Health Systems Trust has summarised South Africa’s National Strategic Plan (NSP) for easy reading. The NSP is a strategic guide for South Africa’s national response to HIV, STIs and TB from 2012 to 2016. It is coordinated by the South African National AIDS Council (SANAC). It aims to inform national, provincial, district and community-level stakeholders with strategic directions when developing implementation plans. The Plan contains baseline data on the various diseases and identifies key populations for HIV and TB response. Its goals are to reduce the number of HIV infections by 50%; ensure at least 80% of patients eligible for antiretroviral treatment are receiving it, with 70% alive and being treated after five years; reduce the number of new infections of TB and deaths by 50%; ensure the rights of individuals living with HIV, TB and STIs are protected; and reduce self-reported stigma associated with HIV and TB by 50%. The Plan also outlines how the goals will be reached, who will oversee implementation of goals and how progress of the NSP will be assessed. Implementing the NSP is estimated to cost R130.7 billion over five years.
Values, Policies and Rights
Incomes have slipped to their lowest level in a decade since Madagascar’s 2009 coup d’etat, and, in parallel, domestic violence has sharply risen, according to IRIN News. The World Bank’s October 2012 economic update estimates that, since 2008, another four million people have fallen below the poverty level. The rising poverty has exacerbated women’s vulnerability in this deeply traditional society. Locals report more domestic conflict over family resources, as well as increased alcohol and drug abuse. Impoverished women also have fewer options to escape violence and are less able to advocate for the safety of themselves and their children. A spokesperson for a legal aid clinic near Antananarivo said that women often feel they have neither the ability nor the right to end abuse. A community spokesperson also reported that most domestic fights were about money and abusive men were often drunk when assaulting their partners.
More than one in three men surveyed in the Democratic Republic of the Congo's war-torn east admits committing sexual assault, and three in four believe that a woman who "does not dress decently is asking to be raped", according to this study. Some 61.4% of men interviewed said women sometimes deserve to be beaten; 42.7% think that if a woman doesn't show physical resistance when forced to have sex, it's not rape; and 27.9% believe that sometimes women want to be raped. Well over 40% of the men polled asserted that a man should reject his wife when she has been raped. The study was carried out in Congo's North Kivu province. A total of 708 men and 754 women aged between 18 and 59 took part in individual interviews and focus group discussions. The self-reporting of men revealed that 34% admit having carried out some form of sexual violence in conflict, homes or other settings. The study, part of the International Men and Gender Equality Survey, also suggests that many men are themselves victims of violence, including sexual violence, and shows a clear association between exposure to violence and increased likelihood of subsequent perpetration. The authors make recommendations including far greater promotion of gender equality in schools and public policy and a massive campaign of psycho-social care for boys and girls exposed to multiple forms of violence at a young age.
Maternal mortality and morbidity (MMM) and HIV represent interlinked challenges arising from common causes, magnifying their respective impacts and producing related consequences. Accordingly, an integrated response will lead to the most effective approach for both, argue the authors of this paper. HIV and MMM are connected in both outcomes and solutions in sub-Saharan Africa, where HIV is the leading cause of maternal death and prevention of unintended pregnancy and access to contraception have been identified as two of the most important HIV-related prevention efforts. In turn, both are central to reducing unsafe abortion, a major cause of maternal death in Africa. The authors propose that a human rights-based framework will help to identify the shared determinants of MMM and HIV. It should also help to establish the health-related human rights standards to which all women are entitled, as well to outline the indivisible and intersecting human rights principles that inform and guide efforts related to HIV and MMM. The authors point to the Millennium Development Goals (MDGs) as a good example of an agreement with quantifiable goals for achieving human rights while emphasising that no single goal can be achieved without progress on all development goals.
To strengthen the rights-based national response to HIV, the Joint United Nations Programme on HIV/AIDS (UNAIDS), with the technical support of the International HIV/AIDS Alliance (the Alliance), initiated a project in 2011 to help national stakeholders integrate human rights programmes into National Strategic Plans (NSPs). This brief report outlines some short-term outcomes and lessons learnt from this initiative. The three regional workshops, held in South Africa, Thailand and Saudi Arabia, have led to concrete outcomes, namely the integration of HIV-related human rights into NSPs in a number of countries. Participants have also initiated (or are planning) innovative human rights projects as a direct result of the workshops. The workshops have given governments, civil society representatives, affected communities and UNAIDS an opportunity to share good practice, exchange views and learn from each other. The challenge remains to continue to apply this learning to the protection and promotion of a rights-based approach in the national response to HIV, and to make the commitments of the 2011 Political Declaration a reality.
Making voluntary family planning available to everyone in developing countries would reduce costs for maternal and newborn health care by $11.3 billion annually, according to this report by the United Nations Population Fund (UNFPA). UNFPA argues that increased access to family planning has proven to be more than just a sound economic investment, with knock-on gains in reducing poverty, exclusion, poor health and gender inequality. Nevertheless, the report finds that financial resources for family planning have declined and contraceptive use has remained mostly steady. The report also calls on governments and leaders to: take or reinforce a rights-based approach to family planning; secure an emphasis on family planning in the global sustainable development agenda that will follow the Millennium Development Goals in 2015; ensure equality by focusing on specific excluded groups; and raise the funds to invest fully in family planning.
Uganda's parliament will, before Christmas, pass a highly controversial bill which seeks more stringent punishments for people engaging in homosexual acts and those perceived to be "promoting" homosexuality, says the speaker of the house. Rebecca Kadaga told hundreds of petitioners in Kampala on 9 November that she would ensure the Anti-Homosexuality Bill, which has been before parliament since 2009, would be passed before the end of 2012. The punishment for “aggravated homosexuality” is life imprisonment. Activists have decried the bill, saying it is a violation of human rights that would make men who have sex with men (MSM) even less willing to access health services. Gay people in Uganda say they face discrimination and are stigmatised by health workers when they seek care in the public and private health system. MSM are considered by the Uganda AIDS Commission to be a "most at-risk population", but because homosexual acts are illegal, there are no policies or services targeting HIV interventions towards them. Legal experts in Uganda have challenged the constitutionality of the bill, arguing it infringes on the right to privacy and freedom of expression and choice.
A landmark ruling on 12 October 2012 by Gaborone's High Court found that gender discrimination based on Botswana's customary law is unconstitutional. The court ruled on a case brought by three sisters, all over 65 years old, challenging a Ngwaketse customary law that holds the right of inheritance to the family home belongs to the youngest son. Critically, the judge made it clear that discrimination cannot be justified on cultural grounds before rejecting out of hand the argument put forward by the Attorney General that Botswana society was not ready for gender equality, said the Southern Africa Litigation Centre (SALC), which supported the sisters' case.
In the 2010/2011 period, South Africa’s Compensation Fund in the Department of Labour paid over US$307 million in compensation for injuries and diseases sustained in the workplace, according to this press release. A department spokesperson said South Africa continued to be plagued by lack of adherence to occupational health and safety, arguing that loss of work-time because of occupational hazards means a loss of income for workers and a decline in gross domestic product (GDP). According to the Department, high-risk sectors accounted for huge compensation fund claims, including iron and steel for $49.5-million, air road transport for $41 million, building and construction for $33 million, agriculture $21 and the chemical sector for $12 million. In the light of these high costs, the Department has announced plans to start working on amendments in the country’s Occupational Health and Safety Act to be completed by the end of the 2012/13. This would include a review of amendment to regulations. The International Labour Organisation welcomed the move, calling for greater emphasis on the importance of prevention in the workplace.
These new guidelines from South Africa’s Department of Labour cover various aspects related to HIV and AIDS in the workplace, especially concerning the elimination of unfair discrimination and promotion of equal opportunity and fair treatment. The Department argues for a multilateral approach to deal with HIV, AIDS and tuberculosis (TB), and the guidelines show how to promote a safe working environment and manage the diseases in the workplace, as well monitoring and evaluation of intervention programmmes. They were developed in partnership with the International Labour Organisation (ILO). The guidelines call for prevention programmes to be sensitive to culture, gender and language with relevant information that is accessible. Employees with HIV or AIDS may not be dismissed on the basis of their status.