South Africa: Balancing Individual Rights Against Public Health

The Center for the Study of AIDS at the University of Pretoria has published its annual review of South Africa's public health practices and legislation concerning HIV/AIDS and TB. The topics addressed include AIDS and rape, drug-resistant TB, male circumcision, routine and mandatory testing, and antiretroviral treatment for prisoners, refugees and migrants, said author Carmel Rickard, a journalist who specializes in human rights.

According to Rickard, the "most shocking" finding of the review involved media coverage of drug-resistant TB. Echoing public anxiety over the country's TB epidemic, media reports often describe patients "as convicts, dangerous to society," thus intensifying stigma.

Absent in the coverage is the experience of Tugela Ferry in KwaZulu-Natal province. The site of an extensively drug-resistant TB outbreak that killed over 200 patients a few years ago, Tugela Ferry is now a pioneer of home-based TB treatment. "Journalists need to know about this option and generally be more critical about drug-resistant TB policies," said Rickard.

A 2007 law has frustrated victims of another alarming epidemic in South Africa -- rape. That law has centralized the process for accessing post-exposure prophylaxis to prevent HIV infection. Previously, access to PEP was treated as an emergency health matter and handled informally.

In addition, the HIV tests offered to rape victims are the cheapest and take weeks to produce results. Activists say a more expensive test would tell survivors whether they are infected within 11 days of the assault.

When laws dealing with AIDS "do not properly factor human rights into the equation, then the decisions can become self-defeating and even worsen the situation," said Rickard.

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