Organizations of people living with HIV in Zambia have appealed to the Government to rescind the decision and revoke the mandatory HIV proclamation forthwith.
The Treatment Advocacy and Literacy Campaign (TALC), Community Initiative for Malaria and Tuberculosis (CITAMplus), Coalition for Zambian Women Living with HIV and AIDS (COZWHA), Network of ARV Users and Zambian Network of Religious Living or Personally Affected by (ZANERELA) have stated that the decision to introduce mandatory HIV testing is illegal and unconstitutional.
In a statement, the five organizations said compulsory HIV testing should be stopped forthwith as it is illegal and unconstitutional in Zambia.
“We would like to commend the Zambian Government on the Launch of HIV Counseling Testing and Treatment Day (HCTT) on the 15th August, 2017 by His Excellence Edgar Chagwa Lungu. This intervention will certainly help in putting more people on treatment that will be found to be HIV positive,” they said.
“However, we express deep concern on the recent announcement during the launch by The Zambian President Edgar Chagwa Lungu that HIV testing, counseling and treatment is now compulsory in Zambia for any person seeking medical treatment in public healthcare facilities. We therefore, appeal to the Government to rescind the decision and revoke the proclamation forthwith,” they stated.
“Compulsory HIV testing is illegal and unconstitutional in Zambia as both the Supreme Court and the High Court in Zambia have found that consent is only present if it is provided freely, without undue influence, coercion, fraud, misrepresentation or mistake”, said Felix Mwanza National Director for TALC.
“While the policy aims, according to President Lungu, to improve HIV testing and treatment adherence rates, on the contrary, coercive measures fuel stigma and drive people away from healthcare facilities” said Carol Nawina Nyirenda Executive for CITAMplus.
“Informed consent is critical to ensure that individuals are empowered in managing their health. It has been shown that an individual’s sense of self-efficacy plays a major role in how one approaches goals, tasks, and challenges regarding one’s health, with directly-evidenced clinical benefits” said Mable Mwale Coordinator for COZWHA.
“The approach also violates healthcare ethics and is contrary to international standards, including World Health Organisation and UNAIDS guidelines on HIV testing and treatment. International guidelines on HIV and human rights from the United Nations Office of the High Commissioner for Human Rights (OHCHR) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) state “public health legislation should ensure that HIV testing of individuals should only be performed with the specific informed consent of that individual”, said Kenly Sikwese from Afrocab.
L”Exceptions to voluntary testing would need specific judicial authorisation, granted only after due evaluation of the important considerations involved in terms of privacy and liberty.”1 The World Health Organisation (WHO) and United Nations Population Fund (UNFPA) similarly state that HIV testing must “only [be] conducted with informed consent”.
They said forcing people to test for HIV or to take HIV treatment creates a disincentive to voluntarily access healthcare services.
“The United Nations Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health has emphasised the negative public health impacts of forced or compulsory treatment: “Just as linking appropriate counselling and treatment to voluntary testing services is an enabling incentive for testing, compulsory treatment measures are a disincentive,” concluded Kennedy Chungu Palangwa from ZANERELA.