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INTRODUCTION

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INTRODUCTION

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  1. Tanzania case study on how AIDS law criminalizes stigma and discrimination but also stigmatizes by criminalizing deliberate HIV infectionMs. Millicent Obaso,Country Director, Futures GroupChief of Party, Health Policy Initiative, TanzaniaXVIII International AIDS ConferenceVienna, AustriaThursday, 22 July 2010

  2. INTRODUCTION • Tanzania National HIV/AIDS Policy (2001) • emphasizes that while the population has to be protected from wilful and intentional spreading of HIV, the rights of PLHIV have to be safeguarded, including protection from stigma and discrimination (S&D) • Effective responses require that human rights of PLHIV and people who are HIV-negative be observed • When human rights are protected, fewer people become infected and even those infected or affected can cope better

  3. HIV/AIDS (Prevention and Control)ACT 2008 (AIDS Law) • Tanzania adopted the HIV/AIDS (Prevention and Control) Act 2008 • To protect the rights of people living with HIV • To protect HIV-negative people from infection • Process began in 2001; wide consultation with many stakeholders

  4. SUPPORTS RIGHTS AND ENCOURAGES RESPONSIBILITY • Rights/Positive Aspects • Rights of PLHIV • Nondiscrimination • Free treatment • Gender sensitive • Responsibility • Get tested • Disclose to partner or spouse • No infection to others (criminalizes deliberate spread)

  5. POSITIVE ASPECTS OF THE LAW The AIDS Law provides for: • Prevention, care, and control of HIV and AIDS • Promotion of public health for persons living with HIV and AIDS • Appropriate treatment • Counseling and care for persons living with or at risk of HIV and AIDS and for related matters • Stepped up efforts to meet the needs of orphans and vulnerable children

  6. PROHIBITION OF STIGMA AND DISCRIMINATION • Several provisions protect the rights of persons living with HIV and AIDS, including for example, Section 15 prohibiting compulsory HIV Testing • Part VII of the law entirely prohibits stigma and discrimination of persons living with HIV and criminalizes it

  7. CRIMINALIZING WILFUL TRANSMISSION OF HIV • The Law stipulates that “Any person who wilfully and intentionally transmits HIV to another person commits an offense, and on conviction shall be liable to life imprisonment • When the law was developed, it targeted those who were infecting deliberately, in a way pre-empting instant justice/mob justice by people in the community

  8. CHALLENGES WITH CRIMINALIZING TRANSMISSION • False assumption that criminalization will deter infection • Difficulty in proving deliberate transmission • It is also feared that HIV testing and disclosure will lead to prosecution and violence instead of treatment and care, especially for women

  9. GENDER DIMENSIONS OF CRIMINALIZATION • Women more likely to be tested - Criminalizing HIV transmission can result in disproportionate prosecution of women because more women are tested as part of pre- or ante-natal medical care and, therefore, know their HIV status • Lack of decisionmaking - Women's inability to safely negotiate condom use or disclosure to partners who might have been the source of their infection is not recognized in the law as a defense against criminal penalties • PMTCT – could women be targeted for deliberate transmission to children? What if they do not have access to ARVs for prevention? Or have limited infant feeding options?

  10. CHOICES • Do we throw out the whole law when many aspects of the law are good (95%) and only 5% on criminalization of deliberate infection is controversial?

  11. OPPORTUNITIES • PLHIV voices need to be heard; people should engage and challenge what is not working • Law provides opportunities to study it, invest in it, identify what works and what does not work • Based on evidence from Tanzania, we can identify how to reform criminalization aspects • Parliamentarians are engaged in dissemination of the law; there is an opportunity to further engage them on reform of the law

  12. ROLE OF THE HEALTH POLICY INITIATIVE • Assisting the Ministry of Health and Social Welfare in collaboration with TACAIDS to develop implementation regulations • Designed a database with the Tanzania Commission for Human Rights and Good Governance to track cases of stigma and discrimination • Translated a popular version of the law into Swahili, being disseminated by PLHIV, MPs, and others • Established an Advocacy and Action Committee (AAC) to publicize the contents of the law so that people can know their rights and be able to identify challenges needing further interventions • Compiling feedback on the criminalization clause

  13. CONCLUSION • PLHIV voices need to be heard. • To make any changes in this law, it will take time - it has to be used by the people and evidence obtained to show what is working and what is not working. • It is, therefore, important not to throw out the baby with the bath water. Let us use the positive aspects of the law that safeguard many rights, including those of PLHIV, as we gather evidence to warrant change.

  14. THANK YOU Learn more about the Health Policy Initiative at www.healthpolicyinitiative.com

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