East Africa: Move Towards Common HIV/AIDS Law (IPS)

Another excellent piece from the Inter Press Service News Agency, whose mission is to give voices to the voiceless.

EAST AFRICA: Move Towards Common HIV/AIDS Law
by Wambi Michael

ARUSHA, Dec 4 (IPS) - All HIV-positive east Africans could soon access free anti-retroviral treatment even as they move freely from country to country, if a new proposed law comes into effect.The East African Community (EAC) is currently developing a law to guide the region’s response to HIV/AIDS.

This comes as the regional block moves towards an integration process that would see more citizens cross the boarders in the five states of Kenya, Uganda, Tanzania, Burundi, and Rwanda.

"With the signing of the protocol on customs union that will enable free movement of persons, you are actually going to see free movement of the virus because people will be interacting more easily as they transact business. The effect of that is that HIV must be seen regionally," said Catherine Mumma, a Kenyan Human Rights Lawyer, who works with consultancy group Africa Vision Integrated Strategies. She led a consultation in the EAC states before the drafting of the new proposed law.

Based upon the consultations, the proposed law aims to provide joint treatment policies for people in the region while they move freely across the borders.

"One other thing is that east Africans would want a law that would enable them to access services anywhere they go in east Africa. So that if you were in Nairobi and you were on ARVs and you only brought two days ARVs and Kenya Airways went on strike, you should be able on the third day to walk into a treatment centre and get treated."

The law will allow for a common stance on HIV/AIDS, which aims to be non-discriminatory. Currently some countries in the region criminalise the treatment of HIV-positive sex workers and gay men.

The presidents of the five member states agreed in November to commence the East Africa common market protocol, which beings in early in 2010. It will allow for the free movement of labour and trade across borders, similar to the Southern African Development Community trade agreement.

Lucy Ng’ang’a, the executive director for the Eastern African National Networks of AIDS Service Organisations (EANNASO) said the proposed law will take on the good parts of the existing laws in the region but also tackle some of the silent issues and make better the areas that are controversial.

For example, Kenya has as a law providing for the free treatment and counselling for HIV-positive people.

One of the controversial areas is the criminalisation of the transmission of HIV/AIDS being suggested by countries like Uganda.

Another controversial area is that in the Penal Codes of Kenya, Rwanda, Burundi and Tanzania prostitutes and gay men, who are considered high risk in HIV/AIDS transmission, are not allowed access to treatment.

Member states like Kenya, Tanzania and Burundi already have laws on HIV/AIDS.

Uganda’s law, the HIV/AIDS Control Bill 2009, was tabled before Parliament in 2008 as a Private Member’s Bill. It has already caused a public outcry because of a clause relating to the criminalisation of HIV transmission between adults.

EANNASO contracted consultancy group Africa Vision Integrated Strategies to study the existing HIV laws within the region and advise on a draft bill for an East African Law on HIV.

The report by the Kenyan-registered consultancy was presented at a regional consultative meeting held between December 3rd and 4th, 2009.

Participants at the meeting in Arusha voiced concern at provisions in the member states laws relating to the rights of People Living With HIV/AIDS and criminalisation of HIV transmission.

Mumma told IPS that most people consulted felt that the issue of wilful transmission of HIV/AIDS should be punishable, but not in the context of the HIV law. It should be dealt with separately because if it was included in the HIV law, it will stigmatise people who may use this law to seek protection and treatment, the East Africa Law Society said.

"HIV should be seen as any other diseases including hepatitis B. And it would better for it to be dealt with in the context of the penal code even if it meant drafting another clause in the penal code," Mumma said.

Sarah Bonaya, a Kenyan Representative at East African Legislative Assembly and also a member of the General Purposes Committee in the parliament, said she was sure that her colleagues in the assembly would support the Bill which may be tabled as a Private Member’s Bill to the East African Assembly.

She was happy that consultations had gone on through the five states to ensure a harmonised law that would address some of the negative provisions within each member state law that would affect management of HIV/AIDS as a region.

The new proposed law on HIV/AIDS would be the second in Africa after the SADC HIV law adapted in November 2008. The SADC law provides a comprehensive framework for harmonisation of HIV and human rights in southern Africa.

Kenya: Opinion piece criticising AIDS Control Act

Aids Control Act ‘a mere shell’
By COLLINS OMONDI
Monday, March 30 2009 at 19:16
Daily Nation

In Summary

• Special Programmes minister has left out some key provisions of the Act which are at the core of fighting stigma
• Lack of consent for testing for HIV and unlawful disclosure of HIV test results fuels stigma and discrimination.

MONDAY WAS THE commencement date for the HIV and Aids Prevention and Control Act 2006.

It is, however, disappointing that the Special Programmes minister has left out some key provisions of the Act which are at the core of fighting stigma and protecting the human rights of people living with Aids.

There is absolutely no justification for subjecting sections 14, 18 and 22 relating to consent for HIV testing and confidentiality of HIV test results to delays.

Undeniably, there exists inextricable links between stigma and discrimination against people living with Aids and violations of privacy and confidentiality to which these sections relate.

Lack of consent for testing for HIV and unlawful disclosure of HIV test results fuels stigma and discrimination. This leads to social and economic suffering for those affected.

Also, the explicit requirement under section 39 to conform to the legal framework governing the conduct of biomedical research does not apply, at least for the time being, though researchers have frequently been blamed for violating rights of people with Aids.

The non-implementation of these sections robs the Act of its raison d’être and jeopardises the effectiveness of provisions on privacy and confidentiality and non-discrimination thus exposing these people to the risk of continued violation of their rights.

It also creates the impression that certain requirements as to consent for testing and confidentiality and biomedical research do not apply as a matter of law for the time being, leading to legal uncertainty and confusion.

As it is, the Act is a mere shell. Needless to say, these sections were not as controversial as certain sections which have been implemented such as section 24 on criminalisation of wilful HIV infection.

Further, assuming there exists issues of concern under certain sections, say consent for HIV testing by “mature minors”, such issues are not so fatal that they should rob the Act of its raison d’être.

Such inevitable issues in any law-making process are easily addressed through amendments in Parliament, as this is the only institution with the legal mandate to change that which it passed into law, or through regulations made pursuant to the Act.

The minister’s action, although it may be guided by a genuine desire to address certain concerns, is wholly ill-advised and is not supported by reasons the government has been giving for the inordinate delay in implementing the Act.

For instance, the 2008 Kenya Country Progress Report to the United Nations General Assembly Session on HIV and Aids cited the need for amendments to the Act to include marginalised groups and other emerging issues.

To what extent the non-implementation of these sections is affected by these concerns remains unclear.

Going by the history of the Act, one can only pray that these provisions are brought into force immediately and that whatever issues that led to the sections being put in abeyance are addressed.

Mr Omondi, a lawyer, is the HIV and human rights project coordinator at the Children’s Legal Action Network (CLAN).

Kenya: Unease over new HIV transmission law

IRIN/PlusNews has published an interesting article analysing the potential impact of Kenya's new criminal HIV transmission law, which was passed in 2006 but has yet to be impemented.

KENYA: Unease over new HIV transmission law

NAIROBI, 12 December 2008 (PlusNews) - In June 2006, a young woman in western Kenya died of HIV-related complications and left a list of about 100 people that she said she had infected with HIV. A new law, approved by the Kenyan president but yet to be implemented, is hoping to prevent wilful transmission.

The HIV and AIDS Prevention and Control Act 2006 has drawn mixed and very sharp reactions. Inviolata Mbwavi, an AIDS activist who went public about her status in 1994, warned that the legislation in its current form appeared to label HIV-infected people as dangerous human beings with whom people should not associate.

"When you criminalise HIV then we are going back to square [one] of trying to stigmatise the virus even more, yet we have not effectively dealt with the stigma associated with HIV. Why do we want to further burden those who are already burdened by coming up with HIV-specific legislation?"

The Kenyan government is divided on the matter. The National AIDS Control Council, a government body set up to coordinate HIV control activities, is strongly opposed to the section that puts the responsibility for not transmitting the virus on those already living with it.

"Why would one bother to go for a test when they already know it could be used against them in a court of law?" said Tom K'Opere, an advocate of the High Court, at a conference organised by the Kenya National Commission on Human Rights to discuss the merits and demerits of the legislation.

"It is ridiculous, because we all know that knowing one's status is one of the most effective ways of containing the scourge, yet we are now trying to discourage this by introducing such a law."

According to the National AIDS Control Council, most Kenyans do not know their status.

Supporters of the law, like Otiende Amollo, a lawyer and member of the task force that collected views from the public before the legislation was drafted, maintain it would go along way in protecting vulnerable groups like women and children, who are particularly vulnerable to sexual assault.

Anne Gathumbi, an officer of the Open Society Initiative for East Africa, which supports and promotes public participation in democratic governance and the rule of law, said: "We know that the majority of those who know their status are women. What we are doing by passing such a law is therefore to condemn people we are claiming to protect to jail."

The new legislation has also brought into question the responsibility of HIV-negative people. "What we are proposing in the law only touches those already [HIV]-positive. We should also look at the responsibility of those who do not have the virus," said Anne Marie, a civil society activist.

"Are we not forgetting that we should vouch for shared responsibility? Let us not create a law because we are desperate to show the world that we are doing something."

Another clause causing concern is the one that gives medical practitioners the authority to disclose the status of patients to their next of kin, violating their right to confidentiality. It remains to be seen whether Kenya will go ahead and implement these contentious clauses.

Kennedy Anyona*, who has lived with the virus for the past four years, says the responsibility of revealing one's status to anybody is a right that should not be delegated to any other party.

"I have a right to confidentiality and that cannot be trampled upon. The responsibility of revealing my status, which is the best thing to do however, rests with me," he said.

"Taking that away means I am being denied my human right to privacy and confidentiality, which are even enshrined in international laws to which Kenya is a signatory."

Kenya: criminal HIV laws in full; discussed in thoughtful article

A reader from Kenya writes to inform me that, "Kenya passed the Sexual Offences Act and the HIV Prevention and Control Act in 2006, and sections 26 and 24 of those acts, respectively, have rather broad provisions criminalizing HIV transmission."

He provided me with a link to a very thoughtful article on the pros and cons of criminalisation HIV transmission from The (Nairobi) Standard, which I reproduce below.

These are the actual laws, available online at www.kenyalaw.org.

26. Deliberate transmission of HIV or any other life threatening sexually transmitted disease.

Deliberate transmission of HIV or any other life threatening sexually transmitted disease.

26. (1) Any person who, having actual knowledge that he or she is infected with HIV or any other life threatening sexually transmitted disease intentionally, knowingly and willfully does anything or permits the doing of anything which he or she knows or ought to reasonably know - (a) will infect another person with HIV or any other life threatening sexually transmitted disease; (b) is likely to lead to another person being infected with HIV or any other life threatening sexually transmitted disease; (c) will infect another person with any other sexually transmitted disease, shall be guilty of an offence, whether or not he or she is married to that other person, and shall be liable upon conviction to imprisonment for a term of not less fifteen years but which may be for life. (2) Notwithstanding the provisions of any other law, where a person is charged with committing an offence under this section, the court may direct that an appropriate sample or samples be taken from the accused person, at such place and subject to such conditions as the court may direct, for the purpose of ascertaining whether or not he or she is infected with HIV or any other life threatening sexually transmitted disease. (3) The sample or samples taken from an accused person in terms of subsection (2) shall be stored at an appropriate place until finalization of the trial. (4) The court shall, where the accused person is convicted, order that the sample or samples be tested for HIV or any other life threatening sexually transmitted disease and where the accused person is acquitted, order that the sample or samples be destroyed. (5) Where a court has given directions under subsection (4), any medical practitioner or designated person shall, if so requested in writing by a police officer above the rank of a constable, take an appropriate sample or samples from the accused person concerned; (6) An appropriate sample or samples taken in terms of subsection (5) - (a) shall consist of blood, urine or other tissue or substance as may be determined by the medical practitioner or designated person concerned, in such quantity as is reasonably necessary for the purpose of determining whether or not the accused person is infected with HIV or any other life threatening sexually transmitted disease; and (b) in the case a blood or tissue sample, shall be taken from a part of the accused person's body selected by the medical practitioner or designated person concerned in accordance with accepted medical practice. (7) Without prejudice to any other defence or limitation that may be available under any law, no claim shall lie and no set-off shall operate against - (a) the State; (b) any Minister; or (c) any medical practitioner or designated persons, in respect of any detention, injury or loss caused by or in connection with the taking of an appropriate sample in terms of subsection (5), unless the taking was unreasonable or done in bad faith or the person who took the sample was culpably ignorant and negligent. (8) Any person who, without reasonable excuse, hinders or obstructs the taking of an appropriate sample in terms of subsection (5) shall be guilty of an offence of obstructing the cause of justice and shall on conviction be liable to imprisonment for a term of not less than five years or to a fine of not less fifty thousand shillings or to both. (9) Where a person is convicted of any offence under this Act and it is proved that at the time of the commission of the offence, the convicted person was infected with HIV or any other life threatening sexually transmitted disease whether or not he or she was aware of his or her infection, notwithstanding any other sentence in this Act, he or she shall be liable upon conviction to imprisonment for a term of not less than fifteen years but which may be enhanced to imprisonment for life. (10) For purposes of this section - (a) the presence in a person's body of HIV antibodies or antigens, detected through an appropriate test or series of tests, shall be prima facie proof that the person concerned is infected with HIV; and (b) if it is proved that a person was infected with HIV after committing an offence referred to in this Act, it shall be presumed, unless the contrary is shown, that he or she was infected with HIV when the offence was committed.

Act 14 of 2006 - HIV AND AIDS PREVENTION AND CONTROL

24. prevention of transmission.

prevention of transmission.

24. (1) A person who is and is aware of being infected with HIV or is carrying and is aware of carrying the HIV virus shall- (a) take all reasonable measures and precautions to prevent the transmission of HIV to others; and (b) inform, in advance, any sexual contact or person with whom needles are shared of that fact. (2) A person who is and is aware of being infected with HIV or who is carrying and is aware of carrying HIV shall not, knowingly and recklessly, place another person at risk of becoming infected with HIV unless that other person knew that fact and voluntarily accepted the risk of being infected. (3) A person who contravenes the provisions of subsections (1) or (2) commits an offence and shall be liable upon conviction to a fine not exceeding five hundred thousand shillings or to imprisonment for a term not exceeding seven years, or to both such fine and imprisonment. (4) A person referred to in subsection (1) or (2) may request any medical practitioner or any person approved by the Minister under section 16 to inform and counsel a sexual contact of the HIV status of that person. (5) A request under subsection (4) shall be in the prescribed form. (6) On receipt of a request made under subsection (4), the medical practitioner or approved person shall, whenever possible, comply with that request in person. (7) A medical practitioner who is responsible for the treatment of a person and who becomes aware that the person has not, after reasonable opportunity to do so- (a) complied with subsection (1) or (2); or (b) made a request under subsection (4), may inform any sexual contact of that person of the HIV status of that person. (8) Any medical practitioner or approved person who informs a sexual contact as provided under subsection (6) or (7) shall not, by reason only of that action, be in breach of the provisions of this Act.

Law on Aids should be realistic and practical for it to be effective
The Standard (Nairobi)
Joyce Chimbi
23/08/2008

When James Kamau was diagnosised with HIV 15 years ago, his world crumpled. That was a time when HIV-positive people were condemned to die.

“HIV is the most stigmatised disease in human history and yet it is not contagious. People are more wary of HIV than TB,” says Kamau.

The Sexual Offences Act and HIV/Aids Prevention and Control Act criminalise wilful transmission of HIV. The objective is to address harmful HIV-related behaviour.

“Although we cannot ignore the criminal law as a tool to deter deliberate transmission of HIV, we would be cheating ourselves if we think the law is a holistic solution,” says Kenya National Commission on Human Rights commissioner Winnie Lichuma.

Though a legislative approach is essential, public health law should take effect instead of a criminal law. Kenya already has a Public Health Act.

“HIV is mostly spread through behaviour that is not criminal. This makes it more of a public health issue than a criminal issue,” says Allan Maleche, a lawyer.

Maleche argues that imprisoning HIV-positive people will not necessarily translate to behaviour change. The contention however is not the law, but rather how to table evidence. For instance, how does one prove he or she has been deliberately infected?

“The aspect of capturing deliberate transmission of HIV through criminal law is very elusive. Without medical records, can a complainant’s claim of being HIV-negative before a sexual encounter hold water?” poses Kamau.

The same predicament has been experienced by HIV/Aids activists in South Africa, Nigeria and Namibia. These governments tried to criminalise wilful transmission and did not go far. Some see the law as an instrument that can only fuel stigma. In addition, those opposed to criminal law claim it is discriminatory and limited as a tool for HIV prevention. They argue the law could even damage important health initiatives against HIV/Aids.

Knowing your status
In effect, it is important to deal with deliberate transmission of the virus as a socio-cultural and economic issue rather than a criminal one. Criminalisation may, in fact, discourage people from getting tested. Someone can easily cite ignorance of status as defence against a lawsuit.

Criminal law emphasises consent between individuals to ensure the people in question have agreed to become intimate and are aware of each other’s HIV status. “I would say consent is where the problem begins. We generally do not have a culture where people are aware of their status. Some of us do not even know exactly when they got infected,” says Florence Anam of Kenya Network of Women with HIV/Aids.

Although she has lived with the virus for three years, Anam says there is no physical evidence of the illness. Had she not been tested, she would have assumed she was HIV negative.

Attempting to employ criminal law perhaps is tantamount to putting the cart before the horse. A more effective approach should involve creating a culture where people strive to know their status. However, there are situations that require the law. For instance, in cases where people’s right to decide when and with whom to have sex have been violated.