Civil society cautions SADC leaders against mandatory HIV testing

Posted by ARASA on August 22, 2013

Civil society cautions SADC leaders against mandatory HIV testing


Windhoek, 22 August 2013 - The AIDS and Rights Alliance for Southern Africa (ARASA), a partnership of 73 non-governmental organizations working in southern and east Africa, has noted with concern reports that several SADC leaders lauded mandatory HIV testing as a viable strategy to curb the spread of HIV during a meeting of Heads of State and Government on AIDS Watch Africa, held on 17 August on the sidelines of the 33rd SADC summit in Lilongwe, Malawi.


“Mandatory HIV testing is a gross violation of human rights to dignity and autonomy which will hinder us from achieving our public health goals and negate the gains we have made in the AIDS response over the past decade,” explained Michaela Clayton, Director of ARASA. “Instead, we should look critically at the underlying causes of the low levels of HIV testing and uptake of prevention and other HIV-related services.”


In successive political declarations on HIV and AIDS, heads of state have acknowledged and committed to the full realization of human rights and fundamental freedoms as crucial to the AIDS response, including eliminating discrimination against people living with HIV and key populations at higher risk of HIV, including men who have sex with men, sex workers and people who inject drugs, and ensuring the right to dignity, autonomy and confidentiality.


Despite this, unacceptably high levels of HIV-related stigma and discrimination and human rights violations at the hands of families, communities, law enforcement officials, health care providers and employers as well as legal and policy frameworks that fail to protect people living with HIV, women and key populations at higher risk of HIV such as men who have sex with men and sex workers continue to present insurmountable barriers to HIV prevention efforts. It is thus not difficult to understand why it is so difficult for many to test for HIV and to access the HIV prevention and treatment services to which they are entitled.


Mandatory HIV testing will not address this problem. In fact fears of mandatory testing and breaches of confidentiality drive individuals at higher risk of HIV away from testing services. Neither will mandatory testing ensure that people who need it can access life-saving antiretroviral treatment. While many countries in the region have significantly increased the numbers of people accessing treatment, only 5 countries have achieved coverage in excess of 80%. In fact the majority of countries in SADC are providing treatment to less than 60% of those who need it.


Thirty years into the HIV response, evidence has shown that successful HIV prevention interventions depend on an environment of safety in which people at risk of HIV can demand and seek services without fear of stigma, discrimination and abuse of their human rights. Successful HIV responses depend on interventions which place human rights at the centre and promote the establishment and strengthening of an enabling legal, policy and social environment in which all people who need it are able to access prevention services without discrimination. “We should continue to protect the dignity of people and ensure agency of citizens to participate in the design and implementation of interventions, to be informed and make decisions about their health and lives, to be protected from harm and to have opportunities to seek redress and accountability for abuses,” added Clayton.


According to the UNAIDS 2013 report on the HIV epidemic in eastern and southern Africa, there has been a 30% reduction in new HIV infections between 2001 and 2011 as well as a 50% reduction in new child infections between 2001 and 2011 in the region. Introducing regressive approaches, such as mandatory testing, that go against evidence of what works carries with it a real risk of negating the gains made.


“During this time of dwindling resources for HIV interventions, we are all seeking more effective and efficient ways of addressing HIV prevalence in the region. Mandatory HIV testing is not and will never be the silver bullet.” explained Clayton. “Let us focus rather on strategic investments and evidence based responses that have been proven to work, such as addressing existing legal, social and economic barriers, as well as the range of human rights violations that fuel HIV vulnerability and impede access to testing, particularly among women and groups at higher risk of HIV. We should focus our efforts on creating the conditions in which people are able to voluntarily access testing and treatment without fear of discrimination and human rights abuses including, particularly in the case of men who have sex with men, sex workers and people who use drugs, police harassment and arrest.”


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The AIDS & Rights Alliance for Southern Africa (ARASA) is a partnership of 73  civil society organisations working together to promote a human rights based response to HIV and TB in the SADC region. For more information on ARASA’s work and its partners please visit: