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Ugandan legislators recently released the latest version of a controversial HIV/AIDS bill that “promotes dangerous and discredited approaches to the AIDS epidemic,” according to Human Rights Watch (HRW). In a response report published by HRW and endorsed by more than 50 organizations and individuals, HRW criticizes Uganda’s proposed HIV Prevention and Control Bill for the repressive nature of several new clauses while pointing out some of its more agreeable aspects.
As written, the draft law threatens human rights and progress toward universal access to treatment. The most alarming changes include the criminalization of intentional transmission of HIV, which could result in life imprisonment; compulsory testing of drug users, pregnant women, sex workers, and victims and charged offenders of sexual violence; and forced disclosure of HIV status. The government’s role in providing access to affordable treatment has been removed from the legislation.
“We know what works and what doesn’t in fighting HIV,” said Beatrice Were of the Uganda Network on Law, Ethics & HIV/AIDS. “This bill, unfortunately, is full of ineffective approaches that violate human rights and will set us back in our efforts to fight the AIDS epidemic and expand HIV programs nationwide.”
The bill’s most troubling traits are particularly unjust to women and high-risk groups. Because women are tested for HIV during pregnancy, a disproportionate number of women will know their HIV status and will thus be prosecuted disproportionately. The bill does not consider and protect a women’s inability to negotiate condom use or to tell a partner about her status — a partner who may have transmitted the disease to her in the first place. The HRW analysis finds that women who transmit HIV to their infants by feeding them breast milk would face criminal prosecution. Although the legislation exempts mother-to-child transmission “before or during the birth of the child,” the law does not protect mothers after child birth — the period of time when breastfeeding occurs. Additionally, there is little mention of counseling or support services for minors.
In short, the bill fails to provide a legal framework favorable to the effective national management of the epidemic. It fails to chip away at the more elusive yet fundamental perpetuators of the disease: stigma and discrimination.
The bill also arrives on the heels of a widely condemned piece of pending legislation, the Anti-Homosexuality Bill, which “prohibits and penalizes homosexual behavior” in Uganda. The bill, proposed on October 14, 2009, contains a life imprisonment punishment for an “offence of homosexuality.” Punishment by death is recommended for those committing “aggravated homosexuality,” whereby the “offender”— or, a partner in a homosexual act — is HIV-positive, or the other partner is disabled or under 18 years old. Those charged would be forced to take an HIV test. The bill also carries penalties for individuals who know about gay persons but do not report them, striking a severe gash in the progress of HIV prevention and treatment efforts by alienating this high-risk group.
The bill will enter Parliament shortly and will most likely become law in early 2010. Its myriad egregious clauses, such as the death penalty, could be altered slightly, but their fates remain to be seen. The gross human rights violations that lurk in the bill — discrimination of vulnerable groups, roadblocks to treatment, privacy of HIV status — will no doubt be carried through to law in some capacity, and these violations bear a striking resemblance to those in the HIV/AIDS bill.
Despite its numerous critiques of the proposed HIV/AIDS law, the HRW report does not ignore some welcome attributes of the legislation, noting that several changes may “improve the potential for human rights protections.” For example, neglecting to inform one’s sexual partner of HIV status and failure to protect oneself from transmission is no longer criminalized, and children born to HIV-positive women will receive treatment and care. Still, the bill lacks a fundamental commitment to protecting the rights and the health of its citizens.
In early December, Elizabeth Mataka, the UN Special Envoy on AIDS in Africa, added her voice to those of the bill’s dissenters. “I emphasize the importance of creating a social environment conducive for HIV prevention and to refrain from laws that criminalize the transmission of HIV and stigmatize certain groups in the population,” she remarked in Kampala, Uganda, on December 2. “These laws can only fuel the epidemic further and undermine an effective response to HIV.”
Papers In Press
Europe’s Shifting Response to HIV/AIDS: From Human Rights to Risk Management
HIV, Hepatitis C, TB, Harm Reduction, and Persons Deprived of Liberty: What Standards Does International Human Rights Law Establish?
Gen Sander and Rick Lines
International Human Rights and the Mistreatment of Women during Childbirth
Rajat Khosla, Christina Zampas, Joshua P. Vogel, Meghan A. Bohren, Mindy Roseman, and Joanna N. Erdman
HIV and the Right to Health in Colombia
Corey Prachniak-Rincón and Jimena Villar de Onís
Transforming Policy into Justice: The Role of Health Advocates in Mozambique
Ellie Feinglass, Nadja Gomes, and Vivek Maru
Reproductive Health Policy in Tunisia: Women's Right to Reproductive Health and Gender Empowerment
Nada Amroussia, Alison Hernandez, and Isabel Goicolea
Letter to the Editor: Moving the Debate Forward in Right to Health Litigation
Octavio Luiz Motta Ferraz
Letter to the Editor Response: On the Heterogeneity and Politics of the Judicialization of Health in Brazil
João Biehl, Mariana P. Socal, Joseph J. Amon
Terminal Patients and the Right to Refuse Medical Treatment in Argentina
Martín Hevia and Daniela Schnidrig
Book review: Advancing Global Health and Human Rights in this Neoliberal Era
Harvard FXB Health and Human Rights Consortium Student Essay Competition:
Human Rights, Law and Abortion in El Salvador
Lessons from Jonathan Mann: The Ten Commandments on Multidrug-Resistant TB
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