The country’s law enacted over four years ago to make access to HIV related services to all people-affected and non-affected a right, has not been popularized and disseminated as it should. However a research reveals that public knowledge about legal rights in relation to HIV can make a difference in mitigating the impact of the virus...
The research indicated that effective implementation of the HIV and AIDS Act of 2008 would reduce premature deaths, stigmatization and improve access to Anti-Retroviral Treatments (ARVs) and other social protection services such as free education and food aid.
The research was conducted between November 2010 and January 2011 by Dr Anna Mdee, the Deputy Director of John& Elnora Ferguson Centre for African Studies (JEFCAS) - University of Bradford, UK in collaboration with Lisa Thorley, a partnership coordinator at JEFCAS and Paul Otieno the Director of Village to Village Tanzania (V2V-Tz) based in Uchira, Same district Kilimanjaro region.
The study interviewed 41 active people in 24 groups in Moshi rural district and 21 in Same district where V2V-Tz has operated since 2008 to enable people living with HIV access their entitlements as stipulated under the law.
It indicated that knowledge on what the HIV and AIDS law provides, empowered People Living With HIV (PLWHA) in the V2V-Tz project area to the extent that they were able to hold meetings with District HIV and AIDS Coordinators and discuss the importance of having localized systems of accessing ARVs and other medication because they were facing challenges in financial, physical and social capitals required to reach dispensation point.
One interviewee from Uchira Village said that she had not collected her medication for several weeks because she could not afford the Ths500 return bus fare to Moshi District Hospital.
Another interviewee during the survey who lived in the mountainous villages of Same District where there is limited transport said that walking to the nearest dispensary would take 5 hours or more.
Further the research respondents confirmed that knowledge on the HIV and AIDS law of 2008 helped PLWHA in Same and Moshi to deal with corrupt health officials as they knew that ARVs were free and no one would demand money from them.
Indeed, had it not been for the efforts of this organization, PLWHA in Moshi and Same to date would not have known that they have legal rights in relation to HIV and AIDS services.
Only one person out of the 41 who were interviewed was aware of the existence of the HIV/AIDS Act, 2008 before being involved with the V2V-Tz project.
“Prior to knowing my rights, I did not know that AVRs were free. I had refused to go to hospital for treatment. Having this knowledge has saved my life”, the study noted one of the respondent as saying.
Interestingly, it was reported that a great number of those who were interviewed during the study were informed to either join or form a support group of people living with HIV at the point of diagnosis.
Others were told were they could access ARVs free of charge but a number of them were not aware that they had a right to access ARVs.
Some participants in the study who were asked why they joined people living with HIV/AIDS groups said they did it for solidarity, comfort and mutual support, to reduce isolation and give a purpose to life.
Others joined the groups for economic reasons to earn a living through projects which would attract funding while others joined groups to exchange ideas, experiences as well as coping strategies to fight stigma and advocate for change.
As a result, the researchers concluded that the testing centres in rural Tanzania are either not aware of the Act or do not have the capacities to disseminate appropriate information.
But why has the country taken so long to popularize and disseminate the HIV and AIDS law of 2008 which the research has proved to have many advantages in combating HIV and AIDS?
The Chairman of Tanzania Commission of AIDS (TACAIDS) Dr Fatma Mrisho says the law delayed to be disseminated widely because regulations to guide implementation were yet to be accomplished.
However, she said, “the regulations are now in place” and that TACAIDS, the Ministry of Health and National AIDS Control Programme (NACP) have started meeting to plan to strategize on popularization and dissemination of the act.
But critics say the reason for delay could be due to the fact that the law introduces some rights in relation to HIV and AIDS such as informed consent on testing, right of partners to notify each other on their HIV status and right of health care which means that the implementation of the law will also see the government being held accountable to provide medication and other social services for people living with the Human Immunodeficiency Virus (HIV) that causes Acquired Immuno Deficiency Syndrome-AIDS.
Jovin Sanga a legal and research officer from Tanzania Women Lawyers Association (TAWLA) admits that most problems related to discrimination of people living with HIV are due to ignorance of the law.
“There are so many laws in the country which are enacted and forgotten about. Most citizens are usually aware that a law exists but do not know the contents. This is the reason why some people end up doing nothing even when their rights are violated,” he adds.
Notably, Sam Onesmo Komba, an activist on HIV issues who was among few people who followed closely the process of making the Tanzania HIV and AIDS Act says the statute, if successfully implemented, can change the trend.
“This is a very progressive law in terms of citizens’ health rights”, noted Komba adding: “Even the current Constitution does not provide right to health, rather it only provides for the right to life”, noted KOMBA the former Tanzania Commission for AIDS legal officer and the current Managing Director of Legal Initiative in Development and AIDS.
Komba cited some of the empowering clauses in the law to include Article 5 (19) which says “The Government shall, using available resources ensure that, every person living with HIV and AIDS, vulnerable children and orphans are accorded with basic health services”.
Regarding accessibility of anti AIDS drugs, he said article 24 (2) of the law stipulates that “The Ministry shall, where resources allow, take necessary steps to ensure the availability of ARVs and other health care services and medicines to persons living with HIV and AIDS and those exposed to risks of HIV infection”.
Likewise, the AIDS activist lawyer says, the country’s HIV and AIDS Act is against stigmatization and discrimination of a person based on HIV grounds and article VII of the act provides punishment of such acts as it says “Any person who contravenes any provision (in relation to stigma) shall be liable to a fine of not less than two million shillings or to imprisonment for a term not exceeding one year or both”.
But since the law is not publicized stigmatisation and discrimination continues to become an obstacle to AIDS fight.
“When I was discovered HIV positive 23 years ago my husband disowned me and my child born with the virus but even today many women suffer discrimination due to their HIV status”, says AIDS grassroots activist based at Bunju, Dar es Salaam, Huluka Mohammed, who decided to declare her status public in 2002 as a way of battling stigma.
Elizabeth Muhangwa, Coordinator of Tanzania Crisis Resolving Centre (CRC) says people both in rural and urban areas should be educated on what the HIV and AIDS Act says on discrimination and access to ARVs and adds” more health facilities able to dispense ARVs should be established countrywide for people to access treatments easily”.
Importantly, combined efforts are required to make the law a worthwhile. Different actors including the government, AIDS institutions, civil societies, health facilities, financial institutions and groups, religious bodies, school, colleges and the media have a role to play to make sure that the law is popularized and widely disseminated for utilization to make a difference in terms of reducing new HIV infections and suffering of those infected.
Perhaps, it is the right time for the Association of Journalists Against AIDS (AJAAT) to pioneer an advocacy meant to mobilize public and private institutions as well as the donors to invest in popularization and dissemination of HIV and AIDS Act of 2008 as V2V-Tz project has tested and proved that it can make a difference in lives of PLWHA.