Uganda: The HIV and AIDS Prevention and Control Bill: Full Text

The HIV and AIDS Prevention and Control Bill, 2010 was published in the Uganda Gazette on April 30 in advance of the first reading yesterday.

HIV and AIDS Prevention and Control Bill, 2010

Uganda: The HIV/AIDS Prevention and Control Bill

According to this report and the Order Paper from today’s session, The HIV/AIDS Prevention and Control Bill was tabled for first reading before Uganda’s Parliament this morning. The bill would criminalize the intentional transmission of HIV. However, the wording of the bill is raising critical concerns among human rights groups.

The Human Rights Watch has a detailed and updated analysis of the bill here. Apparently, this bill has been contemplated for some time and is not simply an effort to carve up the Anti-Homosexuality Bill and attach the pieces to new legislation. Nonetheless, there are concerns raised by the HRW which are valid and I hope will be considered favorably by Uganda’s legislators.

According to the Parliament website, the Parliament is now on recess:

Parliament is on recess following the end of the fourth session of the Eighth Parliament. The recess marks the end of the fourth year of the Eighth Parliament. The Speaker of Parliament Rt.Hon.Edward Kiwanuka Ssekandi hailed Members of Parliament for their harmonious co-existence in a multiparty Parliament. He says cooperation between members of the  different political parties is key to the success of the multiparty political dispensation in Uganda. Pending business not concluded by Parliament in this session will be carried over to the next session that opens in June.

This article on the Parliament website seems to be related to the bill just tabled:

Members of parliament are proposing new strategies to combat the HIV/AIDs disease following reports of stagnation in its eradication in many parts of the country. Legislators propose a refocusing of efforts to implementing effective HIV prevention programs to reduce new emerging infections. A report by the Parliamentary Committee on HIV cites stabilization in disease prevalence between 6.1 and 6.5% during the last five years. This development is partly due to complaceny, behavioural factors and failure to balance efforts between prevention and treatment. Hon Beatrice Rwakimari the chairperson of the committee expressed concern over the shift in the epidemic from people in single casual relationships to those in long term stable relationships.

She told Parliament that the shortage of all cadres of health workers to provide HIV prevention, treatment, care and support services has grossly affected service delivery. Understaffing, low motivation, staff transfers, redeployment and the high attrition rates are affecting continuity in the efforts to fight HIV.

The Parliamentary Committee on HIV noted that AIDS related services have remained inadequate in both scope and coverage, posing a threat to prevention of the disease. Many Ugandans are not aware of their HIV status while almost half of the people eligible to be on ARVs have not been enrolled and cannot access treatment.

The Committee proposed improvements in treatment, care and support systems for all people affected, provision of ARVs,and expansion of all essential care and treatment services to all district health units.

Concerns about HIV/AIDS were outlined in a Parliament summary report of the 2009-2010 session from various committees. Specifically the Uganda Aids Commission reported:

 

III. Uganda Aids Commission (UAC)

The surge in the Prevalence rate of HIV/AIDS 

5.14 The Committee noted with concern that in the recent past, there has been an upward surge in the prevalence of HIV/AIDS in Uganda. The committee is concerned that the current strategy seems to be directed to the young people other than the age group which is most affected by the increasing rate of infection. Current statistics indicate that the new infections are occurring among married couples. According to the latest figures from UAC, the prevalence rate among married couples for men is 9.9% while for women is 12.1%. This is not a good trend.

 5.15 The Committee recommends that government has to design a new strategy in the fight against HIV/AIDS if the new surge is to be effectively responded to. UAC needs to strengthen the campaign on prevention other than popularizing the effectiveness of ARVs since it is not a cure.

When I am able to secure a copy of the bill, I will post it here.

Here is some additional background on the bill.

60 Minutes on US HIV/AIDS intervention in Uganda

Last night, 60 Minutes provided a sympathetic review of the PEPFAR intervention in Uganda. As I have discussed here before, the program has been immensely successful. The broadcast puts real faces on the success (especially the kids) and the problems (extraordinary footage of HIV informing sessions). Near the end of the segment, 60 Minutes interviewed Martin Ssempa but without any mention of the Anti-Homosexuality Bill.


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Bob Simon notes that the spread of HIV is driven by polygamy, “sugar daddies” and sexual networks – all heterosexual issues there. He also documents how US backed drug treatment has brought hope to HIV positive people. I could not help but feel touched by the faces of the children and the pain of the couples who found that one or both of them were HIV positive. The presence of Martin Ssempa without mention of his advocacy for the Anti-Homosexuality Bill is a striking omission in light of the potential for that bill to erode more progress on HIV. The main driver of HIV in Uganda is heterosexual behavior. Ssempa does speak about that, but it certainly seems to me that his recent anti-gay crusade has the potential to undo his good work by making gays the scapegoat for a problem that cannot be solved by the Anti-Homosexuality Bill. I addressed some of these issues in a November, 2009 commentary which I am reprinting after the break.

Continue reading “60 Minutes on US HIV/AIDS intervention in Uganda”

House and Senate consider resolutions opposing Uganda’s Anti-Homosexuality Bill

This comes from Jirair Ratevosian, Deputy Director of Public Policy with The Foundation for AIDS Research, based in Washington, DC. In a letter dated march 22, 50 organizations, primarily relating to AIDS research and treatment, called on the House and Senate to pass resolutions H Res 1064 and SRes 409, respectively. Contact your Senator and Representative to ask them to co-sponsor and vote for these resolutions. Here is the letter supporting the Senate resolution:

March 22, 2010

RE: S. Res. 409

Dear Members of the U.S. Senate:

We, the undersigned organizations, write to urge you to stand in support of the health and human rights of all people, regardless of sexual orientation or gender identity, and support Senate Resolution 409.

S. Res. 409, introduced on February 4, 2010 by Senators Feingold, Coburn, Collins and Cardin calls upon members of the Parliament in Uganda to reject the proposed ‘‘Anti-Homosexuality Bill” that would expand penalties for homosexuality to include the death penalty and require citizens to report information about homosexuality to the police or face imprisonment. The resolution also calls for the governments of all countries to reject and repeal similar criminalization laws, and encourages the Secretary of State to closely monitor human rights abuses that occur because of sexual orientation and to encourage the repeal of laws that permit such abuses.

Criminal penalties against individuals based on their sexual orientation or gender identity violate universal human rights, demean human dignity, and threaten to undermine the effectiveness of the global response to HIV.

The effort to halt and reverse the spread of HIV & AIDS globally is compromised by punitive legal environments that further marginalize communities at high risk for HIV. Gay men and other men who have sex with men (MSM) in low- and middle-income countries are 19 times more likely to be infected with HIV than the general population. Criminal laws that expressly target this population drive the community underground, fueling risk-taking behavior in a climate of fear and silence, and making it difficult to reach MSM with the information and services they need. Investments in PEPFAR, totaling over $32.3 billion since FY 2004, will not achieve their full potential in a political climate that is hostile to key affected populations.

The proposed “Anti-Homosexuality Bill” in Uganda has drawn international criticism—from multiple Democratic and Republican members of the US Congress, Secretary Clinton, the Vatican, and heads of state, including President Obama. Thousands of human rights and health groups as well as physicians and health professionals from around the world and across the U.S. have spoken out against the proposed bill.

In March 2009, the United States signed on to the United Nations Statement on Human Rights, Sexual Orientation and Gender Identity, which reaffirms the universality of human rights and calls for the repeal of same-sex criminalization laws. As U.S. Senators, you have a key role to play in championing the realization of these principles on a domestic and world stage.

We thank you for your leadership in this regard and ask for your continued support to stand up for health and human rights for all, regardless of sexual orientation. We urge you to express your support for these principles by signing on to Senate Resolution 409.

For more information, please contact Krista Lauer and Jirair Ratevosian.

Sincerely,

(signatures of 50 organizations)

Baral S, Sifakis F, Cleghorn F, Beyrer C. Elevated Risk for HIV Infection among Men Who Have Sex with Men in Low- and Middle-Income Countries 2000-2006: A Systematic Review. PLoS Med. 2007, Dec;4(12):e339.

The House letter is here and a blog post with more information is here.

Uganda’s Anti-Homosexuality Bill: Is CNSNews trying to change the subject?

This morning the conservative CNSNews reported on Tom Lantos Human Rights Committee Hearing on Uganda’s Anti-Homosexuality Bill. As I read the piece, I wondered if the reporter was trying to change the subject of the bill. The article seems quite focused on the following section of the Anti-Homosexuality bill pertaining to HIV positive persons:

3. Aggravated homosexuality.

(1) A person commits the offense of aggravated homosexuality where the

(b) offender is a person living with HIV

Offender is not defined in the bill but homosexuality is defined quite broadly and includes touching someone of the same-sex in a sexual manner. Touching is defined as

“touching” includes touching—

(a) with any part of the body;

(b) with anything else;

(c) through anything; and in particular includes touching amounting to penetration of any sexual organ. anus or mouth.

Touching in this manner can get you life in prison. If an HIV positive person touches in this manner, the action is considered “aggravated homosexuality” with death the penalty.

The CNSNews report makes a point to ask those at the Human Rights Committee hearing what they believe should happen with HIV persons who engage in homosexual sex. Here is the specific question:

CNSNews.com:  “It was mentioned today that the death penalty and long prison terms or life imprisonment are absolutely unacceptable and terrible for people who engage in homosexual acts.  And I was wondering if I could get your opinion on something.  Like, what would you—what do you think would be the appropriate way to address someone who knows they are HIV-positive and engages in homosexual relations anyway?  Like, what would be an appropriate penalty or a correct way to address that in your opinion?”

The question seems to assume that HIV-positive people who have sex set out to infect their partners with the virus. Rep. Baldwin gives a reasonable answer to the question.

Rep. Tammy Baldwin (D-Wis.):  “I think that—if there is—well first of all, in many parts of the globe, diagnostic tools aren’t necessarily available and so knowledge of one’s own HIV and its status is not uniformly as high in other places where health care is harder to come by than it is in the U.S.  When somebody has a communicable disease whether it be H1N1 flu, and they go about the public without, you know—potentially doing harm, or a sexually transmitted disease with calculation, tries to expose others, that is something that I think should be punishable and that it’s up to the legislatures of each country to decide what the appropriate penalty level is—how to deter such purposeful, harmful activity as well as protect others if there’s thought that that behavior might continue.”

 

Baldwin: “We’ve tackled that here in the U.S.  I would tell you that it varies from state to state what those criminal penalties or other penalties might be.  We’ve dealt with it not only with regard to sexually-transmitted disease, but diseases like tuberculosis.  And we’ve dealt with it at different times in different ways.  But I don’t think there’s one sort of boiler- plate way.  But again, I want to acknowledge this issue that health care systems are not the same in every country, and in order for this to be intentional, somebody has to know their HIV status.”

Rep. Baldwin makes clear that the actionable offense is intent to harm. However, the CNSNews reporter does not seem to get the crucial distinction – a distinction not made in the Anti-Homosexuality Bill. In the bill, there is no language that requires the offender to have harmful intent. The clear intent of the bill, as was recently confirmed to me by a researcher in the Ugandan Parliament Research Service is “to outlaw all same-sex sexual conduct.” Being HIV-positive gets the strongest penalty. In the bill, intent to harm is not relevant. The CNSNews reporter ignores Rep. Baldwin’s response.

 

CNSNews.com:  “Okay.  So in the case of somebody who does know that they are HIV-positive, are you saying that there should be a penalty then for continuing to engage in homosexual acts?”

Baldwin then tries to get back to the important distinctions involving awareness and intent.

Baldwin:  “Unprotected? I mean, there’s obviously ways to make sure that, you know, there are precautions—there are also universal precautions in medical settings as well as, you know, for those who engage in consensual activity.  But certainly if there is somebody who is using their, you know, their status as a weapon, you know, particularly to do harm, there should be, there should be appropriate penalties for that.  And I’m not going to advise any particular jurisdiction what it should be, but they should grapple with that in a democratic way.”

Even though the title of the article notes that Baldwin addressed purposeful spreading of HIV, the body of the article failed to make the important distinction:

But Baldwin did not say what specific punishment was warranted, particularly in the country of Uganda, which currently is considering legislation that would impose the death penalty on any HIV-positive person who willfully and knowingly engages in homosexual relations.

“Willfully and knowingly” engaging in homosexual relations should not be penalized according to Baldwin; doing so with the intent to spread HIV is what she addressed.  HIV-positive people may engage intimacy with appropriate precautions. Failing to make this distinction might be an oversight on the part of CNSNews or it might be an attempt to change the subject from what the bill says to focus on something that many readers would want to see addressed in law.

However, it is important to note that the bill as written intends “to outlaw all same-sex sexual conduct” and to impose the death penalty on same-sex intimacy, including touching, where one or both parties are HIV-positive, even if the touching is with mutual consent.