HIV activists fear Uganda’s HIV and AIDS Prevention and Control Act is having the opposite effect and causing people to shy away from seeking treatment.
Medical experts and HIV activists fear Uganda’s HIV and AIDS Prevention and Control Act is having the opposite effect and causing people to shy away from seeking treatment.
The controversial Act, which criminalises transmission of the virus, was passed by the Ugandan parliament in May and signed into law by President Yoweri Museveni on 31 July despite strident opposition from HIV activists, who continue to oppose it. It contains clauses which permit medical workers to reveal the status of HIV positive people without their consent.
Dr Lydia Mungherera, a doctor and activist for HIV positive women, says: “Under Clause 14, the Act includes outdated and dangerous provisions for mandatory testing for pregnant women and their partners. Mandatory testing of people living with HIV is a violation of fundamental human rights and accepted principles of informed consent and negatively impacts antenatal care attendance.
“Women will shy away from hospitals and medical services. The devastating results will be that more children will be infected through mother to child transmission of HIV.”
Dr Mungherera, who is living positively with HIV, adds: “We have seen laws and all forms of discrimination come and go against people living with HIV. We are fighting for people in the communities who cannot reach the parliament. When I was in parliament, I saw the Ministers of Health just sit and go with the flow; this clearly told the chair of the parliamentary committee that this is going to backfire. What a parliament Uganda has!”
According to Dr Mungherera, the disclosure of medical information without consent is contrary to international best practices and is a violation of fundamental human rights. She also argues that by criminalising HIV transmission, attempted transmission and behavior that might result in transmission, the legislation is overly broad and difficult to enforce. The Act has also been condemned as discriminatory by Human Rights Watch, which says it will impede the fight against HIV.
Dr Mungherera heads the Mama Club of Women Living with HIV and Teen Mums. She is also a member of the Advocacy Committee on Elimination of Mother to Child Transmission of HIV, led by first lady Jannet Museveni. This body is responsible for the prevention of mother to child transmission in Uganda.
Advocacy is key to reducing infections
Through her advocacy work, Dr Mungherera has come up against a number of misconceptions. For example, some women were suspicious of the government’s motives to tackle transmission of HIV from mothers to their babies, thinking that by giving them medication while in labour (Nevilapine tablets), the government was trying to kill their babies. At the same time, some members of the government have accused HIV positive women of intentionally infecting their unborn children by not going to the hospital. Through Uganda’s Civil Society Coalition, Dr Mungherera argued that women avoid going to hospital because of a lack of information on the issue, not because they intend to harm their unborn children: no mother would want to do that.
The successful advocacy of Dr Mungherera, and others like her, has changed the lives of HIV positive mothers by encouraging them to adopt the concepts of preventing mother-to-child transmission, including through the Option B+ guidelines. According to UNAIDS, there has been a reduction in infections among newborn babies as a result: less than 10,000 babies were born with HIV in 2013 compared to more than 27,000 in 2011 with a further reduction to 5,000 expected by 2015.
Lillian Mworeko is the regional coordinator for the International Community of Women Living with HIV in Eastern Africa, and is also living positively with HIV. She is on the committee of Civil Society Coalition in Uganda and is among those who opposed the HIV Prevention and Aids Control Bill.
“It is disappointing that the members of parliament that we have engaged for so long have ignored all the evidence, science and reason that we advanced as civil society organisations together with technocrats and scientists and chose instead, to act out of fear and unfounded hysteria, betraying the very will of the people that elected them to parliament to represent their issues,” she said.
In a statement to journalists, Dr Vinand Natulya, chairman of the government-run Uganda AIDS Commission, said that the law further stigmatises those living with HIV and discourages people from getting tested. “If this is the law, then a right-thinking person would not get tested so that if he transmits the virus, he can always claim that he did not know he was positive. It is nonsensical,” he said.
Read more about HIV and wider development issues