Fighting stigma is key to AIDS battle - Kenyan AIDS activist
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World leaders are meeting this week in Amsterdam to bolster the battle against an epidemic experts warn may yet spiral out of control. A major cause is the ongoing stigma attached to HIV that prevents those affected from accessing treatment.
“We have made some milestones on a number of issues on HIV, human rights, stigma and treatment but there's still so much to be done," Allan Maleche, Executive Director of the Kenya Legal and Ethical Issues Network on HIV and AIDS (KELIN), told RFI.
Maleche, who is this year's recipient of the Elizabeth Taylor Human Rights Award, has campaigned tirelessly to ensure that human rights is a central component in the fight against the AIDS epidemic.
"Even though we’ve developed new science, policies, we still see people being denied access to treatment, people being jailed for allegedly transmitting HIV to other people (...) that leads to stigma and eventually to discrimination," he says.
Maleche has litigated landmark cases in his native Kenya that have halted the forced sterilization of women living with HIV.
However it was his intervention in August 2010 in preventing three men living with tuberculosis from going to prison that garnered him international recognition.
The men had interrupted their treatment, explains the Kenyan lawer, and as a result, local authorities considered them to be a risk to other people and sentenced them to eight months in prison.
"Stigma remains a problem," he comments. "It is largely caused by fear; fear of getting infected by HIV."
Taking president to court and winning
While transmission of the virus is a concern, Maleche insists a rights-based isolation policy is necessary.
"This particular case that we called 'TB is not a crime' was fundamental," he says.
It led to the Kenyan Ministry of Health launching an isolation policy, which "now ensures that people who interrupt their treatment get people-centred care, and they’re definitely not held in prison," explains Maleche.
Another landmark case took place in December 2016, when the Kenyan High Court declared unconstitutional a presidential directive seeking to collect names of people living with HIV, including names of school going children among others.
"We did write to the head of state [Uhuru Kenyatta] to tell him that his intention in wanting to find children living with HIV and provide them treatment was good, but that the manner in which he sought to get the names, would violate the constitution, the HIV Act and the rights of privacy," insists Maleche.
Asked whether his legal-based approach would be understood by people with little expertise in law, Maleche replied that "access to justice remains a vital component," but unfortunately is "lost" on many donors.
Keeping AIDS fight on track
"Many donors are funding around treatment, but they're forgetting the role of structural barriers that include what kind of legal representation people can get, what kind of accountability mechanisms can you put in the healthcare facilities where these people get their services, whereby if they feel that certain things have gone wrong they have an avenue to raise those concerns," he argues.
"Without those structures in place, it makes it difficult for people to have confidence in their healthcare systems," and ultimately to access treatment, he reckons.
That may delay the ambitious 90-90-90 treatment target of the International Aids conference, that aims to ensure that by 2020, 90% of people living with HIV know about their status, have been diagnosed, and are receiving antiretroviral therapy.
"The 90-90-90 is ambitious, but unless we have more funding, unless we invest more in communities, unless donors live up to their pledges we won't get there," he reckons.
Maleche, who also works with the Global Fund, is hoping that next year's Global Fund replenishment conference in Paris, will raise the funds necessary to keep the eradication of AIDS by 2030, on track.