Hiv/Aids, Human Rights, and Legal Services in Uganda: a Country Assessment

Public Health Program Law and Health Initiative Open Society Initiative for East Africa

Hiv/aids, Human Rights, and Legal Services in Uganda: A Country Assessment

Stella Mukasa Anne Gathumbi

May 2008 A Country Assessment

Published by Open Society Initiative for East Africa (OSIEA) ACS Plaza, Lenana Road P.O. Box 2193-00202, Nairobi www.osiea.org

ISBN: 9966-7059-9-6

For more information: Law and Health Initiative Public health Program Open Society Institute email: [email protected] www.sors.org/initiatives/lawandhealth

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Cover depicts Ugandan Bark cloth

ii HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

Preface

This report presents the findings of a review of rights responses to HIV/AIDS; (4) developing legal services for people living with HIV/AIDS civil society capacity in law and health; and (5) and other vulnerable and at-risk populations using legal strategies in health monitoring. This conducted in Uganda between September and report focuses on the application of Priorities (1) November 2007. Based on interviews with civil and (3) to the Ugandan context, though the other society organizations (CSOs) and community- Priorities are also referenced in the report. based organizations (CBOs) working on HIV, policy makers, people living with HIV/AIDS, In East Africa, LAHI partners with the Open and government bodies, the review examines Society Initiative for East Africa (OSIEA) the legal and policy framework related to HIV/ based in Nairobi to advance legal and human AIDS in Uganda and interrogates the extent rights responses to the region’s HIV/AIDS to which this framework offers real protection epidemic. OSIEA supports and promotes and facilitates access to justice or other public participation in democratic governance, mechanisms of redress for those living with, rule of law and respect for human rights in affected by, or at risk of HIV/AIDS. The review Eastern Africa by awarding grants, developing concludes by identifying several opportunities programs and bringing together diverse civil for programming that will address the dearth of society leaders and groups to play an active HIV-related legal services in Uganda. role in creating a strong institutionalized rights framework that encourages open and informed The Law and Health Initiative (LAHI) is a dialogue about issues of national importance. division of the Open Society Institute’s Public Health Program that advances legal and The invaluable insights and contributions human rights-based approaches to public provided by all those interviewed for this report health worldwide. By combining existing public are hereby acknowledged. health responses with legal and human rights advocacy, LAHI aims both to improve health outcomes and to advance access to justice, Stella Mukasa especially for socially marginalized populations. Anne Gathumbi LAHI’s work in East Africa is anchored within Stella Mukasa is a consultant to OSIEA-LAHI the Initiative’s five global priorities, namely: Anne Gathumbi is the program officer ofOSIEA-LAHI (1) integrating legal and paralegal services into health services; (2) promoting human Edited by Jonathan Cohen, the Law and rights in patient care; (3) supporting human Health Initiative Director

HIV/AIDS, Human Rights, & Legal Services in Uganda iii A Country Assessment

List of Organizations and Persons Interviewed

Eric Naigambi, Uganda Association of Women Lawyers Jacqueline Kasha, Freedom and Roam – Uganda Val Kalende, Freedom and Roam – Uganda Lori Michau, Raising Voices (Gender Based Violence Prevention Network) Mary Kamukama, Health Rights Action Group (HAG) Tina Musuya, Center for Domestic Violence Prevention (CEDOVIP) Dennis Nduhura, Agency for Co-operation and Research in Development (ACORD) Robinah Kaitirimba, Uganda National Health Consumers Organization (UNHCO) Bernard Lukwago, The Aids Support Organization – TASO Esther Mayambala, Uganda Network on Law, Ethics & HIV/AIDS (UGANET) Byenkya Tito, Uganda Law Society, Legal Aid Project Nabwire Jacqueline, National Community of Women Living with HIV/AIDS (NACWOLA) Regina Mutyaba, Law – U (Law and Advocacy for Women – Uganda)/CEWOLAPO Kajubi Caroline, Meeting Point – International Beatrice Were, Action AID International Uganda Juliet Victor Mukasa, Sexual Minorities Uganda (SMUG) Florence Maria Nakafeero, District Health Committee-Masaka Dr Margaret Muganwa, School of Public Health, Makerere University Nakamya Janet, Kisenyi Sex Workers Outreach Project Hon. Erioda Tumwesigye, Parliamentary Committee on HIV/AIDS Night Loy, Fida/ Plan International– Kawempe Sophie Musebeni, Fida/Plan International– Kawempe Zam Nampanda, Fida/Plan International– Kawempe Nalumansi Catherine, Fida/Plan International– Kawempe Macleen Kyomya, Lady Mermaid’s Bureau Namagembe Zam, Lady Mermaid’s Bureau Mr. Francis Adonyoo, Human Rights Focus (HURIFO) – Gulu

iv HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

List of Acronyms

ADR - Alternative Dispute Resolution ART - Anti-Retroviral Treatment ACORD - Agency for Co-operation and Research in Development AMwA - Akina Mama wa Afrika CEDOVIP - Centre for Domestic Violence Prevention. CSW - Commercial sex workers DRB - Domestic Relations Bill FIDA - Uganda Association of Women Lawyers HAG - Health Rights Action Group HCT - HIV Counselling and Testing HIV/AIDS - Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome HURIFO - Human Rights Focus IDPs - Internally Displaced Persons LAP - Legal Aid Project of the Uganda Law Society LCC - Local Council Courts LEDEWO - Legal Defence for Women LGBTI - Lesbians, Gays, Bisexuals, Transgender and Intersexuals LRA - Lord Resistance Army MTCT - Mother to Child Transmission NACWOLA - National Community of Women Living with HIV/AIDS NAFOPHANU - National Forum of PHA Networks in Uganda NAP - National AIDS Policy NSF - National Strategic Framework NSP - National HIV and AIDS Strategic Plan OSIEA-LAHI - Open Society Initiative for East Africa - Law and Health Initiative OVCs - Orphaned and Vulnerable Children

HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

PEP - Post-exposure Prophylaxis PHAS - People Living with HIV and AIDS PLA - Platform for Labour Action PMTCT - Prevention of Mother-to-Child HIV Transmission PWDs - Persons with Disabilities SOCADIDO - Soroti Catholic Diocese Development Organization STIs - Sexually Transmitted Infections SMUG - Sexual Minorities Uganda TASO - The Aids Support Organisation ToR - Terms of Reference UAC - Uganda Aids Commission UDHS - Uganda Demographic and Health Survey UGANET - Uganda Network on Law, Ethics & HIV/AIDS UHSBS - Uganda HIV/AIDS Sero-Behavioural Survey UNAIDS - United Nations Programme on HIV/AIDS UNCST - Uganda National Council for Science and Technology UNHCO - Uganda National Health Consumers Organization UNHS - Uganda National House hold Survey UWONET - Uganda Women’s Network VCT - Voluntary Counselling and Testing

vi HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

Table of Contents

Summary and Main Recommendations...... viii 1.0 Introduction ...... 1 1.1 Objectives of the Assessment...... 3 1.2 Methodology...... 3 1.3 Organization of the Report...... 4 2.0 The Legal and Policy Framework Relating to Hiv/aids in Uganda...... 5 2.1 International and Regional Framework...... 5 2.3 The National Legislative Framework...... 7 2.2 The National Policy Regime...... 15 2.4 Recommendations from the review of the policy and legislative framework...... 22 3.0 Human Rights Abuses Linked to The Hiv Epidemic in Uganda...... 24 3.1 Stigmatization and Discrimination...... 24 3.1.1 Right to Privacy, Consent, and Confidentiality...... 26 3.1.2 Right to information...... 26 3.1.3 Right to the Highest Attainable Standards of Health:...... 27 3.1.4 The Right to Work...... 28 3.1.5 Access to Justice...... 29 4.0 The Demand and Supply of Hiv-related Legal Services...... 30 4.1 Mechanisms for Redress...... 30 4.2 Legal and human rights Programmes providing HIV-related legal services in Uganda ...... 32 4.2.1 Integration...... 32 4.2.2 Litigation:...... 33 4.2.3 Empowerment:...... 34 4.2.4 Law and Policy Advocacy:...... 35 4.2.5 Support Mechanisms:...... 35 4.3 The HIV-related Legal Services “Gap”...... 36 5.0 Programming Opportunities For LAHI/OSIEA...... 38 5.1 Introduction ...... 38 5.2 Recommended Actions Under LAHI’s Priorities...... 39 Priority1: Integration of Legal/Paralegal and Health Services...... 39 Priority2: Human Rights in Patient Care...... 42 Priority3: Human Rights Responses to HIV and AIDS...... 42 Priority4: Capacity Development in Law and Health...... 45 Priority5: Using Legal Strategies in Health Monitoring...... 45 6.0 References ...... 46 List of Cases...... 46 Bibliography...... 46 Annex 1: HIV-related legal services provided through Non-government Initiatives...47

HIV/AIDS, Human Rights, & Legal Services in Uganda vii A Country Assessment

Summary and Main Recommendations

Despite having a myriad policies HIV status; violations of the right to and legal protections related to HIV/ medical privacy; forced HIV testing; AIDS, Uganda still faces a severe criminalization of “invisible” social and generalized HIV epidemic with categories; barriers to employment widespread human rights abuses on the basis of HIV status, denial against people living with, affected by, of education on the basis of HIV and at risk of HIV. While the country status or having HIV in the family; has received international praise for discrimination in gaining access to its responses to the adverse medical medical care; arbitrary eviction from effects of the epidemic, it has paid housing; and lack of access to justice. comparatively limited attention to the epidemic’s legal and human rights Access to justice for all of these abuses implications. This is especially true is hindered not only by the lack of for marginalized populations who are a supportive legal framework and most vulnerable to HIV-related human standard mechanisms for redress, rights abuses: women (especially young but also by context-based factors women, widows, and women living in such as limited knowledge of rights fishing communities); sex workers; among people with HIV and those at orphans and vulnerable children; risk, judicial corruption, inability to lesbian, gay, bisexual, transgender identify perpetrators, limited access to (LGBTI) persons; and internally and affordability of legal aid services, displaced persons. and the stigmatization, discrimination and powerlessness that stem HIV-related human rights abuses from being a member of a socially abound in Uganda, affecting people marginalized group. living with, affected by and at risk of HIV. Stigmatization and discrimination Meeting the demand for timely trigger a wide range of human rights and affordable legal services is abuses for which the great majority of critical to stemming HIV-related those affected have not sought justice. human rights abuses in Uganda and Among the abuses documented for this elsewhere. In Uganda, legal services assessment include: discrimination are often inaccessible, ineffective, on the basis of real or perceived disproportionately accessible, or non-

viii HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

existent. While there are some attempts community. There is a clear gap between in Uganda to provide legal services for policy and practice whereby Government people living with HIV, legal services has not translated its commitments targeting those affected by HIV or on paper into concrete deliverables. at risk of HIV are disproportionately Additionally the policies lack effective fewer. Interventions by the Law and monitoring and enforcement mechanisms Health Initiative (LAHI) and other and require more intensive advocacy in donors should attempt to fill this gap. order to secure accountability. Efforts should both enhance efforts already being taken within the HIV In the absence of a national legal aid legal and policy framework in Uganda, scheme in Uganda, the provision of HIV- and also support new efforts to improve related legal aid services is dominated both accessibility and effectiveness. by non-governmental organizations (NGOs). Local Council Courts appear to Although the legal and policy framework governing HIV in Uganda is be the most utilised dispute resolution responsive to human rights in various mechanism by communities. Yet these respects, an overarching HIV/AIDS courts are not being utilised to address policy and comprehensive national HIV-related infringements of rights. legislation remain outstanding or in Based on consultations with various draft form only. Supportive provisions stakeholder during the review, five currently exist under the Employment types of interventions can be identified: Act, Equal Opportunity Commission integration of legal support into HIV Act, and through case law. Whereas services; strategic litigation to advance the policy regime guarantees some particular rights and create precedent; rights in relation to the adverse medical legal empowerment of people living effects of HIV/AIDS (e.g., access to with, affected by, and at risk of HIV; HIV testing, treatment, and care), advocacy for legislative and policy national legislation still fails to provide reform; and creation of a supportive clear protection against HIV-related environment for gaining access to legal stigma and discrimination. The review services. further reflects some deficiencies in These are local courts established by law that linked to the the policy and legal framework in system of local government and are “informal” in nature, relation to vulnerable categories such as devoid of technicalities. They exist at the village, parish and sub-county levels. Appeals from the sub-county lie to the commercial sex workers and the LGBT Chief Magistrates’ Court.

HIV/AIDS, Human Rights, & Legal Services in Uganda ix A Country Assessment

(1) Integration: Within the realm of HIV to undertake dissemination direct service delivery, a number and sensitization activities of organizations in Uganda through their networks and such as The AIDS Support existing programs. Organization (TASO) have well-established HIV care and (3) Litigation is another strategy treatment programs. LAHI and through which the protective other donors should encourage provisions within existing laws these organizations to integrate can be brought to life. This would a rights component for patients involve defending particular HIV- and others affected within related rights in court through existing health service delivery test cases. Organizations such programmes. This report outlines as LAW-Uganda, the Federation the most promising current of Women Lawyers (FIDA), and opportunities for such integration Health Rights Action Group at the service-delivery level. (HAG) have utilized test-cases as a strategy and should be encouraged (2) Empowerment: Limited to undertake strategic litigation in awareness among people the area of HIV. Examples of test living with, affected by, and cases that can be brought include at risk of HIV of their rights discrimination in the workplace, and entitlements under law mandatory HIV testing, and is a major barrier to effective denial of maintenance and child enforcement of these laws. custody to HIV-positive mothers. Support should therefore be given to disseminating these rights and entitlements. Examples include (4) Legislative and Policy Advocacy the HIV/AIDS Work place Policy, is required to address the the Employment Act, and the deficiencies in various HIV Equal Opportunities Commission policies and laws, to secure formal Act. Organizations that conclusion of rights-based policies conduct legal rights awareness and laws currently in draft form, programmes should be supported and to ensure enforcement of to develop specific and simplified rights-based policies and laws in materials on rights relating to place. More specifically:

HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

. There is potential for advocacy sex workers and the LGBTI to finalize the pending draft community is critical, but HIV/AIDS national policy and needs to be preceded by to enact a rights-based national capacity-building and alliance- HIV/AIDS law. building activities to ensure these organizations are in a . Public hearings, forums, and position to undertake human dialogues to build consensus rights advocacy. Support on controversies arising within should be given to groups of the human rights field as a sex workers and to Sexual result of HIV/AIDS should be Minorities to develop and supported. Dialogues involving implement an alliance- diverse stakeholders need to be building strategy with other conducted on criminalization of human rights organizations. “deliberate” HIV transmission, Consideration should be given mandatory HIV testing for towards making this a joint sexual offenders, and other initiative with Sexual Health issues. The outcome of these and Rights Project (SHARP). multi-stakeholder dialogues should inform the drafting of . Advocacy efforts for the comprehensive and rights- ratification of the Protocol based national legislation on on Women’s Rights in Africa HIV/AIDS. should be supported. Apart from providing women a right . LAHI should support to protection from sexually monitoring and advocacy for transmitted infections, the enforcement of existing including HIV/AIDS, the policies and laws that contain Protocol guarantees women’s protecting provisions, such as rights to adequate, affordable, the HIV/AIDS and Workplace and accessible health services, policy, the Equal Opportunities and confers a duty on the State Law, and the Employment Act. to protect girls and women from practices and situations . Advocacy on behalf of that increase their risk of “invisible” groups such as infection.

HIV/AIDS, Human Rights, & Legal Services in Uganda xi A Country Assessment

(5) Support mechanisms such as provision of core financial support research and the development of and assistance with organizational tools and resource guides to assist development for key grantees as a communities in providing legal services way of ensuring they have sufficient are also an important part of the work institutional capacity to achieve these being done in Uganda to advance HIV goals. and human rights. More detailed recommendations, Finally, given the weak institutional organized according to the five and programming capacities of strategic priorities of the Law and most organizations working at Health Initiative, are presented at the the intersection of HIV and law in end of this report under “Programming Uganda, a key strategy for LAHI Opportunities for the Law and Health and other donors should also be the Initiative.”

xii HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

1.0 introduction

Uganda has braved a severe and According to the UHSBS, Uganda’s devastating epidemic of HIV and AIDS HIV epidemic also shows gender for almost a quarter of a century. variations, with women having a Uganda is a low income country with a higher HIV prevalence than men at 8 per capita gross domestic product (GDP) and 5 percent respectively. The data of US$300/year, and with 31 percent or show variations in HIV prevalence for 8.4 million of its people estimated to be men and women among various age- poor. Results from the 2004-05 Uganda brackets, and a slight increase in HIV HIV/AIDS Sero-Behavioural Survey infection within the married women’s (UHSBS) indicate a stabilisation in HIV category. Of the 130,000 new infections prevalence, with just over 6 percent recorded in 2006, 42 percent were married women with domestic violence of Ugandan adults infected with HIV. cited as the risk factor. UHSBS However, this masks higher rates of data show that less than 1 percent HIV prevalence in Uganda’s war-torn of children are HIV positive with no north, where HIV interventions remain difference in HIV prevalence between scarce to non-existent. In addition, the boys and girls. Ugandan government’s commitment to evidence-based HIV prevention has As elsewhere in Africa, Uganda’s HIV recently been questioned, with new epidemic affects not only individuals, strategies of promoting “abstinence only” but entire families, extended families, among youth threatening to undermine and communities. previous gains in reducing infections. High rates of mortality in the prime The UHSBS indicates that the number of productive life have imposed of HIV positive individuals is set to unprecedented strains on the traditional increase from 1.1 million in 2006 to extended family structure, leading to: about 1.3 million in 2012. The Uganda National AIDS Commission report 2006, page 10 Uganda National Household Survey Report 2005/6 Ibid

HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

. The emergence of new forms of open about their status. Although it discrimination and violation of rights has had considerable benefits for the for AIDS-affected individuals and fight against the epidemic, opening up their families has also given rise to discrimination of people infected with HIV within families, . Vastly increased numbers of orphans at places of work, and in communities. and other vulnerable children, now Discrimination on the basis of actual or estimated at 2 million in the country, perceived HIV status is often reported leading to urgent child protection as the most common type of HIV- challenges related human rights violation, and also . Increasing numbers of child-headed leads to a wide range of other human and widow-headed households rights violations affecting spouses . Disruption of schooling of children, and children. Persons affected by HIV often girls who are forced prematurely especially orphans, widows, commercial into the labour market, further sex workers, and those in the LGBT aggravating their vulnerability community are largely powerless and vulnerable to abuse of their rights in . Adverse effects on economic activity many respects. These require legal due to loss of human capital for protection as do those encountering industrial growth, agriculture, violations or in situations that place teaching, medical care, and other them at risk of HIV. professions. In Uganda, responses to the epidemic The areas listed above, although not initially focused on health interventions exhaustive, reflect the diversity of such as HIV prevention campaigns, care consequences of the HIV epidemic. for the sick, voluntary counselling and These consequences in turn have given testing, and more recently antiretroviral rise to new challenges in the field treatment. There has been considerable of human rights. The epidemic has investment in communication and further disempowered and increased the awareness-creation to stem the further vulnerability of various categories of the spread of HIV. Over time, some responses population. The policy of transparency to the human rights violations of people about HIV/AIDS that has been living with, affected by, and at risk of promoted by the Government of Uganda HIV have been designed in the form of has resulted in increasing numbers legal services. Many of these still have of people infected with HIV becoming yet to take root and ensure accessibility

HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

by those they target. It is therefore OSIEA-LAHI commissioned this timely that the Open Society Initiative country assessment on HIV, human for East Africa has established a Law rights and access to legal services and Health Initiative (OSIEA-LAHI) to in Uganda in order to inform work jointly with partners to promote its programming and develop programming aimed at linking legal and recommendations for other donors and human rights advocacy within health the Ugandan government. This report programmes as a way of improving lives contains the findings of the country of the most vulnerable and marginalized assessment. populations.

1.1 Objectives of the Assessment

The overall objective of the assessment HIV, affected by and at risk of HIV in was to conduct an assessment on HIV Uganda; and human rights in Uganda, with . Identify existing gaps and an emphasis on access to HIV-related opportunities for programming; legal services. More specifically, the consultant was required to: . Identify and recommend possible community-based HIV/AIDS . Review and document the existing organizations that LAHI can work state of legal services for people with to design and implement living with, affected by and at risk of programmes aimed at promoting HIV in Uganda; access to legal services and rights of . Examine the extent to which people people living with, affected by and at living with, affected by and at risk risk of HIV in Uganda. of HIV in Uganda are aware of those legal services, availability 1.2 Methodology of those services, accessibility and The methodology mainly involved review affordability of those services and of reports, policies and laws as well as determine how well they are able to consultations with various stakeholders use those services. and specific respondents categorised . Identify the kind of interventions among people at risk of HIV/AIDS, that promote rights of people with those infected and those affected. The

HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

interviews were limited to Kampala and opportunities for the Law and where the majority of national Health Initiative in both reforming and organizations and bodies have their implementing this framework. head offices. Stakeholders included: policy makers from Parliament, Section Three provides an account of the the Uganda Aids Commission, range of human rights abuses linked Uganda Human Rights Commission to Uganda’s HIV epidemic and briefly and the School of Public Health; explores the means by which Ugandans nongovernmental organizations typically gain access to legal services, involved in the provision of legal aid the legal procedures that are available services, advocacy for human rights, and the ability of people living with, at and addressing the health impact of risk of, and affected by HIV to utilize HIV/AIDS; organizations composed them in terms of accessibility and of or targeting people at risk, such affordability. The section also touches on as commercial sex workers, sexual the extent to which use of legal services minorities, and survivors of sexual would address the abuses identified. violence; and various organizations Turning to the current level of demand working with people living with and supply of HIV-related legal HIV/AIDS including post-test clubs, services, Section Four indicates the community-based initiatives, and options for legal services available, national coalitions. and identifies programmes aimed at providing HIV-related legal services in Uganda. This is followed by an 1.2 Organization of the assessment of the current demand Report for legal services among people living with, affected by and at risk of HIV in The report is presented in five sections Uganda compared to the supply--the that respond to the scope of work “HIV-related legal services gap”. as detailed in the ToR. Section Two describes in detail the legal and policy In conclusion, Section Five identifies framework in Uganda relating to HIV and recommends some new and/or and AIDS and identifies key gaps existing opportunities for programming

The consultant integrated consultations within the process for LAHI based on the programming of Mainstreaming SRH, Gender and Human Rights into gaps emerging from the country the NSP 2007/8-2011/12 in which she was concurrently involved. assessment.

HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

2.0 The Legal and Policy Framework Relating To Hiv/aids in Uganda

2.1 international and Regional Framework

Human rights that are relevant to . International Covenant on Civil and the context of HIV/AIDS are found Political Rights in numerous international and . Convention on the Elimination of all regional covenants, conventions, and Forms of Racial Discrimination declarations. Such rights relate to those people at risk of infection, people living . Convention on the Rights of the Child with HIV/AIDS (PLHA) as well as those . Convention on all Forms of affected (including not only PLHA but Discrimination Against Women. also their extended family members and those in their household). No single In addition to the international human rights treaty specifically deals instruments there are regional with HIV/AIDS and human rights; instruments that deal with region-specific however, many contain provisions issues in the context of HIV/AIDS. that are particularly relevant to the African regional instruments include: context of HIV/AIDS, thus obliging governments to consider these treaties . African Charter on Human and in developing their HIV responses. People’s Rights. Binding instruments to which Uganda is . Optional Protocol to the African state party include: Charter on Human and Peoples’ . Universal Declaration of Human Rights on the Rights of Women in Rights Africa. . International Covenant on Economic, . The OAU Charter on the Rights and Social and Cultural Rights Welfare of the African Child.

HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

. The Protocol to the March 2007, and Uganda Uganda is among African Charter on the was not among them. This is the State parties Rights of Women in an area requiring intensified that have made Africa. advocacy for ratification as commitments to well as enforcement. implement the The Protocol to the African undertakings Charter on the Rights of Uganda is among the State contained in various Women in Africa deserves parties that have made declarations special attention. It is the commitments to implement programmes of only treaty to specifically the undertakings contained action issued by address women’s rights various declarations international in relation to HIV/AIDS, programmes of action issued agencies as part of the and to identify protection by international agencies HIV/AIDS response. from HIV/AIDS as a key as part of the HIV/AIDS component of women’s response. The undertakings sexual and reproductive include: rights. Apart from providing women w a right to protection from sexually Key Actions for the Further transmitted infections, including Implementation of the Programme HIV/AIDS, the Protocol guarantees of Action of the International women’s rights to adequate, affordable, Conference on Population and and accessible health services. It also Development of 2 July 1999; confers a duty on the State to protect w The Political Declaration and girls and women from practices and Further Action and Initiatives to situations that increase their risk of Implement the Beijing Declaration infection, such as child marriage, war- and Platform for Action of 10 June time sexual violence, and female genital 2000; mutilation. w The Political Declaration and Despite its potential to offer protection Further Actions and Initiatives to to women who are the more vulnerable Implement the Commitments made among the population at risk, those at the World Summit for Social infected and also affected, the protocol Development of 1 July 2000; had received only 21 ratifications as of w The United Nations Millennium Protocol on the Rights of Women in Africa, Article 14. Declaration of 8 September 2000;

HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

w The Abuja Declaration and w The International Guidelines on Framework for Action for the fight HIV/AIDS and Human Rights against HIV/AIDS; Tuberculosis and (1997), while not itself binding on other related infectious diseases in governments, provide compelling Africa, 27th April 2001 policy guidance from the Joint United Nations Programme on HIV/ w United Nations Declaration of AIDS (UNAIDS) and the Office of Commitment on HIV/AIDS, June the High Commissioner for Human 2001; Rights (OHCHR) on how to ensure that internationally guaranteed w The ILO Code of Practice on HIV/ human rights underlie national HIV AIDS and the World of Work, 2001 responses.

2.2 The National Legislative Framework

Although the draft NAP and NSP seek Constitution but not as justiciable to ensure a legal response to HIV and rights, while Chapter Four on the AIDS in conformity with international Bill of Rights is devoted to civil and and regional human rights standards, political rights. Under the National Uganda still lacks explicit legislation Objectives and Directive Principles of regarding HIV/AIDS. However, a State Policy in the Constitution, there number of laws have a direct bearing is no specific reference to the right on the human rights of people living to health; rather it is implied under with, affected by, and at risk of HIV. objectives on provision of basic medical services, access to clean and safe water, (i) The Constitution of the Republic food security and nutrition. of Uganda (1995) The Constitution of the Republic of Under Chapter 4 Article 21, the Uganda, enacted in 1995, lacks explicit Constitution provides for equality and reference to HIV/AIDS despite the freedom from discrimination. This country having recognized the disease includes equality before and under the 10 years prior to that the Constitution’s law in all spheres, equal protection of passage. The Constitution has most Constitution of the Republic of Uganda 1995; National economic, social and cultural rights Objectives and Directive Principles of State Policy. Article 30 on the right to education and 40 on economic imbued within the spirit of the rights are the only exception.

HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

Although health status is not the law, and prohibition of among the grounds Article 32 of the Constitution discrimination on grounds enumerated, some provides for affirmative of sex, race, color, ethnic have argued that action in favor of groups origin, tribe, birth, creed or HIV/AIDS constitutes marginalized on the basis religion, social or economic a disability that could of gender, age, disability or standing, political opinion be envisaged under any other reason created by or disability. Although the article. It is also history, tradition or custom, health status is not among possible to argue for a for the purpose of redressing the grounds enumerated, broader interpretation imbalances existing against of Article 21 based some have argued that them. The provisions in on Article 45, which HIV/AIDS constitutes Article 32 clearly did not effectively imports all envisage health status a disability that could other human rights, as a basis or reason for be envisaged under the duties, and freedoms marginalization. Articles article. It is also possible not specifically to argue for a broader mentioned in the 33-36 that follow from this interpretation of Article 21 Chapter 4. contain provisions specific to based on Article 45, which groups that are understood effectively imports all other to be marginalized: women, human rights, duties, and freedoms not children, persons with disabilities, and specifically mentioned in the Chapter 4. minorities. It is only with the recent enactment of the Equal Opportunities Commission Act 2007, that health status Other rights guaranteed under has been added to the bracket of grounds Chapter 4 include protection of the for discrimination and marginalization right to life (Art.22), personal liberty for which equal opportunities should be (Art.23), respect for human dignity and ensured by law. protection from cruel, inhuman and degrading treatment or punishment Whereas Article 23 puts limitations (Art.24), protection from deprivation on the right to personal liberty in the of property (Art.26), right to privacy interest of public safety, including “…the of person, home and other property purpose of preventing the spread of an (Art.27), right to a fair hearing infectious or contagious disease” (Article (Art.28), right to education (Art.30), 23(d)), care should be taken that this and family rights (Art.31). subsection is not pervasively used to infringe on the rights of people living David Ssekigudde Kaggwa in the Daily Monitor Newspaper, 3rd May 2007. with HIV.

HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

The EOC Act is (ii) Equal Opportunities significant in their rights by challenging Act 2007 that it explicitly discrimination and/or The Equal Opportunities provides a legal marginalization. Act of 2007 gives effect to basis for people living with HIV Articles 32(2) and 33(4) of (iii) The Children’s Act and those affected the Constitution, making (1997) the Equal Opportunities to challenge The Children’s Act of 1997 Commission (EOC) the last discrimination contains provisions on the constitutional body to be in any field, welfare and rights of children established more than 10 including law that should apply regardless of years after the enactment and policy. whether or not there is HIV/ of the 1995 Constitution. AIDS in the family. Some of The EOC Act is significant in that the critical provisions in the context of it explicitly provides a legal basis HIV/AIDS and children’s rights include: for people living with HIV and those affected to challenge discrimination • A child’s right to stay with his or her in any field, including law and policy. parents or guardians This is clear from the Act’s preamble, • The duty of the parent, guardian, its definitions of “discrimination” and or other person having custody of “marginalization,” and its Section 14 on the child to maintain the child, the functions of the Commission. The meeting all the child’s needs and definition of discrimination includes rights including education and “health status,” while marginalization guidance, immunization, adequate relates to limitations on the rights diet, clothing, shelter, and medical guaranteed under the Constitution. attention

Given that the law is a recent • The right to play and enjoy leisure. enactment and the Commission not yet established, marginalized persons have (iv) The Employment Act (2006) not at this writing taken advantage The field of employment constitutes of its provisions. However, once the a major site of discrimination and Commission is established and its oppression for people living with regulations gazetted by the Minister, HIV in Uganda. Discrimination it will be possible for people living with occurs in recruitment, termination of HIV to use the Act as a basis to advance employment, deployment and transfers,

HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

grievance resolution and disciplinary is infected with HIV/AIDS; where the measures, and payment of benefits. offender is a parent or guardian or Section 6 of the Employment Act of person in authority over the victim; 2006 prohibits discrimination on the and/or where the offender is a serial basis of HIV/AIDS status among other offender. Although this provision grounds. This law is stronger and more effectively criminalizes deliberate or explicit than the Constitution, and wilful transmission of HIV, in violation it strengthens the principles of the of international guidelines on this issue, HIV/AIDS and the Workplace Policy. the amendment has not generated Moreover it is reinforced by the Equal significant debate on its implications Opportunity legislation discussed above. for public health or human rights. This may be attributed to the limited The prohibition of sexual harassment information on the amendment within under section 7 creates legal protection the public, the limited appreciation of particularly for female employees its implications, and the limited number who are placed at risk of contracting of organizations on groups working on HIV/AIDS through demands for sex HIV-related legal and human rights by their employers. A limitation of the advocacy. provision is that it does not cover sexual harassment between employees, thus The amendment also broadens failing to recognize power relations protection beyond girls under 18 between senior and lower cadres. to cover ‘persons below the age of 19 years’; and further provides for (v) The Penal Code compensation to victims of defilement. Section 129 of the Penal Code was This means that the law of defilement amended in 2006 with the offence protects both boys and girls below 18 of defilement being classified into years of age. two categories, the second one being “aggravated defilement”10. Although largely seen as a deterrent The circumstances for aggravated measure to provide protection to defilement include: where the victim young girls and boys at risk of HIV/ is less than 14 years of age and where AIDS through sexual violence and the offender to his or her knowledge exploitation, it has been interpreted by 10 Penal Code (Amendment) Bill No.20 of 2006. The Bill as some as discriminatory against people assented to by the President to make it law has not yet been gazzetted. living with HIV. In addition to the

10 HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

potentially stigmatizing In addition to inaccessible health services, effect of creating a special the potentially gender-based violence, and crime of HIV transmission, stigmatizing effect deep social marginalization. the provision implies of creating a The risk for lesbians is that all persons accused special crime of HIV aggravated when they are of defilement must be transmission, the subjected to rape and other provision implies that subjected to a mandatory forms of sexual violence all persons accused HIV/AIDS test, thus as part of efforts to make of defilement must exposing the sero-status of them “straight”, which they be subjected to a both victim and offender. endure in silence for fear mandatory HIV/AIDS International human of exposing their sexual test, thus exposing rights experts as well orientation, while justice the sero-status of both as the United Nations eludes them. At the same victim and offender. have cautioned against time, the invisible lives HIV-specific criminal that LGBT persons live cut laws, urging that existing them off from information and services criminal law is sufficient to punish the related to HIV/AIDS. Many gay and few cases in which individuals transmit bisexual men in Uganda believe that HIV with malicious intent. Uganda’s HIV cannot be transmitted through provision needs to be subjected to anal intercourse, while there is a myth further review in order to ensure that among lesbians in Uganda that they the protection of vulnerable children cannot “catch AIDS.” does not negatively affect the rights of others. Similar to the issues of the LGBT community, sex workers are another Another of Uganda’s penal code population in Uganda at high risk of provisions that is relevant to HIV/AIDS HIV but whose protection is limited is Section 145, which categorises same- due to the criminalization of living sex sexual behaviour as conduct against off the earnings of prostitution. Sex the order of nature for which one is workers face harassment by law liable to imprisonment for life. Lesbian, enforcement officers who arrest them gay, bi-sexual, transgender and (LGBTI) under the charge of being “idle and persons are among the most at risk disorderly”, an offence under the Penal populations for contracting HIV/AIDS, Code. They also face sexual violence due to factors such as unprotected sex and exploitation which they endure in

HIV/AIDS, Human Rights, & Legal Services in Uganda 11 A Country Assessment

silence because they lack an effective women wishing to get out of marriages legal basis for seeking redress. At the that among other things exposed them same time, they have limited access to to the risk of HIV/AIDS. Risk factors information and services, both legal and within marriage include extra-marital otherwise, related to HIV/AIDS. sex, insistence on unprotected sex, and rape. In 2003, the law governing divorce (vi) Laws on Marriage and Divorce in Uganda was successfully challenged Uganda’s 2004-2005 HIV sero- in court, and major sections of it were behavioural survey indicated that declared unconstitutional on the grounds the largest proportion (42%) of people of non-discrimination and promoting living with HIV are in the category of equality of the sexes.11 Within the context married or in long-term relationships of HIV/AIDS and human rights, the The process of amending laws on decision enhanced protection for people marriage and divorce towards a more especially women in marital relationships just and gender-equitable family that placed them at risk of contracting law has gone on for over 40 years in HIV/AIDS from their partners. Uganda. During the term of the 7th Parliament (2001-2006), efforts went (vii) Criminal Adultery and as far as drafting a Domestic Relations Bill (DRB) in 2003 which invoked Succession a lot of controversy among various Prior to April 5, 2007, the Penal Code stakeholders and ultimately forced Cap 120 contained varying definitions of government to stall the process. Among criminal adultery for men and women. the most controversial proposals in the The definitions effectively allowed DRB, which also had a direct bearing married men to have sexual intercourse on women’s HIV vulnerability, were with any woman provided she was to out-law polygamy, marital rape and not married, while married women ensure equal property rights. Advocacy were prohibited from having sexual by women’s rights organizations to intercourse with any man regardless place the Bill on the agenda of the 8th of their marital status. Apart from Parliament (2006-2011) is ongoing. contravening the principle of equality between the sexes, the law made it By setting out different grounds difficult for women to prove adultery for divorce for men and women, in divorce proceedings. Moreover, as Uganda’s law on divorce for a long 11 Uganda Association of Women Lawyers, and Others Vs. The time constituted a major hindrance to Attorney General; Constitutional Petition No.2 of 2003.

12 HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

noted above, the divorce law previously home. These are all among the many required women to prove an additional areas in which widows and orphans ground to adultery in order to seek affected by HIV/AIDS traditionally a divorce. The combination of these suffer much injustice. The successful two laws left many women trapped in constitutional petition, if disseminated adulterous marriages, leaving them and enforced, can therefore be utilized to at serious risk of contracting HIV. protect women’s rights and health. In addition to the unequal grounds of divorce, the adultery provisions The constitutional petitions created were also successfully challenged gaps in the laws containing the in the Constitutional Court on non- challenged provisions. In the absence discrimination grounds.12 of an amendment of the underlying legislation or the enactment of a new, The grounds for challenging the gender-equal law on domestic relations discriminatory definition of criminal (neither of which has occurred at this adultery were also used to successfully writing), courts must handle domestic challenge certain provisions in the relations matters on a case by case basis. Succession Act regarding heirship, This has its disadvantages in that if the distribution of intestate estates, presiding judge is not gender-sensitive, appointment of a testamentary they could apply discretion to deny guardian, choice of domicile, and justice and undermine the decision in the remarriage while in occupancy of the constitutional cases. 13 matrimonial home. The restriction (viii) The Public Health Act Cap 281 of heirship to the male child was found The Public Health Act consolidates to be discriminatory against females; Ugandan law regarding the preservation distribution of intestate estates was of public health. The Act defines an found to be discriminatory against infectious disease as one that can be women in polygamous unions; and communicated directly or indirectly by widows were indicated to have an any person suffering from it to another. automatic right to appointment as The Act also includes special provisions guardians with a right to remarry and regarding certain epidemic diseases retain occupancy of the matrimonial ranging from small pox to yellow fever

12 Law & Advocacy For Women in Uganda Vs. Attorney and any other disease declared as such General; Constitutional Petitions Nos. 13/05 & 05/06 by statutory order. Given that HIV/AIDS 13 Law &advocacy For Women In Uganda Vs. Attorney General (supra) was neither known nor anticipated at

HIV/AIDS, Human Rights, & Legal Services in Uganda 13 A Country Assessment

Given that HIV/AIDS the time of passing this was neither known (a) coordinate HIV/AIDS law, the Public Health nor anticipated at activities of Parliament Act and other related the time of passing and provide a link between laws such as the Venereal this law, the Public Parliament with the Diseases Act Cap 284 need Health Act and other Uganda Aids Commission to be carefully examined related laws such as in combating the epidemic and reviewed to assess the Venereal Diseases in Uganda. how they apply to HIV Act Cap 284 need to and whether they have be carefully examined (b) scrutinise the HIV/ potential to advance or and reviewed to AIDS policies and monitor undermine human rights. assess how they and evaluate activities apply to HIV and of government, local Such a review is important whether they have government and other in view of the UNAIDS/ potential to advance bodies aimed at combating OHCHR International or undermine human HIV/AIDS. Guidelines on HIV/AIDS rights. (c) examine and make and Human Rights. recommendations on Guideline 3 thereof relevant Bills and other matters requires States to review and reform relating to HIV/AIDS, and public health laws to ensure that they adequately address public health issues (d) in cooperation with the Uganda raised by HIV/AIDS in order that their Aids Commission and the Ministry provisions are not inappropriately responsible for Health, initiate applied to HIV/AIDS and are in line relevant Bills and motions required with international human rights for combating the epidemic in obligations. Uganda.

(ix) Towards a National Law on In line with this mandate, the HIV/AIDS Committee on HIV/AIDS began a In recognition of the need to pay serious process of drafting a comprehensive bill attention to the issue of HIV/AIDS, the to be debated as national legislation on Parliament of Uganda established a HIV/AIDS. The Bill is at this writing Standing Committee on HIV/AIDS and with the legislative counsel and once Related Matters. The Committee on ready will be subject to public dialogue. HIV/AIDS is mandated to: The essence of the bill is to protect

14 HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

rights of people living with HIV, while for debate through the procedure for balancing this with the responsibility private members bills, they will not to protect the rest of the population not resist efforts by government to adopt yet infected. Although the Committee the bill and have it debated through the plans at this writing to move the bill regular procedure.

2.3 The National Policy Regime

A review of the national policy and control of HIV/AIDS is listed as one legal framework on HIV/AIDS reveals of the areas to be addressed under a glaring gap between what Uganda the components of the minimum has agreed to on paper and what it health care package. The elements has implemented in practice. The of intervention under this include Government of Uganda has produced a mitigation of the socio-economic number of policies that cover different impact of the epidemic. The aspects of health and health care policy also addresses sexual and including HIV/AIDS. There are also reproductive health and rights, sectoral policies that are concerned including antenatal and obstetric with either particular, sectors, specific care, family planning, adolescent health issues or particular population reproductive health, and violence groups. The major policies that are against women. Under “legal aspects,” relevant to the HIV/AIDS response are the policy provides for updating, as follows. formulating, and disseminating laws, regulations and enforcement (i) The National Health Policy mechanisms relating to, among other Uganda’s National Health Policy things, stigmatization and denial due aims at ensuring a good standard to ill-health or incapacity. of health for all people in Uganda. The policy emphasizes a minimum Although the National Health Policy health care package for all, and seeks contains provisions supportive of to strengthen the decentralization the HIV/AIDS response, including of health care services to ensure protection of legal rights, the main participation and management at challenge remains their translation into lower levels. The prevention and concrete service delivery.

HIV/AIDS, Human Rights, & Legal Services in Uganda 15 A Country Assessment

(ii) The Draft Uganda National emphasis is on the provision of drugs AIDS Policy (NAP) for treating opportunistic infections and The Uganda AIDS Commission finalized for reversing the progression of HIV and formulation of the National AIDS Policy AIDS, including ARVs to all PLHA who in 2005 and forwarded it to Cabinet are clinically eligible. for approval. The policy is described The draft policy contains a section on as being “rights-based” or promoting legislative strategies for prevention of a rights-based response based on a HIV. This section states that: number of core principles, of which the following specifically relate to human • Behaviors and environments that rights: put individuals at risk of HIV infection shall be targeted with • Greater involvement of persons relevant information, education, living with HIV and AIDS (GIPA) communication and competence • Equal rights for all people, meaning strategies underpinned by the that being at a higher risk of HIV review, formulation or enforcement infection or sero-status shall not of relevant legislation; be used as grounds for decisions • Legislation on sexual abuse and that negatively impact on people’s exploitation of minors, adults and livelihood and well-being spouses will be reviewed in light of • Non-discrimination on the basis of HIV and AIDS; gender, sex, age, religion, race, social • HIV testing will not be mandatory. and HIV status. In the area of impact mitigation at The draft policy contains both individual and community level, the policy and legislative strategies for policy states that the legal framework achievement of its aims and objectives. (including traditional and customary The policy strategies listed in the law) will be reviewed to ensure a legal draft NAP are classified into three response to HIV and AIDS in conformity categories: mitigation of adverse with international and regional human health impacts; impact mitigation at rights standards. The following will be individual and community levels; and specifically considered: research and utilization of research products. Under policy strategies for • Anti discriminatory and other mitigation of adverse health impacts, protective laws that protect people

16 HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

who are infected and affected by HIV protective laws that govern the legal and AIDS; and ethical aspects of HIV related research. • Legal/administrative procedures for seeking redress; Although pending formal approval • General confidentiality and privacy by Cabinet, the draft National AIDS laws; Policy provides a strong basis for the promotion and protection • Laws addressing of human rights for people workplace rights; The draft National AIDS Policy provides living with HIV, those • Access to legal services a strong basis for at risk of infection and for those infected and the promotion and those affected. The fact affected. protection of human that the policy remains • Under the legislative rights for people a draft is a limitation strategies for research living with HIV, those particularly because it and utilization of research at risk of infection can not be relied on as a products, the policy states, and those affected. basis for accountability among other things, that: for implementation or lack thereof. The policy • Research that involves human is not a public document and therefore subjects, including drug and vaccine cannot reach those who need to rely trials, must be based on legislated on it. However, as the review of other ethical standards and implemented policies below shows, the draft policy through a proper monitoring is inspirational to the development of strategy. other sector- or issue-specific policies on • All HIV and AIDS-related HIV/AIDS. researchers shall be required to obtain clearance from the National (iii) The National HIV and AIDS Council for Science and Technology Strategic Plan (NSP) (2007/8 (UNCST) and deposit reports of their – 2011/12) research findings with UNCST and In 2000-2001, the Government of UAC. Uganda through the Uganda AIDS Commission formulated the National The policy further adds that the legal Strategic Framework (NSF) on HIV/ framework will be reviewed to enact AIDS to cover a period of five years.

HIV/AIDS, Human Rights, & Legal Services in Uganda 17 A Country Assessment

The Uganda Aids Commission then The NSP has three service thematic developed a National Strategic Plan areas, namely, prevention, care and (NSP) 2007/8 – 2011/12 to guide the treatment, and social support. The national response to HIV/AIDS over service thematic areas are supported by the subsequent five years. While the strengthened systems of delivery that NSP includes considerable guidance include institutional arrangements and on legal and human rights responses human resource requirements, research to the epidemic, it is noteworthy for its and development, resource mobilization silence on the lesbian, gay, bisexual and management, monitoring and and transgender (LGBT) community, evaluation and infrastructure placing this population outside the requirements. ambit of protection and bringing the NSP into conflict with the principle Among the highlights in the NSP that of non-discrimination on the basis of are important for promoting a human sexuality that is contained in the draft rights response is the identification and National AIDS Policy described above. targeting of vulnerable and most at risk populations. These are defined in the Text Box 3.2: NSP to include commercial sex workers, Strategic actions from the Draft NSP relevant to fishing communities, uniformed services, Protection of Human and Legal Rights internally displaced persons, persons Prevention with disability, orphaned and vulnerable w Accelerating prevention of sexual transmission of HIV targeting children (OVCs), and discordant couples vulnerable and most at risk populations. (i.e. couples in which one partner is HIV- Strategic Action: Improve relevant legislative and policy framework that promotes the support of vulnerable groups and criminalizes deliberate positive and the other is HIV-negative). transmission of HIV and AIDS. Text Box 3.2 highlights priority areas and strategic actions under each of the Care and treatment service thematic areas that are relevant w Increase equitable access to Anti-Retroviral Treatment. w Prevention and treatment of opportunistic infections. to the rights of people living with HIV Strategic Action: Promote positive living and empower PHA networks to and vulnerable groups. It is noteworthy lead prevention of HIV transmission. that criminalization of deliberate transmission of HIV and AIDS is among Social support w Ensure legal and appropriate social and community safety nets to the strategic actions anticipated under benefit PHA households, OVC, women, girls and other disadvantaged the NSP.14 groups w Ensure there is sensitization and awareness creation on human rights 14 See further discussion on criminalization in section 2.3 (v) and protection mechanisms on The Penal Code

18 HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

(iv) The National Policy Guidelines for Voluntary HIV Counseling and Testing (VCT) (2003) and National Policy Guidelines for HIV Counseling and Testing (HCT) (2005). Uganda adopted national test clubs, care and support, guidelines for voluntary The guidelines and referral for additional HIV counseling and testing contain special services. in 2003. These guidelines provisions relating apply to all actors to testing and The guidelines contain involved in VCT service counseling for special provisions relating provision, and provide children, emphasizing to testing and counseling that VCT services should human rights and for children, emphasizing be considered a public the best interests of human rights and the best preventive service and the child as guiding interests of the child as should be provided free in principles. guiding principles. The age public health institutions. of consent for VCT is set at 12 years, although children In relation to the rights of PHAs, the between 12 and 18 can only consent VCT guidelines spell out the following: with the approval of their guardians/ parents. This provision may limit the • The guidelines emphasize the right seeking of VCT services by adolescents, of the individual to consent to an HIV despite research showing that many are test, irrespective of the reasons for sexually active before age 18. the test. According to the guidelines, it is also the client’s decision whether In February 2005, the VCT Guidelines and how to disclose the results of were reviewed and integrated into their HIV test to others. the National Policy Guidelines for • Requiring HIV testing from HIV Counseling and Testing (HCT). people seeking employment, study The purpose of this was to develop an opportunities or other services can all-embracing policy catering for all lead to discrimination and should be circumstances under which HIV testing condemned. takes place. Some of the areas addressed by the HCT policy include VCT, routine • VCT should be provided along with testing and counseling (RTC) and a range of supportive services, home-based HIV counseling and testing including ongoing counseling, post- (HBHCT), testing of people seeking

HIV/AIDS, Human Rights, & Legal Services in Uganda 19 A Country Assessment

employment, studies or certain services, for “positive discrimination” for certain testing following occupational exposure, groups, by giving priority for free ARVs mandatory testing in a clinical setting, to the following categories: testing of legal minors (above 18 but incapable of functioning like an adult), • HIV-infected mothers identified and testing of special categories. through prevention of mother- to-child transmission (PMTCT) The shift from VCT to the more general programmes, as well as their HIV- “HCT” presents a risk, particularly infected family members (also known where clients are not well informed as “PMTCT-plus”) of their continued right to VCT. If • Infants and children clinicians are able to test patients for HIV without the latter’s explicit • HIV-infected people already enrolled and informed consent, this creates an in care and support activities opportunity for adverse consequences of • HIV-infected participants involved in HIV testing, including discrimination health research projects for HIV/ and violence upon disclosure of status. AIDS. To the extent that the HCT guidelines endorse mandatory testing in a clinical The policy adds that, while considering setting, there is a contradiction with the above, efforts would be made to the draft NAP which was also drafted ensure that patients outside the above in 2005. This is an area currently categories with limited or no ability to requiring intense scrutiny and advocacy pay would benefit from fully subsidized in Uganda. ARVs. The latter could easily constitute the majority of PLHA in Uganda. (v) The Anti-Retroviral Treatment (ART) Policy for Uganda (vi) The Policy for Reduction of the The Anti-Retroviral Treatment (ART) Mother-to-Child HIV Transmission Policy for Uganda, 2003) formulated (2003) by the Ministry of Health is guided by Uganda’s policy on prevention of the core values of equity and universal mother-to-child transmission (PMTCT) access. It is also based on a human of HIV, adopted in 2003, includes rights approach that seeks to guarantee provisions relating to treatment, an improved quality of life for people voluntary counseling and testing, living with HIV. The policy provides breastfeeding, infant feeding, vitamin

20 HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

supplementation, and STI diagnosis (vii) The National Policy on HIV/ and treatment, all in relation to AIDS and the World of Work PMTCT. In particular, the policy As far back as 2003, the Uganda recommends that: Ministry of Gender, Labor and Social Development formulated a National • HCT services should be available in Policy on HIV/AIDS and the World the same facility where antenatal of Work. The goal of the policy is to services are provided to ease “provide a framework for prevention integration of the two services. of further spread of HIV/AIDS and mitigation of the socio-economic • Every HIV-positive mother and impact within the world of work in her partner should be given Uganda”. information about the benefits and risks of breastfeeding and the use The guiding principles of the policy of alternative feeding options to related to law and human rights include enable them make informed choices the following: on infant feeding. • Non-discrimination at the place • All women should be supported of work on the basis of known or in a non-judgmental manner perceived HIV status (including irrespective of their choices with provisions for non-discrimination regard to infant feeding. HIV- in recruitment, termination of positive women who choose not employment, deployment and to breastfeed their infants should transfers, grievance resolution and be supported to safely adopt disciplinary measures, and payment replacement feeding options. of benefits)

• Routine administration of • Confidentiality, including the right multivitamins in pregnancy and to privacy and no obligation on vitamin in postpartum mothers and employees to reveal their HIV status in children to the employer The policy is not explicit on the issue • Prohibition of compulsory of stigma against HIV-positive women HIV testing as a condition of in health care settings, or of violence recruitment, promotion or career and discrimination upon disclosure of development; and provision of HIV the HIV status of a pregnant woman. testing.

HIV/AIDS, Human Rights, & Legal Services in Uganda 21 A Country Assessment

2.1 Main recommendations from the review of the policy and legislative framework The foregoing review illustrates Specific recommendations for that while Uganda’s policy regime improving and implementing the guarantees at least some HIV-related policy and legal framework include the human rights especially in relation following: to the medical dimensions of the epidemic (for example, access to HIV . The need for interventions to speed testing, treatment, and care), the up finalization of the pending draft country’s laws still fail to provide HIV/AIDS national policy. This clear protection to vulnerable groups should then be followed by enactment against HIV-related stigma and of a rights-based national HIV/AIDS discrimination. The review reveals legislation. LAHI should explore significant deficiencies in both partnerships with groups working the policy and legal framework in on HIV Policy and Legislative relation to criminalized populations framework. . such as sex workers and the LGBT . Ratification of the Protocol on community. The lack of an effective Women’s Rights in Africa with enforcement mechanism to support emphasis on the potential for the policy framework is an additional strengthening HIV/AIDS integration gap requiring intensive advocacy. in reproductive health rights should Significant advances have been made be supported. under the Employment Act, the Equal Opportunity Commission Act, and . Another intervention that needs to recent case law; however, evidence be undertaken is Public hearings of utilization of protective legislation (forums) and a dialogue process to and constitutional decisions is still build consensus on controversies limited because the enactments and arising within the human rights decisions are at this writing relatively field as a result of HIV/AIDS. recent. The real test will therefore Dialogue needs to be conducted on be in attempts to rely on the existing issues such as criminalization of protective framework to defend rights, transmission, mandatory testing in addition to strengthening the for sexual offenders and such framework itself. others. The outcome of the dialogue

22 HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

involving various stakeholders enforcement. Support should should inform the drafting of a therefore be given to dissemination comprehensive national legislation of the rights and entitlements on HIV/AIDS. contained in laws and policies that address HIV-related human . LAHI should support monitoring rights issues. Examples include and advocacy for enforcement of the the HIV/AIDS Work place Policy, protective policies and laws such the Employment Act and the Equal as the HIV/AIDS and Workplace Opportunities Commission Act. policy, the Equal Opportunities Organizations that conduct legal Law and the Employment Act. rights awareness programmes could This should be done with The be supported to develop simplified Platform for Labour Action (PLA) materials for dissemination and to an organization focusing on rights undertake sensitization activities in the workplace. through their programmes. . Whereas there is need to address . Litigation is another strategy the situation of the invisible through which the protective categories such as sex workers provisions within the laws can be and the LGBTI community, brought to life. This would involve opportunities for any form of defending rights in courts of law advocacy on their behalf are still through test cases. Organizations limited due to the deeply entrenched that engage in strategic litigation negative attitudes towards these can take a lead on this. Test cases categories even within the human can be brought on discrimination rights movement. The advocacy at the workplace, mandatory therefore needs to be preceded with testing and denial of maintenance alliance building activities for the and child custody for HIV positive wider population to appreciate the mothers. plight of these groups.

. The limited awareness of HIV- More detailed recommendations related rights and entitlements regarding the implementation of HIV- contained in the laws and policies related legal services are discussed later is a major setback to their in this report.

HIV/AIDS, Human Rights, & Legal Services in Uganda 23 A Country Assessment

3.0 Human Rights Abuses Linked to The Hiv Epidemic in Uganda

3.1 stigmatization and Discrimination Consultations for this report showed The stigma of immorality appears to that people living with, affected by, justify the various forms of abuse to or at risk of HIV encounter many which they are subjected, placing them overlapping forms of differential in constant fear for their personal treatment, exclusion, or restrictions security. Organizations working with against them. This may be due to both populations reported sexual their real or perceived HIV status, violence, whether against lesbians or because of their membership in a in an effort to “make them straight” socially stigmatized group that leaves or against sex workers at the hands them vulnerable to HIV. The stigma, of pimps and clients. In interviews, discrimination and human rights sex workers reported having been violations combine to form a vicious forcefully subjected to unsafe sex, circle: they create, legitimize and robbed of their personal belongings, reinforce each other. and either underpaid or not paid at all for their services. They said they Sex workers and LGBT had been arrested by the persons in Uganda “You negotiate and agree with the police and forced to pay person you believe to be a client. face a particular kind for their liberty in cash After feeding you and giving you of stigmatization and drinks, they introduce another or sex. These and other discrimination that person who is sometimes visibly abuses increased their stems from belonging ill and force you to have unsafe vulnerability to HIV/AIDS, to a social category that sex with them on entirely different in addition to violating terms. We never report such is considered immoral. violations.” their basic rights. Sex Worker, Kampala

24 HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

In situations where sex workers and or from acknowledging their HIV LGBT persons are HIV-positive, this status publicly.16 The forms of stigma has reinforced their resolve to remain and discrimination faced by people silent for fear of suffering multiple living with HIV are multiple and discrimination. It was reported that to complex, with the burden on women date, only one lesbian in Uganda had being especially heavy. Women living been bold enough to disclose her HIV with HIV are doubly stigmatized- positive status within her community of as “people living with HIV” and as lesbians15. “women.”

Girls and women represent a much Widows and orphans larger but also fundamentally I handled a case of a woman of HIV also encounter who initially indicated a marginalized and excluded group in HIV-related need for legal assistance to Ugandan society. Girls and women who stigmatization and have custody of her children have survived rape, sexual violence and discrimination in of tender age. On further probing I found out that she abduction face the added abuse of being Uganda. They may be stigmatized by their communities. They had taken an HIV test. When rejected and expelled she informed her spouse are often evicted, regarded as not good from the matrimonial of her positive status, he enough for marriage, and blamed for the home, with the turned violent, asked her to abuse they suffer. Their ostracization widows being blamed leave the home and denied her custody of the children. prevents them from enjoying their for bringing HIV into full range of civil, political, social and the family and the The frequency of reporting cultural rights. orphans considered such cases and other similar a burden. In many ones is what inspired us to For people living with HIV in Uganda, establish a specific project cases they are denied stigmatization and discrimination to promote legal rights of shelter. Orphans represent a major obstacle to effective PHAs. face a high rate of HIV prevention, treatment, care, and Reported by Fida Programme school drop-out, due support. The Agency for Cooperation Officer to many factors such in Research and Development (ACORD) reported that fear of as discrimination within school and discrimination at work, school or other the loss of parental support. Orphaned spaces prevented people living with and vulnerable children may be forced HIV from seeking treatment for AIDS 16 ACORD: GOOD PRACTICES for Challenging Stigma and Discrimination and Rights Promotion of People Living 15 This was disclosed during an interview with Freedom and with HIV&AIDS. A Case of Tanzania and Uganda 2006- Roam. 2007.

HIV/AIDS, Human Rights, & Legal Services in Uganda 25 A Country Assessment

into child-labour, which increases HIV information on people living with vulnerability especially among girls. HIV often leads to fear of accessing information and services, as disclosure Legal aid service providers interviewed of status can lead to discrimination and for this report said that they had other abuse. handled a number of cases of women who were subjected to violence or denied Violations of the right to privacy child custody or maintenance upon were also cited as a concern during disclosing their positive HIV status to consultations with the Sexual their spouses. Minorities Coalition. Members of the Coalition revealed that their right to 3.1.1 Rights to Privacy, Consent, privacy was under constant threat, and Confidentiality so that they not only hid their living In a 2005 study by the Health Rights addresses but also the locations of Action Group (HAG) on the status of their organizations. A specific case on human rights among people living violation of the right to privacy was with HIV/AIDS, people living with HIV filed against the Attorney General by a reported they had their sero-status coalition member of Sexual Minorities disclosed without their consent, while Uganda (SMUG)18. others were subjected to mandatory 17 HIV testing. Mandatory HIV testing 3.1.2 Right to information prior to joining the Police Force was also The right to freely receive and impart reported as an issue that the Uganda information lies at the core of reducing Network on Ethics, Law and HIV/AIDS vulnerability to HIV infection and the (UGANET) was handling with that promotion of dignity for those living with institution, and on which a public HIV and AIDS. The right to information interest test case could be filed. includes seeking and receiving information about HIV prevention and Violations of consent and confidentiality treatment options. The right should represent both a denial of basic rights also extend to seeking, receiving and and a threat to public health. Failure imparting information about one’s to maintain confidentiality of medical human rights as a person living with,

17 UNVEILING THE TRUTH; The Status of Human Rights affected by, or at risk of HIV. Among People living with HIV/AIDS in Uganda and their involvement in initiatives targeting communities, 2005. By 18 A discussion of the facts of this case is barred by the sub- Health Rights Action Group (HAG). judice principle.

26 HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

The HAG study on HIV and human legally challenged as contradicting the rights found that awareness of human right to information. rights among people living with HIV in Uganda was low. This finding 3.1.3 Right to the Highest was affirmed during consultations Attainable Standard of Health with organizations representing In a paper for the Human Rights and people living with HIV, sex workers, Peace Centre of Uganda (HURIPEC), LGBT persons, and legal aid service Twinomugisha aptly observes that providers, as well as policy makers. for people living with HIV, access to anti-retroviral treatment (ART) and to Since approximately 2003, the Uganda treatment for opportunistic infections government has placed considerable is critical to the enjoyment of their emphasis on the promotion of right to life and to health.19 According ‘abstinence’ within HIV/AIDS to HURIPEC paper, by the end of 2006, information campaigns targeting there were 91,500 people living with young people. Sexually explicit HIV on ART in Uganda, representing HIV/AIDS information approximately 39% of has been censored from those who needed it. government-sponsored The gap between This included 9,500 school curricula such as need and delivery of children, representing the Presidential Initiative ART reflects that in approximately 11% of on HIV/AIDS Strategy for Uganda, availability children who needed ART. and access to ART Communication to Youth Despite this progress, are not treated (PIASCY). This strategy the gap between need as entitlements has generated controversy and delivery of ART giving rise to legal in part because young reflects that in Uganda, obligations, much as people may be denied availability and access to they might be taken information about ART are not treated as seriously as a policy condoms and safer sex entitlements giving rise issue. options, while the National to legal obligations, much Sero-Behavioral Survey as they might be taken of 2004/5 revealed that 14 seriously as a policy issue. percent of both men and women aged 19 Ben Twinomugisha: Protection of the Right to Health 15-24 reported having had sex before Care for Women Living with HIV/AIDS in Uganda: The Case of Mbarara Hospital; HURIPEC Working Paper No.5 age 15. This policy can and should be April 2007.

HIV/AIDS, Human Rights, & Legal Services in Uganda 27 A Country Assessment

A further issue related to the right to re-integrate the ex-Lord Resistance to the highest attainable standard of Army (LRA) rebels without subjecting health is rape within marriage and them to formal trials for human sexual violence, which not only violate rights violations. Preliminary reports bodily integrity and freedom from from the consultations indicate that violence, but also increases women’s communities prefer to re-integrate and vulnerability to HIV infection. The use traditional mechanisms for justice Uganda Demographic and Health and reconciliation.20 It is important to Survey of 2005/6 shows that women are monitor how issues of sexual violence more likely to have experienced both that exposed so many women and physical and sexual violence than men. girls to HIV will be resolved in the The survey further shows that almost Peace Process. There is a need to one-sixth of Ugandan women (16%) monitor whether women infected with who have been pregnant experienced HIV through conflict rape get justice violence during pregnancy. Victims and ARVs, as well as support legal of sexual violence frequently indulge services for these women through in self blame and do not seek medical organizations like Human Rights assistance. This in turn denies them Focus based in Gulu. the opportunity to benefit from post exposure prophylaxis (PEP) with anti- 3.1.4 The Right to Work retrovirals to protect them from HIV Stigmatization and During an interview with infection. PEP is not readily available discrimination underlie ACORD it was reported for survivors of sexual violence in a range of human rights that an employee of an Uganda, as the focus of the policy is abuses related to the right FM radio station in Gulu occupational exposure. to work in Uganda. The district (Uganda) who had HAG study on HIV and been dismissed based on In the case of women and girls from human rights reported HIV status was reinstated areas affected by conflict in northern that people living with following intense advocacy Uganda, the Juba Peace Process could HIV had been dismissed by a community-based be an opportunity to seek justice from work due to their paralegal programme involving both people for sexual violence. At this writing, HIV status, while others living with and those consultations with the communities on had been denied promotion affected by HIV. Agenda Item 3 on Reconciliation and or employment benefits. Accountability are ongoing. The major 20 “Kony should be forgiven-IDPs”; New Vision Newspaper, issue of discussion is whether or not Friday 24th August 2007, Page 4.

28 HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

Such abuses can continue unabated to a prohibited social category; in the absence of strong enforcement powerlessness and lack of faith in the of an explicit law prohibiting justice system; corruption; inability discrimination on the basis of health to identify perpetrators; limited status. It is therefore important to access to and affordability of legal aid monitor whether the provisions in services; and lack of a supportive legal the recently enacted Employment Act framework for access to justice. and related policy are being utilised for the benefit of people living with The human rights abuses examined HIV in the workplace. Organizations in this short summary are clearly not like ACORD, Platform for Labour exhaustive but rather demonstrative Action and HAG have the capacity to of the challenge posed by the HIV spearhead such activities. epidemic on Uganda’s human rights regime. They are also not 3.1.5 access to Justice isolated from one another, but Any discussion on human rights rather overlapping and mutually abuses in the context of HIV/AIDS reinforcing—just as the various would be incomplete if it did not human rights protections are address the issue of access to justice. interdependent. Starting with As the foregoing assessment of specific stigmatization and discrimination, human rights violations has shown, a ripple effect of violations that in the vast majority of cases, human reinforce each other is set in motion. rights abuses linked to the HIV epidemic in Uganda are endured in The remainder of this report examines silence and ultimately coupled with how HIV-specific legal services can the denial of justice. Several factors help to address these violations and are responsible for this, including: advance the health and human rights limited of knowledge of rights; fear of people living with, affected by, and of seeking justice due to belonging at risk of HIV in Uganda.

HIV/AIDS, Human Rights, & Legal Services in Uganda 29 A Country Assessment

4.0 The Demand and Supply of Hiv-related Legal Services

4.1 Mechanisms for redress Legal procedures and mechanisms legal aid service providers in Uganda available to assert human rights in provided information on the ranking Uganda include both governmental of dispute resolution fora in Uganda.22 and non-governmental mechanisms. Respondents from all categories Governmental mechanisms include involved in the survey indicated formal courts, the Police, the Uganda that LC Courts are the most utilized Human Rights Commission21, Local dispute resolution fora. LC courts Council Courts, the Probation and were followed by the Police, traditional Welfare Office, the Administrator leaders, probation offices, and finally General’s Office, and the Department formal courts. It is noteworthy that for Labor and Registration of although their mediation services are Trade Unions. Non-governmental free or largely subsidized, legal aid mechanisms include programmes service providers were not ranked for legal aid, advice and counseling, highly among dispute resolution fora advocacy, and paralegal services. by communities. This was mainly attributed to the limited accessibility Despite what appears to be a wide range and visibility of legal aid providers. of options for seeking legal redress, access to justice continues to elude The 2006 survey on LC Courts and legal many Ugandans, particularly those who aid services further highlighted the encounter HIV-related human rights reasons for ranking LC Courts higher abuses. A recent survey on operations than other dispute resolution fora. Most of Local Council Courts (LC Courts) and 22 The Legal Aid Basket Fund (Labf) & Undp/uncdf: Joint Survey on Operations of Local Council Courts and 21 Article 52 (1) (a) and 52 (2) Constitution of the Republic of Legal Aid Service Providers, 2006 by Nordic Consulting Uganda Group (U) Ltd.

30 HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

users indicated that they concluded The above findings of the 2006 survey their matters through LC Courts, and on LC Courts and legal aid services where this did not happen, they tried to are only partially applicable to the exhaust all other possible avenues before search for justice in relation to HIV trying the formal courts if at all. Indeed, related abuses. As the previous the “other dispute resolution fora” section argues, due to a range of referred to in Table 4.1 below mainly context-based factors often having refers to the formal court system, with to do with stigma, discrimination or other dispute resolution fora falling in criminalization, human rights abuses between LC Courts and formal courts as linked to the HIV epidemic in Uganda a preferred method of dispute resolution. are still largely endured in silence Table 4.1: Reasons for ranking of and not even reported to and handled dispute resolution fora by the LC Courts. It follows therefore that although people living with, Positive attributes of Other dispute resolution affected by and at risk of HIV should LC courts fora access the standard legal procedures . They are our first contact . They will always require available to assert human rights in with government. evidence that you have been Uganda, they are doubly constrained to the LC first by the limitations within these . They live within the . Far from the users in terms of procedures that affect all Ugandans community and are distance. accessible. (highlighted by Table 4.1), as well as by the context-based factors peculiar . They are conciliatory . They are adversarial and the to their situation of HIV-related leaving both parties conflict never really ends. satisfied. vulnerability.

. They are convenient and . The process is cumbersome. OSIEA-LAHI should balance its not complicated. “causes fatigue” support to enhance use of both formal . They have background . It depends on who argues and informal mechanisms in order to information better and has a better lawyer. realize wider impact. In particular, . They are cheaper . More expensive OSIEA-LAHI should provide support . They are faster . They delay and cases never to programmes that specifically provide end. HIV-related legal services as discussed in the next section. Source: Joint Survey Report on Local Council Courts and Legal Aid Service Providers, 2006.

HIV/AIDS, Human Rights, & Legal Services in Uganda 31 A Country Assessment

4.2 Legal and human rights Programmes providing HIV-related legal services in Uganda Whereas Uganda has braved the 4.2.1 integration Projects HIV/AIDS epidemic for almost Services within this category include two decades, the longest existing the provision of legal services within the programme for the provision of HIV- context of other HIV-related services related legal services among those for treatment and care or prevention. identified during the assessment, In Uganda, services in this category the Uganda Network on Ethics, mainly benefit people living with HIV. Law and HIV/AIDS (UGANET), has The integration may be done by the spanned a period of only eight years, same organization within existing with the majority under five years of programmes, or it may involve a joint initiative or collaboration between existence. organizations with different focus areas The provision of HIV-related and competencies. Although these services are at no cost to the target legal services in Uganda is clearly group, their accessibility is strictly dominated by non-governmental limited to members from the targeted service providers. Based on communities. Examples of integration consultations conducted, services programmes identified during the can be grouped into four major survey include the integration of categories of Integration, Litigation, “will writing” into training activities Empowerment, and Law and by the Training Centre of The AIDS Policy Advocacy. A fifth category, Support Organization (TASO), a joint Supportive Mechanisms, helps initiative between Federation of Women individuals benefit from legal services Lawyers-Uganda (FIDA-U) and Plan by addressing other aspects of their International, and a weekly legal aid livelihoods and vulnerability. A clinic at the National Community description of the services and ability of Women Living with HIV/AIDS of people living with affected by and (NACWOLA). FIDA-U has also at risk of HIV to utilize them in terms found it necessary to employ in-house of accessibility and affordability counsellors to provide support to HIV- follows below. positive clients on an as-needed basis.

32 HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

This approach has proved effective in Aid Project of the Uganda Law Society handling HIV-related complaints. provide representation for some of their clients, or mediate between parties Under their Domestic Violence and in some cases send authoritative Demonstration Project, Centre communication in support of their for Domestic Violence Prevention clients to relevant persons or offices. (CEDOVIP) has integrated support for victims of domestic violence by Litigation also involves the filing of linking with Police stations and legal strategic cases to set precedents and/or aid organisations in the areas they establish key relevant principles that cover. Masaka Diocesan Development can be relied upon by many others in Organization (MADDO) has a future. Examples include the cases programme of Legal Defence for Widows already highlighted in this report and Orphans (LEDEWO) that links involving LAW-Uganda, FIDA-U and with other development initiatives of by individual lawyers. The only HIV- the organization. specific test case ever is the one filed by SMUG and is still pending before the Courts. 4.2.2 Litigation Projects This category includes services for legal In terms of accessibility, apart from representation of individuals, class strategic litigation which has a wide actions, strategic litigation, and related impact, individual litigation services supportive interventions. The services have limited coverage. Although mainly benefit people living with HIV litigation lawyers may handle large and those affected. The approach to numbers of cases, they tend to be legal representation takes different limited to people who are within a forms from one organization to another. 10 km radius, leaving a large unmet Organizations like TASO have used a demand. The cost of transport to pursue law firm retained by the organization legal services, which at times involve to undertake representation of clients multiple trips, is also not within the with serious cases; others like Human means of the majority of clients. Rights Action Group have referred their cases to organizations or law firms In line with its mandate, the Uganda providing pro-bono services. Although Human Rights Commission has powers not restricted to HIV-related issues, to investigate complaints of violations organizations like FIDA-U and Legal of human rights lodged by individuals

HIV/AIDS, Human Rights, & Legal Services in Uganda 33 A Country Assessment

What consistently and give remedies such as on HIV and human rights emerges in the UHRC compensation or any other targeting people living reports, however, legal remedy or redress.23 is the lack of with HIV, health service Its head office is in Kampala improvement in the providers, LC Court with regional offices in Fort right to health care officials, the police, and Portal, Kampala, Mbarara, for people living with the wider community. Gulu, and Soroti. Although HIV/AIDS in prisons Organizations like ACORD the Commission has issued or other places of and LEDEWO have trained an Annual Human Report detention. both people living with for 9 of the 10 years it has HIV and other community been in existence, it is not members as paralegals, possible to gauge from the records while others have done skills-based which complaints have been HIV- training on issues such as will-writing. related. What consistently emerges in The production of a Patients’ Charter, the UHRC reports, however, is the lack training manuals, pamphlets, posters of improvement in the right to health and other Information, Education and care for people living with HIV/AIDS Communication (IEC) materials as in prisons or other places of detention. well as radio programmes and other The 9th Annual report indicates that media-based activities are part of although there is improved access empowerment. Examples of service to ARVs for HIV infected persons in providers identified include Agency detention, the effect is diminished by for Relief and Development (ACORD), the poor diet of the prisoners. HAG, FIDA-U, National Forum for PHA Networks (NAFOPHANU), Hope 4.2.3 Empowerment Projects after Rape, ActionAid International- The majority of services assessed for Uganda, and Uganda National Health this report fall under the category of Consumers and Users Organization empowerment, targeting people living (UNHCO). with, affected by and at risk of HIV with the information and tools they Similar to the services under litigation, need to defend their own rights. Legal these are cost-free but have a rather empowerment approaches include limited coverage around the country. sensitization and awareness creation Although service providers are national organizations, they operate in a limited 23 Article 52 (1) (a) and 52 (2) Constitution of the Republic of Uganda number of communities.

34 HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

4.2.4 Law and Policy Advocacy campaigns or inform the development Projects of interventions such as that done by Although not directly part of service HAG, ACORD, the periodic HIV/AIDS delivery, this category of projects seeks Sero-Behavioural Surveys, as well as to ensure a conducive legal and policy the Housing and Demographic and framework for the protection of human Health Surveys under the Uganda rights of people living with, affected Bureau of Statistics. by and at risk of HIV. Areas of focus identified include the Employment Related to research are monitoring Act and Policy, national legislation on activities such as the Situational HIV/AIDS, the Sexual Offences Bill, Analyses on the Status of Human Domestic Relations Bill, the Bill on Rights for PHAs such as those Trafficking in Persons, and ratification conducted by HAG, sex workers, and of the Optional Protocol to the African the LGBT community. Other aspects Charter on Women’s Rights in Africa. of monitoring that are important but Key actors include Centre for Domestic not yet being undertaken include Violence Prevention (CEDOVIP), projects focusing on enforcement of the Uganda Women’s Network (UWONET), relevant policies and laws. Another Uganda Women’s Parliamentary aspect of research is the need for Association (UWOPA), Uganda review of various pieces of legislation Network on Law, Ethics and HIV/AIDS and their implications on HIV/AIDS (UGANET), Platform for Labour Action, and human rights. and LAW-Uganda. The Parliamentary Raising Voices is an organization that is Committee on HIV/AIDS is also a skilled with the translation of large and critical player in this category. complex issues that arise in the area of violence into practical methodologies 4.2.5 Projects on Research, Documentation and and tools for use at the community Development of Resource level. In 2003, Raising Voices developed Materials – “Support a resource guide on mobilising Mechanisms”. communities to prevent domestic Services in this category mainly include violence that has been found effective by practical interventions that support its users in East and Southern Africa.24 and enhance the delivery of HIV- related legal services. Such activities 24 Lori Michau & Dipak Naker: Mobilising Communities to Prevent Domestic Violence. A Resource Guide for include research to support advocacy Organisations in East and Southern Africa, 2003.

HIV/AIDS, Human Rights, & Legal Services in Uganda 35 A Country Assessment

The organization is at this writing about could be utilised in establishing shelters to conclude the development of another for battered women. resource guide, “SASA,” that contains practical tools and methodologies for the The National Community of Women analysis of power in the link between Living with HIV/AIDS (NACWOLA) violence and HIV and targeting HIV/ Memory Project and activities of the AIDS organizations. School of Public health can also be categorised among support mechanisms. In 2006, LAW-Uganda developed a The Memory Project of NACWOLA training manual on legal support to involves the documentation of the survivors of domestic violence and family tree and life histories by PLHAS established a pilot shelter for battered that they then leave behind for their women, which ran for a year. The shelter children to read. The School of Public provided a space for battered women Health undertakes has developed a who would be linked to the police, a course unit on Law, Ethics and HIV medical clinic and a counsellor. Lessons that would enhance the capacity of taken from the pilot were valuable and actors especially health practitioners.

4.3 The HIV-related Legal Services “Gap”

It is clear from the level of HIV- services, and lack of a supportive legal related human rights abuse in Uganda framework. Overcoming these factors that there is a tremendous need for is crucial to any effort to advance HIV- HIV-related legal services. However, related human rights. meeting this need requires both generating demand for legal services, Text Box 4.3: and generating a sufficient supply of Selected quotes regarding Legal Aid Service legal services to meet that demand. Provision In Uganda, demand for HIV-related legal services remains low for several “We do not have any legal aid service provider in the district.” reasons, including limited knowledge of rights, fear of seeking justice due “We have heard about legal aid providers on radio but we to membership in a prohibited social have never been there.” category, powerlessness, inability to “How does Fida work? How do we get them? Would they identify perpetrators, limited access to come and train us if we invited them?” Source: Joint Survey Report on Local Council Courts and Legal Aid Service Providers, 2006.

36 HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

Moreover, a comparison between the that only 6 km away from the town had potential level of demand for HIV- never heard of the service provider in related legal services and the supply that area. of services reveals a serious gap. This gap is reflected in the low availability, Closely related to issues of access are accessibility, affordability, and quality issues of quality. Some legal services of legal services. In other words, are ineffective at addressing HIV-related even those who have confidence in the abuses, often because of long delays in justice system and seek legal services the formal justice system. Increasing the to assert their rights are very unlikely quality of existing legal services, including to find them. building the capacity of service providers to use alternative mechanisms including It has been noted that although traditional justice, should be a priority. legal service providers are usually national agencies or organizations, The assessment observed that whereas their operations are limited in terms there have been some attempts to provide of geographical scope. Those that legal services for people living with HIV, indicate operations in a number legal services targeting the affected of districts are limited to small and at risk are disproportionately sections of the community in those fewer. For instance, there are no legal districts. For instance the joint aid service providers targeting fishing programme between FIDA-U and Plan communities in Uganda, yet they are International which covers Kawempe among the most at risk populations. Division covers only 6 of the 19 The assessment similarly identified parishes there, despite demand from total gaps in legal service provision for other parishes The 2006 Joint Survey the prohibited and therefore “invisible” on LC Courts and legal aid revealed populations of sex workers and LGBT that legal aid service providers were persons. The organizations serving these not as visible or accessible as had been two groups restricted their operations assumed by the survey team. to the provision of basic information and services on HIV/AIDS and lacked As text box 4.3 illustrates, legal aid the capacity to address the human service providers are largely urban- rights issues. Their linkages with other based with limited facilities to conduct mainstream human rights organizations outreach. In one district, a community were also found to be quite limited.

HIV/AIDS, Human Rights, & Legal Services in Uganda 37 A Country Assessment

5.0 Programming Opportunities for The Law and Health Initiative

5.1 introduction

It is the finding of this review that the “legal services gap” in the first the available legal services in Uganda place. LAHI should seek to support do not nearly match the huge need initiatives that will integrate legal for general legal aid services, let services into existing HIV/AIDS alone the needs of people living programs, expand and scale-up the with, affected by and at risk of HIV/ few services that have attempted to AIDS, who face a range of additional respond to the needs of those affected issues and vulnerabilities. While and most at risk, enhance efforts some nongovernmental HIV/AIDS already being taken within the legal organizations have attempted to and policy framework, and ensure integrate legal support into their more equitable service provision work, there are hardly any legal and to improve both accessibility and human rights services directly related effectiveness. Interventions should to HIV/AIDS in Uganda. also ultimately lead to a more balanced position in targeting people Interventions by the Law and Health living with, people affected and those Initiative (LAHI) should attempt to at risk of HIV/AIDS. fill this gap, both by supporting HIV- related legal services and addressing the underlying issues that create

38 HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

5.2 Recommended Actions under LAHI’s Priorities LAHI’s Global Strategy25 outlines a . Empowerment: activities that have number of priorities that fit in well a wide impact on promoting positive- with the findings of this review. These living priorities are (1) integrating legal . Conciliatory approaches: and health services, (2) promoting strategies limiting backlash and human rights in patient care, (3) vindictiveness; supporting human rights responses to HIV and AIDS, (4) developing civil . Accessibility: activities to fill society capacity in law and health, programming gaps and ease access and (5) using legal strategies in health for the target groups. monitoring. . Sustainability: strategies building on existing mechanisms, including In determining specific activities to cost effective strategies; be supported under these priorities in Uganda, the following criteria should . Efficiency: strategies that yield wide be considered: impact results with a block cost. . Cost-effectiveness: activities to . Inclusiveness: activities targeting ensure access to justice at minimal most at risk populations. financial cost; In relation to the above priorities and . Time: activities to minimize the criteria, proposed interventions include: duration of dispute resolution;

Priority 1: Integration of Legal/Paralegal and Health Services Supporting HIV/AIDS and legal aid with, affected by and most at risk of organizations to integrate, mainstream HIV fits in well with LAHI’s priority and scale-up legal aid service provision of integrating legal and paralegal to include targeting those living services into health services. All

25 Open Society Institute Public Health Program, Global service providers involved in treatment Strategy for the Law and Health Initiative, January 2007, and care recognized that inclusion of available at http://www.soros.org/initiatives/health/focus/ law/articles_publications/publications/strategy_20071211. legal services would greatly enhance

HIV/AIDS, Human Rights, & Legal Services in Uganda 39 A Country Assessment

the quality and effectiveness of their HIV care and treatment programmes services, but are limited by resources. that could explore integrating legal Integration can be done using the services include are the development following approaches: programmes of the Catholic Church such as Soroti Catholic a) Integration of legal services into Diocese Development Organization programmes focusing on HIV (SOCADIDO) and GULU Catholic treatment and care Diocesan Development Programme. This would ensure broader and more Given their wide reach, there is effective coverage because treatment potential to explore possibilities of and care programmes are more integration of legal services into their equitably represented throughout the already existing treatment and care country. Organizations like TASO programmes. which has eleven operational centers in 4 regional offices in the country b) Integration of HIV legal services as well as a training centre provide within existing legal aid a good model for integration through programmes expansion of their will writing project As already illustrated in this review, to cover other human rights aspects FIDA-Uganda in collaboration with of HIV. Human rights and HIV can Plan International have already also be included in the training implemented a programme in one provided at the TASO Training Centre. district offering legal aid specifically Another organization, Meeting Point for those living with and affected by International, providing care and HIV. FIDA also collaborates with treatment in three informal settlements NACWOLA to run a weekly legal aid would go a long way toward enhancing clinic for the membership of NACWOLA its services by integrating legal who are mainly women living with services to respond to the rights-related HIV. The Legal Defence Programme challenges they encounter. Centre for Widows and Orphans implemented for Prevention of Domestic Violence by the Masaka Diocese Development have gained valuable experience in Programmes also provides a good model integrating legal protection within of integration. Such initiatives should their Domestic Violence Demonstration be evaluated for their effectiveness Project in another informal settlement. with the purpose of expanding them Other groups that have elaborate for wider reach and ensuring that they

40 HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

also target the socially marginalized d) Strategic litigation based on populations of sex workers and LGBT integration projects persons who at the moment have no As LAHI’s strategy notes, integrated access to HIV-related legal services. legal and health services can be used Programmes for HIV-related legal as the basis for identifying cases for services targeting fishing communities strategic litigation. Indeed, experience would also address a serious gap. has shown that there are limitations LAHI should explore posibilities of in pursuing litigation for individual partnership with groups working with cases. Court procedures take long to conclude and are tedious and expensive. fishing communities to address legal In that regard, strategic litigation and human rights challenges relating to and test cases on protective legal HIV and AIDS. provisions and mechanisms such as the Equal Opportunities Commission c) Integration of HIV legal services are recommended because they would at the Local Council Courts generate a wider impact in a more It is the finding of this report (Section efficient manner. Support could be 4) that although legal aid service provided to organizations that engage in organizations offer services for free or strategic litigation to file test-cases on are largely subsidized, they remain discrimination against people living with invisible and inaccessible to potential HIV, especially using the new laws on users. Most people opted to utilize the employment. Coupled with this should LC Courts in resolving their disputes. be support to advocate for the speedy LC Courts therefore play a significant creation of the Equal Opportunities role in promoting access to justice Commission that will address violations and should be capacitated to deal of rights of vulnerable groups. with violations relating to HIV/AIDS. Organizations that work with LC At the individual (non-strategic) case Courts could be supported to expand level, to the extent possible, support their training programmes to ensure should go towards mechanisms for they target the officials who preside Alternative Dispute Resolution (ADR) over the LC Courts and equip them to protect rights of people living with, with sufficient knowledge on HIV and affected and at risk of HIV. Cases such human rights to enable them resolve as sexual and domestic violence that those disputes in line with human cannot be settled out of court should be rights principles. pursued through formal processes.

HIV/AIDS, Human Rights, & Legal Services in Uganda 41 A Country Assessment

Priority 2: Human Rights in Patient Care As alluded to in this report and the Patient Rights Charter developed by LAHI Global Strategy, health services UNHCO and adopted by the Ministry can too often be places of abuse and of Health should be a good beginning coercion rather than treatment and point. The training and awareness- care. Indeed, one of the barriers to raising being conducted by UNHCO on the realization and access to justice patients’ rights should be extended to as highlighted in this report for those specifically include those affected and living with HIV and those most at risk at risk of HIV so that they are able to populations is the lack of awareness seek redress on violations. Awareness of rights not only amongst those and sensitization on HIV and human populations, but also amongst the rights should also be targeted at the health and legal service providers general public to ensure they do not as well as the general public. As violate those rights and act as advocates increasing numbers of people living to prevent violations. Groups that work with HIV gain access to health on patients’ rights could be supported care, there will be a need to support to intensify the work on this with a promotion of human rights in patient focus on those affected and most at risk care to both the consumers of health populations. services as well as the providers. The

Priority 3: Human Rights Responses to HIV and AIDS

Priority 3 represents an opportunity responses based on a human rights to support national advocacy for response to HIV. This is perhaps most legislative and policy reform related clearly evidenced by the continued to HIV. Priority areas for HIV and criminalization of the “invisible” social human rights advocacy in Uganda categories of sex workers and LGBT include: persons.

a) Criminalization of “invisible” The situation of sex workers and the social categories LGBT community warrants special Despite Uganda’s having a plethora attention. Their status is effectively of policies on HIV and AIDS, there prohibited, placing them at heightened are still glaring gaps in terms of risk of HIV. The assessment showed

42 HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

that these categories are b) Criminalization of The situation of sex far from a point where wilful HIV infection workers and the they can defend their Although Uganda LGBT community rights or seek support has not enacted HIV- warrants special from others. They have specific legislation, the attention. Their no strategic targets, Parliamentary Committee status is effectively lack skills for planning, on HIV/AIDS in Uganda prohibited, placing cannot retain legal is at this writing in them at heightened services, and need to the process of drafting risk of HIV. raise allies within the a bill on HIV/AIDS. human rights movement Moreover, as noted in the country. The Uganda AIDS above, a recent amendment of the commission fails to mention them in penal code introduced the offence its national strategic plan, further of “aggravated defilement” that heightening their invisibility. It is effectively criminalizes deliberate or therefore recommended that in order wilful transmission of HIV. While for these categories to meaningfully this may be a better approach rather benefit from legal services, they should than creating a new crime in a new first receive support for institutional law, it is nevertheless necessary strengthening and coalition-building that proactive action be taken to ensure sufficient public debate on the In seeking to initiate programmes for draft bill to guard against importing these populations, there is need to make provisions into the Ugandan draft reference to other findings conducted to bill from other jurisdictions that determine funding needs and capacity criminalize not just wilful infection 26 gaps for these groups. Another avenue but also knowledge of ones HIV status for ensuring their rights may be the and failing to inform a sexual partner. establishment of a defenders fund Hand in hand with creating fora through the East and Horn Human for debate on criminalization, other Rights Defenders Network, which would issues relating to rights of PLWA and in turn build the capacity of these those at risk that need to find voice groups and provide legal support in the in the debate on policies and laws event of violations. are compulsory testing, premarital testing, testing of pregnant women, 26 A situational analysis of sex workers in Uganda; Lady mermaids bureau, Off the Map; Cary Johnson. and protection of OVC’s.

HIV/AIDS, Human Rights, & Legal Services in Uganda 43 A Country Assessment

Human rights advocacy organizations violence, even though PEP has could be supported to convene been proven to prevent infection public debates on the human rights with HIV when administered implications of the proposed HIV/ within a certain time frame. AIDS legislation. The debates would CEDOVIP in collaboration with provide a platform for dialogue on other partners is already working contentious issues towards consensus- on expansion of the provisions of building. The Parliamentary the policy to include post-rape care Committee on HIV/AIDS is also a and treatment. critical partner in this regard. They should also receive technical support . Ratification of the Protocol on in reviewing the draft bill with a Women’s Rights in Africa. The view to proposing changes that would protocol contains specific provisions promote and protect rights of the aimed securing rights of women vulnerable groups and people living and girls in the face of HIV/AIDS with HIV. and ratification process should be supported.

c) Other Law and Policy Advocacy . Establishment of the Equal Other strategies that could be persued Opportunities Commission. under this priority include advocacy This Commission is mandated campaigns on: to resolve disputes relating to . An Overarching HIV/AIDS employment matters. Given the Policy. This would agitate for the wide discrimination of PLWA’s in conclusion of the pending HIV the workplace, the COALITION policy that would be the reference ON EOC should be supported to point for all other policies on HIV in expedite the process of establishing Uganda. this commission.

. Finalization of a Comprehensive . Other laws that need to be reformed PEP policy. The PEP draft policy or enacted to protect those affected caters for PEP provision only and most at risk of HIV include the in occupational exposure cases. Domestic Relations Bill under the It fails to provide for treatment DRB Coalition and matrimonial with PEP for survivors of sexual property laws.

44 HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

Priority 4: Capacity Development in Law and Health It is the finding of this report that in Sub Saharan Africa, hence the there are hardly any legal and human limited number of interventions at rights interventions directly targeting the intersection between health and people living with, affected by and rights. OSIEA-LAHI should address at risk of HIV in Uganda. Besides this need by investing in capacity being overstretched by their current development programs that create a interventions, the dearth of HIV cadre of health and legal professionals related legal and human rights services committed to advancing legal and points to a weak capacity on the part human rights responses in public of institutions that offer both care and health. The Makerere University’s treatment and other mainstream legal Faculty of Law and School of Public aid programmes to design innovative Health offers a window of opportunity programs to address this gap. It is also to explore possibilities of formalized an acknowledged fact that health and health and human rights training for human rights is a relatively new field both students and legal and health for both health workers and lawyers professionals.

Priority 5: Using Legal Strategies in Health Monitoring

Uganda has benefited from a dramatic Rights Conventions and has recognized increase in resources directed at basic rights in its constitution that are addressing the HIV/AIDS crisis from fundamental to responding effectively various donor sources like the Global to HIV. In line with these commitments Fund to Fight AIDS Tuberculosis and LAHI could support efforts in health Malaria, Presidents Emergency Plan for budget monitoring with a specific focus Aids Relief amongst others. While that on tracking HIV/AIDS funding in order to has enabled scale up of treatment and analyze the allocations and expenditure care programs, these resources hardly from a human rights perspective. go to programming that addresses Secondly the tracking should enable the legal and human rights for people use of budgetary allocations as indicators living with AIDS and other vulnerable of adherence of the human rights and at risk populations. Uganda is frameworks that the country has pledged a signatory to International Human to uphold in the fight against HIV/AIDS.

HIV/AIDS, Human Rights, & Legal Services in Uganda 45 A Country Assessment

References

List of Cases 1. Uganda Association Of Women Lawyers, 2. Law &Advocacy For Women In Uganda Vs. And Others Vs. The Attorney General; Attorney General; Constitutional Petitions Constitutional Petition No.2 of 2003. Nos. 13/05 & 05 of 2006

Bibliography 1. Annual PEAP Implementation Review (Draft) 11. On the frontline: A review of policies and Report (2007). policies to address AIDS among Peacekeepers 2. Ben Twinomugisha: Protection of the Right and Uniformed services, UNAIDS 2003; to Health Care for Women Living with 12. Penal Code (Amendment) Bill No.20 of 2006. HIV/AIDS in Uganda: The Case of Mbarara The Bill as assented to by the President to Hospital; HURIPEC Working Paper No.5 make it law has not yet been gazzetted April 2007. 13. Protocol on the Rights of Women in Africa. 3. Bridging Government unjustified policy: 14. Situation analysis (2004): The impact of HIV Stigmatization, harassment, exposure to and AIDS on Fishing Communities in Uganda HIV/AIDS/STIs; A Situation Analysis of Sex 15. The Legal Aid Basket Fund (Labf) & workers in Uganda. Commissioned by Lady Undp/Uncdf: Joint Survey on Operations Mermaid’s Bureau, 2004. of Local Council Courts and Legal Aid Service 4. Constitution of the Republic of Uganda 1995; Providers, 2006 by Nordic Consulting Group 5. Daily Monitor Newspaper, 3rd May 2007. (U) Ltd. 6. Lori Michau & Dipak Naker: Mobilising 16. Uganda AIDS Commission (2005): National Communities to Prevent Domestic Violence. HIV/AIDS Mapping Report A Resource Guide for Organisations in East 17. Uganda Demographic and Health Survey and Southern Africa, 2003. 2005/06 7. Ministry of Health Kampala, Uganda: March 18. Uganda National Household Survey 2006 2006, UGANDA HIV/AIDS Sero-Behavioural 19. Uganda Network on Law, Ethics and HIV/ Survey 2004-05. AIDS, Annual Report 2005 8. National Forum for PHA Networks in 20. UNAIDS 2003: Developing a Comprehensive Uganda; A Simple Guide on How to Make a HIV/AIDS/STIs Program for Uniformed Will, May 2005. Services 9. National Forum for PHA Networks in 21. UNDP Human Development Report 2006 Uganda; Human Rights Information 22. UNVEILING THE TRUTH; The Status of Pamphlet: Specific Reference to People Living Human Rights among People living with with HIV/AIDS, May 2005. HIV/AIDS in Uganda and their involvement 10. New Vision Newspaper, Friday 24th August in initiatives targeting communities, 2005. By 2007. Health Rights Action Group (HAG).

46 HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

Annex 1: HIV-related legal services provided through Non-government Initiatives27

Category Specific Services of Service Service Providers provided Provision 1. Counsellors within Legal FIDA-U Integration Aid Clinics 2. Legal Services within CEDOVIP Domestic Violence Project 3. Legal Services within PLAN INTERNATIONAL AND HIV/AIDS and Service FIDA-U. Delivery Interventions 4. Legal Aid Services NACWOLA within PHA activities

1. ADR, advice and FIDA-U, HAG, LAP, UGANET Litigation counselling, Referral 2. Strategic litigation FIDA-U, LAW-U, SMUG, LEDEWO

1. Training on “Will FIDA-U, NAFOPHANU, Empowerment Writing”, Training UGANET Manuals and Pamphlets 2. Legal Rights Awareness ACORD, HAG, and Sensitization; NAFOPHANU, UGANET, Challenging Stigma & CEWOLAPO, ACTIONAID Discrimination (Use INTERNATIONAL -UGANDA of Media, Drama, Literature) 3. Paralegal Training FIDA-U, HAG 4. Patients’ Charter UGANDA HEALTH CONSUMERS AND USERS

27 The list provided here is not exhaustive but merely represent groups that were interviewed as part of this assessment. HIV/AIDS, Human Rights, & Legal Services in Uganda 47 A Country Assessment

Category Specific Services of Service Service Providers provided Provision Law and Policy 1. Advocacy on PARLIMENTARY Advocacy Comprehensive National COMMITTEE ON HIV/AIDS, Legislation NAFOPHANU, SMUG, CEDOVIP, ACTIONAID INTERNATIONAL-UGANDA 2. Monitoring enforcement ACORD, PLA of policies 3. Advocacy on Supportive FIDA-U, CEDOVIP, LAW-U, Legislation (DRB, UWOPA, DRB Coalition Domestic Violence, Sexual Offences, Trafficking,

48 HIV/AIDS, Human Rights, & Legal Services in Uganda A Country Assessment

HIV/AIDS, Human Rights, & Legal Services in Uganda 49 A Country Assessment

he Law and Health Initiative (LAHI), a division of OSI’s Public Health Program, promotes legal T action to advance public health goals worldwide. LAHI supports legal assistance, litigation, and law reform efforts on a range of health issues, including patient care, HIV and AIDS, harm reduction, palliative care, sexual health, mental health, and Roma health. LAHI’s priorities include integrating legal services into health programs, strengthening human rights protections within health settings, and developing training and education programs in law and health. A special focus is on supporting organizations and advocacy campaigns dedicated to ending human rights abuses linked to the global AIDS epidemic. By bringing together legal, public health, and human rights organizations, LAHI seeks to build a broad movement for law-based approaches to health and for the human rights of society’s most marginalized groups.

The Open Society Initiative for East Africa (OSIEA) promotes public participation in democratic governance, the rule of law, and respect for human rights by awarding grants, developing programs, and bringing together diverse civil society leaders and groups. OSIEA plays an active role in encouraging open, informed dialogue about issues of public importance in East Africa.”

50 HIV/AIDS, Human Rights, & Legal Services in Uganda