COERCIVE measures fuel stigma and drive people away from healthcare facilities, says Community Initiative for Malaria and Tuberculosis executive director Carol Nawina Nyirenda.
And Treatment Advocacy and Literacy Campaign national coordinator Felix Mwanza says compulsory HIV testing is illegal and unconstitutional in Zambia.
TALC, Community Initiative for Malaria and Tuberculosis (CITAMplus), Coalition for Zambian Women Living with HIV and AIDS (COZWHA), Network of ARV Users and Zambian Network of Religious Living or Personally Affected by (ZANERELA) has expressed deep concern on the announcement during the launch of HIV Counselling Testing and Treatment Day (HCTT) on August 15 by President Edgar Lungu that HIV testing, counseling and treatment was now compulsory in Zambia for any person seeking medical treatment in public healthcare facilities
They stated that while they commend the government on the launch as the intervention would help in putting more people that will be found to be HIV positive on treatment, they appealed to the government to rescind the decision and revoke the proclamation forthwith.
Compulsory HIV testing is illegal and unconstitutional in Zambia as both the Supreme Court and the High Court in Zambia have found that consent is only present if it is provided freely, without undue influence, coercion, fraud, misrepresentation or mistake,
And Nyirenda stated that while the policy aims, according to President Lungu, to improve HIV testing and treatment adherence rates, on the contrary, coercive measures fuel stigma and drive people away from healthcare facilities.
COZWHA coordinator Mable Mwale stated that informed consent was critical to ensure that individuals are empowered in managing their health.
It has been shown that an individual’s sense of self-efficacy plays a major role in how one approaches goals, tasks, and challenges regarding one’s health, with directly-evidenced clinical benefits,
Kenly Sikwese from Afrocab stated that government’s approach also violated healthcare ethics and was contrary to international standards, including WHO and UNAIDS guidelines on HIV testing and treatment.
International guidelines on HIV and human rights from the United Nations Office of the High Commissioner for Human Rights (OHCHR) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) state “public health legislation should ensure that HIV testing of individuals should only be performed with the specific informed consent of that individual”, stated Sikwese. “Exceptions to voluntary testing would need specific judicial authorisation, granted only after due evaluation of the important considerations involved in terms of privacy and liberty.”1 The World Health Organisation (WHO) and United Nations Population Fund (UNFPA) similarly state that HIV testing must “only [be] conducted with informed consent.
Kennedy Chungu Palangwa from ZANERELA stated that forcing people to test for HIV or to take HIV treatment creates a disincentive to voluntarily access healthcare services.
“The United Nations Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health has emphasised the negative public health impacts of forced or compulsory treatment: “Just as linking appropriate counselling and treatment to voluntary testing services is an enabling incentive for testing, compulsory treatment measures are a disincentive,”” stated Palangwa.