Insights into Editorial: HIV Bill offers steps to end discrimination and ensure equality for affected groups
More than two years after it was introduced in Rajya Sabha, a revised draft of the HIV and AIDS (Prevention and Control) Bill, 2014, which makes discriminating against a person living with HIV/AIDS a punishable offence, was recently cleared by the Union Cabinet.
- The HIV and AIDS Bill, 2014 has been drafted to safeguard the rights of people living with HIV and affected by HIV.
- What was until now achieved through executive orders will, once Parliament passes the Bill, be laid down in statute.
Main aim of the Bill:
The Bill seeks to give a legislative framework to existing norms of non-discrimination against people living with HIV/AIDS — most crucially, making it a legally punishable offence to deny such a person health insurance on the ground of the infection that causes lowering of immunity.
The Bill incorporates feedback from stakeholders, and also recommendations of the Parliamentary Standing Committee on Health and Family Welfare to which it was referred after being introduced in Rajya Sabha in February 2014.
Salient features of the new Bill:
- The Bill prohibits any individual from publishing information advocating feelings of hatred against HIV positive persons and those living with them.
- The bill makes it compulsory for the central and state governments to provide for antiretroviral therapy (ART) and related health hazards (management of infections) to all HIV patients.
- The Bill provides for the appointment of an ombudsman.
- It prohibits all acts of discrimination against HIV-positive people, or those living with such people. It also lists various grounds on which discrimination against HIV positive persons and those living with them is prohibited.
- The bill also safeguards the employment, educational services, public facilities, property rights, holding public office, and insurance for people living with HIV.
- It makes the consent of the person compulsory for any kind of HIV tests, medical treatment and research.
- The bill ensures that an HIV person below the age of 18 years has the right to reside in a shared household and enjoy the facilities of the household.
- According to the Bill, each state will appoint an ombudsman to inquire into complaints related to the violation of the act and the provision of health care services. Also, cases relating to HIV positive persons shall be disposed of by the court on a priority basis.
What’s left out?
The Bill brings a rights-based approach to AIDS treatment, making it imperative for both the central and state governments to provide treatment “as far as possible”. Though the Bill lays down that treatment is the right of the patient, it stops short of making it a legal right — and therefore, a patient who is denied ART treatment cannot ordinarily drag any government to court.
How many people are living with HIV/AIDS in India currently?
Approximately 21 lakh people are living with AIDS, as per government estimates. The adult prevalence is in the range of 0.3%, of which around 40% are women. Some states have more people living with HIV/AIDS than others. Four high-prevalence states of Andhra Pradesh, Maharashtra, Karnataka and Tamil Nadu account for about 55% of the total cases in the country. The prevalence of HIV has been decreasing over the past decade.
The stigma of having HIV or AIDS in India remains intense, despite having the worlds third-largest population of people with either. And that stigma isn’t just social: it frequently means that patients end up having to cough up much more money for either insurance or medical treatment simply because of their condition. Some places even simply turn away people with HIV or AIDS.
This law makes that sort of discrimination criminal, while also easing the process by which people living with HIV or AIDS get access to treatment. Even if it cannot do away with the stigma itself, the law offers a clear legal recourse and should loom large as a threat for insurers and hospitals that don’t recognise the evils of turning down or discriminating against people with HIV or AIDS.
Since the new law is intended to both stop the spread of the disease and help those who have become infected get antiretroviral therapy as well as equal opportunity, it will take a high degree of commitment to provide effective drugs to all those in need. Most importantly, the HIV Bill is a result of numerous consultations with all the communities affected by HIV and other stakeholders, within and out of government, standing together to prevent the spread of HIV. The success of the Bill is partly guaranteed because of the PLHIV community, which has the highest stake, has been involved at each turn the Bill has taken. When it becomes law, the HIV Bill will not suffer for lack of persons pushing its implementation. However, its success will have far-reaching impacts on other health legislations that need to be enacted.