As the East African Community (EAC) becomes more integrated, countries in the region are developing a common HIV Prevention and Management Bill that will establish minimum standards for HIV services in the five states - Burundi, Kenya, Rwanda, Tanzania and Uganda.
The East African Common Market comes into effect in July; in a region with a combined population of 126 million and significant variations in HIV prevalence, experts say the anticipated growth in cross-border movement necessitates a regional view of - and uniform response to - the HIV epidemic.
A recent one-day stakeholders' consultative meeting in the Rwandan capital, Kigali, brought together national health officials, parliamentarians, development partners and civil society organizations to develop a common understanding of the proposed bill.
"If I'm doing business in Rwanda and I am an HIV-positive Kenyan, I should be able to access HIV services just like a Rwandan while there," said Catherine Mumma, lead consultant on drafting the bill.
The legislation is intended to provide a basic legal framework in countries where no HIV laws exist, and to address disparities in HIV/AIDS responses across the region. Under the EAC Treaty, regional law supersedes national law.
"The regional law provides guidelines and principles... they can adopt the law wholesale or develop their own regulations and laws, as long as they don't contravene the spirit and letter of the regional one," Julius Sabuni, of The Eastern Africa National Networks of AIDS Service Organizations, explained.
The bill promotes a human rights approach to HIV, outlawing discrimination, guaranteeing rights to privacy and ensuring the provision of healthcare regardless of HIV status. However, some aspects have already led to controversy: delegates from the EAC armed forces have reiterated the need for commanders to know the HIV status of their soldiers and for mandatory HIV screening before deployment.
Disappointingly for human rights activists and HIV programmers, the latest draft of the bill makes no mention of high-risk groups such as commercial sex workers, men who have sex with men or intravenous drug users.
|Even if this [bill] won't pass this year... it has pushed the EAC on health, HIV and human rights|
In addition, following a previous consultation in the Ugandan capital, Kampala, the authors of the bill agreed that because criminal law is not an area of cooperation under the EAC treaty, laws criminalizing the deliberate transmission of HIV – which exist in Kenya and in a draft Ugandan bill - are more appropriately addressed in the penal codes of partner states.
Activists and programme implementers are trying to repeal sections of national laws that contravene human rights and criminalize HIV-positive people.
According to Mumma, these compromises were made to achieve consensus. "If the five countries do not agree on the law it will not happen, period," she said.
She noted that the bill's development had generated important debate around some of the more complicated aspects of the pandemic. "Even if this [bill] won't pass this year, in my view it has pushed the EAC on health, HIV and human rights," she added.
The bill has been submitted to the East African Legislative Assembly for discussion during the next session, which starts in April.