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Universal Access and Human Rights: Statement on World AIDS Day
Zimbabwe Association of Doctors for Human Rights (ZADHR)
December 10, 2009

World AIDS Day provides an opportunity to remind ourselves of what has been achieved and of the work still to be done on HIV/AIDS. In 2009, Zimbabwe recorded further decline in the prevalence rate of HIV from 15.6% to 13.7%. An indicator that progress is being made. However only 180 000 of an estimated 400 000 persons in urgent need of antiretroviral therapy (ART) are currently on treatment. It is clear that universal access - for everyone, everywhere - to treatment, prevention, care and support as a fundamental human right is far from being realised and more concerted efforts are required to achieve this.

Universal access can never be achieved as long as there is violation of the human rights of people living with HIV/AIDS. However, PLWHA in Zimbabwe are still subject to stigma and discrimination; are still denied their right to work; and are often left in poverty that deprives them of their dignity. The human rights of PLWHA to universal access cannot be fulfilled in the absence of guarantees on availability, accessibility of quality of treatment, prevention, care and support. In addition to these guarantees, a human rights approach to HIV/AIDS must focus on eliminating discrimination and stigmatisation as a primary goal, guaranteeing universal access, decreasing vulnerability, promoting meaningful participation of people living with HIV/AIDS in decision making and ensuring access to information.

It is deplorable that some ART sites are charging PLWHA an 'administration' or 'card fee'- essentially user fees - to access free drugs. This undermines the intention to promote universal access and prevents those without access to financial resources from exercising their right to seek medical attention and access treatment. ZADHR calls on the Ministry of Health and Child Welfare to take steps to address this and ensure that People Living with HIV/AIDS are exempt from all health care fees in the public health care system and that these exemptions are enforced despite present funding challenges within the health system.

Currently, there is no clear strategy in place to ensure the realisation of human rights for people living with HIV/AIDS (PLWHA) in Zimbabwe. The Zimbabwe HIV and AIDS National Strategic Plan (2006 - 2010) does not use the language of 'human rights' nor does it articulate specific strategies to realise it. Consequently the monitoring and evaluation plan for the strategy does not make any provision for tracking realisation of rights of PLWHA. Thus, failure to use the language of human rights and identify specific steps to be taken towards their fulfilment often translates into the inability to take the actions that the realisation of human rights requires. The human rights of PLWHA in Zimbabwe cannot come to be realised unless intentional action is taken going forward to review existing legislation, policies, strategies and programmes and ensure that all future legislation, strategies and programmes are rights-based.

Whilst policy frameworks, such as the National HIV/AIDS Policy make a contribution to approaches to HIV/AIDS it is important that the intentions on human rights in the National HIV/AIDS Policy are made effective by complimentary legislation. The enactment of legislation which specifically protects the human rights of PLWHA is paramount. This should include an enforceable provision for the right to health under which universal access is guaranteed within the bill of rights of a new Zimbabwean constitution.

Finally it is important to remember as this year's mantra of 'universal access and human rights' is chanted, that universal access to treatment and prevention will transform HIV/AIDS into a manageable chronic illness which will demand a Zimbabwean health system that can provide life-long regular follow-up to PLWHA. This can only be done within a functional, equitable and effective health system, on its own a fundamental human right.

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