Translated from French with Deepl.com – Scroll down for original article
Human rights groups that have set up the Tracking (In)Justice project are denouncing the use of the anti-spit mask, which police forces such as the Royal Canadian Mounted Police (RCMP) regard as an ‘essential’ tool.
The mask, which is placed over the head of an arrestee who wants to spit or bite police officers, is causing controversy. The mask has been used during certain interventions after which the arrested person died, although no link has been formally established between the use of the mask and the person’s death.
A useful and used tool
The Calgary Police Service uses the anti-spit mask.
According to its data (New Window), this tool was used 70 times in 2022 and 2023, more often than pepper spray, but less often than conducted energy weapons.
Members of the RCMP also use them, but their use is not systematically recorded, because the RCMP considers the mask to be a restraint device in the same way as handcuffs,’ she said in an email to Radio-Canada.
According to the RCMP, the mask prevents biological contamination from diseases and infections such as hepatitis and HIV. It says that this type of injury is the most frequently mentioned by officers.
A controversy
Alexander McClelland, Associate Professor at the Institute of Criminology and Criminal Justice at Carleton University in Ottawa, believes that the personal protection argument does not hold water.
We don’t know of many diseases that are transmitted solely by saliva. For example, HIV and hepatitis C are not transmitted by saliva. COVID-19 is an airborne disease. So you need a mask to prevent it, not a mesh fabric,’ says the member of Tracking (In)Justice, which brings together several organisations and collects data on the application of the law and criminal law.
Alexander McClelland believes that the mask is a dehumanising tool that serves no purpose other than to prevent a person from spitting, which could be avoided by de-escalation measures.
A dangerous tool?
I know that there have been about nine cases in Canada [between 2014 and 2022] where people have died after using balaclavas,’ says Alexander McClelland. They are used when a person is forcibly immobilised on the ground, a bonnet is applied and they are sprayed with pepper spray.
The RCMP is clear on this point: the bonnet must not be used to control a prisoner. To this end, it cites studies showing that the use of the mask, according to the manufacturer’s instructions, is safe.
However, in an internal memo (New Window), Alberta Health says the following: [Anti-choking] bonnets interfere with airway assessment and management and present a considerable risk, for example if the patient vomits or chokes. Agitation is also increased by interference with the patient’s vision.
Supervision measures
Masks are safe if staff follow a precise protocol.
They are supposed to be used in a context where no other type of force is applied and when the person [to whom the bonnet is applied] is seated and able to breathe effectively and normally,’ says Alexander McClelland.
When other types of force are applied, such as ground restraint, or if someone is handcuffed, or if someone is in a heightened state of anxiety because they are being held by the police, they may not be able to breathe effectively,’ he adds.
What’s more, the measures surrounding the use of this bonnet vary from one police force to another.
In the RCMP, the bonnet is considered a restraint device. It is therefore not subject to the same requirements as tools that fall into the Intervention Options category, which includes pepper spray, for which there are strict training and recertification requirements.
Prohibited use
In Australia, the anti-spit mask has been abolished.
Alexander McClelland explains that Australia made this decision following the death of a man in custody. It’s because [the masks] can be damaging and cause a lot of harm to people who are arrested or incarcerated,’ says McClelland.
For its part, the RCMP says it has no intention of stopping using them, but that if objective medical evidence shows the tool to be dangerous, it will take it into account.
Le masque anti-crachat, un outil controversé
Des groupes de défense des droits de la personne qui ont créé le projet Tracking (In)Justice dénoncent l’utilisation du masque anti-crachat, alors que les corps de police tels que la Gendarmerie royale du Canada (GRC) le perçoivent comme un outil « essentiel ».
Ce masque, qui est mis sur la tête d’une personne en état d’arrestation qui veut cracher ou mordre les policiers, suscite la controverse. Le masque a été utilisé durant certaines interventions après lesquelles la personne arrêtée est morte,bien qu’aucun lien n’ait été formellement établi entre l’utilisation du masque et la mort de la personne.
Un outil utile et utilisé
Le service de police de Calgary a recours au masque anti-crachat.
Selon ses données (Nouvelle fenêtre) (en anglais), cet outil a été employé 70 fois en 2022 et en 2023, soit plus souvent que les aérosols capsiques (gaz poivre), mais moins que les armes à impulsion électrique.
Les membres de la GRC y ont aussi recours, mais son usage n’est pas systématiquement répertorié, car elle considère le masque comme un dispositif de contrainte, au même titre que des menottes, dit-elle dans un courriel envoyé à Radio-Canada
Selon la GRC, le masque permet d’éviter la contamination biologique de maladies et d’infections comme des hépatites et le VIH. Elle affirme que ce type de blessures est le plus fréquemment mentionné par les agents.
Une polémique
Le professeur agrégé de l’Institut de criminologie et de justice criminelle à l’Université Carleton à Ottawa Alexander McClelland estime que l’argument de la protection individuelle ne tient pas la route.
Nous ne connaissons pas beaucoup de maladies qui se transmettent uniquement par la salive. Par exemple, le VIH et l’hépatite C ne se transmettent pas par la salive. La COVID-19 est une maladie qui se transmet par l’air. Il faut donc un masque pour l’éviter, pas un tissu en maille, affirme le membre de Tracking (In)Justice, qui regroupe plusieurs organisations et qui collecte des données sur l’application de la loi et du droit pénal.
Alexander McClelland juge que le masque est un outil déshumanisant, qui n’a d’autre utilité que d’empêcher une personne d’envoyer des crachats, ce qui pourrait être évité par des mesures de désescalade.
Un outil dangereux?
Je sais qu’il y a eu environ neuf cas au Canada [entre 2014 et 2022] où des personnes sont mortes après l’utilisation de cagoules, affirme Alexander McClelland. Elles sont utilisées lorsqu’une personne est immobilisée de force sur le sol, qu’on lui applique une cagoule et qu’elle est aspergée de gaz poivré.
Or, la GRC est claire sur ce point : la cagoule ne doit pas servir à contrôler un prisonnier. À cet effet, elle cite des études qui démontrent que l’usage du masque, selon les indications du fabricant, est sécuritaire.
Toutefois, dans une note interne (Nouvelle fenêtre) (en anglais), Service de santé Alberta dit ceci : Les cagoules [anti-crachat] gênent l’évaluation et la gestion des voies respiratoires et présentent un risque considérable, par exemple si le patient vomit ou s’étouffe. L’agitation est aussi accrue par l’interférence avec la vision du patient.
Des mesures d’encadrement
Le masque est sécuritaire, si les agents suivent un protocole précis.
Ils sont censés être utilisés dans un contexte où aucun autre type de force n’est appliqué et lorsque la personne [à qui on enfile la cagoule] est assise et capable de respirer efficacement et normalement, assure Alexander McClelland.
Lorsqu’on applique d’autres types de force, comme la contrainte au sol, ou si quelqu’un est menotté, ou si quelqu’un est dans un état d’anxiété accru parce qu’il est retenu par la police, il peut ne pas être en mesure de respirer efficacement, ajoute-t-il.
De plus, les mesures entourant l’usage de cette cagoule varient selon les corps policiers.
À la GRC, la cagoule est considérée comme un dispositif de contrainte. Elle n’est donc pas soumise aux mêmes exigences que les outils qui entrent dans la catégorie Options d’intervention, dont fait partie l’aérosol capsique, pour laquelle il y a des exigences strictes en matière de formation et de recertification.
Un emploi proscrit
En Australie, le masque anti-crachat a été aboli.
Alexander McClelland explique que ce pays a fait ce choix à la suite du décès d’un homme en détention. C’est parce que [les masques] peuvent être dommageables et causer beaucoup de tort aux personnes arrêtées ou incarcérées, affirme le spécialiste.
De son côté, la GRC déclare qu’elle n’a pas l’intention d’arrêter de l’utiliser, mais que, si des preuves médicales objectives démontrent la dangerosité de l’outil, elle va en tenir compte.
Working to end punitive laws and policies that impact people living with HIV is never easy, but this year has been especially hard, as we fought to maintain that delicate balance between moving forward in our advocacy and preventing the erosion of our previous gains fuelled by the anti-rights movement and the growth of right-wing populism.
For the first time since the COVID-19 pandemic hit, we saw an increase in the number of reported HIV-related prosecutions: 86 cases in 18 countries. This compares with 49 cases in 16 countries last year and 54 cases in 20 countries in 2021. This year, as in previous years, the highest number of case reports come from the EECA region (Uzbekistan and Russia), followed by the United States (10 cases – a significant decrease) and the United Kingdom (5 cases – a worrying increase).
It is possible that we were seeing more case reports because there were actually more cases, but we must always consider these reported cases to be illustrative of what is likely to be a far more widespread, poorly documented use of criminal law against people living with HIV.
Although many people arrested or prosecuted were heterosexual men, we also saw a range of intersectional identities impacted by HIV criminalisation – particularly sex workers who may also have been transgender and/or people of colour and/or with a migration background. It is clear that a convergence of multiple levels of criminalisation, discrimination and other vulnerabilities leads to over-policing of the bodies and behaviours of people living with HIV.
It’s also clear that sustained advocacy by civil society in Mexico – which began in earnest when the HIV JUSTICE WORLDWIDE coalition supported the creation of the Mexican network in 2017 – is really making a difference. In March, the state of Nayarit repealed its infectious disease law that had mostly applied to people with HIV. The district of Mexico City is on its way to repeal a similar law. And another Mexican state, Baja California Sur, modernised the wording of the same law to attempt to destigmatise it, by removing the concept that communicable diseases are only prosecutable if sexually transmitted.
In the United States, we continued to see a marked reduction in the number of cases as the movement to repeal or modernise HIV criminalisation laws continued to grow due to ongoing, sustained advocacy by networks of people living with HIV with support from philanthropic funders as well as federal and state political leaders and public health institutions. Although, no states fully repealed their HIV-specific laws in 2023, and law reform proposals in Indiana, Minnesota, and North Dakota failed to pass, there were some important victories in Tennessee. Here, both law reform and strategic litigation bore fruit, the former by removing mandatory sex offender registration for those convicted under the HIV law, and the latter resulting in a ruling that Tennessee’s ‘aggravated prostitution’ statute violated the Americans with Disabilities Act.
Canada – another former global HIV criminalisation leader – continued to report fewer cases, with just one new reported case in 2023. As in the United States, this is the result of many years of sustained advocacy, although the federal government has still not responded formally to its 2022 public consultation on substantially reforming its approach to HIV criminalisation. The Canadian Coalition to Reform HIV Criminalization, led by HIV JUSTICE WORLDWIDE coalition partner, the HIV Legal Network, issued a strong statement on World AIDS Day calling for action.
AFRICA
Unlike previous years, the only country on the African continent with reported new HIV criminalisation cases in 2023 was Kenya, where lawmakers are still planning to follow Uganda in enacting even more criminalisation aimed at LGBTI people – as are Botswana, Ghana, and Niger. Following the December 2022 dismissal of the constitutional challenge to Kenya’s HIV-specific provisions in the Sexual Offences Act, there are plans to appeal and to continue to lobby for change.
People living with HIV in the EECA region continue to face multiple challenges. In just the first six months of 2023, there were 20 cases of alleged “intentional HIV transmission” to sexual partners in Uzbekistan’s Tashkent region – the highest HIV criminalisation case count anywhere in the world. The majority of those prosecuted appeared to be women. This comes as no surprise given that an analysis of cases and laws across the ECCA region by our HIV JUSTICE WORLDWIDE partners, the Eurasian Women’s Network on AIDS (EWNA), found that women living with HIV bear the brunt of the “legalised stigma” of HIV criminalisation in the region.
One of the main reasons for the high number of cases in the EECA region is the integration of HIV criminalisation within healthcare policies: newly diagnosed individuals are made to sign a paper acknowledging their legal liability for HIV prevention often without receiving adequate or meaningful counselling or support. In Russia – where the second highest number of cases were reported – a study found that most HIV clinicians support HIV criminalisation, and in Kazakhstan it was revealed that 1-in-1000 people newly diagnosed with HIV in 2022 filed a police report blaming someone else for their infection.
December saw two contrasting developments in Western Europe. Just as Ireland’s Supreme Court overturned the country’s first-ever sexual HIV criminalisation case – partially based on now well-established limitations of scientific evidence being able to prove who infected whom – a lower court in Latvia convicted someone of alleged HIV transmission for the first time.
Although ending HIV criminalisation cannot rely on science alone, it can help limit unjust prosecutions while we work to end the HIV-related stigma, discrimination and structural inequalities that drive criminalisation.
BRINGING SCIENCE TO JUSTICE
This year, we celebrated five years since the publication of the ‘Expert Consensus Statement on the Science of HIV in the Context of Criminal Law’ with our ‘Five-Year Impact Report’ and an HIV Justice Live! webshow focused on bringing science to justice. Both proved that the Expert Consensus Statement remains relevant, accurate and extremely useful.
To ensure that communities continue to lead, and to further enable the building of an intersectional movement to end punitive laws and policies that impact people living with HIV in all diversity, we made our online platform for e-learning and training, the HIV Justice Academy, more widely available in Spanish and Russian, to complement our English and French versions.
In 2023, the HIV Justice Academy was visited by several thousand learners from 110 countries. We were thrilled to learn that graduates of our flagship HIV Criminalisation Online Course told us that they really benefitted from the course, finding it relevant, interesting, and engaging.
RENEWED FOCUS FOR 2024
We will begin 2024 with a renewed focus to achieving HIV justice as we continue to:
build the evidence base by gathering relevant data and information from around the world.
raise awareness across multiple platforms and communities of the harms of HIV criminalisation.
create, collate, and disseminate advocacy tools and resources to foster more effective responses to damaging laws, policies, and media narratives; and
bring individuals and national, regional, and global networks and organisations together, as part of the HIV JUSTICE WORLDWIDE coalition, to catalyse change.
EECA Judges’ Forum on HIV, Human Rights and the Law meet to discuss challenges presented by punitive laws
Judges from Eastern Europe and Central Asia gather in Moldova to discuss the region’s pressing issues around health, HIV, human rights and the law
The Eastern European and Central Asian Judges’ Forum on HIV, Human Rights and the Law – an independent body of judges from the region yearly convened by UNDP – starts their two-day meeting on 27 November 2023 in Chișinău, Moldova, to discuss challenges that punitive laws present to the full realization of the rights of people living with and affected by HIV.
The Forum, started in Moldova five years ago, returns this year to address challenges that remain in the region, as well as to highlight the progress made by countries like Moldova in addressing them.
“The Ministry of Justice is taking all measures to bring criminal policy in line with European standards, ensuring human rights is a priority. To this end, sanctions have been adjusted in criminal law with the aim of humanizing and clearly distinguishing cases of drug use from drug dealing. In addition, it is proposed to diversify the penalties in order to promote alternatives to imprisonment. Improving the human rights protection system remains a priority for the Ministry of Justice, and each of us understands that we must apply a proactive policy in the area of combating drug use, enhancing the role of the judiciary in ensuring the rights of this category of people are reconceptualized,” noted Veronica Mihailov-Moraru, Minister of Justice of the Republic of Moldova.
“At the core of our discussions during the Forum are real people – individuals whose lives and rights depend on the decisions made within the walls of courtrooms. It is our responsibility to protect these rights, to champion the cause of justice, and to ensure that no one is left behind in our fight against HIV,” said Andrea Cuzyova, UNDP Deputy Resident Representative to the Republic of Moldova.
The Eastern Europe and Central Asia (EECA) region is among three in the world where HIV infections and deaths are still on the rise. Fifteen countries in the region still criminalize HIV transmission, and many others, in law or practice, restrict access to life-saving services for key populations. People who use drugs are still the most impacted by HIV in the region; rigid drug policies often drive people away from vital health services. This exacerbates the HIV epidemic and facilitates high incarceration rates, contributing to a burgeoning tuberculosis epidemic and other health and social challenges for individuals upon release.
Prior to the war in Ukraine, labor migration has been a significant driver of HIV and TB epidemics in the EECA region, and currently internally displaced persons and migrants have limited access to vital health services, including HIV and tuberculosis, and legal support. HIV decriminalization and pro-active drug policy reforms are long overdue in the region.
“We now have evidence that countries with more enabling societal and legal environments where punitive policies are replaced with those that put people and health at the center and protect rights to non-discrimination are associated with bigger declines in HIV incidence,” said Vera Ilyenkova, Adviser, Key populations & Communities engagement in UNAIDS Regional Support Team for Eastern Europe and Central Asia. UNAIDS report this year focused on the opportunities that countries can take for legal reform and innovation to stem HIV epidemics.
“A large number of incarcerated people across the Eastern European and Central Asian region are serving prison terms for drug related offenses, in many cases simple possession with no harm to others. It is time to reflect on whether this is an effective measure, whether it is the right public investment, whether it is justified and proportionate. I invite all participants to the Judges forum to consider that the answer to these questions is NO and that drug policies in the region should undergo significant reforms” said Prof. Michel Kazatchkine, Special Advisor to the World Health Organization Regional Office for Europe (WHO/Europe)
The role of judges in addressing health and other social issues is critical. The justice system can either impede or facilitate social and public health efforts to provide equitable health care, thus ultimately contributing to the achievement of universal health coverage. In addition, an independent, impartial, accountable and professional judicial system, as well as the protection of fundamental rights, is increasingly a topic of discussion in the region, where some countries are candidates for EU accession.
“Our region is presented with many challenges and as judges we are also impacted. The choice is ours – not to pay attention to the issues or to ask hard questions and to apply the law with the view of protections of human rights, so that no one is left behind,” said Sharof Alanazarzoda, Judge of the Supreme Court of the Republic of Tajikistan and member of the Forum Steering Committee.
The two-day forum includes judges from Ukraine, Georgia, Kyrgyzstan, Tajikistan, Kazakhstan, Uzbekistan, Moldova; high-level officials from Moldova, Eastern and Central European and Central Asian Commission on Drug Policy; development partners and civil society leadership from the region and from Moldova. Topics addressed will include HIV decriminalization, EU integration, drug policy reform, migration and fostering collaboration between civil society, UN, and the judiciary in achieving high-level targets on HIV elimination.
UK: New Crown Prosecution Service guidance on cases of alleged HIV transmission states that undetectable viral load stops HIV transmission
U=U acknowledged in prosecutors’ guidance in England and Wales
New Crown Prosecution Service guidance on cases of alleged HIV transmission state that an undetectable viral load stops HIV transmission. While the previous guidance stated that a person’s viral load at the time may provide a defence because it was believed to reduce transmission risk, it did not clearly set out the medical consensus is that this risk is zero. Cases should no longer be taken to court in England and Wales when a person has an undetectable viral load and is aware that Undetectable = Untransmittable (U=U).
In England, Wales and Northern Ireland, concealing or lying about living with HIV is not viewed as a sexual offence. This is unlike jurisdictions that have specific HIV non-disclosure laws. However, reckless or intentional transmission of an STI is viewed as a form of grievous bodily harm that can result in criminal charges.
Since 2019, the National AIDS Trust has been working with the Crown Prosecution Services (CPS) to update their guidance to accord with medical knowledge regarding the lack of risk if someone has an undetectable HIV viral load. The latest guidance issued last week clearly specifies the conditions that must be met for a charge of this nature to occur. Importantly, this only applies to sexual transmission and not to other modes, such as needle-sharing.
Prior to seeking out expert witnesses to rule out other sources of infection, and to confidently ascertain if one person transmitted HIV to another, prosecutors need to work through a series of conditions that need to be met for there to be sufficient evidence for a criminal charge. Gathering information for these conditions involves police investigation and will likely be intrusive for both the accuser and the accused.
To begin with, the person making the accusation must have an STI that amounts to a form of grievous bodily harm. While this harm need not be either permanent or dangerous, it should require treatment and have lasting consequences. Based on previous court judgements, the two STIs that qualify are HIV and herpes. Since 2001, there have been more than 30 people convicted of reckless HIV transmission, one of intentional HIV transmission and one of recklessly transmitting herpes in England and Wales. The rest of this article will focus on cases related to HIV.
The second condition is that the accused must have HIV at the time of having sex with the accuser. This can be proven in several ways, including via medical records, during interrogation or upon the discovery of medications such as antiretrovirals.
The next condition is that the accused knew they had HIV at the time of sex. If they were unaware of their status, and only diagnosed or became aware after having sex with the accuser, there would be insufficient evidence to meet this condition. If the couple had sex multiple times, and the accused was diagnosed or became aware during this period, it would similarly be difficult to prove that they knew their status at the time of transmission. Additionally, it could be the accuser who transmitted HIV to the accused, instead of the other way around. Thus, prosecutors need to carefully consider dates of diagnoses and other relevant evidence.
This condition is not completely straightforward: there is the possibility that the accused was not necessarily diagnosed with HIV but could otherwise have known they had it (through showing clear symptoms, or transmission to other sexual partners, for instance).
The fourth condition is central to building the prosecution’s case: the person living with HIV must have intended to transmit it or knew there was a risk and went on to have sex with the accuser anyway. Intentional cases of HIV transmission are few and far between.
For most cases – those related to reckless transmission – there are several important factors to consider. If the person living with HIV believed that they took reasonable steps to prevent transmission, such as using a condom or having an undetectable viral load, this could be a defence against this condition. However, as transmission can occur even in the instance that reasonable steps are taken, the central question is whether the accused believed they were putting the other person at a significant risk of HIV infection.
Here, a range of factors need to be considered, including what the accused was told about prevention, their level of infectiousness, their knowledge of how treatment works, whether they understood the information, if they ejaculated inside their partner and the number of sexual encounters. The possibility that inadequate information was provided by the medical practitioner also needs to be considered.
Importantly, the updated guidance specifically references an undetectable viral load. It acknowledges that a person living with HIV with a known undetectable viral load cannot be seen to recklessly transmit the virus if they were relying on their undetectable status as a means of preventing infection. Here, it is crucial to determine if the person living with HIV was undetectable at the time of sex, or whether they believed that they were, based on both viral load tests and consultations with their doctor.
While there is no legal obligation for the person living with HIV to inform their sexual partners of their HIV status, if the accuser consented to sex when they knew their partner had HIV, evidence of this knowledge is a defence against a reckless transmission charge.
The final condition is that the accused (and nobody else) in fact infected the accuser with HIV. The guidance acknowledges that this condition may be challenging to prove, especially in cases where a person has multiple sexual or needle-sharing partners. It is also intrusive and can require a great deal of investigation, time and expert evidence. Thus, this step should only be undertaken when the previous conditions are confidently met. If the prosecution cannot rule out the possibility that the infection came from another sexual or needle-sharing partner, there is insufficient evidence to meet this condition and therefore to prosecute, regardless of whether the preceding steps could be proven.
In the instance that expert evidence is required to prove that the accused infected the accuser, the guidance mentions methods such as phylogenetic analysis. It correctly states that this form of evidence may prove with certainty that the accused did not infect the accuser, but not that they did – as both people could have acquired the genetically similar virus from a third person. Additionally, recency assays can be used to determine whether an HIV infection is recent or longstanding, which can form part of the evidence. There is currently no objective scientific method to determine that one person transmitted HIV to another with complete certainty.
The National AIDS Trust has commended the updated guidance, as it is notable that it aligns with current scientific understanding. However, they also acknowledged that HIV criminalisation remains inherently problematic.
“We believe treating the reckless transmission of HIV as a criminal issue does more harm than good and does not result in reduced transmissions or a greater public understanding of HIV,” they say. “The updates to the guidance can go some way to ensure that cases are handled sensitively and consider the facts around HIV today. It’s essential that the CPS continue open dialogue with people living with HIV, community organisations and clinicians to ensure that the guidance reflects the most up to date evidence and that it is supporting good practice.”
Looking back on all that happened in 2022, we are cautiously optimistic that 2022 will be seen as a turning point in the global movement to end HIV criminalisation. We celebrated promising developments in case law, law reform and policy in many countries and jurisdictions over the past year, building on the momentum of 2021. Although there is much more work yet to do, it’s clear that progress is being made — thanks primarily to the leadership of people living with HIV.
Continuing a trend that began two years ago, overall there seems to have been a decline in the number of HIV-related prosecutions. This year we identified media reports of 49 new HIV criminalisation cases in 16 countries plus seven US states. This compares to 54 new cases in 20 countries last year (which was still fewer than reported in previous years). This year, the highest number of case reports came from Russia, followed by the United States (with multiple cases in the state of Florida), and France.
It is possible that we are seeing fewer media reports because there are actually fewer cases, but we must always consider these known cases to be illustrative of what is likely a more widespread, poorly documented use of criminal law against people living with HIV. The media, public health authorities and law enforcement may still be distracted by the global financial crisis precipitated by Russia’s invasion of Ukraine and the impact of COVID-19 — a pandemic that continues to disproportionately impact people living with HIV.
After being near the top in previous years, Belarus has been bumped off the ‘most cases’ list. Last year, the Belarus Investigative Committee reported 34 new HIV-related criminal cases. It’s highly likely that this year there were some (unreported) cases, but it’s also clear that the number of cases has been slowing down since 2020, possibly due to ongoing discussions with the government to limit the use of the criminal law.
Canada used to be a global leader in HIV criminalisation, but no new cases were reported this year. In fact, the only case reports from Canada were about the overturning of a conviction by the Ontario Court of Appeal after it accepted there was no realistic possibility of transmission as the accused woman had an undetectable viral load, and another Ontario Court of Appeal acquittal based on the accused man’s elite controller status. These positive rulings follow many years of sustained advocacy, which has also led to the federal government opening a public consultation on reforming the criminal law. The Canadian Coalition to Reform HIV Criminalization has welcomed this consultation as a first step to concrete action on law reform.
Earlier this year, Taiwan’s Supreme Court also recognised the prevention benefit of treatment by upholding the acquittal of a man with an undetectable viral load who was accused of alleged HIV exposure. But elsewhere in Asia, Singapore continues to unjustly prosecute gay men living with HIV under draconian laws, despite being celebrated for recently repealing their colonial-era law that criminalised sex between men. Singapore is also the world leader in prosecuting gay men for not disclosing a possible HIV risk before donating blood. That’s why we issued our Bad Blood report in September, which concludes that the criminalisation of blood donations by people with HIV is a disproportionate measure — the result of both HIV-related stigma and homophobia, and not supported by science.
In the United States, we continued to see a reduction in the number of states with HIV-specific criminal laws thanks to the ongoing advocacy by networks of people living with HIV supported by human rights and public health organisations. In 2022, Georgia modernised its law and New Jersey became the third US state to fully repeal its HIV-specific criminal law. President Biden again highlighted HIV criminalisation in his World AIDS Day proclamation stating that “outdated laws have no basis in science, and they serve to discourage testing and further marginalize HIV-positive people.” In October, the Presidential Advisory Council on HIV/AIDS unanimously passed an historic resolution on molecular HIV surveillance that will be critical to protecting the human rights and dignity of people living with HIV. But problematic new laws continue to be enacted despite strong opposition from civil society. In November, Pennsylvania’s Governor, Tom Wolf, signed into law an overly broad, unscientific statute that makes it a felony to pass on a communicable disease, including HIV, when someone “should have known” they had the disease.
There was also mixed news from the African continent. In March, Zimbabwe became the second African country to repeal its HIV-specific law (the Democratic Republic of Congo repealed its law in 2018). This victory is testament to the effectiveness of a multi-year, multi-stakeholder campaign that began with civil society advocates sensitising communities and parliamentarians, notably the Honourable Dr Ruth Labode, Chairperson of Parliamentary Portfolio Committee on Health and Child Care. She began pushing for a change in the law in 2018, having previously been in favour of the provision which she thought protected her female constituents. And in October, the Central African Republic also enacted a new HIV law that focused primarily on social protections for people living with HIV, without any criminalising provisions.
Also in October, the Lesotho High Court issued a positive judgment following a constitutional challenge to sections of the Sexual Offences Act that impose a mandatory death sentence on persons convicted of sexual offences if they were living with HIV. Following interventions from members of the HIV JUSTICE WORLDWIDE coalition and others, the Court ruled that people living with HIV have the same right to life as all others — and commuted the sentence.
The news elsewhere on the continent, however, wasn’t so positive. After six years of waiting, a constitutional challenge to some of the most problematic, criminalising sections of Uganda’s HIV/AIDS Prevention and Control Act was dismissed outright in November. We are anxiously awaiting the ruling in a similar challenge in neighbouring Kenya. It was filed five years ago and has since been postponed several times. This year, we also lost Ugandan nurse and HIV criminalisation survivor, Rosemary Namubiru, who was a posthumous recipient of the Elizabeth Taylor Legacy Award at this year’s International AIDS Conference.
Women — who were accused in around 25% of all newly reported cases this year — also face criminal prosecution in relation to breastfeeding or comfort nursing, mostly across the African continent. In addition, women living with HIV continue to be threatened with punitive public health processes and child protection interventions for breastfeeding their children in multiple countries. That’s why this year we created the short film, Mwayi’s Story, to highlight the injustice and facilitate discussion about HIV and breastfeeding. We also worked with our HIV JUSTICE WORLDWIDE coalition partners to publish a paper in the peer-reviewed, open access journal Therapeutic Advances in Infectious Diseases to highlight these problematic and unjust approaches to women with HIV who breastfeed or comfort nurse.
This year, we learned from the Eurasian Women’s Network on AIDS, working with the Global Network of People Living with HIV, about how women living with HIV are both disproportionately impacted by HIV criminalisation across the Eastern Europe and Central Asia (EECA) region and also leaders in research, advocacy and activism against it. Their report illustrates how HIV criminalisation and gender inequality are intimately and inextricably linked. Case studies include a woman in Russia who was prosecuted for breastfeeding her baby and several women in Russia who were blackmailed by former partners who threatened to report them for alleged HIV exposure as a way to control, coerce, or abuse them.
The disproportionate impact of HIV criminalisation on women was also the focus of a World AIDS Day statement by the Organization of American States (OAS) calling on Member States to end HIV criminalisation. Earlier in the year, Argentina had enacted a new, comprehensive and non-punitive HIV, STI and TB law.
Our greatest achievement this year was the creation of the HIV Justice Academy. We are very proud of this online platform for e-learning and training which we believe will be a catalyst in building the wider movement to end punitive laws and policies that impact people living with HIV in all their diversity. Already available in English and French, we’ll be launching in Spanish and Russian early next year.
Did we turn the corner in 2022? Only time will tell, but if there is one thing we know for sure it is that changing hearts and minds with respect to HIV criminalisation is a long road with many ups and downs along the way. We know that important progress was made in 2022 and that we begin 2023 with fresh analysis, new tools and a renewed spirit of solidarity.
Lesotho high court finds imposition of death sentence solely on the basis of HIV status unconstitutional
Court decision upholds that people living with HIV have the same right to life as all others
Joint news release from the Southern Africa Litigation Centre, AIDS and Rights Alliance for Southern Africa, Lesotho Network of People Living with HIV and AIDS, HIV Legal Network and HIV Justice Network
On 25 October 2022, the High Court of Lesotho in the case of MK v Director of Public Prosecutions and Others issued a judgment on a constitutional challenge to certain sections of the Sexual Offences Act that impose mandatory HIV testing on persons accused of sexual offences, and subsequently impose a death sentence on persons convicted of sexual offences solely based on their HIV-positive status.
The case was supported by the Southern Africa Litigation Centre (SALC), AIDS and Rights Alliance for Southern Africa (ARASA), HIV Legal Network – all members of HIV JUSTICE WORLDWIDE (HJWW) Steering Committee coordinated by the HIV Justice Network (HJN) – as well as Kenya Legal & Ethical Issues Network on HIV and AIDS (KELIN). Lesotho Network of People Living with HIV and AIDS (LENEPWHA) was admitted as Amicus Curiae. The petitioner and Amicus Curiae were represented by Advocate Molati, Advocate Mokhathali, Advocate Masaeso, Advocate Mohau (K.C) and Advocate Letuka.
The petitioner challenged the constitutionality of section 32(a)(vii) of the Sexual Offences Act which appeared to impose a mandatory death sentence on people convicted of sexual offences who were HIV-positive and were aware of their status. The petitioner also challenged section 30 of the Act, which requires mandatory HIV testing for persons arrested and charged under the Act. The petitioner argued that the imposition of a mandatory death sentence solely on the grounds of HIV status, and mandatory HIV testing upon arrest, breached the constitutional rights to life, equality and non-discrimination, equal protection of the law, privacy, and dignity and that they contribute to stigma against people living with HIV.
In a judgment written by Justice Makara, the High Court, sitting as a Constitutional Court, declared that section 32(a)(vii) of the Sexual Offences Act was unconstitutional to the extent that it imposes a death sentence solely on the basis of a person’s HIV status, as this was discriminatory and amounted to inhumane treatment. The Court said that people convicted of sexual offences should be sentenced according to the mitigating or aggravating circumstances rather than HIV status alone, and that the law should be interpreted so as not to require a mandatory death sentence for a person living with HIV.
“People living with HIV have the right to life, as all people do. Imposing the death penalty based on a person’s HIV-positive status is the most extreme form of discrimination possible. We welcome the Lesotho High Court’s decision to end this terrible human rights violation.” Edwin J Bernard, HIV Justice Network, global coordinator, HIV JUSTICE WORLDWIDE.
“While recognizing the serious impact of sexual violence, the judgment is an acknowledgment that the over-broad use of criminal laws and sanctions solely based on HIV status is unjust and not justified by a scientific and human-rights based approach” Maketekete Alfred Thotolo, Executive Director, LENEPWHA.
A new report published today (July 22nd 2022) by the HIV Justice Network (HJN) on behalf of HIV JUSTICE WORLDWIDE shows that the global movement to end HIV criminalisation continues to achieve remarkable successes, despite the many challenges that COVID-19 has brought.
Advancing HIV Justice 4: Understanding Commonalities, Seizing Opportunities provides a progress report of achievements and challenges in global advocacy against HIV criminalisation. The report generally covers a three year period ending 31 December 2021 where Advancing HIV Justice 3 ended. However, significant law reform developments that took place in the first quarter of 2022 are also included in report’s maps and analysis.
The successes
During the reporting period, four HIV criminalisation laws were repealed; another HIV criminalisation law was found to be unconstitutional; and six laws were ‘modernised’ (i.e. applied up-to-date science on HIV-related risk or harm and/or legal and human rights principles to limit the application of the law) five of which were in the United States.
In addition, we saw precedent-setting cases in four countries and policy recommendations or improvements in four further countries — all of which have the potential to limit the overly broad application of the law to people living with HIV based on HIV-positive status.
While legislative processes slowed down or stalled in some places due to COVID-19 diminishing capacity for advocacy, more HIV criminalisation laws were modernised or repealed in the United States than during any other time period, the realisation of a maturing PLHIV-led HIV decriminalisation movement that began a decade or more ago.
These outcomes were primarily due to sustained advocacy – most of it led by PLHIV networks working with allies – using a wide range of strategies. These are analysed in the report by HJN’s senior policy analyst, Alison Symington.
The challenges
However, too many HIV criminalisation cases and continued high numbers of HIV-related criminal laws continue to be of great concern, requiring more attention, co-ordinated advocacy, and funding.
Our global audit of HIV-related laws found that a total of 82 countries (111 jurisdictions) have criminal laws that are HIV-specific. Of those, we are aware of 52 jurisdictions in 35 countries that have applied their HIV-specific criminal laws.
Another 89 jurisdictions in 48 countries have applied non-HIV-specific, general criminal laws in an overly broad manner since the first prosecution in 1986.
Our case analysis shows that HIV criminalisation continues to disproportionately impact women, racial and ethnic minorities, migrants, gay men and other men who have sex with men, transgender people, and sex workers.
Although the total number of cases has diminished in some US states as well as in countries that were previously HIV criminalisation hotspots – Canada, Czech Republic, Norway, Sweden, and Zimbabwe – too many unjust prosecutions and convictions continue to be reported.
During the reporting period, we recorded 275 cases in HJN’s Global HIV Criminalisation Database. However, when we include case numbers from several Eastern European and Central Asian countries that provide official data, we estimate almost 700 criminal cases over the reporting period.
Notwithstanding the limitations of tabulating cases globally, the highest number of reported cases during the period covered by this report were in:
The report is available to download in English, French, Russian and Spanish.
Advancing HIV Justice 4 was conceived and edited by HJN’s executive director, Edwin J Bernard, and HJN’s senior policy analyst, Alison Symington. Alison Symington researched and wrote all chapters except for ‘Global Overview’, which was researched and written by Edwin J Bernard, using data collected by Sylvie Beaumont and analysed by Tenesha Myrie.
Additional input was provided by: Gonzalo Aburto (The Sero Project), India Annamanthadoo (HIV Legal Network), Stephen Barris (Ex Aequo), Sophie Brion (International Community of Women Living with HIV), Janet Butler-McPhee (HIV Legal Network), Nyasha Chingore-Munazvo (AIDS and Rights Alliance for Southern Africa), Kenechukwu Esom (United Nations Development Programme), Elie Georges Ballan (The Joint United Nations Programme on HIV/AIDS – UNAIDS), Alfredo González (Hondureños Contra el SIDA), Julian Hows (HIV Justice Network), Deidre Johnson (Ending Criminalization of HIV and Overincarceration in Virginia Coalition), Cécile Kazatchkine (HIV Legal Network), Svitlana Moroz (Eurasian Women’s Network on AIDS), Immaculate Owomugisha Bazare (Uganda Network on Law Ethics and HIV/AIDS), Stephen Page (Nevada HIV Modernization Coalition), Cedric Pulliam (Ending Criminalization of HIV and Overincarceration in Virginia Coalition), Florence Riako Anam (Global Network of People Living with HIV), Mianko Ramaroson (The Joint United Nations Programme on HIV/AIDS – UNAIDS), Demario Richardson (Missouri HIV Justice Coalition), Sean Strub (The Sero Project), and Alexandra Volgina (Global Network of People Living with HIV).
We would especially like to acknowledge the courage and commitment of the growing number of people living with HIV and allies around the world who are challenging laws, policies and practices that inappropriately regulate and punish people living with HIV. Without them, this report — and the victories reported herein — would not have been possible.
We gratefully acknowledge the financial contribution of the Robert Carr Fund to this report.
Mwayi’s Story: a short film about courage, women’s rights, and HIV justice
Today we are delighted to share with the world a new short film, Mwayi’s Story, produced by the HIV Justice Network on behalf of HIV JUSTICE WORLDWIDE.
We wanted to produce a film that was authentic to the lived experience of an HIV criminalisation survivor but without making her go through the trauma of having to relive the experience by telling her story again.
HJN’s video, visuals and webshows consultant, Nicholas Feustel, who produced and directed the film, said: “Since this story is primarily about mothers and children, we decided to produce the film in the style of an illustrated children’s storybook. We searched for a female illustrator working in sub-Saharan Africa and found the wonderful Phathu Nembilwi of Phathu Designs.
“For our narrator, we found Upile Chisala, a storyteller from Malawi known for her short and powerful poems.”
The script by HJN’s Senior Policy Analyst, Alison Symington, was written in consultation with our Supervisory Board member, Sarai Chisala-Tempelhoff, a Malawian human rights lawyer and legal researcher with over 15 years of experience in women’s access to justice.
We also worked with our HIV JUSTICE WORLDWIDE partners, Southern Africa Litigation Centre (SALC) and AIDS and Rights Alliance for Southern Africa (ARASA), to ensure that the film was relevant to their ongoing advocacy in the region. In fact, Mwayi’s Story had its world premiere last week on Zambia’s Diamond TV, in anticipation of a verdict in a similar breastfeeding case.
The film will be shown in a number of forums over the next few months, including at AIDS 2022. It will soon be subtitled in French, Russian and Spanish, and we are also looking for partners to translate additional subtitles if they think the film can be useful in their own advocacy. If you’re interested you can get in touch with us at breastfeeding@hivjustice.net. We will send you the English subtitle file for translation. After you return the file to us, we will upload it to YouTube.
Mwayi’s Story is part of our ongoing work to end the criminalisation of women living with HIV for breastfeeding and comfort nursing, including our Breastfeeding Defence Toolkit. It is our goal to collaborate with advocates, researchers, service providers, organisations and community members around the world to raise awareness and prevent further unjust prosecutions against women living with HIV who breastfeed or comfort nurse. We are grateful to both the Elizabeth Taylor AIDS Foundation and the Robert Carr Fund for their financial support for this work, and this film.
UPDATE: Speakers now confirmed for #BeyondBlame2021!
Beyond Blame, our flagship meeting for activists, human rights defenders, criminal legal system and public health system actors, healthcare professionals, researchers, and anyone else working to end HIV criminalisation, is returning for a special eve-of-World AIDS Day edition.
Beyond Blame is a unique opportunity to learn why HIV criminalisation matters, as well as hear about the wide range of initiatives and strategies that have been used by activists, lawyers, networks, and organisations around the world to work towards ending the inappropriate use of criminal law to regulate and punish people living with HIV.
We will be highlighting some of the successes and challenges of the global movement to end HIV criminalisation over the past year, including work on ending the criminalisation of women living with HIV for breastfeeding, exploring whether scientific advances, such as the prevention benefit of treatment (U=U) and Molecular HIV Surveillance, help or hinder our movement and much, much more.
Beyond Blame will take place in English, with interpretation available in French, Russian and Spanish.
The proverb says, “It takes a village to raise a child”. But what if a mother in the village is living with HIV, and some of the villagers stigmatise her? What if that stigma creates a situation where the mother living with HIV is unjustly criminalised because of her HIV status? Then it takes more than a village to get justice for that woman. It takes a global movement to end HIV criminalisation to sensitise and train lawyers and expert witnesses. It takes national communities of women living with HIV to support that woman following her release, and to educate the community in which she lives about HIV.
Introduction
In 2016, a Malawi court convicted a woman living with HIV of “negligently and recklessly doing an act likely to spread the infection of any disease which is dangerous to life” under section 192 of the Malawi Penal Code. She had attended a village meeting with her baby which she breastfed as usual before passing the child to her grandmother. Another woman then asked her to hold her baby. It was alleged that this child began breastfeeding briefly before the woman realised what was happening. The child’s mother then reported the incident to the police. The woman was arrested and without legal advice or representation, pleaded guilty, was convicted, and sentenced to nine months’ imprisonment with hard labour.
In addition, the accused woman was taking antiretroviral therapy. The chances of HIV transmission through even long-term breastfeeding are very low (which is why WHO guidelines recommend it when access to infant formula and clean water are limited) and the chances of transmission during the brief period the baby allegedly fed were infinitesimally small. In fact, the accused woman’s own child, who was routinely breastfed, has not acquired HIV, calling into question any suggestion that she intended to cause harm to the other woman’s child. Perversely, for a system that unjustly condemned her for risking harm to the other woman’s child, her own baby was imprisoned with her, without any arrangements for appropriate feeding and care, negating any notion that the legal system’s purpose was to protect children.
Following media reports of her initial conviction, numerous individuals and organisations – including HJN and our HIV JUSTICE WORLDWIDE partners, ARASA and SALC – became involved in the case, ultimately changing the outcome for the woman and her family, and laying the groundwork for further anti-HIV stigma advocacy and education in the region. Her story demonstrates the vital role that education, training, strong networks, and community play in the pursuit of HIV justice.
Living with HIV-related stigma
When interviewed at her home in 2019, the woman referred to as “EL” talked about her life:[1]
[1] The initials EL are used instead of her full name following a court order of anonymity to protect her privacy. The interview took place in 2019, during the village visit described later in this article.
“As kids, there were the two of us — me and my brother. My parents faced challenges raising us. Finding the basic necessities like soap and food was a tall order, let alone talking about going to school. It was difficult to get learning materials as well as proper clothes to wear at school. I worked hard in class but couldn’t get past Standard 5 at primary school. Eventually I dropped out, and my brother did the same, … My daily life was taken up doing house chores just like any other girl in the village, as well as helping my parents with farming. At 16, I got married.”
EL further described how she was diagnosed HIV-positive in 2015 after a de facto compulsory HIV test at an antenatal visit. She already had two children and was pregnant with her third. She had heard about HIV but did not know much about it. EL said that the healthcare workers provided a lot of assistance, giving her accurate information about HIV, including the importance of adhering to her antiretroviral treatment (ARVs).
EL and two of her children. Photo: Amos Gumulira/UNDP Malawi
EL said that she generally enjoyed life in her village, although at times she was subject to stigma and discrimination:
“When I went to fetch water at the community borehole, people would laugh at me, and whenever I wanted to participate in community work, you would find pockets of community members talking ill about me. Some people used to insult me, calling me names. But I persevered because my relatives, including the Village Headman himself, gave me support and always stood by my side.”
Members of EL’s family also faced discrimination. “Due to lack of information, a lot of people thought HIV was hereditary and because I was diagnosed HIV-positive, this meant that all my family members had HIV, and they were discriminated against,” EL said.
EL wonders if more could have been done to help her fight stigma. In particular, EL gained a lot of knowledge about HIV from the counselling she got when diagnosed, but perhaps she could have been better equipped with information to share with people in her community:
“A lot of people don’t know that if you adhere to ARVs, you reduce the risk of transmitting HIV to others. This information needs to be passed on to many people. There are also other issues to do with ARVs. A lot of people don’t have adequate information on the effects of ARVs and at the end of the day, they start pointing fingers at each other, giving people room to start speculating about issues to do with witchcraft.”
EL’s prosecution had repercussions for her whole village. One woman from the community explained:
“I was there and very close to where EL was sitting. Yes, she was carrying another woman’s child. This other woman had given the child to EL for safe keeping while she went to stand in a queue, but honestly speaking, I didn’t see EL breastfeed the child. I just heard some people who were sitting a distance from where we were sitting, as they started pointing accusing fingers at her.”
She said that things moved so fast that before they could think of anything to stop what she called “the rumour.” It had gotten out of hand and people started saying that EL had intentionally breastfed the child to transmit HIV.
After receiving a summons, EL voluntarily turned herself in at the police station. She was accompanied by the Village Headman (her grandfather) who wanted first-hand information about what crime she was alleged to have committed. That same day, police transferred EL to a larger town, where she was remanded for three days. At the age of 29, this was the first time that EL had ever left her village.
Days later, she appeared in court and the charge sheet was read out. EL recounted that she had not understood what was happening and could not make arguments because she had no legal representation. EL agreed with the summary of events as they were described, so she was found guilty and was imprisoned together with her youngest child.
She described life in prison as “hell”:
“After a week, my brother showed up to give me my ARVs. All this talk about a woman with HIV breastfeeding. I breastfed but I also found it tough to feed my baby while in prison because there was no provision of special food for babies. We were eating nandolo (pigeon peas) almost every day with Msima ya Mgaiwa (maize meal). And there was only one toilet for a cell of more than 50 people.”
After some time, relatives and other members of her community started visiting, giving her money she could use to buy soap and food for her baby. “When we heard from our Village Headman that she had been arrested, we were so devastated”, a woman from EL’s village explained. “We raised funds for some members to go and give her support only to learn that she had been transferred to one town, then another, but some of us did manage on several occasions to visit her and offer our support when she was in prison.”
Then, out of the blue, EL received a message that some people had come looking for her. She went to meet them: a lawyer, Wesley Mwafulirwa, and his paralegal. They explained why they were there and asked if she would like them to appeal on her behalf. She accepted enthusiastically. “I was excited but at the same time I was confused because I could not believe that I could be so lucky to have these people come to help me.”
Fighting the charges
Solicitor Wesley Mwafulirwa had volunteered to attend training to address legal barriers to prison health and human rights presented by the Southern African Litigation Centre (SALC). He travelled from Malawi to South Africa to attend the training which addressed useful regional and international mechanisms, and presented insights about legal practice and strategic litigation to support prison health and human rights, particularly for those facing heightened vulnerability to HIV and TB.
At the training, two lawyers spoke about their pro bono work. Wesley remembers one of them, Allan Maleche (Executive Director of KELIN), saying that each participant should take at least one case when they go back to their country. It was a turning point in Wesley’s career.
He had not been home long when he saw an article in the newspaper about an HIV-positive person convicted for trying to spread HIV. That person was EL.
Wesley, who lives in a small town in northern Malawi, drove for more than ten hours to get to the jail where EL was incarcerated. He explained his determination, saying “I was so fired up! I’d just come from SALC’s training … and I said, ‘I want to take up this case’.”
Wesley interviewed EL and offered to take her case pro bono. Wesley contacted SALC, who offered technical support. Their first step was to get an order for anonymity to protect EL’s identity and gain greater control over media reporting. Next, they faced an ethical question. They wanted to challenge the constitutionality of the law but that would take a long time. Because EL was in prison, they decided to undertake a criminal appeal instead. They applied for EL to be let out of custody on bail pending appeal. This is usually a difficult application to win, but they were successful and EL was released from prison.
In the appeal, the court was asked to consider whether the conviction could be justified, whether the penal provision was constitutional (arguing it was overly broad and vague), and whether the sentence was manifestly unjust. Wesley used his learnings from the SALC training to raise international principles and instruments relating to sentencing, which the court referenced and upheld. Michaela Clayton, then Executive Director of the AIDS and Rights Alliance for southern Africa (ARASA), and now a member of HJN’s Supervisory Board, provided expert testimony. Another expert witness, Dr Ruth Brand, identified through HJN’s global network, gave expert scientific evidence to show the risk of HIV transmission had been “infinitesimally small.”
The case was heard by Honourable Justice Zione Ntaba, who held that the proceedings in the trial court were irregular and “blatantly bias” against EL, compromising her right to a fair trial. Justice Ntaba found the charge sheet had been defective and therefore EL’s plea should not have been recorded as guilty. She noted the law must be sensitive to the accused’s knowledge or belief (or lack of) that HIV would be transmitted. Justice Ntaba decided the conviction could not be justified, acknowledging human rights principles against the overly broad criminalisation of HIV non-disclosure, exposure, or transmission. EL’s sentence was set aside. (The Constitutional challenge was referred to a full-member panel of the Constitutional Court although the case was not pursued.)
Notably, Justice Ntaba was a member of the African Regional Judges Forum to discuss HIV, TB and Human Rights (a process which is owned and planned by the judges and run with support from UNDP and funding from the Global Fund).
Fighting the stigma
Shortly after EL’s arrest, the Coalition of Women and Girls Living with HIV and AIDS in Malawi (COWLHA) and the Malawi branch of the International Community of Women Living with HIV/AIDS (ICW-Malawi) discussed the case at a roundtable meeting. At first, everyone was surprised and even laughed, questioning how she could have breastfed someone else’s child. They had never heard of a criminal case involving infant feeding and did not understand what they were dealing with.
During their discussions, COWLHA and ICW-Malawi agreed that the prosecution of EL was a manifestation of stigma and misinformation about HIV in the community. They learned more about the unjust measures that EL had experienced, like being imprisoned without being given a chance to be heard and not being given the chance to prepare and take her medication and things she needed to care for her child. COWLHA and ICW decided to get involved.
Representatives from COWLHA and ICW meet with members of EL’s village. Photo: COWLHA/ICW
Concerned that EL could face social and community hostility after her release, COWHLA and ICW planned a visit to the village to provide psychosocial support to EL and to work with traditional community leaders to provide community sensitisation on HIV, addressing issues of stigma and discrimination. Their efforts helped change some community members’ ideas about HIV.
The community formed two support groups— one for youth and another for adults (notably both were predominantly female groups). They have conducted numerous activities, including home visits, supporting children to go to school, helping the elderly with house chores, and they have a garden where they grow vegetables and rice. They hoped to access loans to become self-reliant. They also had a list of issues they wanted to learn more about, including preventing mother-to-child transmission, sexual and reproductive health, positive living, stigma and discrimination, and treatment literacy.
Visiting EL at home
In September 2019, a three-member team comprising Edna Tembo (Executive Director of COWLHA), Charity Mkona (ICW Board Chair), and Peter Gwazayani (media consultant), set out for EL’s village.
The team was welcomed by the Group Village Headman, who took them to EL’s house. EL recognised Edna from the work COWLHA and ICW-Malawi had done in the community previously. EL welcomed the team with a big smile.
EL and her husband looked cheerful as they laid a mat on the veranda of their house for the visitors. Her mother later joined the discussion.
EL was interested to learn that HJN wanted to write about her case and the type of interventions that had been helpful, to share the story with advocates for HIV justice around the world.
EL recounted that when she returned to the village, “most members of my community received me with happiness, particularly my relatives. The day I arrived, they were jubilant. They celebrated with songs that we normally sing during special occasions in the village.”
COWLHA ED Edna Tembo and Charity Mkona of ICW chat with EL, her husband and her mother (at far distance). Photo: COWLHA/ICW
EL lives with her husband, five children and her mother in a compound made up of three grass thatched houses. She introduced her children:
“The oldest is 13 and she goes to school, as do the second and third. The fourth, a little girl, is the child I was with in prison. She has not yet started school. And then there is this one, who I am breastfeeding. She is the fifth one. She has been tested for HIV on two occasions and will be going for the last test soon. The other two tests have come back HIV-negative.”
EL’s accuser and her family still lives in the same village which has presented some difficulties. EL said that on several occasions she had tried to greet them when they passed each other, but she had been ignored. “They don’t talk to me but from deep down in my heart, I have no grudges against them,” EL said. “I am just living my normal life,” EL says, although now she says that she would never agree to carry anybody else’s child, for any reason.
Moving beyond criminalisation
With respect to the community-level interventions, lawyer Annabel Raw, who worked at SALC during the time they supported the EL case said:
“As lawyers, we would never have thought to consider such an intervention had ICW-Malawi and COWLHA not shared their insights and been willing to support the client and her community. Their work has been so important to ensuring that meaningful justice was done to combat the actual root cause of the prosecution — stigma and discrimination — and to reconcile EL with her community.”
Engaging with the community also influenced ICW-Malawi and COWLHA’s thinking about HIV criminalisation. COWLHA’s Edna Tembo noted that:
Supporting people who have been prosecuted, particularly women, gives them power, … However, it is very important to stress that psychological support is absolutely vital for those who have been prosecuted. That includes family support, and a supportive community environment enabling acceptance of an individual accused.”
Tembo was also quick to emphasise that there is more work to be done. That work includes awareness raising and ongoing support to the community, especially to identify and train volunteers, empowering them to provide services at community level and to link them to health facilities and district offices for continued support and mentorship.
EL carries her youngest child home. Photo: Amos Gumulira/UNDP Malawi
EL described her dreams for the future:
“My wish now is to see my children progress in school so that they become productive citizens in this community and help it grow. That’s my dream. If they get educated, they will be able to stand on their own and support others. My husband is not employed and it is a challenge to get money for school fees for our children. We would love to get a loan or training to have greater knowledge of economic empowerment because we want to be self-reliant. We would then love to lease some land to grow rice to sell to pay back the loan.
“It’s also my wish to see the lives of all people in the community uplifted. We farm but on a small-scale. If we were to be supported with funds, I’d love to see the community establish big rice farms, working in groups, harvesting for consumption and for sale. In so doing, we would be able to uplift our lives for the better.”
Further Information
Learn more about Wesley’s experiences in EL’s case here and here.
Learn more about the African Regional Judges Forum here.
The full High Court judgement is available here, with a summary included here.
Read more about the successful HIV and AIDS Management Act community advocacy here.
This article is based on information provided by ICW-Malawi and COWLHA following their visits to EL’s village, and an interview with Wesley Mwafulirwa published by UNDP. HJN provided financial and logistical support for the village visits thanks to a grant provided to the HIV Justice Global Consortium from the Robert Carr Fund for civil society networks.
You can select your preferred language from the 'Select Language' menu at the top of the page.
Continue
We use cookies to ensure that we give you the best experience on our website. By continuing to use our site, you are agreeing to our use of cookies. You can change your cookie settings at any time if you want. Find out more in our Privacy & Cookie Policy.
