Africa, Development & Aid, Headlines, Health

RIGHTS-UGANDA: 20 Years On, People With AIDS Still Suffer Discrimination

Evelyn Kiapi Matsamura

KAMPALA, Oct 27 2003 (IPS) - Ugandan Magdalena Achero (not her real name) is a bitter woman. As a school teacher, in a country which has been hailed as a beacon of hope for people living with HIV/AIDS, she has experienced discrimination firsthand.

Last month she received a discouraging message from the local education officer.

"The District Education Officer said, since everyone in the district knew my HIV status, he could not post me to any school. He said I should look for a school that would accept me, and convince the community to tolerate me, then go back to his office for posting or transfer to that school," she says.

Achero, an AIDS campaigner, from the eastern district of Tororo, has nowhere to complain, since Uganda has no policy, or law, proscribing discrimination on grounds of HIV/AIDS.

Achero’s remarks were narrated by Christine Aguti Kudinet of ‘The AIDS Support Organisation’ (TASO) during a preparation meeting Oct. 25, a day before the opening of the 11th ‘International Conference for People Having HIV/AIDS’ in the capital, Kampala.

The five-day gathering, organised by ‘Health Rights Action Group’ (HAG), has attracted 800 delegates, 200 of whom are from Uganda.

Kudinet, who is also HIV-positive, regrets that "some health workers (in her district) are denying services to people living with AIDS, especially women in labour".

Some are left lying in beds without treatment, and discharged prematurely, she says.

Kudinet, a member of ‘People Living With HIV/AIDS’, says children are also sometimes discontinued from their studies because the schools "cannot waste money on a dying person".

"There is also denial to inheritance rights to suspected HIV-positive widows and children because they think they will die soon," she says.

"After learning that you are HIV positive, chances of upgrading or training on the job are limited and accessing loans is also hard because they think you will die before paying the loans," Kudinet adds.

Although Uganda has been recognised as ‘the first African country to have subdued a major HIV/AIDS epidemic’, it has no coherent policies or laws that protect people living with HIV/AIDS from discrimination and stigmatisation.

Uganda has reduced HIV infection rate to five percent, the most dramatic decline in the world.

A recent study, ‘The Status of Human Rights Among People Having AIDS in Uganda And Their Involvement In Initiatives Targeting Communities’, says people living with the virus are being denied "a right to education, healthcare, gainful employment, property ownership, and sexual and reproductive rights, right to privacy and right to non-discrimination".

"The women were found to be more prone to human rights abuse than the men," the report says.

The report, compiled by ‘Health Right Action Group’, a local non-governmental organisation, also found that limited information and knowledge about HIV/AIDS and human rights were provided to the public. "More educated respondents knew more, and indeed men knew more than women, while the illiterate/less educated knew less," it said.

"Therefore, there is need for increased education about human rights to both people living with HIV/AIDS and the community. Programmes targeting women and children must be put in place. There is also need to address the special needs of the youth so that they can control their sexuality to avoid infection," says George Muwanguzi, a lawyer and HIV/AIDS activist.

Uganda has over 1.5 million people living with HIV/AIDS. Since the first AIDS case was diagnosed 20 years ago, over one million people have died of the disease, with over 80,000 of them being children.

Even with a fall in price of the anti-retroviral drugs from 1,000 U.S. dollars in the early 1990s to as little as 30 U.S. dollars today, 120,000-150,000 people remain in urgent need of treatment, as only 15,000 of these have access to the drugs, in a country where 90 percent of the population live below poverty line of one U.S. dollar a day.

"The poor suffer more because they do not have the money," Muwanguzi argues.

Although there is no official workplace policy on HIV/AIDS, some private employers have been trying to develop their own policies to keep their workers healthy.

For Standard Chartered Bank, a policy on HIV/AIDS was developed in 1998 and provision of anti-retroviral drugs (ARVs) to their staff started this year after realising that the epidemic was having a very big impact on their staff.

"The bank considers that it has a corporate social responsibility to support HIV/AIDS preventive efforts and to protect the basic human rights of those who in the work place are HIV positive," says Lawrence Nsubuga of the Standard Bank. "Employees are critical to the success of our business. We realise that loss of an employee is not only a personal and family tragedy, but also a direct loss to the Bank in terms of recruitment, productivity, retraining and other costs."

Information is availed to employees on the pandemic, its magnitude, impact and preventative measures, emphasising non-discriminatory policies, procedures and practises in managing affected individuals.

"The approach to individuals who have HIV/AIDS is the same as those with any other progressive or debilitating illness and with all the support this entails," Nsubuga explains.

The Bank considers medical information very confidential and employees are under no obligation to notify management of their status, but encouraged to establish it in case of need for ARVs, according to him.

"The issue of confidentiality is well addressed and our staffs have gained the confidence in the scheme. Should the test be positive, then the outcome is between the doctor and the patient," Nsubuga explains.

Uganda’s ‘AIDS Control Programme’ (ACP) manager, Dr Elizabeth Madraa told IPS that a national strategic plan to increase access to HIV/AIDS drugs has been set up, and prices of the drugs are expected to drop further. She said 11 referral hospitals stock ARVs, along with 215 other small centres countrywide.

"Now that prices of the drugs have fallen, there is need to train medical personnel on how to administer the drugs," she said.

Madraa said, in the past two-and-a-half years, the number of people accessing the anti-retroviral drugs has risen from 800 to 15,000. "The price has fallen to 50 U.S. dollars and below but that is still not enough for the ordinary Ugandan.

"Our target is that by 2005, we hope to reach 50 percent of the 150,000 in urgent need, and by 2007, we hope to be able to provide access to all. >From the ‘Global Fund for HIV/AIDS’, nine million U.S. dollars and another 62 million U.S. dollars have already been approved for ARVs, and three million U.S. dollars from the ‘World Bank Uganda HIV/AIDS Programme’ will be released soon.

During a July trip to Africa, U.S. president George W. Bush pledged a five-year, 15-billion-U.S.-dollar plan to combat HIV/AIDS in Africa.

According to the UNAIDS progress report, close to 40 percent of countries, including half of the countries in sub-Saharan Africa, have yet to adopt anti-discrimination legislation to protect people living with HIV/AIDS. "Governments must recognise that developing laws that protect the rights of people living with HIV/AIDS is essential to an effective response to the epidemic," said Ben Plumley of the Joint United Nations Programme on HIV/AIDS (UNAIDS).

Of the 42 million people living with HIV/AIDS worldwide, over 29 million live in sub-Saharan Africa.

John Rwomshana of the ‘Uganda AIDS Commission’ says he is praying that a national policy against discrimination is released soon so that people like Achero will benefit.

"Action, not lip service, is urgently needed if some 8,700 people are to stop dying each day of HIV/AIDS (in Uganda) due to lack of (ARV) therapy," said Rubaramira Ruranga, founder of National Guidance and Empowerment Network of People Living with HIV/AIDS in Uganda.

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