另外兩個人的心聲,
05:43
who are on the sharp end of the law.
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他們都直接被這些法律影響。
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The first is Nick Rhoades. He's an American.
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第一個是美國人,Nick Rhoades。
05:47
And he was convicted under the U.S. State of Iowa's law
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根據美國愛荷華州法律,他被定罪了--
05:51
on HIV transmission and exposure --
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罪行: 蓄意散播愛滋病毒--
05:54
neither of which offense he actually committed.
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然而他根本沒有這個意圖。
05:58
(Video) Nick Rhoades: If something is against the law
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(視頻)Nick Rhoades: 被宣判違反法律條文,
06:01
then that is telling society
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就像是在告訴社會大眾
06:02
that is unacceptable, that's bad behavior.
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這是不可接受的不良行為。
06:05
And I think the severity of that punishment
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我認為這種懲罰的嚴重性在於
06:07
tells you how bad you are as a person.
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告訴你你是一個多麼糟糕的人。
06:11
You're a class B felon,
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你是個 B 類重罪犯,
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lifetime sex offender.
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一生都是個性犯罪者。
06:16
You are a very, very, very bad person.
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你是一個非常,非常,非常不好的人。
06:20
And you did a very, very, very bad thing.
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你做了一件非常,非常,非常不好的事情。
06:24
And so that's just programmed into you.
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這就像是精神制約,
06:26
And you go through the correctional system
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你必須接受行為治療,
06:29
and everyone's telling you the same thing.
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且你身邊所有人都像是在說:
06:31
And you're just like, I'm a very bad person.
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你是個很不好的人。
06:36
Shereen El-Feki: It's not just a question
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Shereen El-Fek:這問題的嚴重性
06:38
of unfair or ineffective laws.
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不只是法律的不公正或無效力。
06:41
Some countries have good laws,
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一些國家有良好的法律
06:43
laws which could stem the tide of HIV.
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可以阻止愛滋病毒的蔓延。
06:46
The problem is that these laws are flouted.
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問題是這些法律被藐視了。
06:49
Because stigma gives unofficial license
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愛滋病毒感染者或高風險者
06:52
to treat people living with HIV
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被社會大眾
06:54
or those at greatest risk
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貼上了恥辱的標籤,
06:56
unlike other citizens.
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他們不配當一般公民。
06:58
And this is exactly what happened
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而這正是住在納米比亞的
07:00
to Helma and Dongo from Namibia.
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Helma和Dongo所親身經歷的事情。
07:03
(Video) Hilma: I found out
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(視頻)Helma: 那天我去醫院
07:05
when I went to the hospital for a pregnancy check-up.
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去做妊娠的例行體檢。
07:08
The nurse announced that every pregnant woman
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護士公布每個懷孕的女人
07:11
must also be tested for HIV that day.
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都必須接受愛滋病感染測試。
07:13
I took the test and the result showed I was positive.
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我做了測試,結果表明我被感染了。
07:16
That's the day I found out.
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這天,我得知我是愛滋病患者。
07:19
The nurse said to me, "Why should you people bcome pregnant
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那護士對我說:"為什麼你們這種人
07:22
when you know you are HIV positive?
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明明感染愛滋病還要懷孕?
07:23
Why are you pregnant when you are living positive?"
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你們幹嘛要懷孕?"
07:26
I am sure now that is the reason they sterilized me.
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我敢肯定,這是他們消毒我的原因。
07:29
Because I am HIV positive.
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因為我是愛滋病毒陽性。
07:34
They didn't give the forms to me
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他們拿給我一些表格,
07:37
or explain what was in the form.
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沒有做任何解釋,
07:40
The nurse just came with it
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那護士在表格上
07:43
already marked where I had to sign.
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標記我要簽名的欄位,
07:45
And with the labor pain,
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我正經歷分娩的痛楚,
07:47
I didn't have the strength to ask them to read it to me.
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無力要求他們對我解釋那些表格,
07:54
I just signed.
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我就乖乖的簽名了。
07:56
SE: Hilma and Nick and our man in the kingdom
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SE:Helma,Nick和那個故事中的主角,
08:00
are among the 34 million people living with HIV
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根據統計,是世界上3千4百萬愛滋病感染者
08:04
according to recent estimates.
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其中的一員。
08:06
They're the lucky ones
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他們是幸運的,
08:08
because they're still alive.
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因為他們還活著。
08:10
According to those same estimates,
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根據相關估計,
08:11
in 2010 1.8 million people died
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2010年有1百80萬人
08:15
of AIDS related causes.
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死於愛滋病。
08:18
These are terrible and tragic figures.
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這些數字令人驚恐。
08:21
But if we look a little more broadly into the statistics,
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但如果我們更詳細的看這些統計,
08:26
we actually see some reason for hope.
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我們可以找到一絲希望的曙光。
08:29
Looking globally, the number of new infections of HIV is declining.
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綜觀全球,新的愛滋病感染人數,
08:34
And looking globally as well,
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與愛滋病死亡人數,
08:37
deaths are also starting to fall.
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都正在下降。
08:40
There are many reasons for these positive developments,
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有很多原因促進這個發展,
08:42
but one of the most remarkable
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其中一個最引人注目的
08:44
is in the increase in the number of people around the world
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是越來越多人開始接受
08:48
on anti-retroviral therapy,
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抗轉錄病毒療法,
08:50
the medicines they need to keep their HIV in check.
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這療法可以有效抑制愛滋病毒發作。
08:54
Now there are still many problems.
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現在,仍有許多問題待解。
08:56
Only about half of the people who need treatment
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只有約一半需要治療的人
08:59
are currently receiving it.
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得到該治療。
09:01
In some parts of the world --
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在世界上有些地方--
09:03
like here in the Middle East and North Africa --
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像在中東和北非--
09:06
new infections are rising and so are deaths.
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新感染病例與死亡人數正在攀升。
09:09
And the money, the money we need
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而我們需要的經費,
09:12
for the global response to HIV,
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對抗全球愛滋病毒的經費,
09:14
that is shrinking.
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卻在萎縮。
09:17
But for the first time
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但,這是第一次,
09:19
in three decades into this epidemic
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從這流行病蔓延的三十年來,
09:23
we have a real chance to come to grips with HIV.
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我們真正有機會來對付愛滋病毒。
09:27
But in order to do that
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為了做到這一點,
09:29
we need to tackle an epidemic of really bad law.
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我們需要對抗這些普遍存在的壞法律。
09:33
It's for this reason
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正是出於這個原因
09:34
that the Global Commission on HIV and the Law,
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聯合國簽署建立了:全球愛滋病法
09:36
of which I'm a member,
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監督委員會,
09:38
was established by the agencies of the United Nations --
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我正是其中的一員,
09:41
to look at the ways that legal environments
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去監督響愛滋病毒感染者
09:43
are affecting people living with HIV
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和那些高風險族群
09:45
and those at greatest risk,
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所處在的法律環境。
09:48
and to recommend what should be done
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並且建議如何
09:49
to make the law an ally, not an enemy,
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使法律不是敵人,是盟友,
09:53
of the global response to HIV.
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共同對抗全球愛滋病毒。
09:55
Let me give you just one example
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讓我給你舉個例子
09:58
of the way a legal environment
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正確的法律環境,
10:00
can make a positive difference.
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可以帶來積極的改變。
10:03
People who inject drugs
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注射毒品的人
10:06
are one of those groups I mentioned.
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是的我提到的族群之一。
10:07
They're at high risk of HIV
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他們是感染愛滋病的高危險群,
10:10
through contaminated injection equipment
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經由受污染的注射設備
10:11
and other risk-related behaviors.
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和其他危險行為而感染。
10:14
In fact, one in every 10 new infections of HIV
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事實上,每10個感染人之中,
10:18
is among people who inject drugs.
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就有一個是毒品注射者。
10:21
Now drug use or possession
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現在毒品濫用或持有
10:23
is illegal in almost every country.
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幾乎在每個國家都是違法的。
10:25
But some countries take a harder line on this than others.
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但一些國家對此採取更強硬的手段。
10:30
In Thailand people who use drugs,
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在泰國,使用毒品,
10:32
or are merely suspected of using drugs,
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或只是受到懷疑有在用毒,
10:35
are placed in detention centers,
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就會被關在羈留中心,
10:37
like the one you see here,
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如同您看到的,
10:39
where they are supposed to clean up.
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他們被迫在此斷毒癮。
10:41
There is absolutely no evidence
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世上絕對沒有任何證據
10:44
to show that throwing people into detention
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指出只要把人關在拘留所
10:47
cures their drug dependence.
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就可以治療毒品依賴。
10:49
There is, however, ample evidence
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反而,有充分的證據顯示,
10:51
to show that incarcerating people
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把人當囚犯監禁,
10:53
increases their risk of HIV and other infections.
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會增加愛滋病毒和其他感染的風險。
10:58
We know how to reduce HIV transmission and other risks
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我們知道如何減少毒品注射者感染愛滋病
11:04
in people who inject drugs.
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與其他疾病的風險。
11:06
It's called harm reduction,
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這是藉由提供
11:08
and it involves, among other things,
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清潔針頭,注射器,
11:10
providing clean needles and syringes,
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提供毒品替代療法,
11:13
offering opioid substitution therapy
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和其他經過驗證
11:16
and other evidence-based treatments
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有療效的治療法,
11:18
to reduce drug dependence.
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來減少藥物依賴性。
11:20
It involves providing information
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另外包括衛生教育,
11:23
and education and condoms
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保險套的使用宣導,
11:25
to reduce HIV transmission,
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提供愛滋病毒檢測,
11:28
and also providing HIV testing
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提供諮詢,
11:30
and counseling and treatment
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都可保護人們
11:32
should people become infected.
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降低感染機率。
11:34
Where the legal environment allows for harm reduction
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這種減低傷害的法律環境
11:38
the results are striking.
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帶來驚人的成效。
11:40
Australia and Switzerland
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澳大利亞和瑞士
11:42
were two countries which introduced harm reduction
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這兩個國家在愛滋病毒傳播的初期,
11:44
very early on in their HIV epidemics,
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就推出減低傷害的法律環境,
11:47
and they have a very low rate of HIV
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它們的毒品注射者感染愛滋病
11:50
among injecting drug users.
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的機率非常低。
11:52
The U.S. and Malaysia
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而美國和馬來西亞
11:55
came to harm reduction a little later,
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較慢推行減低傷害法律環境,
11:57
and they have higher rates of HIV in these populations.
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它們在此有較高的愛滋病毒感染率。
12:01
Thailand and Russia, however,
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至於泰國和俄羅斯,
12:03
have resisted harm reduction
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拒絕推行減低傷害,
12:05
and have stringent laws
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並用嚴酷的刑法,
12:06
which punish drug use.
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來懲治毒品濫用。
12:08
And hey, surprise,
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所以,嘿,
12:09
very high rates of HIV among people who are injecting drugs.
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毒品注射者很多都感染了愛滋病毒。
12:15
At the Global Commission we have studied the evidence,
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我們的委員會已研究證據,
12:18
and we've heard the experiences
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聆聽親身經歷者
12:19
of over 700 people from 140 countries.
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7百多人,涵蓋140 個國家。
12:24
And the trend? Well the trend is clear.
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這個趨勢是很明顯的。
12:26
Where you criminalize people living with HIV
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只要感染者或高風險族群被當成罪犯,
12:29
or those at greatest risk,
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無論何處,
12:31
you fuel the epidemic.
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是對這流行病火上加油。
12:33
Now coming up with a vaccine for HIV
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現在愛滋病毒疫苗,或甚至解藥
12:38
or a cure for AIDS --
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已經快要問世了,
12:39
now that's rocket science.
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這門科學非常複雜。
12:41
But changing the law isn't.
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但改變法律不複雜。
12:43
And in fact, a number of countries are starting to make progress
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事實上,許多國家正如火如荼的
12:46
on a number of points.
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展開改革。
12:48
To begin, countries need to review their legislation
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首先,國家需要審查其立法,
12:52
as it touches HIV and vulnerable groups.
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因為它涉及到愛滋病與弱勢群體。
12:55
On the back of those reviews,
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審查之餘,
12:57
governments should repeal laws
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各國政府應廢除那些
12:59
that punish or discriminate against people living with HIV
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懲罰或歧視愛滋病毒感染,與高風險者
13:02
or those at greatest risk.
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的不良法律。
13:05
Repealing a law isn't easy,
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廢除法律並非易事,
13:07
and it's particularly difficult
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且變得格外困難
13:09
when it relates to touchy subjects like drugs and sex.
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當它涉及毒品和性別等敏感話題。
13:13
But there's plenty you can do while that process is underway.
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但,在這進程中,我們能做很多事。
13:17
One of the key points is to reform the police
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其中一個關鍵點,是警方的改良。
13:21
so that they have better practices on the ground.
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使他們在法律改革中有更好表現。
13:24
So for example, outreach workers
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例如那些分發保險套
13:26
who are distributing condoms to vulnerable populations
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到弱勢族群的外展工作人員,
13:29
are not themselves subject to police harassment
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不會自己受到員警騷擾,
13:32
or abuse or arbitrary arrest.
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謾罵或任意逮捕。
13:35
We can also train judges
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我們還可以訓練法官,
13:36
so that they find flexibilities in the law
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讓他們在法律中找到彈性,
13:39
and so that they rule on the side of tolerance
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用寬容來裁定
13:42
rather than prejudice.
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而不是偏見。
13:44
We can retool prisons
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我們可以整備監獄,
13:46
so that HIV prevention and harm reduction
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預防,與減少愛滋病毒危害
13:49
is available to prisoners.
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監獄裡的囚犯。
13:51
The key to all this is reinforcing civil society.
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最為關鍵的,是加強民間團體的力量。
13:56
Because civil society is key
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因為,民間團體
13:58
to raising awareness among vulnerable groups
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可以幫助弱勢族群意識到
14:01
of their legal rights.
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他們擁有的法律權利。
14:02
But awareness needs action.
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但只有意識是不夠的。
14:04
And so we need to ensure
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我們需要採取行動,
14:05
that these people who are living with HIV
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確保這些愛滋病患者
14:08
or at greatest risk of HIV
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或高風險族群
14:09
have access to legal services
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能有管道獲得法律服務,
14:12
and they have equal access to the courts.
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且確保他們平等出庭的機會。
14:15
And also important is talking to communities
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另外,與社區對話也極為重要。
14:18
so that we change interpretations
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這樣,我們能對宗教與習俗法條
14:20
of religious or customary law,
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從新詮釋,
14:22
which is too often used
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讓它們不再助長
14:24
to justify punishment and fuel stigma.
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不合理的懲罰和歧視。
14:28
For many of us here
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對很多在場的人來說,
14:29
HIV is not an abstract threat.
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愛滋病毒不是個抽象的威脅,
14:32
It hits very close to home.
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它的影響伸手可處。
14:35
The law, on the other hand,
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另一方面,法律,
14:37
can seem remote, arcane, the stuff of specialists,
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看似艱澀,遙遠而神秘,只有專家才懂,
14:42
but it isn't.
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但這不是事實。
14:44
Because for those of us who live in democracies,
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因為對於我們這些生活在有抱負有理想
14:47
or in aspiring democracies,
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的民主國家的人民,
14:49
the law begins with us.
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法律起始於我們。
14:52
Laws that treat people living with HIV
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法律必須起始於平等,
14:55
or those at greatest risk with respect
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無論是對待愛滋病族群
14:58
start with the way that we treat them ourselves: as equals.
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或是對待我們,皆須平等。
15:03
If we are going to stop the spread of HIV in our lifetime,
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如果我們要愛滋病毒在我們這一代停止蔓延,
15:07
then that is the change we need to spread.
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公平法律,就是我們必須發揚的觀念。
15:11
Thank you.
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謝謝。
15:12
(Applause)
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(掌聲)
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