Mixed feelings to calls for universal HIV testing

During a recent Southern African Development Community meeting in Malawi, the regional leaders held that SADC countries, and Africa in general, need to adopt universal compulsory testing for HIV, rather than leave individual citizens to decide.
Cuba, one of the world’s success stories in the fight against HIV/AIDS, has used a similar approach to curtail the HIV/AIDS pandemic in that country.
Personally, I support leaders like President Robert Mugabe of Zimbabwe and Joseph Kabila of the DRC for making such a call. I believe it is one of the best options available because of its long-term benefits, especially in SADC – one of the world’s most affected by the HIV/AIDS pandemic.
But judging from the responses the last column has attracted ‑ the proposal for universal testing has generated mixed feelings.
While some people concur with the Zimbabwean and DRC leaders, others are of the opinion universal testing might infringe upon human rights, especially for people living with HIV/AIDS.
Although it was just a proposal by the SADC Heads of State, as they did not specify how the mandatory testing would be implemented, sceptics are already up in arms against the idea.
Some claim that forcible testing is a violation of bodily integrity and autonomy so people should not be detained solely to conduct forced medical procedures, including testing for HIV.
Forcing people to be tested for HIV is nothing but the violation of human rights and stigmatised vulnerable groups, they claim.
Since its emergence, testing and treatment of HIV/AIDS continues to generate serious legal and ethical questions.
For instance, when a test for HIV antibodies was first introduced, there were calls for compulsory testing and quarantine of those testing positive and Cuba was one of the countries to adopt the policy.
Activists are of the opinion that compulsory HIV-testing risks violating human rights, and that it may lead to abuse against people who test positive.
Rather governments can deal with the issue of HIV/AIDS by focusing on access to health care and public information.
International health authorities, including UNAIDS, the World Health Organisation (WHO) and the Office of the United Nations High Commissioner for Human Rights have all opposed forcible HIV testing and the isolation or quarantining of people with HIV as incompatible with public health and human rights standards. However, Sandie Tjaronda, the Executive Director of Namibia Network for AIDS Service Organisations (Nanaso) is of the opinion that universal testing might be the way to go.
Tjaronda, whose organisation supports hundreds of HIV/AIDS organisations and individuals, has welcomed the proposal by SADC Heads of State to have universal compulsory testing for HIV policy adopted in Southern Africa. He believes that if adopted (universal testing) it would be a critical and essential gateway to HIV prevention, treatment, care and support services.
Tjaronda said universal compulsory testing could be the best way to deal with HIV, especially at the early stage, whereby the priority should be given to the early affected people including expectant mothers.
Early awareness of one’s HIV status maximises opportunities for the people living with the virus to go for treatment; thereby greatly reducing complications including death as well as preventing transmission of the virus from mother to unborn baby.
“Compulsory testing for HIV/AIDS does not mean people should get tested against their will or by force but people should be encouraged through awareness campaigns and distribution of relevant information, to go for testing on that date,” he said
Tjaronda emphasises the need to avail voluntary HIV testing and counselling through a wide range of service delivery models and approaches, including provider-initiated testing and counselling which involves the routine offer of testing to all people receiving medical care in high-prevalence settings.
These include sexual health and tuberculosis (TB) and drug treatment clinics, antenatal and postnatal services.
He said people should also be encouraged to do testing in non-medical settings by non-medical personnel, such as in community outreach programmes, couples testing, door-to-door offer of testing, home-based testing and others.
“All I can tell you is that as long as the universal compulsory testing for HIV won’t have implications on human rights, there is nothing wrong with coming up with a date whereby all the people will voluntarily go for HIV testing ,” says Tjaronda.

August 2013
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