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| Sunday, 18 May 2003 |
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Sri Lanka well poised to curb AIDS - US AIDS expert The Sri Lankan government has an obligation to provide its citizens basic AIDS treatment and ensure that confidentiality is respected, a US AIDS expert said recently. Prof.Laurel Fletcher, Acting Clinical Professor of Law and Director of the International Human Rights Law Clinic at the University of California, Berkeley who spoke on 'Right to Health:State Obligations to HIV AIDS Treatment' at the BMICH recently observed that 20 years into the AIDS epidemic the international community has begun to condemn the immoral and unfair practice of providing HIV care only to those fortunate enough to afford it. Denying to the majority of people living with AIDS the life saving treatment available to an affluent few is tantamount to the abrogation of a basic human right, she said. Prof.Fletcher observed that although the total number of reported HIV cases in Sri Lanka is relatively low, at around 418 cases according to World Bank sources, such figures are misleading due to a variety of social factors. For instance, Health care workers report that families of patients who have died of AIDS request that the actual cause of death not be divulged as they feel that they would be ostracised by the community. Lack of accurate testing and diagnosis also causes under-reporting. Further, it is a well-known fact that individuals do not die of AIDS itself but rather of other diseases such as pneumonia and tuberculosis as a result of a weakening of their immune systems caused by the HIV virus. As such, it is not unusual for the cause of death to be reported as a disease other than AIDS and in such cases even family members would not be aware that the patient had in fact succumbed to AIDS, she observed. Prof.Fletcher pointed out that the UNDP has estimated that without effective intervention, the number of HIV infected individuals in Sri Lanka would increase to 8000 by the year 2005. Vulnerable populations include the local sex industry which according to World Bank sources employs 30,000 women and girls and 15,000 men and boys. Drug users are also highly vulnerable, she pointed out. Prof.Fletcher however observed that at any rate, Sri Lanka is categorised as a low incidence country and is easily poised to confront the epidemic. It has a vibrant public health infrastructure with over 600 hospitals many of which could be excellent sites for pilot projects for integrated HIV treatment and care. The state too has a legal obligation in the context of human rights to provide basic AIDS treatment including retro-viral medication. The Sri Lankan government while not yet committed to make universal AIDS treatment available, has agreed to consider proposals for treatment of HIV positive mothers to prevent the transmission of the disease to their offspring. The World Bank has also agreed that it would fund HIV treatment programmes, though the request to do so should come from the Sri Lankan government. She also observed that the government has committed itself to increase educational programmes to promote social acceptance and non-discriminatory attitudes towards people living with AIDS and highly vulnerable groups. This becomes particularly important since patients may suffer discrimination in housing, employment and the delivery of healthcare itself. Confidentiality is also important especially in a country like Sri Lanka where people are known to burn houses of individuals suspected of AIDS. She noted that there were even cases of doctors and healthcare officials refusing to treat patients suspected of having AIDS. Laboratory technicians are also known to refuse to perform tests on such individuals, she added. |
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