Political turmoil in Haiti has delayed an important parliamentary bill giving people living with HIV/AIDS new legal rights, a gap in Haiti's 'almost-successful' response to AIDS.
"In Haiti," says Saurel Beaujour, "people with AIDS are the most despised section of society, along with the mentally ill."
A 43-year-old electrician by training, Beaujour knows what he is talking about: as executive officer for many years of an umbrella organisation for AIDS-infected Haitians, he comes across daily instances of discrimination against AIDS patients.
But stigma against people with HIV/AIDS remains a largely unaddressed issue in a poor country that is otherwise thought to have scored greater successes against the epidemic than many of its neighbours in the Caribbean region.
"You don't need to have a lot of money," says Adeline Benoit, a professional pastry cook, who stopped working after learning about her infection, fearing she would be ostracized. "What is important is human assistance, especially when one feels physically and mentally weak: it is good to know that you have someone on whom you can count."
Haiti is a country where the rate of HIV-infection has plummeted from 6.2 percent to 4.9 percent in just three years; where people with HIV/AIDS are widely consulted over national policies to tackle the epidemic; where awareness of the disease is high (three out of four adults know how HIV is transmitted); and where the use of condoms has increased.
A number of factors are responsible for turning Haiti into what The Economist magazine recently called an "almost-success story". These include the fact that the government was quick to come up with a national strategy in partnership with various organisations; the involvement of infected and affected people in the fight; a strong radio-led public awareness campaign; and access to – but not dependence on – donor funds.
But Beaujour is unimpressed. The national strategy, he says, largely remains on paper – adding that 150 people die of AIDS every day in this nation of eight million people.
"The reason is not the virus, strictly speaking, but rather the lack of medicines," says Beaujour. Today, the number of people living with HIV having access to medicines is estimated at some 2,000.
In Haiti, treatment with anti-retroviral (ARV) drugs costs $100-120 per month – which is too expensive for most AIDS patients. At the country's leading treatment and research centre, Gheskio, about 60 percent of the patients are unemployed, a doctor at the centre said.
In this situation, one problem that Beaujour and other activists point to is the absence of any legislation to regulate the status of people with HIV/AIDS. Although a bill on the rights of people living with HIV has been pending before the health committee of the Haitian parliament, this is yet to be ratified because of political instability.
In fact, some observers believe ratification may have to wait for a few years because of the absence of a parliament and general political instability in Haiti following the ouster of the president Jean-Bertrand Aristide in an armed uprising in February.
The mandate of most members of parliament expired in January this year, but with no elections held, the parliament has become non-functional. This has made it impossible to pass any laws – especially on controversial issues such as the rights of people with HIV/AIDS, where opinion is divided.
The absence of a legislature to help enforce the national strategy means that on the ground, much work, such as in preventing HIV/AIDS in prisons, remains stalled.
"We set up a programme to combat HIV/AIDS among prison inmates that should have started in January 2004. But it has been postponed to October due to the political instability," says Pierre Esperance, who leads the National Coalition for the Defence of Haitians' Rights.
The question of legislation on HIV/AIDS was introduced for the first time during a roundtable held by the Association of National Solidarity for Infected and Affected Persons in June 2003 in the capital Port-au-Prince, where many speakers – including government officials – recognised that the discrimination faced by people with HIV/AIDS constituted a violation of human rights.
This draft bill comprises 42 articles and aims to protect both people with HIV/AIDS and those who are not infected by the virus, seeking punishment for individuals who knowingly infect others with HIV. It has the backing of activists like Beaujour. "People with AIDS have rights, but duties as well," he says. "I urge those who are aware of their HIV-positive status not to transmit the virus to others."
The problem, however, mostly lies at the other end. Many people with HIV/AIDS complain that they have been victims at their work places; many more cases go unreported. Some cases, however, have been reported at health centres where doctors refuse to touch AIDS patients.
"I believe that people with HIV/AIDS have the right to work as everybody else," says Renan Hedouville of the Lawyer's Committee for the Respect of Individual Freedoms, stressing that his organisation is ready to defend anyone whose right to work has been violated because of their HIV status.
Activists also want legislation to guarantee people with AIDS the right to health in a country with some 200,000 children orphaned by AIDS.
Esperance believes the government must not only protect the civil and political rights of people with HIV/AIDS, but also their social and economic rights: "A person living with HIV/AIDS has the right to life and the right to health as guaranteed by the Haitian Constitution."
Hugo Merveille is a staff writer for the daily 'Le Nouvelliste'.