Writing about AIDS from any perspective, legal or otherwise, is curiously not as easy as it would seem. A confrontation with ethical questions and issues of discrimination in the context of HIV/AIDS engenders questions bordering on social and natural justice; any dicussion of peoples and situations in this framework cannot be easy. The narrative does transcend the legal or intellectual discourse.
The fight against HIV/AIDS and all its appurtenances in Nigeria is one that has been fought from multiple platforms: from the policy level to the medical, from media advocacy to NGO participation. It is common knowledge that the legal has not been the dominant platform in Nigeria. However, it should not be particularly difficult to engender a legal relationship between Nigeria and the scourge if we follow the lead provided by legal and media writings, the decided cases (albeit few), advocacy groups, including NGOs, etc.
The primary legal and ethical questions to be addressed range from Consent to testing procedures, Legality of Mandatory Testing (often couched as mandatory but not compulsory) as both a requirement for job offers, educational admissions, etc., Confidentiality in relation to health records, the availability of Pre- and Post-testing Counselling, Discrimination on the ground of the status, etc. Other ethical-legal issues include stigmatization, health inequities both within and between the genders and human rights abuses (with particular reference to the impact on women living within the stereotypical construct within which they are conscripted), which increase the prevalence of the scourge.
Notably, other legal grounds of challenge exist within the discourse on the legal rights of people living with HIV/AIDS. Besides the issue of stigma and discrimination in public spaces, other legal challenges can be brought against government policy decisions (health policies or otherwise) which negatively affect the rights of people living with HIV/AIDS. The lack of cohesive and justiciable laws on both the fact of discrimination and the scourge itself is another site for legal challenge.
Nigeria's National Policy on Aids provides a useful list of legal and ethical issues
to be addressed in the area of HIV/AIDS in Nigeria. Researchers and scholars can refer to pages 16 and 17 of the Policy available online at http://www.nigeria-aids.org/documents/NationalHIVPolicy.pdf for an overview of these issues some of which I have highlighted above.
The articles below speak to some of these issues. Emuakpor's paper addresses discrimination against people living with HIV/AIDS in both the courts and the clinics. The author concludes that the "HIV/AIDS epidemic has evolving legal issues and ramifications".
Aniekwu picks on gender and human rights dimensions of HIV/AIDS, a dimension that is often unemphasized in scholarly writings on this issue in Nigeria. HIV/AIDS with its links to human rights abuses disproportionately affects women. A critical legal analysis such as that provided by Aniekwu opens up an avenue for discourse.
Oziengbe addresses the question: "Can Persons living with HIV/AIDS testify in Court?" Without knowledge of the circumstances against which this author writes, this question - posed by the Nigerian Vanguard - may appear to be an odd one. Yet, it flows from empirical facts of the experiences of many people living with HIV/AIDS in Nigeria.
Finally, there is an excerpt from Tan Lyn writing from China on Nigeria's promise to enact a law backing HIV and Malaria drugs. Ahmed Abdulkadir, special adviser to the Nigerian president, in an interview conducted during the anti-malaria conference in China's southern Guangzhou city is reported as affirming that: "We will try to have the legislation passed. We've done all administrative work, it's at the final stage. We will send it to the national assembly so it can be passed... We will dismantle all those barriers so that our local industries are able to produce all of these drugs, all ACTs and all ARVs." Abdulkadir heads a taskforce to produce the drugs.
It is yet another (legal) promise of hope for healthcare in Nigeria. Whether this promise will translate to reality is a question whose answer lies in the future.
How Do Nigeria's Health-Care Personnel Treat Patients with HIV/AIDS?
Vincent Iacopino et al.
People living with HIV/AIDS (PLWA) face many forms of stigma and discrimination. This is the case in whichever country they may live, as has been shown in a number of previous research studies. In addition to experiencing unfair treatment in their families, communities, and places of work, PLWA may encounter discrimination from health-care professionals. This can interfere with effective prevention and treatment. Discriminatory practices in the health-care sector may also appear to legitimize other forms of discrimination against PLWA.
Vincent Iacopino and colleagues from the organization Physicians for Human Rights, in collaboration with researchers from Policy Project–Nigeria and the Center for the Right to Health (also in Nigeria) investigated the problem in Nigeria. With a population of roughly 130 million, Nigeria is home to one in 11 of the 40 million PLWA worldwide. Around 6% of adult Nigerians are thought to be HIV-positive, and there will be an estimated 310,000 AIDS deaths this year. The indications are that infection rates will increase. Until now, little has been known about the nature and extent of discrimination against patients with HIV/AIDS in Nigeria...
http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1176243&blobtype=pdf
Stigmatization and discrimination: HIV/AIDS and the law in Nigeria
Scott-Emuakpor RE.
Abstract
The quality of life of people living with HIV/AIDS is less commonly researched as it should be. Much as we know about the disease and its progression, little is known of the regression of human rights. We hypothesize that the early diagnosis of HIV infection and openness about an individual's HIV status is most vital for effective prevention and care. HIV-related stigma and discrimination remains an enormous barrier towards effectively containing the spread and prevention of the epidemic. We observe that the Constitution of the Federal Republic of Nigeria guarantees fundamental human rights. In addition, Nigeria has ratified some international and regional human rights instruments relating to HIV/AIDS. However, there is currently no specific legislation on HIV/AIDS. Human rights violations are widespread, ranging from common place non-consensual HIV testing to the arrest and containment by quarantine of all AIDS patients by the military administrator of a state or the ruling of a High court judge to a plaintiff who had tested HIV positive, that she not be allowed to give evidence, unless a medical expert satisfied the court that her presence would not endanger the lives of other people in the courtroom. The victims of these human rights violations have no recourse in the courts of law in Nigeria because the law courts which are supposed to uphold the rule of law and enforce it when necessary, are perpetuating the very violations for which redress is being sought in the first place. These factors undermine effective prevention, care and support. We recommend continued education to challenge stigmatization and discrimination. The Government needs to expedite its response to HIV/AIDS human rights related issues, implement policies and enact legislation. It is our conclusion that the HIV/AIDS epidemic has evolving legal issues and ramifications.
http://gateway.nlm.nih.gov/MeetingAbstracts/102281323.html
Gender and Human Rights Dimensions of HIV/AIDS in Nigeria
Nkoli I. Aniekwu
Abstract
Until very recently, researchers paid little attention to sex or gender issues in HIV/AIDS. When differences between females and males on health matters were considered at all the focus was clearly on women's reproductive lives and not on factors affecting the spread of the disease. There was hardly any consideration of the influence of inequalities on the spread of HIV/AIDS and on outcomes of infection between the sexes. Hitherto, health policies and programmes focused on biological aspects of diagnosis, treatment and prevention. In this paper, the author seeks to provide an understanding of the social factors as well as identification of the capacity of human rights to develop an effective response to the disease. It is a gender perspective on human rights with specific implications for women in the context of HIV/AIDS.
http://links.jstor.org/sici?sici=1118-4841(200212)6%3A3%3C30%3AGAHRDO%3E2.0.CO%3B2-G#abstract
Anti-Discrimination Law in Nigeria
John Oziegbe
Abstract
The constitutional provisions against discrimination are hardly justiciable. John Oziegbe makes a case for HIV carriers in places of work The Black's Law Dictionary (Eight Edition), defined discrimination as a practice that confers privileges on certain class or that denies privileges to a certain class because of race, age sex, nationality, religion, or handicap or differential treatment, especially a failure to treat all persons equally when no reasonable distinction can be found between those favoured and those not favoured. Recently, the Vanguard News paper on its Law and Human Rights page x-rayed the frustrations, embarrassment, predicament and the worst form of discrimination faced by People Living With HIV/Aids (PLWHA). That report was titled "Can a PLWHA testify in Court?" This report was necessitated by the recent ruling of the Court of Appeal Lagos in an Appeal brought by a HIV/AIDS patient (Appellant) who was dismissed from her place of work and sought to challenge the wrongful dismissal.
http://www.justiceinitiative.org/db/resource2?res_id=102740
Nigeria to enact law to back malaria, HIV drugs
Tan Ee Lyn
Nigeria is in the final stages of passing a law that will allow local drugmakers to produce more life-saving medicines for its people to fight malaria and HIV/AIDS...
The country has 14 companies making anti-retroviral drugs (ARVs) to control HIV/AIDS and eight companies producing artemisinin-based combination therapies (ACTs) to treat malaria, but production levels are far from sufficient...
http://www.alertnet.org/thenews/newsdesk/B708301.htm
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