With clauses to establish a tax-fed fund for prevention, care and treatment of HIV, banning discrimination against people living with HIV, and provisions to ensure accurate and relevant information about the risks of acquiring HIV, Uganda would seem to be getting back on track to fight its HIV epidemic with its new HIV and AIDS Prevention and Control Bill. But in the nation where the recently passed Anti-Homosexuality Law has already led to the closing of one successful HIV research, treatment and prevention program, and where prevalence of the virus continues to rise in the face of discredited policies and programs, nothing is simple.
While the exact text of The HIV and AIDS Prevention and Control Bill headed for President Yoweri Museveni’s desk as early as today remains unavailable, it is close enough to this version, created in 2010 that the parts that are most destructive to public health have the same numbers and the same wording. That includes clause number 41 setting a fine and ten years in prison for “Intentional Transmission of HIV,” and clause number 39, with its fine and five-year sentence for “Attempted transmission of HIV.”
With those clauses alone, “that pretty much give people an incentive to remain ignorant of their HIV status,” AIDS-free World co-founder and co-director Paula Donovan notes, “It’s impossible to take the bill apart and say this is good, and this is bad. As a whole, it’s overwhelmingly dangerous and ill-considered.”
While the Ugandan Parliament is today tweaking sections of the bill that include an inaccurate definition of antiretroviral medicines (the version linked to above defines ARVs as “antiretroviral drugs used to boost the white blood cell count to fight the progress of HIV in the human body”) parliament members already have confirmed the penalties for “intentional” and “attempted” HIV transmission, as well as clauses obligating health workers to divulge the HIV status of others to their patients if they deem it necessary, mandating testing for sexual assault victims, and mandating testing and treatment for pregnant women.
“If a pregnant woman is accused of not taking her antiretroviral medicine properly, or nursing in a way that is not in accordance to guidelines, logic says that woman would be charged with attempted transmission or intentional transmission. And sent to prison,” Donovan said.
“The terrible thing about all of this is that it’s a whole law based on paranoia,” Donovan added. “Without any evidence of people who are infected with HIV who want to spread it to others.”
Like the Anti-Homosexuality Law passed by Parliament in December and signed by Museveni in February, the bill and the clauses public health experts cite as most damaging appear to be propelled in part by a determination not to be subjected to Western standards, Donovan said. That is ironic, because many more people in the United States and Canada have been prosecuted for HIV transmission, under existing laws, than in Africa, she said.
At the same time, Donovan notes, the law could actually lead to the prosecution, fining and imprisonment of those who passed it under even the most generous interpretation of clause number 44, on “Misleading information or statement.”
Its provisions include: “A person who makes or causes to be made any misleading statements or information regarding curing, preventing, or controlling HIV contrary to this section shall be liable on conviction to a fine of not more than two hundred and forty currency points or to imprisonment of not more than 10 years or to both.”
Museveni will have 30 days to consider that, along with the rest of the bill.