KAMPALA, 25 June 2014 (IRIN) – Inadequate funding coupled with harsh laws targeting same sex unions could erode the gains so far made in the fight against HIV in Uganda, activists warn.
Uganda: Parliament passes ‘deeply flawed’ HIV law, takes ‘giant leap backwards’: urge President Museveni to veto
After years of intensive debate and strong local and international advocacy against many of the problematic clauses found within Uganda’s omnibus HIV law, yesterday Uganda’s Parliament passed the HIV Prevention and Control Act virtually unchanged from this 2010 version.
The bill includes mandatory HIV testing for pregnant women and their partners, and allows medical providers to disclose a client’s HIV status to others. The bill also criminalises ‘wilful and intentional’ HIV transmission, attempted transmission, and behaviour that might result in transmission by those who know their HIV status. There are some excellent analyses of the problematic provisions at The Observer (Uganda) and the Science Speaks blog.
Clauses 39 (‘attempted transmission of HIV’) and 41 (‘intentional transmission of HIV’) were adopted in the debate last week, as were clauses 13, 14 and 15 on mandatory and routine testing, with unverified reports that the ambit of clause 13 (‘HIV testing for purposes of criminal proceedings’) was broadened further. (Follow Parliament Watch Uganda [@pwatchug] on Twitter for latest details of the actual text).
Today, two press releases from Human Rights Watch, HEALTH Global Advocacy Project, and Uganda Network on Law, Ethics & HIV/AIDS (UGANET) and The International Community of Women Living with HIV (ICW) condemned the passage of the law in the strongest terms. They are likely to be the first of many.
“This HIV bill is yet another step backward in the fight against AIDS in Uganda,” said Maria Burnett, senior Africa researcher at Human Rights Watch. “It is founded on stigma and discrimination and based on approaches that have been condemned by international health agencies as ineffective and violating the rights of people living with HIV.”
Mandatory HIV testing and the disclosure of medical information without consent are contrary to international best practices and violate fundamental human rights, the three groups said. The criminalization of HIV transmission, attempted transmission, and behavior that might result in transmission by those who know their HIV status is overly broad, and difficult to enforce.
[…]
“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,” said Dorah Kiconco, executive director of Uganda Network on Law, Ethics & HIV/AIDS. “The president should not sign this bill and instead ensure a rights-based approach, recognizing that people living with HIV will prevent transmission if they are empowered and supported.”
[…]
“At the upcoming international AIDS conference, Uganda will be the example to all the countries gathered of how not to write laws on the HIV response,” said Asia Russell, international policy director at Health GAP (Global Access Project). “Parliamentarians are doing precisely the opposite of what Uganda should be doing to fight HIV.”
ICW’s press release is below
Today’s passage of the HIV Prevention and AIDS Control Bill represents a dangerous backslide in Uganda’s efforts to respond to HIV. While the bill may have been intended to facilitate and improve the HIV response in Uganda, the bill contains many poorly conceived and fear- induced provisions that have no place in a public health and human-rights-based response to HIV. As passed, this bill will actually weaken Uganda’s HIV prevention efforts and will have a detrimental and disproportionate impact on the rights of women and girls and in particular women living with HIV.
The International Community of Women Living with HIV Eastern Africa is extremely concerned about the devastating impact this law will have on the daily lives of women in Uganda. “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” said Lillian Mworeko, Regional Coordinator ICW EASTERN AFRICA.
The bill includes outdated and dangerous provisions for mandatory testing for pregnant women and their partners under Clause 14 (b) and (c). Mandatory testing of people living with HIV is a violation of fundamental human rights and accepted principles of informed consent and will negatively impact antenatal care attendance. Women—who will likely be the frequent target of these provisions— will shy away from hospitals and medical services. The devastating result will be that more children will be infected through mother to child transmission of HIV. Uganda is currently making strong strides towards zero infections from mother to child through use of proven strategies that emphasize voluntary counseling and testing. But Uganda’s gains could be lost if women are forced to test every time they visit a health facility. HIV testing of pregnant women, their partners and victims of sexual offenses must always be voluntary and conducted with informed consent.
“The fact that Uganda is even considering mandatory testing of pregnant women or victims of sexual offenses, represents a major step backwards for a country which showed early promise as an effective responder to HIV. Unfortunately, fear and ignorance have won the day in Uganda.” said Jessica Whitbread, Global Director of the International Community of Women Living with HIV.
Despite growing international consensus that criminalization is actually counter productive to the HIV prevention strategies, the Bill creates unnecessary and ill-advised additional criminal laws that criminalize attempted and intentional transmission of HIV. The International Community of Women living with HIV unequivocally opposes the criminalization of HIV status. The existing penal code already includes sufficient provisions to address criminal acts, creating additional parallel set of laws will just serve to persecute and punish people living with HIV. Criminalization will disproportionately impact women, who are more likely to know their HIV status through pregnancy related medical care. This provision will do little else but result in increased stigma and discrimination against people living with HIV, which are key drivers of the HIV epidemic.
Furthermore, the bill empowers medical workers to disclosure a person’s HIV sero status to a third party. Clause 21 (e); “where any other person with whom an HIV infected person is in close or continuous contact including but not limited to a sexual partner, if the nature of contact, in the opinion of the sexual medical practitioner, poses a clear and present danger of HIV transmission to that person;” Not only is this provision a clear violation of human rights and confidentiality but it is ripe for abuse by medical workers. Disclosure by medical workers of a person’s HIV status based purely on an individual opinion represents an institutionalized form of stigma and discrimination and dramatically increases the likelihood of violence against women living with HIV.
These poorly considered provisions at their best violate human rights and enshrine stigma and discrimination into law and at their worst will cause many people to shy away from accessing programs that work, such as prevention, treatment and care and support services including elimination of mother to child transmission services (eMTCT). Sadly, this bill undermines the very services that Uganda needs more than any other country in the world.
“Uganda is already facing a serious backslide from its early advances in responding to HIV, Uganda is currently one of three African countries experiencing increases in their HIV prevalence rates previously from 6.5% to 7.3 %. The passage of this Bill will only serve to increase this backslide and the President must save Uganda from this backlash”, says Margaret Happy, the Sexual Reproductive Health and Rights Officer, ICW Eastern Africa.
ICW Eastern Africa urges His Excellency Yoweri Kaguta Museveni, the President of Uganda, to rise above all and not assent to this Bill which is in contradiction of the commitments made by his wise assent to the East African Community HIV & AIDS Prevention and Management Act, 2012 .
Uganda: ‘Trial by media’ of nurse accused of exposing a child to HIV via injection sets a ‘dangerous precedent’
The ongoing case of Rosemary Namubiru, the Ugandan nurse accused of exposing a child to HIV during the course of administering an injection, is highlighted in a powerful press release issued yesterday by AIDS Free World. Fortunately, Ms Namubiru is being supported by several advocacy and human rights organisations as well as by individual HIV advocates in Uganda.
The inflammatory media coverage (an example of which is this horribly invasive TV news story, above) not only increased HIV-related stigma and violated Ms Namubiru’s right to a fair trial, but is also being used to help justify the passing of the draft HIV Prevention and AIDS Control Bill 2010 which includes a number of problematic provisions including mandatory HIV tests for pregnant women and their partners, and forced disclosure of HIV status to a newly diagnosed person’s partner by a medical practitioner. In addition, the Bill contains two overly broad and problematic HIV-specific criminal statutes.
In late 2009, a group of more than 50 Ugandan and international organisations and individuals released a report criticising many of the provisions of an earlier draft. That early advocacy resulted in the removal of a criminal penalty for the transmission of HIV from mother to child through breastfeeding.
Advocacy co-ordinated by the Uganda Network on Law, Ethics and HIV/AIDS (UGANET), continues to argue that the unfavourable clauses must be completely removed and that Uganda must assent to the East African Community (EAC) HIV & AIDS Prevention and Management Act which contains provisions meant to supersede Ugandan law.
Read the entire press release below and download the PDF version here.
HIV-Positive Nurse Tried by Media
––Uganda’s first court case dealing with criminalization of HIV transmission could have far-reaching consequences––
February 11, 2014 (Kampala, Uganda)––Rosemary Namubiru, a Ugandan nurse, stands accused of exposing a child to HIV during the course of administering an injection. The incident incited a media firestorm, leading to Namubiru’s arrest and trumped-up charges of attempted murder. That these were baseless charges was confirmed at the opening of the trial today when the charge was changed to criminal negligence; charges that could still carry up to seven years in prison. As the trial begins, it is clear that the damage has already been done. Namubiru was tried and convicted in the public eye by the media, violating her rights and presumption of innocence.
The implications of this case are far-reaching: the Namubiru case appears to be the first in Uganda’s courts dealing directly with HIV exposure and transmission. Efforts to criminalize HIV transmission, and the failure of both the media and the prosecutors office to act responsibly, set a dangerous precedent and could have grave consequences for the fundamental rights of people living with HIV and AIDS in Uganda and beyond.
Case Summary
Rosemary Namubiru, 64, a nurse with 35 years of experience, was working at the Victoria Medical Centre in Kampala, Uganda. On January 7, 2014, Namubiru was attempting to give an injection to an ill 2-year-old patient. Neither she nor the mother could calm the distraught child. With the child writhing and kicking, the needle accidentally pricked Namubiru’s finger; she stopped what she was doing, washed and bandaged her pricked finger, and returned to the child. She was eventually able to administer the injection.
Uncertain about whether the same needle was used throughout, the mother became concerned about the possibility that her child had been exposed to HIV. It was confirmed that Namubiru is HIV-positive and is on anti-retroviral drugs. The child was given an HIV test; the results were negative. A precautionary 2-month post-exposure prophylaxis regimen was initiated, after which the child will be re-tested.
Rosemary Namubiru was arrested in front of a bevy of journalists. She was held by the Criminal Investigations Department for four days before her first appearance in court. She was charged with attempted murder, which carries a sentence of up to life imprisonment, and remanded to Luzira National Prison to await trial. On February 7, 2014, she was denied bail and returned to prison to await trial. Minutes before the trail began on February 11, 2014, the prosecutor announced the charge would be changed to “negligent act likely to spread infection of disease.” With this new charge in place, the prosecutor began to call its witnesses, and the trial is ongoing.
Trial by media
Since the moment of her arrest, Rosemary Namubiru has been found guilty in the court of public opinion. Even though research has shown that the likelihood of HIV transmission from a needle puncture is miniscule––only 0.32% of those exposed to HIV through a subcutaneous puncture became infected––Namubiru has been singled out and vilified in the press because of her HIV-positive status.
Here are just a few of the libelous accusations that appeared in the media reports in the immediate aftermath of her arrest:
* An article with the headline “Killer nurse charged with attempted murder” went on to accuse Namubiru of “maliciously infecting her patients, mainly the children with her HIV positive blood.”
* Another claimed that she “drew her own HIV-infected blood and injected it into a two-year old child.”
* Shortly after Namubiru’s arrest, one article stated that police were “investigating allegations that the woman has been engaging in the act for a pretty long time.”
* An article that appeared in The Africa Report speculated about Namubiru’s mental state, calling her “the fiendish nurse” and claiming “the baby’s incessant cries drove her mad.”
* One journalist opined that “as police struggled to find an appropriate charge to punish such an evil act, it became clearer that our laws are inadequate to cover such emerging but deadly crimes.”
* An editorial about the case declared, “The majority of our doctors and nurses may well be great professionals, but it’s also true that among them are many people who do not harbour good intentions for one reason or another. These could be inherently evil-minded, bitter or mentally unstable.”
False and sensational accounts by irresponsible media can prejudice the outcomes of trials and violate the fundamental human rights of people living with HIV and AIDS. Section 28 of Uganda’s constitution guarantees that every person charged with a criminal offence shall “be presumed to be innocent until proved guilty.”
A miscarriage of justice
Even before the trial began, serious questions surfaced regarding Rosemary Namubiru’s ability to receive a fair hearing. From the spectacle of her arrest—recorded by media who were clearly alerted in advance–-to the baseless original charge of attempted murder, and the rush to trial before the defense could prepare, it is clear that this is a sensationalized case.
Throughout the process, there have been numerous violations of Rosemary Namubiru’s rights:
* According to Section 23(4)(b) of the Ugandan constitution, an accused person can only be held for up to 48 hours before a hearing. Namubiru was held for four days before her first court appearance.
* The prosecution argued against granting bail, stating that Namubiru poses a grave risk to the public, even though there is no evidence of intent to commit any crime.
* Namubiru had no lawyer present when police extracted a statement from her; she was unable to access legal counsel until she had been in detention for a week.
* The Prosecutor claimed on February 7, 2014 that the State had completed its investigation and was ready to proceed to trial. Namubiru’s lawyers had not yet seen the State’s evidence, and were informed that they would receive the file the day before the trial was slated to begin. Section 28 of Uganda’s constitution guarantees that every person charged with a criminal offence shall “be given adequate time and facilities for the preparation of his or her defence.”
What are the broader implications of this case?
HIV advocates fear that the Namubiru case could set a dangerous precedent, in terms of both the criminalization of HIV transmission and the treatment of people living with HIV and AIDS.
Many advocates worry that the case could be used to justify passing the proposed HIV Prevention and AIDS Control Bill 2010. The bill includes two overly-broad sections on the criminalization of HIV, as well as a number of other troubling provisions that would restrict the rights of persons living with HIV and AIDS. If the government moves to legislate the criminalization of HIV, specific groups—including pregnant women, who are easily identified within the chain of transmission—could be targeted for criminal charges. (For more on the proposed bill and its implications, please visit www.uganet.org).
AIDS-Free World unequivocally disagrees with the notion of having a separate criminal code for people who are HIV-positive. If a person attempts to do bodily harm to another, regardless of the means, the existing laws should apply. By creating laws that specifically criminalize HIV transmission, the courts place the emphasis on the person, rather than the crime.
The media frenzy created by this case illustrates the degree to which HIV stigma still exists. Many advocates warn that the introduction of HIV-specific laws would be a dramatic setback in efforts to eliminate discrimination, particularly in the workplace.
Expert global guidance on the criminalization of HIV transmission
In its landmark report, the Global Commission on HIV and the Law recommended that:
“To ensure an effective, sustainable response to HIV that is consistent with human rights obligations:
2.1. Countries must not enact laws that explicitly criminalise HIV…exposure. Where such laws exist, they are counterproductive and must be repealed.
2.2. Law enforcement authorities must not prosecute people in cases of HIV…exposure where no intentional or malicious HIV transmission has been proven to take place.
2.4. Countries may legitimately prosecute HIV transmission that was both actual and intentional, using general criminal law, but such prosecutions should be pursued with care and require a high standard of evidence and proof.
—–
Rosemary Namubiru is being supported by several advocacy and human rights organizations, including the International Community of Women Living with HIV, Eastern Africa (ICWEA), Uganda Network on Law, Ethics and HIV/AIDS (UGANET), The National Forum of People Living with HIV in Uganda and AIDS-Free World (NAFOPHANU), and by individual HIV advocates including Canon Gideon Byamugisha, Milly Katana, Major Rubaramira Ruranga.
Global Commission on HIV and the Law Jan 2014 newsletter highlights important legal and policy developments as well as new resources
We are pleased to share this first Newsletter Issue of 2014 containing several important developments. Perhaps most significantly, there have been a number of controversial recent anti-LGBT rulings and legislation around the world. In the same week in December, both Nigeria and Uganda adopted harsh new anti-LGBT related laws, which no doubt will have repercussions on the HIV response in those countries. Also, in December in response to the Supreme Court of India’s overruling of an earlier lower court decision to strike down an anti-sodomy law, effectively recriminalizing same sex behavior, former Commissioners of the Global Commission on HIV and the Law jointly issued a statement expressing dismay at the decision of the country’s top court. On a more positive note, in October Uzbekistan lifted all restrictions on entry, stay and residence for people living with HIV – see this UNAIDS infographic on current travel restrictions for PLHIV.
Several national and local level dialogues on HIV, human rights and the law were held in recent months, including in Brazil (November), China (December), Democratic Republic of Congo (November), and Dominican Republic (June). On 28-31 October, the first Eastern and Southern Africa Regional Judicial Dialogue on HIV and the Law was held in Nairobi. Also in October, UNDP and UNAIDS organized an information session on access to affordable medicines in Nay Pyi Taw, Myanmar, attended by more than 30 parliamentarians. Visit our recently updated interactive map for more information on efforts by UN agencies, including UNDP and UNAIDS, in partnership with governments, civil society and international donors, to support countries in creating enabling legal environments for HIV responses and advance the findings and recommendations of the Global Commission on HIV and the Law.
A number of key knowledge products were published this past quarter, such as: Judging the epidemic: A judicial handbook on HIV, human rights and the law (UNAIDS, 2014); Protecting the rights of key HIV-affected women and girls in health care settings: A legal scan (UNDP, SAARCLAW, WAP+, 2013); HIV and human rights manual for the Democratic Republic of the Congo (French) (UNDP, 2013); Young people and the Law in Asia and the Pacific: A review of laws and policies affecting young people’s access to sexual and reproductive health and HIV services (UNESCO, UNFPA, UNAIDS, UNDP, Youth Lead, 2013); and Compendium of Judgments for Judicial Dialogue on HIV, Human Rights and the Law in Eastern and Southern Africa (UNDP, 2013).
Uganda: Remove mandatory testing, mandatory disclosure and criminalization clauses in draft HIV-specific law, say activists
A coalition of HIV/AIDS activists has asked parliament to amend some clauses in the HIV/AIDS Protection and Control Bill 2010 before enacted into law. The activists said the HIV Prevention and Control Bill 2010 in its current form has clauses that will deter the fight against the epidemic. The amendments they want include removing mandatory testing, mandatory disclosure and criminalization. They also want the title of the Bill changed to HIV/AIDS Prevention and Management Bill. “Policy makers should treat this matter with urgency,” said Stella Kentutsi the Executive Director, National Forum of People Living with HIV/AIDS Networks in Uganda.
Nigeria's anti-gay law, condemned by US, Britain and Canada, will harm HIV response, says UNAIDS
Local and international groups fighting AIDS warned on Tuesday that a new Nigerian law criminalizing same-sex marriage and gay organizations will jeopardize the fight against the deadly disease. Activist Dorothy Aken’Ova said the new legislation, already dubbed the “Jail the Gays” law, will endanger and even criminalize programs fighting HIV / AIDS in the gay community. Aken’Ova is executive director of Nigeria’s International Center for Reproductive Health and Sexual Rights based in Minna, Niger state.
The UN agency to fight AIDS and the Global Fund to Fight AIDS, Tuberculosis and Malaria expressed “deep concern that access to HIV services for lesbian, gay, bisexual and transgender people will be severely affected by the new law in Nigeria, further criminalizing LGBT people, organizations and activities, as well as people who support them.”
UNAIDS said the law could harm Jonathan’s own presidential initiative to fight AIDS, started a year ago. Nigeria has the second largest HIV epidemic globally, with an estimated 3.4 million people living with HIV. The disease affects many more gay men than heterosexuals, with 2010 statistics estimating national HIV prevalence at 4 percent compared to 17 percent among gay men, according to UNAIDS.
President Goodluck Jonathan’s spokesman confirmed Monday that he had signed the Same Sex Marriage Prohibition Act on Jan. 7, providing penalties of up to 14 years in jail for gay marriage and up to 10 years’ imprisonment for membership or encouragement of gay clubs, societies and organizations. The U.S., Britain and Canada have swiftly condemned the law, with Secretary of State John Kerry saying Monday that it “dangerously restricts freedom” of expression and association of all Nigerians.
Human rights activists reported that dozens of gay men were being arrested in northern Nigeria in an apparent response to the law. The law also criminalizes people and groups who support “the registration, operation and sustenance of gay clubs, societies and organizations, processions or meetings in Nigeria.” Those convicted could be jailed for 10 years.
Even before it was the passed, the law was being used to persecute gays, Aken’Ova said. In Bauchi state, she said police entrapped four gay men and tortured them into naming others. She said the police have drawn up a list of 168 wanted gay men, of whom 38 have been arrested recently. An AIDS counsellor told the Associated Press he helped get bail for the men. He spoke on the condition of anonymity for fear he would be arrested as well.
Jonathan, Nigeria’s president, has not publicly expressed his views on homosexuality. But his spokesman, Reuben Abati, told The Associated Press on Monday night, “This is a law that is in line with the people’s cultural and religious inclination. So it is a law that is a reflection of the beliefs and orientation of Nigerian people … Nigerians are pleased with it.”
Uganda: New Anti-Homosexuality Bill a setback for Uganda’s HIV response
The draconian Anti-Homosexuality Bill passed by Uganda’s parliament on 20 December would deliver a major blow to the response to HIV/AIDS if it was enacted by President Yoweri Museveni, activists have warned.
Those found guilty of homosexual acts can be jailed for up to 14 years under the new law, a sentence that increases to life in “aggravated” cases, such as those committed by an HIV positive person, or those involving minors, the disabled and serious offenders.
Civil society activists fear that high-risk groups such as men who have sex with men (MSM) and sex workers – whose HIV prevalence is 13.7 and 33 percent respectively – will see their already limited access to prevention and treatment further eroded.
Amnesty International called the law “a grave assault on human rights [which] makes a mockery of the Ugandan constitution.
“President Museveni should avoid the trap of scapegoating a vulnerable minority in the interests of short-term political gain,” said Daniel Bekele, Africa director at Human Rights Watch.
“He should recognize that this repugnant bill is of no benefit to Ugandans – that it only serves to jeopardize basic rights – and reject it.”
The United States government has also called for the bill not to be enacted.
African HIV criminalisation achievements and challenges highlighted at ICASA 2013
The African continent has more countries with overly broad and vague HIV-specific laws relating to HIV non-disclosure, exposure and/or transmission than any other global region, nearly all of which have been enacted in the past decade.
Although North America is the continent with the most known prosecutions, 26 African countries have overly broad and/ or vague HIV-specific criminal laws with a further three countries considering new HIV-specific criminal laws. This is worrying and disappointing given the growing evidence base and consensus of international agencies that such laws are counterproductive to HIV prevention efforts and generally fail to deliver ‘justice’.
Although there are few known prosecutions the majority of those prosecuted have been women – who are usually the first in a couple to know their HIV status due to routine antenatal testing and who are often erroneously accused of bringing HIV into a relationship.
In addition, South Africa recently prosecuted alleged criminal HIV transmission as attempted murder despite no evidence of intent to harm. (Read the judgement from the High Court of South Africa on alleged HIV exposure being attempted murder here.)
However, there have been some positive legal changes brought about by local advocacy supported by international civil society and UN agencies. Since 2010, at least four countries – Congo, Guinea, Senegal and Togo – have revised their existing HIV-related legislation or adopted new legislation that restrict use of criminal law to cases of intentional transmission.
And more recently advocacy in Malawi and Nigeria has resulted in the removal of overly broad HIV-specific criminal statutes from draft omnibus HIV Bills.
View the poster below or download the A4 double-sided printable version of the poster here.
Tanzania: Official urges government leaders to create mandatory HIV testing law
A Ward Executive Officer in Mkanyenge ward, in Kishapu District, Sima Philbert, has urged the government to come up with a law for mandatory HIV testing in order to effectively combat the pandemic.
http://www.dailynews.co.tz/index.php/local-news/25417-call-for-law-for-mandatory-hiv-testing
Australia: South Australia Government plans mandatory HIV testing following blood or saliva exposure to police
ANY offender whose blood or saliva comes into contact with a police officer will be compelled to undergo a mandatory blood test, under new laws to be introduced by the State Government. Premier Jay Weatherill will today outline the measure – and another significant community safety initiative involving police – at the Police Association of SA annual delegates conference.
The move will ensure any officer faced with the risk of contracting a communicable disease is made aware of the possible threat much faster, instead of having to rely on their own test results – often many months later. Mr Weatherill said police needed to be protected. “We know that there are some instances where police officers are exposed to infectious diseases, such as hepatitis C or HIV when an officer is arresting, restraining or detaining an offender,” he said.
“These laws mean that if an officer is exposed to a risk of contracting these diseases, the offender will be required to undertake a blood test. While officers are already blood-tested in these situations, some diseases are not detectable for months. This means officers can be left waiting for a considerable amount of time, which can be stressful for them and their families. Test results from the offender will provide early information to reduce the anxiety about risk of infection.”
Police say that over the past year, there were 279 incidents where officers came into contact with blood, 118 incidents involving officers being spat on and two occasions where an officer suffered a needle-stick injury.