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Press Release - September 29, 2002
HIV/AIDS
Human Rights Commission says compulsory HIV/AIDS testing is bad public health policy -as well as unconstitutional.
The Chairperson of the Human Rights Commission, Justice Sailosi Kepa, said today that the debate over proposals to introduce compulsory testing for HIV/AIDS should take account of international practice on the issue.
“The Fiji Constitution prohibits all medical procedures unless the person concerned gives her or his informed consent. But this is not an issue where human rights principles compete with good public health policy. On the contrary, this is an area where human rights and public health are in harmony because the overwhelming consensus of expert opinion around the world is that mandatory testing for HIV/AIDS is not a sound or justifiable strategy for controlling the spread of HIV”
The Chairperson said, "The view of the United Nations AIDS organisation is that "there is no evidence that mandatory testing achieves public health goals. UNAIDS therefore discourages this practice". He said UN policy was explicit that countries should "discourage mandatory testing".
The Human Rights Commission also noted the view of the World Health Organisation that - "Mandatory testing and other testing without informed consent has no place in an AIDS prevention and control programme."
It also observed that the Council of Europe has resolved that - "Compulsory testing is unethical, ineffective, unnecessarily intrusive, discriminatory and counter-productive."
It noted too the view of the Canadian Advisory Committee on AIDS that - "Compulsory or mandatory testing, with the exception of testing blood, organ, tissue, ovum or sperm donors, was unwarranted in all cases." Justice Kepa said, "the question of compulsory HIV testing has now been raised in Fiji. It is important that those who may be developing policy in this area take account of the experience and views of leading international agencies. Compulsory testing is a discredited strategy -in public health terms not just in human rights terms."
Justice Kepa said, "Mandatory testing raises additional issues. Might the necessary resources be better used in educating people about safe-sex practices? Who is to be selected for testing and on what basis? What privacy safeguards are there in relation to the identities of infected people? And what are the state's health care responsibilities towards people diagnosed without their consent? But one of the most serious questions is whether compulsory testing might actually be counter-productive. As the Ontario Law Reform Commission noted when they studied the subject, if groups perceived to be at risk are targeted for coercive testing they will simply go underground. They will then be further alienated from safe-sex messages and other public health initiatives. As a result HIV risks would be increased not decreased. Driving at-risk groups underground, instead of working cooperatively with them, is not a rational policy."
Justice Kepa also said "The New Zealand AIDS Foundation is a respected agency which has contributed greatly to New Zealand's internationally acclaimed response to the AIDS epidemic. NZAF said in a recent paper about the compulsory testing of refugees that …"There is no evidence that restrictive policies work in the battle against HIV. The best way to prevent the epidemic from spreading is a health promotion approach, which seeks to promote healthy practices in order to avoid infection, and which establishes a cooperative approach with populations at high risk in the design of prevention strategies. Furthermore, implementing a coercive regime based on testing and exclusion may have consequences that run contrary to public health goals and is likely to incur significant costs itself. There is good cause to believe that coercive measures might actually hinder efforts to control the spread of HIV and its related costs.
Justice Kepa concluded - "One of the attractions of compulsory testing is that Governments can make themselves look as if they are doing something about AIDS. That is why compulsory testing has been adopted in a number of US jurisdictions. But such an approach is driven by political considerations not sound public health policy. All over the world compulsory testing for HIV is a discredited strategy. Here in Fiji we should reject bad policies not adopt them. This is especially so if, as leading opinion suggests, mandatory testing is a counter- productive strategy for controlling the spread of the HIV/AIDS epidemic."