HIV/AIDS continues to spread throughout the world, shadowed by increasing challenges to human rights at both national and global levels. The virus continues to be marked by discrimination against population groups, those who live on the fringes of society or who are assumed to be at risk of infection because of behaviors, race, ethnicity, sexual orientation, gender or social characteristics that are stigmatized in a particular society. In most of the world, discrimination also jeopardizes equitable distribution of access to HIV related tools for prevention and care, including drugs necessary for HIV/AIDS care. As the number of people living with HIV and AIDS continues to grow with different social structures and legal system as is the case in Botswana, HIV/AIDS related human rights issues are not only becoming more apparent, but also becoming increasingly diverse. Botswana is finding itself at crossroads in trying to comprehend with the complex issues that are beginning to emerge such as homosexuality and prostitution.
The historical development of HIV/AIDS in Botswana remains a jig saw puzzle with the first case reported around 1985 in the small mining town of Selibe-Phikwe, which to this day remains the vortex of AIDS epidemic. Botswana’s response to the HIV/AIDS was slow which may have contributed to the highest rates of morbidity and mortality. People were dying in chillingly high numbers and no family was spared. It was either one was infected or affected, politicians and herd boys alike, CEOs, accountants, economists, business men and women, academics and domestic workers, lawyers, land surveyors and engineers etc. HIV/AIDS did not know boundaries and HIV/AIDS related burials became a weekend special and a common place for social gathering. Life expectancy dropped significantly to lower levels, quality of life declined with the old and the young left as care givers. As a result Botswana could not just continue watching as its people were dying. As noted by Dr Patson Mazonde “…If we did nothing we could lose the country’, (New York Times June 14 2004).
In mid-November 2005 Former President Festus Mogae stunned the Botswana Nation as well as the International Community when he decided to take it upon himself to walk the talk by taking an HIV/AIDS test live on Botswana National Television. Mogae, an Oxford-educated economist is arguably one of the most outstanding African statesmen, a global icon and a champion of HIV/AIDS has continued to make his voice heard by providing a stewardship role needed to ensure existence of a strong political commitment and leadership by facilitating a conversation on health and human rights practices in Botswana.
In October 2011, Mogae made utterances at the National Aids Council (NAC) that once again shocked and stunned the Botswana Nation when he called for explicit decriminalization of sodomy. He became sympathetic to Men who have sex with Men (MSM) as well as commercial sex workers and also called for provision of condoms in prisons. In his presentation Mogae said the Church way does not work and has failed in history and therefore, it was deceitful for anyone to think there was no homosexuality. For instance, Italy is a catholic state well known for prostitution said Mogae; there is divorce among Muslims, though they have very strict rules, Mmegi Monitor 17 October 2011. Although Mogae called for the decriminalization of sex work and advocated for gay rights, he absolved himself from gay tendencies and practices by stating that he was not gay ….. ‘I am heterosexual. I look at women, I don’t look at men. But there are men who look at other men’.
Mogae also acknowledged that he was making the call now because he was constrained to make such calls when in political office and therefore could not risk losing elections by advocating for gay rights and prostitution. He also stated that he was now calling for the rights of inclusion and policy reforms because according to him it was difficult to promote safe sex when the two practices were illegal.
Whilst Mogae opened up a dialogue and setup a tone and an agenda for discussion and adoption advocating for policy change for the ostensible beneficiaries who are often at high risk and sometimes called the ‘voiceless poor’ his actions were viewed with great suspicion. Mogae’s noble and sincere ideas that called for the application of the Yogyakarta Principles were viewed not as noble and sincere. They were received differently by different people with some arguing that Mogae’ was merely playing to the international gallery by presenting such a controversial topic to Batswana who are predominantly conservative. Others viewed it as a mere public relations exercise and that Mogae was merely a messenger acting on instructions to test the waters. Mogae’s commitment to his call was also questioned as to why he saw it fit to present such a topic now and this was not helped either by his response ……that he could not undertake such a position during his tenure in office simply because he could not afford to lose elections just for gays. As if to imply that now that he was no longer holding political office he simply did not give a damn and does not care whether elections are won or lost by advocating for gay rights and legalization of prostitution. Others argued from a moral stand and questioned whether gays and lesbianism is not Un-African and against the call of nature.
Mogae was also criticized on the basis that his presentation was not backed up by detailed comprehensive action plan neither was it supported by evidence based research and availability of scientific data. The only thing that Mogae did they stated was his acknowledgement that during his tenure in office he had instructed the police not to harass and arrest prostitutes because in his view, ‘police have better things to do than to chase people engaged in consensual transaction….after all prostitution is a service in demand’. He had also stated that sex work did not violate human rights and should not be confused with social norms. Thus decriminalizing sex work was merely being humane to those who had been forced into the vice by protecting them and regulating the industry.
Whilst I do agree with Mogae that prostitutes do not violate any human rights when providing service, it must be noted that Mogae took a human rights based approach in playing the advocacy role. His presentation was primarily focused on the right to health of prostitutes and gays as high risk populations and their access to health services. Mogae did not give an illustration and or classification of commercial sex workers. He did not talk about the problems and challenges encountered by the profession in areas where it is legalized and regulated. He did not spell out whether sex workers as legitimate parties would be in a position to discuss their conditions of service and neither did he discuss the vulnerability of women who are at greater risks because of men who are husbands during the day and gays at night (hidden behaviors). Economic needs, lower social status, biological vulnerability, structural, social and cultural issues sometimes forces poor women into risk work of transactional sex and these should be the focus and not promotion of women to sell their bodies in a market place. Life style, drug use and the desire to keep up with fashion and maintain some high life status are some of the issues that need to be addressed among men who have sex with men. Drug junkies are often forced to sell themselves in order to maintain their life style. There is also corporate prostitution as well as sexual relationships amongst peers in organizations that have contributed to spillover effects such as marriage wrecking and the spread of HIV/AIDS. There is prostitution in the church as well and the word of God being abused by sexual perverts masquerading as saints and church counselors. There is a high rate of cross border prostitution as well as the influx of illegal immigrants who are providing cheap sex. Access to pornography has brought in explorative sexual practices where sodomy is even practiced by heterosexuals. International travel to meetings and conferences has also exposed and introduced many people to the world of commercial sex, where frequent visits are made to sex shops for sexual pleasures using the per diem.
The question then arises – how do we deal with all these moral decays? All these call for reduction and intervention strategies that will also focus on men as well.
It is evident from the foregoing discussion that to many the perspective of the right to health seems remote. First there is what is called the legal question; how can health be a right since there is no binding legislation demanding just that? Secondly there is the feasibility question; how can the state of being in good health be a right, when there is no way of ensuring that everyone does have good health and lastly there is the policy question? Why think of health rather than health care, as a right since health care is under the control of policy making, not the actual state of health of the people? Let’s discuss.
Seleke is a Fulbright Scholar currently serving as a Global Health Fellow, Geneva, Switzerland. He writes here in his personal capacity.
