New legislation on HIV in Zambia will violate human rights

The Alliance is dismayed that Zambian president Edgar Lungu has announced the legalisation of mandatory testing and treatment for HIV in all hospitals, without informed consent of patients.

testingIn Zambia the president plans to make HIV testing and treatment in hospitals mandatory

President Lungu made the announcement on 15 August at the launch of an HIV campaign in Zambia’s capital Lusaka, as reported by

The Alliance’s head of knowledge, Enrique Restoy, said: “Mandatory HIV testing is unethical as it breaches the human rights of people subject to it. It is also ineffective for HIV prevention, and it can be harmful to individuals who find out that they are HIV positive.

“If confirmed, this decision will undermine the human rights of people affected by or at risk of HIV and the effectiveness of the HIV response in Zambia.”

Mandatory HIV testing and counselling denies people the right to privacy, the right to decide about one’s health, and the right to liberty and security. It may also lead to a violation of the right to non-discrimination, as it may be combined with unjust measures restricting the freedom of movement for people living with HIV.

Any restriction of the human rights of a person on the basis of a real or suspected HIV positive status is discriminatory and cannot be justified by public health concerns.

Ineffective in preventing the spread of HIV

Not only does mandatory HIV testing violate human rights, but it is also ineffective for preventing the spread of HIV.

“The test does not detect HIV in people who have been recently infected,” said Restoy. “It therefore needs to be undertaken regularly. This requires a rapport of confidence between the person and the facility that carries out the testing. This regularity cannot be guaranteed, for example, in the case of the many migrants and other people on the move who are at high risk of HIV.”

People who suspect that they are HIV positive will tend to avoid any situation where mandatory testing may be carried out because they will fear that the results of the test will be used against them. This will prevent them from seeking health advice, and accessing any care and referral services.

Also, people who are tested without their consent are not likely to change their behaviour, even if it means intimate partners are exposed to risk.

The alternative: voluntary testing and counselling

The Alliance takes a human rights-based and person-centred approach, advocating for voluntary HIV testing and counselling.

This is in line with the World Health Organization who also oppose mandatory HIV testing and have defined five key components that must be respected and adhered to by all HIV testing and counselling services. The ‘5 Cs’ are: consent; confidentiality; counselling; correct test results; connection to prevention, care and treatment.

Restoy said: “We believe that everyone has the right to know their HIV status, to access HIV prevention, treatment, care and support, and to not be discriminated against based on their HIV status. However, mandatory HIV testing is ineffective for preventing the spread of HIV and it is crucial that any testing, counselling and treatment must be done voluntarily, with the informed consent of the patient.”