HIV/AIDS, LAWS, ETHICS AND HUMAN RIGHTS
Ms. Veronica Cenac, attorney at law and HIVAIDS Consultant
By Carol Phillip-Tudor
Stigmatization and discrimination are major contributing factors which fuel the spread of the HIV/AIDS epidemic. Largely, patients are wary of the lack of privacy in the handling of confidential and sensitive matters when put in the hands of health care workers. Tantamount in their minds are the religious and cultural taboos and the overall implausibility of keeping matters unquestionably private in small islands.
Accordingly, the Caribbean Heads of Governments have mandated the CARICOM Secretariat, through the Pan Caribbean Partnership Against HIV/AIDS (PANCAP), to examine the regional response to the virus. The objective is to strengthen, through advocacy, policy, development and legislation, the capacity to reduce the spread of HIV/AIDS. New legal parameters are of the essence if any meaningful progress is to be made in curbing the stigmatization and discrimination of HIV/AIDS.
The first legal consultation was held on July 5th and ran concurrently with other consultations held on the issue; one held specifically on September 5th. These consultations are in accordance with the National AIDS Secretariat’s efforts to revise the Nation’s strategic plans relating to the spread of HIV/AIDS and to assess the views of the cross section of the populace of St. Kitts and Nevis.
The violation of Human Rights quickly becomes the issue. The violation of human rights occurs when stigmatizing attitudes leads to discriminatory practices; the right to work, the right to privacy and to live peaceably and without disgrace particularly when in poor health.
Laws and Ethics are crucial to the debate on stigma and discrimination. Issues such as: buggery, access to sexual and reproductive health care by minors without parental consent-( sometimes one parent is collusively privy to certain abuses happening in the home); “sex workers” such as prostitutes, forced sex of boys or men; which has no provisions in the laws classifying this violation as rape; and the deliberate disregard for the consenting age - were considered to be aspects of society that contributed heavily to the transmission and spread of the HIV/AIDS virus.
Ms. Veronica Cenac, attorney at law and HIV/AIDS consultant, presented her findings and recommendations on October 23th at Ocean Terrance Inn, Fortlands. Pulling from issues identified by National consultations, she identified the vast problem areas: Religion, communication, role of government, cultural taboos, access to care, job security, rights of privacy, society free of harassment, penalties for breach of confidentiality, willful transmission, civil society involvement, mandatory training for school counselors and the prevalent ignorance surrounding the virus.
Ms Cenac said, “The insurance companies are thirty years behind in St. Kitts on the issue of HIV/AIDS. The insurance companies will deny your claims if you are HIV positive. There have been cases where if you are found to be HIV positive at the time of death, the insurance companies will nullify your claims. There you start to realize the linkage between insurance and human rights.”
Another critical area is the prison population. Mrs. Gardenia Destang-Richardson of the National AIDS Secretariat said, “Prison officers, because we are a homophobic society, were adamant that sex was not happening in prison. However, when we did the testing we found a 2.4% HIV prevalence. We were not able to determine whether the diseases were contracted there in prison or whether it was brought in with them.”
Ms. Cenac’s main recommendation is to place individuals at the centre of activity, which will create equality and equity, accountability, empowerment and participation, “The basic approach is that every person has a right to health care,” she said.
From a legal prospective, she recommends the implementation of Constitutional Amendments, Anti-Discrimination Laws, and Representative Action particularly on behalf of persons affected with the virus who wish to retain his or her privacy, Standard Confidentiality Laws, Amendment and Enactment of the nurses and registration act. And for doctors who breach confidentiality, laws that would support fines, reprimand or removal from the register, including refusal to renew medical licenses.
St. Kitts and Nevis would appear poised to lead the region in the area of de-stigmatization of HIV/AIDS having as a Federation received a Grant from the Brazilian Global funds of $1.8 million for the use of treatment for persons affected with the virus. Furthermore, the Prime Minister, Hon. Dr Denzil Douglas, is Spokesperson of Caricom Pan American Partnership Against Aids. The Grant is for five years with a renewable 3 years period. However, it is noteworthy that the grant agreement has not yet been signed and should have started before now in May of this year.
The accumulative findings by the National Assessment team along with the legal recommendations of Ms. Veronica Cenac will be sent to the National HIVAIDS Secretariat and then to PANCAP. With the support of key stakeholders, CEDA, USAID and UNDP an action plan of Law, Ethics and Human Rights would optimistically be implemented.
