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 Copyright© 2008, Open Society Initiative For East Africa All rights reserved. No part of this publication maybe reproduced, stored in a retrieval system, or transmitted in any form or any means without the prior permission of the publisher. 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 Designed & Printed by Noel Creative Media Ltd. 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 v 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