Human Rights and HIV/AIDSTable 4.2Important human and legal rights and their implementationPopulation cohortsPeople Living with HIV/AIDS (PLWHA)l The right to life–treatment andhealthcare, employment, confidentialityand privacy, protectionfrom violence, form groups andassociationsl The right to equality and nondiscrimination–inhealthcare,employment, insurance, travel andmovement, services, marriage andfamilyl The right to information–ontreatment, safer sex options, harmreduction methodsl The right to privacy andconfidentiality–in healthcare,employment, legal/ judicial systemsl The right to bodily integrity andautonomy–consent in treatmentand testingl The right to health–access to thebest available medication ataffordable pricesl The right to reproductive choicesand decision making–continuing orterminating pregnancy, decisionabout fertility (in the context ofsterilisation that HIV-positivewomen are subjected to withoutconsent)Human rightsOverview of laws and their implementation in South <strong>Asia</strong>There are no specific legislation in the region either protecting orinfringing upon the rights of PLWHA. However, many constitutionsprovide certain fundamental rights including the right to equalityand non-discrimination, right to life and liberty as well as privacy, 37which are pertinent in the context of HIV/AIDS. Though there islack of protective legislation, many national strategies state thatPLWHA are entitled to fundamental human rights and freedom,including the right to confidentiality as part of the right to privacy.In Nepal this right is considered inviolable except as provided bylaw. 38 Public health institutions in some countries are obligated notto discriminate between patients on the basis of HIV status and toprovide treatment for opportunistic infections. Despite suchguarantees, discrimination of PLWHA in healthcare settings is notan uncommon experience. Breach of confidentiality about HIV statusis another significant issue in the context of healthcare settings.Inability to access services due to fear of stigma and discriminationis a significant concern for PLWHA in this regard. There are severalexamples in the region of people having lost their jobs because theytested HIV positive In Maldives, administrative measures sayingthat there should be no discrimination against PLWHA with regardto employment applies only to those in civil service and governmentownedcompanies. 39 PLWHA are also systematically deniedinsurance, as insurance schemes in general exclude liability for HIVrelatedexpenses.Injecting drug usersl The right to life–civil rights againstarbitrary arrest and harassment bylaw enforcement and others,reintegration/rehabilitationl The right to health–information,treatment, non-discrimination inhealthcare, access to harmreduction strategies (clean needles,syringes and paraphernalia)Overview of laws and their implementation in South <strong>Asia</strong>Various drugs such as opium and cannabis have traditionally beeneaten, drunk or smoked in most countries of the region. 40 ollowingthe introduction of heroin, however, injecting drug use is nowcommon. The prevalence of injecting drug use varies considerablywithin and between countries, from very low levels estimated inAfghanistan to up to 93 per cent in some places in Bangladesh.Most of the South <strong>Asia</strong>n countries are signatories to the Conventionagainst Illicit Traffic in Narcotic Drugs and Psychotropic Substances,1988 and the Single Convention on Narcotic Drugs, 1961. There isalso a SAARC Convention on Narcotic Drugs and PsychotropicSubstances<strong>Regional</strong> Human Development <strong>Report</strong>HIV/AIDS and Development in South <strong>Asia</strong> 2003 89
Human Rights and HIV/AIDSllDecriminalisation of drug use andreform of related laws used toexploit IDUsThe right to equality and nondiscrimination–toservices includinghealthcaresigned in 1998. The countries have implemented laws that criminalisedrug use, the cultivation of opium poppy and cannabis; production,processing, buying, selling, trading, keeping and trafficking of drugs.The penalty for violation of laws related to drugs can vary fromvarious lengths of imprisonment to death sentence in severalcounties, including Sri Lanka and India. Laws for the treatment andrehabilitation of drug users have mainly been adopted as part ofpunitive measures in Afghanistan 41 for policing the use andpossession of drugs. There are reports that due to lack of treatmentfacilities in Nepal, a large number of drug users have been roundedup and put in prison where the ‘cold turkey’ 42 method of treatmentis followed. Injecting drug users are being arrested throughout theregion for carrying needles and syringes 43 and most legislation doesnot provide space for the implementation of harm reductionprogrammes. Needle exchange programmes have been introducedand are funded by some governments, such as that of the state ofManipur in India, Iran and Nepal. However, legally, such initiativesmay amount to abetment of offences under the drug laws of thecountry. In most of the countries in the region, offenders of druglaws make up a very substantial part of prison populations.Sex workerslllllThe right to life–civil rights againstarbitrary arrest and harassment bylaw enforcement agencies andothers, right to form groups andassociations, right to assemblereedom of speech and expression–to publish educational andinformation materialsThe right to health–information,treatment, non-discrimination inhealthcare, access to harmreduction strategies (condomdistribution, safer sex, educativematerials)Decriminalisation of homosexualintercourse and reform in relatedlaws used to exploit men who havesex with menThe right to equality and nondiscriminationto services includinghealthcare, protection fromobscenity lawsOverview of laws and their implementation in South <strong>Asia</strong>Even though the awareness of HIV/AIDS among sex workers isrelatively high in countries of the region, condom use remains low.Legal evictions of sex workers within many countries in South <strong>Asia</strong>have intensified feelings of mistrust and harassment between sexworkers and law enforcement officials. While sex work is not acrime in itself in many of the countries, brothel and street-basedsex work is illegal. Iran is an exception, where execution (by firingsquad or stoning) is the maximum penalty for sex workers and suchexecutions are common. 4490<strong>Regional</strong> Human Development <strong>Report</strong>HIV/AIDS and Development in South <strong>Asia</strong> 2003