Government should consider regulatory impact assessment of HIV/AIDS control Act

Recently while on an evening sip at a liquor store, I clapped my eyes on an ARV tin in an open display on the counter. Aware of the ability of alcohol to impair judgement, the service girl forearmed her rummy of her status in a rather unusual manner. This roused my mine to the South African HIV Control Act

By Julius Peter Ochen

Despite science and research, conventions and conferences, songs and plays, despite good intentions and bold initiatives, campaign slogans and hopeful promises, despite it all, the furry of HIV/AIDS is taking its toll under our watch.

“Learn with me the lesson of history and grace, so my children will not be afraid to say the word AIDS when I am gone. And your children may not whisper it at all” Mary Fisher in August 1992. But 30 years down the road, the reality of HIV/AIDS is conspicuously clear. Fisher’s hope is as dead as herself.

The recent surveillance data presented by Uganda Aids Commission, reveals increased scourge especially in urban areas scaling way above national average of 5.1, with Mabara, Fort Portal, Gulu and Entebbe Cities in double digit figures.

As early as 1987, Governments world over embarked on legislative measures to prevent and control spread of AIDS. In our own backyard, President Museveni signed into law the HIV/AIDS Prevention and Control Act as amended on 31/07/2014.

Just like the Botswana Public Health Act, this most carped piece of legislation amongst other things includes mandatory HIV testing for pregnant women and their partners, and allows medical providers to disclose a patient’s HIV status to others. The bill also criminalizes HIV transmission, attempted transmission, and behaviours that might result in transmission by those who know their HIV status. 10 years and counting, there is not much to show of the amended legislation. No reported and prosecuted cases of behaviours that might result in transmission, clearly showing gaps.

Public policy management practices world over encourages governments to recurrently undertake regulatory impact assessment, some time as early as 5 years in implementation to adjust to rapid changes in policy eco-system ushered by globalization.

This very HIV/AIDS Prevention and Control Act 2014, mandates the Minister of health to annually submit to Parliament a report on implementation of the Act.  The report referred to in the Act, in addition to any other information prescribed by regulations, contains the following information; the effectiveness of the act, the challenges faced in enforcing the Act and recommendations on challenges faced in implementation of the Act. I am yet to set my eyes on any report.

Recently while on an evening sip at a liquor store, I clapped my eyes on an ARV tin in an open display on the counter. Aware of the ability of alcohol to impair judgement, the service girl forearmed her rummy of her status in a rather unusual manner. This roused my mine to the South African HIV Control Act

On 27 April, 2015, the then South African President Zuma signed an unconventional bill which commentators described axxxs the greatest step in the history of the HIV war.

The law mandates that every person who gets tested and found to be HIV positive would not just get counselling and medications, but also get a mark in the form of a tattoo near their genitals. The framer of the Act said the mark is to protect those who can’t say no to sex.

“I mean if you can’t read between the lines, you should read between the legs because that’s where the status would be tatted. The choice to be HIV positive is now in your hands or your genitals for that matter,” the President implausibly announced as he transitioned the Bill into an Act.

In my mind’s eyes, and in the face of ugly surveillance reports, Uganda needs to open discussion on HIV/AIDS control once more. In the apparent over weighing economic situation in the country, my mind is further alive to those wealthy men who, while peddling on the strength of ARVs are on the filthy mission of spreading the virus.

The worry that per-occupies most Ugandan women while lowering their panties is pregnancy, not the status of the vectors. What if the status was tattooed around genitals? Maybe, just maybe they would think twice.

The annual facility – level cost of providing HIV treatment, care and support to adult HIV patients in Uganda is average UGX 567,000/. About 1.5million people are living with HIV/AIDS. If 1,000 persons are getting HIV everyday as reported, then HIV treatment, care and support budget will soon hit a trillion shilling per financial year

The Uganda health expenditure per capita as reported in 2021 is just about $43, inverating the drain to already burdened citizens, subsequently entrenching poverty facilitated by health service costs. We must not give up the war.

The author is public policy pundit of Kampala Analytica