Uganda: Protect, Don’t Punish, People With HIV

KAMPALA - Uganda's parliament should amend a proposed law on HIV/AIDS to remove
punitive and discriminatory provisions and to ensure that the rights of
people living with HIV/AIDS are protected, Human Rights Watch said
today, after the controversial bill was introduced.

The 2010 HIV/AIDS Prevention and Control Act was introduced on May
19, 2010 by the Honorable Beatrice Rwakimari, Chairperson of the
Committee on HIV/AIDS and Related Matters, following months of debate
about provisions that mandate HIV testing, force disclosure of HIV
status, and criminalize behavior that might result in transmission among
those who know they are HIV-positive. HIV prevalence has increased in
Uganda in recent years, with over a million people living with HIV and
more than 100,000 newly infected each year. It is estimated that 80
percent of those living with HIV in Uganda are unaware of their HIV
status.

"The bill contains measures that have been proven ineffective against
the AIDS epidemic and that violate the rights of people living with
HIV," said Joe Amon, Health and Human Rights director at Human Rights
Watch. "The HIV epidemic in Uganda is getting worse, and this bill is
another example of misguided, ideological approaches and lack of
leadership."

The bill as currently written codifies discredited approaches to the
AIDS epidemic and contains dangerously vague criminal provisions.
Contrary to international best practices, the bill would criminalize HIV
transmission and behavior that might result in transmission by those
who know their HIV status.

The bill would discourage voluntary HIV testing, while making testing
mandatory for pregnant women, their partners, suspected perpetrators
and victims of sexual offenses, drug users, and prostitutes, in
violation of fundamental principles of consent. The bill also allows
medical practitioners to disclose a patient's HIV status to others,
breaching confidentiality standards. These provisions could potentially
endanger those who are infected by exposing them to stigma,
discrimination, and physical violence.

Human Rights Watch and 50 Ugandan and international organizations
commented on an earlier draft of the bill and released a 10-page analysis of it in
November 2009. UNAIDS also released a 23-page critique of the bill, and a
coalition of Ugandan civil society groups published a joint position
statement that criticized many provisions of the draft bill. Since then,
the law was partially improved by removal of criminal penalty for the
transmission of HIV from mother to child through breastfeeding.
Reflecting these changes, Human Rights Watch released an updated analysis of the bill
this month.

Uganda's government has recently received international criticism for
a proposed "anti-homosexuality" law mandating the death penalty for
individuals living with HIV who engage in homosexual sex, regardless of
the use of HIV prevention, and including a requirement that individuals
report suspected homosexuals to the government within 24 hours.

"Like the anti-homosexuality bill, the HIV/AIDS bill tramples on
rights and encourages stigma and intolerance," Amon said. "The
international community and Ugandan civil society have been vocal and
clear about the problems in the bill. It is time for Uganda's parliament
to listen and amend these damaging provisions."

One consequence of the law would be to require all HIV testing
programs in the country to amend their pre-test counseling to inform
individuals of the law and its potential consequences, Human Rights
Watch said. Those being tested would need to understand that the
consequences of a positive test result could include disclosure of their
HIV status without their consent by medical personnel and criminal
liability for failure to adopt HIV prevention measures. International
research projects in Uganda that conduct HIV testing may also have to
modify and resubmit their protocols to ethical review boards, Human
Rights Watch said.

International guidelines issued by UNAIDS, the UN Development
Program, and the World Health Organization oppose criminalization of
transmission because it deters people from getting tested and
stigmatizes people with HIV. In contrast to the Ugandan bill, a pending
East African model law on HIV/AIDS provides broad protections for people
living with HIV and does not include provisions for criminalization of
transmission.

Mandatory testing undermines the rights of women and girls to
security of their person, does not meet the consent requirement set out
in medical ethics and international human rights law, and is
discriminatory. Under the provisions of the bill, for example, if a
woman tested positive, she could be liable for prosecution unless she
abstained from sex with her husband or partner or was able to ensure
that any partner used a condom. Combined with the bill's grant of
discretion to medical practitioners to disclose an individual's status
to other parties, the law exposes women in particular to intimate
partner violence and abandonment.

The bill also would criminalize a wide and ill-defined range of
conduct, such as breach of safe practice, obstruction, and making
misleading statements. A vague catch-all "general penalty" clause in the
bill would allow for criminal prosecution resulting in up to 10 years
imprisonment for contravening any provisions in the bill.

"For Uganda to address its HIV epidemic effectively, it needs to
partner with people living with HIV, not blame them, criminalize them,
and exclude them from policy making," Amon said. "Recognizing that
rights-based approaches are critical, and that people living with HIV
will prevent transmission if they are empowered and supported, would
allow Uganda's HIV response to get back on track."