10 August 2011:
10 Reasons Why Parliamentarians Should Reject the Adoption of the Draft 2010 HIV/AIDS Policy

The Botswana Network on Ethics, Law and HIV/AIDS (BONELA) has followed the debate surrounding the Draft 2010 HIV and AIDS Policy in Parliament with keen interest. BONELA urges Members of Parliament (MPs) to REJECT the draft policy based on the following reasons:

1. The policy is regressive and has since been overtaken by local and global trends surrounding the response to HIV and AIDS. It has been acknowledged world over that HIV and AIDS can only be effectively addressed by ensuring universal access to prevention, treatment, care and support. This approach allows for targeted interventions for those groups identified as most at risk populations (MARPS) such as prisoners, men who have sex with men, sex workers and refugees. To this extent, the policy is irrelevant and thus impractical as it does not deal with present day challenges. Minister for Presidential Affairs and Public Administration, Mokgweetsi Masisi refers to sexual orientation in the Foreword to the policy, yet surprisingly, the policy itself is silent on the issue. 
2. Whilst government tiptoes around the issues of MARPS, there is clearly a need for alignment as our laws have already acknowledged issues of sexual orientation (Employment Act of 2010). In addition, the said HIV/AIDS policy is divorced from the Second National Strategic Framework (NSFII), MARPS strategy and the national HIV/AIDS research agenda that clearly indicates the need to target MARPS for successful HIV/AIDS interventions. Unlike the NSFII, it lacks strategic focus or direction to effectively lay values and strong direction for other national policies and even legislation. It is vague and lacking in force, we thus beg for a rigor in ensuring that this alignment is recognized and reject the piecemeal policy, if we are to achieve the Botswana Vision 2016 goal of “zero new infections by 2016”.
3. In 2008, the Government of Botswana passed the Public Service Act which removes health status and nationality as a basis for discrimination. However, the draft policy is inconsistent with the said law in that it permits testing for HIV before employment. 
4. Further, the use of the word “citizens” throughout the document is a concern; it is a contradiction to the principle of non discrimination on the basis of nationality and is also contradictory to the 2006 Political Declaration on HIV / AIDS commitment in which states committed to: ‘intensifying efforts to eliminate all forms of all discrimination against and to ensure the full enjoyment of all human rights fundamental freedoms by people living with HIV and members of vulnerable groups [especially foreign prisoners, refugees] in particular to ensure their access to all services, while respecting their confidentiality and privacy’.
5. Similarly, the silence on provision of Prevention of Mother-to-Child Transmission (PMTCT) to foreign women who have children out of wedlock with Batswana men is a cause for concern. These women do not have access to prevention of vertical HIV transmission to their children, unlike children born to a Motswana woman and a foreign man. It is a contradiction of the internationally protected right to non discrimination on the basis of nationality.
6. The policy also takes away the right to privacy of would-be army workers. This provision is not aligned to the Public Service Act. The provision also goes against the Article 15 of the African Union Charter on Human and People’s Rights that Botswana is party to, as well as the International Covenant on Economic, Social and Cultural Rights (ICESCR) that protects the right to employment. It goes against the international best practice of universal access, zero new infections and zero discrimination. In comparison, the 1998 Policy, currently under review, better addresses non discriminatory in this regard.
7. Government has a duty of care over a prison that includes health, food, and shelter. If government fails to perform any of those duties, then they have no moral and legal authority to continue detaining inmates. There is growing evidence regionally and globally that there is HIV transmission in prisons. The policy makes no such acknowledgement and in fact, the national antiretroviral (ARV) policy effectively excludes access for foreign prisoners [who are guests of the state] and it has been noted regionally that this practice is embarrassing and very regressive. Botswana is urged to deport all foreign prisoners living with HIV to their countries if she is not willing to treat them so that they may access treatment and care in their own countries. Failure to treat foreign prisoners again means continued cross infection, possible development of resistant strains and it is a violation of the fundamental right to access to the highest attainable standard of healthcare, dignity and the right to be free from inhumane and degrading treatment prisoners should still enjoy like everyone else.
8. The new body of knowledge shows that treatment is prevention as it lowers the risk of HIV transmission. In the long-run it is cost effective to prevent new infections that will require treatment if they are not prevented. For instance there are same sex sexual relations between all inmates including foreigners. 
9. This draft policy, like the 1998 one, lacks concrete steps to show how it will inform legislation. In addition, it was not preceded by any recent consultation as the last consultation was conducted as far back as 2005 and the national response has since evolved exponentially. 
10. Although policies are useful guidelines, we are now at a time that we need a law and it is regrettable that parliamentarians are spending time on policies that would not change the status quo and not legislating.