12 June 2010
Mandatory HIV testing is controversial and the topic surfaced previous week building up last week seeing it settled the same week before it became a major issue. The topic was first started by some organizations of drug users and people living with HIV, which voiced firm opposition to the proposed move by Project ORCHID to conduct 100 % HIV testing in its targeted intervention projects. More organizations joined the chorus to flay the proposed move eventually leading to a meeting among the conflicting parties to settle the issue.
Thus the issue went on till a joint meeting was held among the drug users organizations, Project ORCHID and the NSACS, where the controversial proposed mandatory HIV testing was withdrawn. The topic brought out the issue of human rights which was seen as the basis for the withdrawal of the proposed move finally terming it as“miscommunication.”
If HIV testing was made mandatory, many of the drug users would not have come forward for availing other necessary cares, as was visible from their opposition to it, which would eventually affect the HIV and AIDS prevention programmes. One can say that respecting human rights is important in addressing the HIV and AIDS disease. Of course, mandatory testing, when used responsibly, can be very helpful in reducing the spread of HIV especially among high risk communities but as argued by activists it amounts to violation of human rights. Mandatory HIV testing means forced testing on the individual who is not given any choice to decide but to give in to testing his HIV status. Thus it becomes compulsory testing. Human rights activists are concerned with such tests compromising patient’s confidentiality and freedom of choice. It is argued that failure to protect confidentiality will lead to discouraging people from seeking necessary care.
The fact is, for the response to HIV to be effective, the human rights of the people concerned should be respected and fulfilled. Conducting mandatory HIV testing by violating individual rights can instead lead to increased stigma and abuse and help little in achieving HIV prevention goals.
However, voluntary HIV testing programmes accompanied by respect to human rights of an individual, ensuring confidentiality and linked to counseling and treatment can see positive results in respect of HIV prevention and further transmission. Besides informed consent, human rights in this sense would also largely mean protection from stigma, discrimination and abuse if testing is conducted.
Studies find that mandatory HIV testing make people complacent about HIV and AIDS and those who test negative will falsely assume that they are safe and maintain that HIV is not their problem but someone else’s problem.
People should be made to take an HIV test only because it is in their best interest to do so. It should not be forced upon them.
Seen from the surface level, the human rights issue outweighs and gains over mandatory testing. However, there is also a need to understand the problems faced by the health workers especially in the context of drugs users. Carrying out harm–reduction programmes among drug users is not considered easy as drug use is secretive or illegal and for which they are not easily reachable unless they come forward.
Many organizations or health workers are known to persuade the police not to arrest drug users who come in for new syringes, counseling or other precautionary measures. Many a times they come into conflict with the laws, Church and other authorities and they have to differ with them as their target is to reach out to those who need their service. For difficulties such as these, people also advocate mandatory HIV testing to certain groups of people, in the interest of public health.
A growing number of authorities around the globe are making it mandatory for couples to determine their health status before marriage; pregnant women are compulsorily made to undergo HIV testing because of the risk of infection to newborn babies; high risk communities are compelled to undergo HIV tests etc.
But, yes, compulsory HIV testing is also an important part of an effective HIV and AIDS prevention strategy. When people know they are HIV positive, they can take necessary preventive steps and keep themselves healthy.
Whatever the points of arguments are, an individual’s willingness to avoid unsafe behaviour is what HIV prevention banks upon. Everyone must have a right to decide to determine their health status but everyone also has a responsibility to avoid unsafe behaviour.
On to another issue; ‘Jihadi’ as commonly understood is killing oneself in the act of killing others. ‘Jihadi’ was the term used by Envoy to the collective leadership of GPRN/NSCN, Kughalu Mulatonu against the Naga NGOs advising them not be become one (Jihadi) while referring to the ban on Manipur vehicles by NSF in Naga inhabited areas which was adding misery to the people’s life there already affected adversely by ANSAM protest. If such ban is prolonged, it could lead people to starvation and onto death.
Understanding the message in this context, one can assume that if such blockade is imposed on Nagaland by anyone for an indefinite period, Nagas will too starve to death which would be seen as an act of suicide (read Jihad) after first pushing people in Manipur to death.
So it is possible that the message can be understood as asking the Naga NGOs to lift the ban which will be reciprocated by others and so not to starve themselves to death.
But this is not what many people might assume given the past statements of the GPRN/NSCN leader who have issued warnings to NGOs and individuals. He has recently warned Naga NGOs not to hold Manipur to ransom by blocking trucks from entering Manipur via Nagaland as it violated all basic norms of human rights.
So it leaves enormous room for the NGOs to be apprehensive about his statement and hold him responsible for any harm that might befall them. It remains to be seen how or if Mulatonu will explain the ‘Jihadi’ statement.
K. Filip Sumi
Tuesday, Feb 21st
Last update:05:44:44 AM IST