The South African cabinet has approved a new policy prohibiting discrimination against soldiers and would-be recruits on the basis of their HIV status. Previously, HIV-positive members of the South African National Defence Force (SANDF) could be excluded from recruitment, international deployment and promotion, but a 2008 high court decision declared such policies unconstitutional and gave the SANDF six months to amend them. The AIDS Law Project (ALP) expressed disappointment about the length of time the SANDF took to comply with the court order and the persistence of unfair discrimination against HIV-positive soldiers and recruits, but in October one of the men, Sergeant Sipho Mthethwa, became the first known HIV-positive soldier to be deployed on international service. The SANDF had argued that people living with HIV were unfit to withstand the stress and physical demands of foreign deployments. An estimated 25% of SANDF employees are HIV positive, higher than the national adult prevalence of 18%.
Values, Policies and Rights
CIVICUS, the World Alliance for Citizen Participation, condemns the introduction of the Anti-homosexuality Bill 2009 in the Uganda Parliament on 14 October 2009. The Bill seeks to roll back international human rights obligations undertaken by Uganda by declaring that the provisions of any international legal instrument contradictory to the spirit of the Bill shall be null and void. It seeks to criminalise the work of civil society organisations that promote the rights of lesbian, gay bisexual and transgendered persons through cancellation of registration and punishment of the head of the organisation with seven years imprisonment. Other provisions of the Bill identified as repugnant by Civicus include punishment by death for HIV infected persons if they have sexual relations with a person of the same gender; life imprisonment for attempting to contract a marriage with a person of the same gender; deportation from Uganda of citizens or permanent residents if they have sexual relations with a person of the same gender; and life imprisonment for sexual relations between people of the same gender. CIVICUS urges the Parliament and the Government of Uganda to respect the human rights of its people and uphold commitments to the International Bill of Rights and the Ugandan Constitution.
International Affairs Directorate, Health Canada: March 2009
The United Nations Convention on the Rights of Persons with Disabilities (CRPD) should be used as a tool to improve access to HIV services for disabled people, who are often marginalised in national HIV policies, according to this new report. People with disabilities (PWDs) experience all the risk factors associated with HIV, and are often at increased risk because of poverty, severely limited access to education and health care, lack of information and resources to facilitate 'safer sex', lack of legal protection, increased risk of violence and rape, vulnerability to substance abuse, and stigma. HIV and AIDS were implicitly included in the CRPD under article 25a, where ‘State Parties shall provide PWDs with the same range, quality and standard of free, affordable health care and programmes as provided to other persons, including in the area of sexual and reproductive health and population-based public health programmes’. It was also noted that disabled people could not claim their right to health services unless they were educated about these rights.
The purpose of the research programme introduced in this article is to provide new knowledge regarding comprehensive multisectoral approaches to breaking the negative cycle of poverty and mental ill-health. The programme undertakes an analysis of existing mental health policies in four African countries (Ghana, South Africa, Uganda, Zambia), and evaluates interventions to assist in the development and implementation of mental health policies in those countries, over a five-year period. The four countries in which the programme is being conducted represent a variety of scenarios in mental health policy development and implementation.
The aim of this analysis is to describe the content of mental health policy and the process of its development in South Africa. Quantitative data regarding SA's mental health system was gathered using the World Health Organization (WHO) Assessment Instrument for Mental Health Systems. Semi-structured interviews provided understanding of processes, underlying issues and interactions between key stakeholders in mental health policy development. The study found that the process of mental health policy implementation has been hindered by the low priority given to mental health, varying levels of seniority of provincial mental health coordinators, limited staff for policy and planning, varying technical capacity at provincial and national levels, and reluctance by some provincial authorities to accept responsibility for driving implementation. National leadership in the development of new mental health policy is required, with improved communication, provincial-level responsibility for implementation and commitment to capacity building.
Debate has emerged that pits health-systems support against targeted health campaigns. In classical terms, the debate may be framed as the Bismarck model versus the Beveridge model, but this dichotomy is increasingly viewed as being as false as that which seeks to pit vertical schemes of health against horizontal. In truth, development of systems capable of delivering health, generally, or specifically targeted campaigns and health initiatives, all rely on the existence of health financing mechanisms that offer universal access to health. The specific nature of such financing schemes and service delivery models will vary between nations. To assume that universal health coverage necessarily requires a single-payer government mechanism would be a mistake, and adherents to that position doom the people of the poorest nations to generations of medical deficiency. Whether a nation chooses a mixed economy model of coverage, single-payer mode, donor-issued voucher mechanism, or other innovative models of universal financing is not the issue. Provision of universal health coverage is the issue facing the entire global health construct. Sadly, for most of the world's populations universal health coverage remains a mirage, blurred further out of focus by the present world financial crisis.
This book brings together leading researchers from a variety of disciplines to examine three areas: health disparities and inequity due to gender, the specific problems women face in meeting the highest attainable standards of health, and the policies and actions that can address them. It also brings together experts from a variety of disciplines, such as medicine, biology, sociology, epidemiology, anthropology, economics and political science, who focus on three areas: health disparities and inequity due to gender; the specific problems women face in meeting the highest attainable standards of health; and the policies and actions that can address them. Highlighting the importance of intersecting social hierarchies (such as gender, class and ethnicity) for understanding health inequities and their implications for health policy, contributors detail and recommend policy approaches and agendas that incorporate, but go beyond commonly acknowledged issues relating to women’s health and gender equity in health.
Aggravated homosexuality will be punished by death, according to a new bill tabled in Parliament of Uganda on 13 October 2009. The private member’s bill was tabled by Ndorwa West MP, David Bahati (NRM). A person commits aggravated homosexuality when the victim is a person with disability or below the age of 18, or when the offender is HIV-positive. The bill thus equates aggravated homosexuality to aggravated defilement among people of different sexes, which also carries the death sentence. The Bill, entitled the Anti-Homosexuality Bill 2009, also states that anyone who commits the offence of homosexuality will be liable to life imprisonment. A person charged with the offence will have to undergo a mandatory medical examination to ascertain his or her HIV status. The bill further states that anybody who attempts to commit the offence is liable to imprisonment for seven years. The same applies to anybody who aids, abets, counsels or procures another to engage in acts of homosexuality or anybody who keeps a house or room for the purpose of homosexuality. The bill also proposes stiff sentences for people promoting homosexuality – a fine of 100 million Ugandan shillings or prison sentences of five to seven years.
This study considered whether female youths from communities with higher sexual violence were at greater risk of negative reproductive health outcomes. It used data from a 2003 nationally representative household survey of youths aged 15–24 years in South Africa. The key independent variable was whether a woman had ever been threatened or forced to have sex. The variable was aggregated to the community level to determine, with control for individual-level experience with violence, whether the community-level prevalence of violence was associated with HIV status and adolescent pregnancy among female, sexually experienced, never-married youths. The study found that youths from communities with greater sexual violence were significantly more likely to have experienced an adolescent pregnancy or to be HIV-positive than were youths from communities experiencing lower sexual violence. Youths from communities with greater community-level violence were also less likely to have used a condom at their last sexual encounter. Individual-level violence was only associated with condom non-use. Programmes to reduce adolescent pregnancies and HIV risk in South Africa and elsewhere in sub-Saharan Africa must address sexual violence as part of effective prevention strategies.
Strict observance of state sovereignty, once a mainstay of international relations, has given way to a global concern to protect human rights wherever they are threatened. On paper, at least, Africa shares this international commitment in its establishment of monitoring bodies like the African Commission on Human and Peoples’ Rights and the African Union’s Peace and Security Council. But how central are human rights to the actual conduct of international relations by the continent? Are they merely a ‘variable concern’? There are no simplistic answers to this question. Africa has long been committed to supporting the rule of law, safeguarding refugees, protecting women and children, encouraging youth participation, and promoting democracy. But, as ever, national interest still plays an important role when it comes to defining how the continent relates to the world. The author argues that China’s policy of non-interference in the internal affairs of its trading partners has the potential to foster corruption, fuel armed conflicts and encourage human rights violations. African governments, it is proposed, should ensure that their emerging foreign policy solutions, whatever they are, do not compromise the commitment they have already made to foster human rights and good governance.