Op-ed: Taking the Rights Path to End AIDS in Belize

As we commemorate World AIDS Day 2024 under the theme, “Take the Rights Path,” we are reminded that the fight against HIV and AIDS transcends medical advancements. It demands a commitment to human rights and social justice. For Belize, this theme resonates powerfully as the country grapples with a concentrated HIV epidemic that disproportionately impacts marginalized populations.

Tackling Belize’s HIV Epidemic: An Urgent Priority

Belize, with an HIV prevalence of 1.3% among the general population, has one of the highest prevalence rates in Central America and ranks above the Caribbean average of 1.2%. An estimated 3,700 people are living with HIV in the country with about half of them on treatment. While new infections have declined by 29% since 2010, surpassing the regional average reduction of 22%, challenges persist.

Young people aged 15-24 years accounted for 18% of all new infections in 2023, signaling a need for tailored interventions. Key populations, particularly gay, bisexual and other men who have sex with men (MSM), face disproportionately high prevalence rates, underscoring their heightened vulnerabilities.

AIDS-related deaths have risen by 14% since 2010, with more males than females succumbing to the disease, underscoring the urgent need for better early diagnosis, treatment coverage, and retention in care. For the second consecutive year (2023–2024), national data indicates that males aged 20–49 are being newly diagnosed with HIV at a rate 1.5 times higher than females in the same age group. Furthermore, over 40% of people living with HIV who are linked to care are lost to follow-up, highlighting significant gaps in appointment adherence. The management of advanced HIV disease remains a major challenge, threatening Belize’s progress toward achieving its National Strategic Plan goals.

Despite these challenges, Belize has achieved notable milestones. The elimination of Mother-to-Child transmission of HIV and syphilis was a landmark public health achievement in 2023. Additionally, Belize decriminalized the transmission, exposure, and non-disclosure of HIV through a legislative amendment of its Criminal Code in 2023—a progressive step that reflects the country’s commitment to reducing structural barriers. This will go a long way to lessen stigma and boost support for those living with HIV, promoting openness and better healthcare access. 

However, stigma, discrimination, and inadequate resources continue to hinder access to critical services, particularly for people living with HIV and for key populations. The high demand for psychological and legal aid services highlights the diverse challenges faced, including domestic violence and substance abuse. According to the Inter-American Commission on Human Rights (IACHR), in its 2023 Annual Report, women, girls and adolescents -  including indigenous women, migrant women, and those facing intersectional marginalization - often experience gender-based exclusion from the community, discrimination in employment, police brutality and harassment. Such acts against marginalized groups create fear and discourage individuals from seeking essential health services, perpetuating health disparities and social exclusion. Despite the country’s progress - including legislative advancements such as decriminalizing consensual same-sex activities - LGBTI individuals, sex workers, and people living with HIV continue to face societal discrimination that limits their ability to access justice and healthcare safely. This highlights the importance of addressing structural barriers and creating a legal and social environment that respects and protects human rights for all​.

Prioritizing Human Rights for long term impact 

Human rights are fundamental to the health and well-being of every individual and central to ending AIDS as a public health threat. Respecting, protecting, and fulfilling human rights ensures the dignity of all and is critical for achieving Belize’s development goals.

Human rights violations, such as pervasive stigma and discrimination faced by people living with HIV and key populations, exacerbate the HIV epidemic. Many of them experience judgment and breaches of confidentiality in healthcare settings, leading to delayed testing, treatment interruptions, and missed prevention opportunities.

To address these barriers, Belize must focus on:

• Expanding Prevention Efforts:
  Scale up pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) programs. Ensure access to STI screening and treatment services, particularly for MSM and young men, using innovative approaches such as digital media, self-testing, index testing, and partner notification through social and sexual network testing.
• Addressing Stigma:
  Implement culturally sensitive, evidence-based anti-stigma training for healthcare workers and community actors. Create inclusive, judgement-free environments where individuals feel safe seeking care.
• Strengthening Health Systems:
  Build integrated data systems to track progress, improve retention in care, and protect patient autonomy and confidentiality as well collaborating with Civil Society and communities in tracking violations of human rights and seeking redress. Ensure that services are available, accessible, acceptable, of good quality and safe for all.
• Empowering Communities:
  Strengthen community-led initiatives to deliver HIV services and expand safe spaces for Persons living with HIV, and key populations and other vulnerable populations. Capacity building and certification of Lay Testers (peer navigators) should be expanded to enhance their role in bridging gaps in care and to assist in bringing people back to care.

A Call to Action

Belize has demonstrated resilience and progress in its HIV response. Landmark achievements, such as the elimination of Mother-to-Child transmission and recent decriminalization reforms, are testament to the government’s commitment. However, the rise in AIDS-related deaths and persistent barriers to care highlight the need for urgent, rights-based interventions. 

In the words of UN Secretary-General António Guterres, “Ending AIDS as a public health threat by 2030 is achievable. But reaching this goal requires breaking down the barriers keeping people from vital services.”

On this World AIDS Day, the United Nations urges policymakers, civil society, and healthcare providers in Belize to take bold steps to end AIDS by 2030:

1. Further Dismantle Barriers:
   Build on the success in repealing discriminatory laws, including reducing the age of consent for adolescent access to medical services in line with the Convention on the Rights of the Child, which Belize has domesticated as part of its national laws. Advocate for legal protections that reduce stigma and discrimination in all settings. Push the Equal Opportunities Bill through the legislature. 
2. Invest in Prevention:
   Expand comprehensive prevention services, including PrEP, HIV self-testing, and STI care, targeting MSM and young men.
3. Support Community Leadership:
   Empower civil society organizations to lead the response through capacity-building and sustainable funding mechanisms.
4. Commit to Data-Driven Interventions:
   Strengthen monitoring and evaluation systems to guide evidence-based programming and ensure accountability.
5. Ensure Sustainable Financing:
   Mobilize domestic resources to complement donor funding and secure the long-term sustainability of Belize’s HIV response.

By prioritizing human rights, empowering communities, and fostering strategic partnerships, Belize can accelerate its journey toward ending AIDS and achieving Sustainable Development Goal 3: ensuring health and well-being for all. Let us commit to taking the rights path, ensuring a future where health, dignity, and equality are universal realities for all Belizeans.