TEDxSummit
Shereen El-Feki: HIV -- how to fight an epidemic of bad laws
Shereen El-Feki: 如何对抗如流行病般的不好法律
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爱滋病不只是作为流行病四处蔓延，和其相关的不好的法律条文也到处可见，这些法律将带病者视为囚犯。在多哈举办的这场TEDx高峰会上，Shereen El-Feki 提出了强而有力的论证，指出这些将爱滋病污名化的法律，甚至会助长疾病的扩散。
Shereen El Feki - Arab sexuality expert
Shereen El Feki works and writes on sexuality and social change in the Arab world. Full bio
Shereen El Feki works and writes on sexuality and social change in the Arab world. Full bio
Double-click the English transcript below to play the video.
00:16
Let's begin with a story.
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我先与大家分享一个故事。
00:20
Once upon a time --
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从前——
00:22
well actually less than two years ago --
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事实上是不到两年以前——
00:25
in a kingdom not so very far away,
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在一个不是很遥远的国度，
00:28
there was a man
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有一个人，
00:30
who traveled many miles
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他不远千里
00:31
to come to work at the jewel in the kingdom's crown --
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想要去王国的心脏工作——
00:35
an internationally famous company.
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一家国际著名公司。
00:38
Let's call it Island Networks.
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我们姑且称它为岛屿网络。
00:41
Now this kingdom had many resources
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这个王国拥有丰富的资源
00:44
and mighty ambitions,
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和雄雄的野心，
00:46
but the one thing it lacked was people.
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万事俱备只欠人员。
00:48
And so it invited workers from around the world
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因此它邀请世界各地的工人
00:52
to come and help it build the nation.
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来参与国家建设。
00:54
But in order to enter and to stay
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然而为了进入这个王国并在其领土上停留，
00:57
these migrants had to pass a few tests.
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这些移民必须先通过一些测试。
01:01
And so it was, our man presented himself
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因此，我们的主人公
01:03
to authorities in the kingdom,
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来到该王国的权威机构面前，
01:05
looking forward to settling into his new life.
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期望着能开始他的新生活。
01:08
But then something unexpected happened.
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然而出人意料的事情发生了。
01:12
The medical personnel who took blood samples from the man
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从男人身上抽取血样的医务人员
01:15
never actually told him what they were testing for.
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没有告诉他他们在检测什么。
01:19
He wasn't offered counseling before or after the test,
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在测试前或测试后向接受测试者提供顾问咨询服务是最佳的医疗做法，
01:23
which is best medical practice.
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然而这个男人却没有得到这项服务。
01:25
He was never informed of the results of the test.
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也没有人告知他测试的结果。
01:28
And yet, a couple of weeks later,
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但是，几周之后，
01:31
he was picked up and taken to prison
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他却被送进了监狱，
01:34
where he was subjected to a medical exam,
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进行体检，
01:36
including a full-body search
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他甚至在牢房中所有其他犯人面前
01:39
in full view of the others in the cell.
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接受了全身搜查。
01:43
He was released, but then a day or two later,
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他被释放后一两天，
01:46
he was taken to the airport and he was deported.
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就被送往机场遣返回国。
01:51
What on earth did this man do
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这个男人到底做了什么，
01:55
to merit this treatment?
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以至于受到如此对待？
01:57
What was his terrible crime?
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他到底犯下了什么可怕的罪行？
01:59
He was infected with HIV.
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他是艾滋病毒携带者。
02:03
Now the kingdom is one of about 50 countries
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该国对艾滋病病毒携带者
02:06
that imposes restrictions on the entry or stay
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入境及在国内停留加以限制，
02:10
of people living with HIV.
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世界上有类似规定的国家大约有五十个。
02:13
The kingdom argues
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该国宣称，
02:15
that its laws allow it to detain or deport foreigners
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法律赋予他们权利拘留或者遣返
02:20
who pose a risk to the economy
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对该国的经济、安全、公共健康
02:22
or the security or the public health
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以及道德标准
02:26
or the morals of the state.
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造成危险的外国人。
02:28
But these laws, when applied to people living with HIV,
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然而用这样的法律限制艾滋病携带者，
02:32
are a violation of international human rights agreements
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却违反了这些国家都签署了的
02:35
to which these countries are signatories.
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国际人权协定。
02:38
But you know what?
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但是你知道吗？
02:40
Matters of principle aside,
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不谈原则问题，
02:41
practically speaking, these laws drive HIV underground.
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从实际的角度出发，这样的法律造成了艾滋病的隐蔽化。
02:46
People are less likely to come forth
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人们越来越不愿意
02:49
to be tested or treated or to disclose their condition,
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接受测试、治疗或者公开他们的情况，
02:53
none of which helps these individuals
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这些法律声称保护的人群和社区
02:56
or the communities these laws purport to protect.
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没有从中得到任何帮助。
03:00
Today we can prevent the transmission of HIV.
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现在我们已经可以预防艾滋病病毒的传播。
03:04
And with treatment, it is a manageable condition.
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通过合理的治疗病情完全可以得到控制。
03:07
We are very far from the days
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人类应对令人恐惧的疾病的可行方法一度只有
03:10
when the only practical response to dread disease
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放逐那些患病的人，
03:13
was to have banished the afflicted --
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如“被流放的麻风病人”。
03:16
like this, "The Exile of the Leper."
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但那样的日子早已远去。
03:19
So you tell me why, in our age of science,
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为什么在科学技术高度发达的今天，
03:22
we still have laws and policies
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我们仍旧有这样来自迷信时代的
03:25
which come from an age of superstition.
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法律和政策呢？
03:28
Time for a quick show of hands.
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我们可以花一点点时间现场测试一样，
03:31
Who here has been touched by HIV --
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在座的接触过艾滋病的人请举手——
03:34
either because you yourself have the virus
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无论是你自己是病毒携带者
03:37
or you have a family member or a friend or a colleague
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还是你有家人、朋友、同事是病毒携带者
03:41
who is living with HIV?
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都算接触。
03:43
Hands up.
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请举手。
03:44
Wow. Wow.
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哇，哇，
03:46
That's a significant number of us.
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数量相当可观。
03:49
You know better than anyone
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那你们都应该清楚
03:52
that HIV brings out
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艾滋病会暴露人性中
03:54
the best and the worst in humanity.
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最美好和最丑陋的东西。
03:57
And the laws reflect these attitudes.
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而法律则会反映社会对艾滋病的态度。
04:00
I'm not just talking about laws on the books,
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我指的不光是文件上的法律，
04:03
but laws as they are enforced on the streets
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还有在街头
04:06
and laws as they are decided in the courts.
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以及法庭中被践行的法律。
04:09
And I'm not just talking about laws
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而且我指的不仅是与艾滋病病毒携带者
04:12
as they relate to people living with HIV,
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直接相关的法律，
04:14
but people who are at greatest risk of infection --
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还有与高危人群相关的法律——
04:17
people such as those who inject drugs or sex workers
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如注射毒品的人、性工作者、
04:21
or men who have sex with men
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与男性发生性关系的男性、
04:23
or transgendered persons
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变性人、
04:25
or migrants or prisoners.
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移民以及囚犯。
04:28
And in many parts of the world that includes women and children
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在世界上的很多地区女性和孩子也是极易感染的
04:31
who are especially vulnerable.
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高危人群。
04:33
Now there are laws in many parts of the world
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世界上很多地区的法律
04:36
which reflect the best of human nature.
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都反映了人性最美好的一面。
04:39
These laws treat people touched by HIV
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这些法律本着同情和接受的精神
04:43
with compassion and acceptance.
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来对待与艾滋病有接触的人群。
04:46
These laws respect universal human rights
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这些法律尊重普世人权，
04:49
and they are grounded in evidence.
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有理有据。
04:52
These laws ensure that people living with HIV
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这些法律确保艾滋病病毒携带者
04:55
and those at greatest risk
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和高危人群
04:57
are protected from violence and discrimination
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不受暴力和歧视伤害，
05:00
and that they get access to prevention and to treatment.
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并有能力预防艾滋病或者得到治疗。
05:05
Unfortunately, these good laws
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不幸的是，这些好的法律
05:07
are counter-balanced by a mass
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所发挥的作用
05:10
of really bad law --
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被大量糟糕的法律所抵消——
05:13
law which is grounded in moral judgement
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如以道德指责为依据的法律、
05:17
and in fear and in misinformation,
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以恐惧和错误的信息为依据的法律、
05:20
laws which specifically punish people living with HIV
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惩罚艾滋病病毒携带者
05:24
or those at greatest risk.
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或者高危人群的法律。
05:26
These laws fly in the face of science,
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这样的法律忽略科学事实，
05:28
and they are grounded in prejudice
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以偏见、无知、不科学的传统，
05:32
and in ignorance and in a rewriting of tradition
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以及对宗教的片面解读
05:35
and a selective reading of religion.
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为依据。
05:39
But you know what? You don't have to take my word for it.
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但你知道吗？你不必相信我的话。
05:41
We're going to hear from two people
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我们来听另外两个人的心声，
05:43
who are on the sharp end of the law.
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他们都直接被这些法律影响。
05:46
The first is Nick Rhoades. He's an American.
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第一个是美国人，Nick Rhoades。
05:48
And he was convicted under the U.S. State of Iowa's law
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根据美国爱荷华州法律，他被定罪了--
05:52
on HIV transmission and exposure --
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罪行： 蓄意散播爱滋病毒--
05:55
neither of which offense he actually committed.
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然而他根本没有这个意图。
05:58
(Video) Nick Rhoades: If something is against the law
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（视频）Nick Rhoades： 被宣判违反法律条文，
06:02
then that is telling society
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就像是在告诉社会大众，
06:03
that is unacceptable, that's bad behavior.
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这是不可接受的不良行为。
06:05
And I think the severity of that punishment
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我认为这种惩罚的严重性在于，
06:08
tells you how bad you are as a person.
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它告诉你你是一个多么糟糕的人。
06:12
You're a class B felon,
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你是个 B 类重罪犯，
06:14
lifetime sex offender.
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一生都是个性犯罪者。
06:17
You are a very, very, very bad person.
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你是一个非常，非常，非常不好的人，
06:21
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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这就像是精神制约，
06:27
And you go through the correctional system
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你必须接受行为治疗，
06:30
and everyone's telling you the same thing.
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而且你身边所有人都像是在说：
06:32
And you're just like, I'm a very bad person.
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你是个很不好的人。
06:37
Shereen El-Feki: It's not just a question
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Shereen El-Feki：这问题的严重性
06:39
of unfair or ineffective laws.
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不只是法律的不公正或无效力。
06:42
Some countries have good laws,
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一些国家有良好的法律，
06:44
laws which could stem the tide of HIV.
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可以阻止爱滋病毒的蔓延。
06:47
The problem is that these laws are flouted.
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问题是这些法律被藐视了。
06:50
Because stigma gives unofficial license
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爱滋病毒感染者或高风险者
06:53
to treat people living with HIV
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被社会大众
06:55
or those at greatest risk
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贴上了耻辱的标签，
06:56
unlike other citizens.
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他们不配当一般公民。
06:59
And this is exactly what happened
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而这正是住在纳米比亚的
07:00
to Helma and Dongo from Namibia.
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Helma和Dongo所亲身经历的事情。
07:04
(Video) Hilma: I found out
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（视频）Helma： 那天我去医院
07:05
when I went to the hospital for a pregnancy check-up.
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去做妊娠的例行体检。
07:08
The nurse announced that every pregnant woman
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护士宣布每个怀孕的女人
07:12
must also be tested for HIV that day.
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都必须接受爱滋病感染测试。
07:14
I took the test and the result showed I was positive.
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我做了测试，结果发现我被感染了。
07:17
That's the day I found out.
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这天，我得知我是爱滋病患者，
07:20
The nurse said to me, "Why should you people bcome pregnant
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那护士对我说："为什么你们这种人
07:22
when you know you are HIV positive?
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明明感染了爱滋病还要怀孕?
07:24
Why are you pregnant when you are living positive?"
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你们干嘛要怀孕?"
07:26
I am sure now that is the reason they sterilized me.
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我敢肯定这是他们给我绝育的原因，
07:29
Because I am HIV positive.
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因为我是爱滋病毒携带者。
07:34
They didn't give the forms to me
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他们没给我表格，
07:37
or explain what was in the form.
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也没有解释表格上有什么，
07:41
The nurse just came with it
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那个护士只是在表格上
07:43
already marked where I had to sign.
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标出我要签名的栏位。
07:46
And with the labor pain,
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我正经历分娩的痛楚，
07:47
I didn't have the strength to ask them to read it to me.
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无力要求他们对我解释那些表格，
07:55
I just signed.
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我就乖乖的签名了。
07:57
SE: Hilma and Nick and our man in the kingdom
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SE：Helma，Nick和那个故事中的主角，
08:00
are among the 34 million people living with HIV
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根据统计，是世界上3千4百万爱滋病感染者
08:05
according to recent estimates.
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其中的一员。
08:07
They're the lucky ones
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他们是幸运的，
08:09
because they're still alive.
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因为他们还活着。
08:10
According to those same estimates,
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根据相关估计，
08:12
in 2010 1.8 million people died
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2010年有1百80万人
08:16
of AIDS related causes.
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死于爱滋病。
08:19
These are terrible and tragic figures.
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这些数字令人惊恐。
08:22
But if we look a little more broadly into the statistics,
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但如果我们更详细地看这些统计，
08:26
we actually see some reason for hope.
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我们可以找到一丝希望的曙光。
08:30
Looking globally, the number of new infections of HIV is declining.
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综观全球，新的爱滋病感染人数
08:35
And looking globally as well,
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与爱滋病死亡人数，
08:38
deaths are also starting to fall.
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都正在下降。
08:41
There are many reasons for these positive developments,
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有很多原因促进这个发展，
08:43
but one of the most remarkable
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其中一个最引人注目的
08:45
is in the increase in the number of people around the world
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是越来越多人开始接受
08:48
on anti-retroviral therapy,
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抗转录病毒疗法，
08:50
the medicines they need to keep their HIV in check.
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这个疗法可以有效抑制爱滋病毒发作。
08:55
Now there are still many problems.
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现在仍有许多问题待解，
08:57
Only about half of the people who need treatment
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只有约一半需要治疗的人
09:00
are currently receiving it.
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能得到该治疗。
09:02
In some parts of the world --
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在世界上有些地方--
09:04
like here in the Middle East and North Africa --
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像在中东和北非--
09:06
new infections are rising and so are deaths.
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新感染病例与死亡人数正在攀升。
09:10
And the money, the money we need
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而我们需要的经费，
09:13
for the global response to HIV,
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对抗全球爱滋病毒的经费，
09:15
that is shrinking.
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却在萎缩。
09:18
But for the first time
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但，这是第一次，
09:20
in three decades into this epidemic
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从这流行病蔓延的三十年来，
09:23
we have a real chance to come to grips with HIV.
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我们真正有机会来对付爱滋病毒。
09:27
But in order to do that
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为了做到这一点，
09:29
we need to tackle an epidemic of really bad law.
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我们需要对抗这些普遍存在的坏法律。
09:33
It's for this reason
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正是出于这个原因，
09:35
that the Global Commission on HIV and the Law,
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联合国签署建立了全球爱滋病法
09:37
of which I'm a member,
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监督委员会，
09:38
was established by the agencies of the United Nations --
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而我是其中的一员，
09:41
to look at the ways that legal environments
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去监督爱滋病毒感染者
09:44
are affecting people living with HIV
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和那些高风险族群
09:46
and those at greatest risk,
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所处在的法律环境。
09:48
and to recommend what should be done
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并且给出建议，
09:50
to make the law an ally, not an enemy,
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如何使法律成为对抗全球爱滋病毒
09:53
of the global response to HIV.
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的盟友而不是敌人。
09:56
Let me give you just one example
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让我给你举个例子来说明，
09:58
of the way a legal environment
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正确的法律环境
10:01
can make a positive difference.
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可以带来积极的改变。
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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是我提到的族群之一。
10:08
They're at high risk of HIV
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他们是感染爱滋病的高危险群，
10:10
through contaminated injection equipment
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通过受污染的注射设备
10:12
and other risk-related behaviors.
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和其它危险行为而感染。
10:15
In fact, one in every 10 new infections of HIV
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事实上，每10个感染人之中，
10:18
is among people who inject drugs.
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就有一个是毒品注射者。
10:21
Now drug use or possession
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现在毒品滥用或持有
10:24
is illegal in almost every country.
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几乎在每个国家都是违法的。
10:26
But some countries take a harder line on this than others.
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但一些国家对此采取很强硬的手段。
10:30
In Thailand people who use drugs,
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在泰国，使用毒品，
10:33
or are merely suspected of using drugs,
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或只是受到怀疑有在用毒，
10:36
are placed in detention centers,
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就会被关在扣留中心，
10:38
like the one you see here,
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如同您看到的，
10:40
where they are supposed to clean up.
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他们被迫在此断毒癮。
10:42
There is absolutely no evidence
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世上绝对没有任何证据
10:45
to show that throwing people into detention
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指出只要把人关在拘留所
10:47
cures their drug dependence.
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就可以治疗毒品依赖。
10:50
There is, however, ample evidence
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反而，有充分的证据显示，
10:52
to show that incarcerating people
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把人当囚犯监禁，
10:54
increases their risk of HIV and other infections.
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会增加爱滋病毒和其他感染的风险。
10:59
We know how to reduce HIV transmission and other risks
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我们知道如何减少毒品注射者感染爱滋病
11:05
in people who inject drugs.
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与其他疾病的风险。
11:07
It's called harm reduction,
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这叫做减低伤害。
11:09
and it involves, among other things,
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包括清洁针头，注射器，
11:10
providing clean needles and syringes,
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提供毒品替代疗法，
11:14
offering opioid substitution therapy
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和其他经过验证
11:16
and other evidence-based treatments
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有疗效的治疗法，
11:19
to reduce drug dependence.
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来减少药物依赖性。
11:21
It involves providing information
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还有卫生教育，
11:23
and education and condoms
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保险套的使用宣导，
11:25
to reduce HIV transmission,
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提供爱滋病毒检测，
11:29
and also providing HIV testing
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提供咨询，
11:31
and counseling and treatment
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都可保护人们，
11:33
should people become infected.
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并降低感染机率。
11:35
Where the legal environment allows for harm reduction
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一个减低伤害的法律环境
11:38
the results are striking.
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会带来惊人的成效。
11:41
Australia and Switzerland
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澳大利亚和瑞士，
11:42
were two countries which introduced harm reduction
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这两个国家在爱滋病毒传播的初期，
11:45
very early on in their HIV epidemics,
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就推出减低伤害的法律环境，
11:48
and they have a very low rate of HIV
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它们的毒品注射者感染爱滋病
11:51
among injecting drug users.
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的机率非常低。
11:53
The U.S. and Malaysia
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而美国和马来西亚
11:55
came to harm reduction a little later,
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较慢推行减低伤害的法律环境，
11:58
and they have higher rates of HIV in these populations.
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它们则有较高的爱滋病毒感染率。
12:02
Thailand and Russia, however,
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至于泰国和俄罗斯，
12:03
have resisted harm reduction
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它们拒绝推行减低伤害，
12:05
and have stringent laws
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并用严酷的刑法，
12:07
which punish drug use.
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来惩治毒品滥用。
12:09
And hey, surprise,
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所以，嘿，
12:10
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爱滋病毒。
12:15
At the Global Commission we have studied the evidence,
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我们的委员会已研究了证据，
12:18
and we've heard the experiences
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并聆听了亲身经历者，
12:20
of over 700 people from 140 countries.
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共7百多人，涵盖140个国家。
12:24
And the trend? Well the trend is clear.
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这个趋势是很明显的。
12:27
Where you criminalize people living with HIV
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只要感染者或高风险族群被当成罪犯，
12:30
or those at greatest risk,
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无论何处，
12:31
you fuel the epidemic.
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都是对这流行病火上加油。
12:34
Now coming up with a vaccine for HIV
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找出爱滋病毒的疫苗
12:38
or a cure for AIDS --
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甚至解药，
12:40
now that's rocket science.
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那是非常复杂的科学。
12:42
But changing the law isn't.
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但改变法律并不那么复杂。
12:44
And in fact, a number of countries are starting to make progress
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事实上，许多国家正如火如荼的
12:47
on a number of points.
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在展开改革。
12:48
To begin, countries need to review their legislation
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首先，国家需要审查
12:52
as it touches HIV and vulnerable groups.
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涉及到爱滋病与弱势群体的法律。
12:56
On the back of those reviews,
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审查之后，
12:58
governments should repeal laws
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各国政府应废除那些
13:00
that punish or discriminate against people living with HIV
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惩罚或歧视爱滋病毒携带者与高风险者
13:03
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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废除法律并非易事，
13:08
and it's particularly difficult
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当它涉及毒品和性等敏感话题的时候，
13:09
when it relates to touchy subjects like drugs and sex.
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更是格外困难。
13:14
But there's plenty you can do while that process is underway.
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但，在这个过程中，我们还能做很多事，
13:17
One of the key points is to reform the police
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其中一个关键点，是警方的改进，
13:22
so that they have better practices on the ground.
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他们在执法中应有更好表现。
13:24
So for example, outreach workers
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例如那些分发保险套
13:26
who are distributing condoms to vulnerable populations
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到弱势族群的外展工作人员，
13:29
are not themselves subject to police harassment
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不应自己受到警员骚扰，
13:32
or abuse or arbitrary arrest.
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谩骂或任意逮捕。
13:35
We can also train judges
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我们还可以训练法官，
13:37
so that they find flexibilities in the law
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让他们在法律中找到弹性，
13:40
and so that they rule on the side of tolerance
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用宽容来裁定，
13:43
rather than prejudice.
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而不是偏见。
13:45
We can retool prisons
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我们可以整备监狱，
13:47
so that HIV prevention and harm reduction
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预防与减少爱滋病毒
13:50
is available to prisoners.
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危害监狱里的囚犯。
13:52
The key to all this is reinforcing civil society.
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而最为关键的，是加强民间团体的力量，
13:57
Because civil society is key
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因为民间团体
13:58
to raising awareness among vulnerable groups
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可以帮助弱势族群意识到
14:01
of their legal rights.
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他们拥有的法律权利。
14:03
But awareness needs action.
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但只有意识是不够的，
14:05
And so we need to ensure
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我们还需要采取行动，
14:06
that these people who are living with HIV
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确保这些爱滋病患者
14:08
or at greatest risk of HIV
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或高风险族群
14:10
have access to legal services
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能有通道获得法律服务，
14:13
and they have equal access to the courts.
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且确保他们平等出庭的机会。
14:16
And also important is talking to communities
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另外，与社区对话也极为重要。
14:18
so that we change interpretations
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这样，我们能对宗教与习俗法条
14:21
of religious or customary law,
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做重新诠释，
14:23
which is too often used
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让它们不再助长
14:25
to justify punishment and fuel stigma.
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不合理的惩罚和歧视。
14:28
For many of us here
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对很多在场的人来说，
14:30
HIV is not an abstract threat.
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爱滋病毒不是个抽象的威胁，
14:33
It hits very close to home.
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它的影响伸手可触。
14:36
The law, on the other hand,
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另一方面，法律，
14:38
can seem remote, arcane, the stuff of specialists,
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看似艰涩，遥远而神秘，只有专家才懂，
14:43
but it isn't.
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但事实并不是这样。
14:45
Because for those of us who live in democracies,
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因为对于我们这些生活在民主国家，
14:48
or in aspiring democracies,
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或正在追求民主的国家的人民，
14:50
the law begins with us.
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法律起始于我们。
14:53
Laws that treat people living with HIV
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法律必须起始于平等，
14:56
or those at greatest risk with respect
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无论是对待爱滋病族群，
14:58
start with the way that we treat them ourselves: as equals.
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或是对待我们，皆须平等。
15:03
If we are going to stop the spread of HIV in our lifetime,
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如果我们要爱滋病毒在我们这一代停止蔓延，
15:08
then that is the change we need to spread.
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那我们必须广泛推动这个变革。
15:12
Thank you.
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谢谢
15:13
(Applause)
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(鼓掌)
ABOUT THE SPEAKER
Shereen El Feki - Arab sexuality expertShereen El Feki works and writes on sexuality and social change in the Arab world.
Why you should listen
Dividing her time between London and Cairo, TED Fellow Shereen El Feki works on issues related to health and social welfare in the Arab region -- including intimate attitudes toward sexual (and political) freedoms, as explored in her new book, Sex and the Citadel.
Half-Egyptian and half-Welsh, El Feki was brought up in Canada. She started her professional life in medical science, with a PhD in molecular immunology from the University of Cambridge, and later worked as healthcare correspondent at The Economist. She also is a former vice chair of the United Nations' Global Commission on HIV and Law. While she has worked in regional media as a presenter with the Al Jazeera Network, and continues to write on social issues in the Arab world, her passion lies in projects that aim to better understand, and surmount, the social challenges facing Arabs, particularly young people.
Read a Q&A with Sheeren El Feki on the TED Fellows site.
Shereen El Feki | Speaker | TED.com