The Botswana Network on Ethics, Law and HIV/AIDS (BONELA) has written to President Ian Khama, urging him not to sign the Public Health Bill into law.
Should President Khama sign the Bill into law, it would mean, among other things, that HIV testing is soon to become compulsory.
In a letter addressed to President Ian Khama and signed by BONELA Executive Director, Uyapo Ndadi, the human rights organisation expressed concern that several of the provisions in the Bill will potentially harm the people of Botswana.
“….BONELA hereby request Your Excellency to use your office to address this concern and send the Bill back to Parliament for further scrutiny and amendments,” reads the letter.
BONELA says Botswana has the legacy of protecting the right of people living with HIV.
“We also note that Botswana has played role in the region in establishing best practices in dealing with HIV/AIDS pandemic, in particular dramatically scaling up access to treatment and thus ensuring that people living with HIV live longer and more productive lives,” states BONELA.
The organisation says it has seen more people coming forth to test for HIV, chiefly because of the conducive and enabling environment that the government has created.
“However, we believe that the enactment of the Public Health Bill will represent a step backwards for Botswana, casting a shadow over its momentous achievements in the areas of HIV/AIDS, health services and human rights,” says BONELA.
The organisation also expressed concern that the Bill in its current form goes against the Constitution of Botswana and places numerous burdens on the people of Botswana that are not justified from a public health or human rights perspective.
“For example in its current form, the Bill differentiates between different users of health services. The Bill affords rights to persons with non-communicable disease but does not afford the same rights to people with communicable disease. Communicable diseases refer to any disease transmitted directly or indirectly from one person to another,” says BONELA, adding that the Bill proceeds to apply stringent measures and offences to persons with communicable diseases, with no differentiation made between the seriousness and the risk of infection posed by communicable diseases. Such differentiation between communicable and non-communicable disease suggest outdated notions of disease control and will only perpetuate stigma against people with communicable diseases, including those with HIV.
BONELA says there is no public health justification for limiting rights of persons based on their status.
“The provisions in the Public Health Bill contains provisions on confidentiality of HIV test. However, some of the sections which allow disclosure of information about HIV testing and HIV behaviour are too sweeping in application and likely to lead to infringements of the right to privacy,” says BONELA. ┬á
The organisation also states that whilst the Bill explicitly prohibits mandatory HIV testing, various sections proceed to allow mandatory HIV testing without any apparent legitimate objective.
“For instance, if a patient declines an offer to test for HIV (maybe for good reasons, such as fearing domestic violence, as a result of a positive result) he or she may be ordered before our court with a view to forcing them to test,” said BONELA.
BOENELA also takes issue with an HIV test being required, unless it is an emergency before a dental or surgical procedure.
“Our view is that this will result in people being scared to access health services. We have noted, through our studies and experiences that people living with HIV still experience stigma and discrimination. The success of HIV response in Botswana depends on people accessing testing and treatment services voluntarily and in large numbers,” said BONELA.