Analysis: GODFREY CHITALU
I DON’T know why it has taken this long for mandatory HIV testing to be implemented in our country. Like most Zambian families, mine has not been spared by the ravages of HIV and AIDS.
The infected and affected should laud President Lungu for taking that bold decision.
When I learnt that mandatory HIV testing will be the rule of our land, I not only ululated but took time to counsel my siblings on the ripple effect of HIV and AIDS.
We should as a country not elevate HIV and AIDS above fearful malaria and dreaded tuberculosis. This trio forms an axis of communicable diseases responsible for high rates of illness.
Before I further my discourse, I should not trash the chorus of opposition to this move. So far, and in typical style, the opposition FDD have come out guns blazing. Through their mouthpiece, Antonio Mwanza, they cried wolf; “mandatory HIV testing is unethical; a violation of human and bodily rights and is detrimental to health”.
In tandem to these remarks, Treatment, advocacy and literacy campaign national co-ordinator Felix Mwanza said: “This move will result in people shunning health institutions.” If it wasn’t for the weightiness of this matter, I should have dismissed the Mwanza-squared assertions using my tribal powers.
A decade ago, through a matrix of polygamous religion with a cult following some of my family members contracted HIV and AIDS. To worsen matters, they belonged to a sect that prohibited its members from seeking medical attention. We were entwined in a web that basically required wrestle mania from the sect, which we did successfully.
The survivors, some of whom came out with the virus, had to be cajoled to openly discuss their status through voluntary counselling and testing. It was and has been hard because of the stigma. Equalisation has come through a mandatory move that will relegate HIV to mere malaria and headache. To me, mandatory tests actually permanently remove the stigma associated with the disease.
I advocate that whoever chooses to go to a clinic has taken that first step towards waiving his or her consenting rights. It is now left to the medical staff to have conversational discretion and protection of medical records that ensue from the visit. In itself, mandatory counselling, coupled with medical discretion and patient doctor professionalism can never be a violation.
I do not think our medical staff will arbitrary test every person who goes to the clinic for HIV/AIDS. It is a costly venture akin to shooting in the darkness. I suppose there will be a certain criteria followed as part of medical diagnostics. This is the point most people are missing.
Remember, in the past, mandatory testing involved pregnant women for double protection reasons. This facet has borne more fruits in the HIV and AIDS fight. The President is just generalising what has been happening with expectant mothers.
My understanding of this subject is two-fold; we voluntarily go to seek medical attention and therefore should allow the professionals to do their job. If there is any screening for blood in blood banks, semen, organs and tissues or any other requested biological samples, HIV screening must be included.
I don’t think, it would auger well to conduct HIV tests on anyone who goes to a clinic with eye and ear itchings. Lest we drive out high risk people like sex workers into illicit medical centres for fear of stigma. We should follow this declaration with massive sensitisation about the new status quo.
While we lauded the genesis of voluntary counselling and testing, we saw how the voluntary part was necessary at the advent of HIV and AIDS, but surely we should move with times and cut off both the voluntary and counselling to fast track treatment.
Testing should be the in-thing whether a medical staff is involved or not. Small wonder the NGO – Society for Family Health – has launched close to 100,000 self-testing kits. This to me was a John the Baptist move, which we should hail. Yes, in the past pre- and post-test counselling ruled and informed consent, confidentiality and privacy was guaranteed for those testing – the question is; who has the time in this fast world?
Even in the wake of window period uncertainties, we should not let our people die because we are riveted to World Health Organisation cautions and precautions. We should now concentrate on ensuring that our medical facilities are equipped to handle HIV and AIDS services, treatment is available, false positives are eliminated and that generally, medical staff and medicines are available. This is an indictment on the government to unequivocally provide medical services as and when required.
I support this strategy because I had kith and kin in the densely-populated Chawama compound, where I saw first-hand unnecessarily deaths at the behest of ignorance and insistence of HIV and AIDS. In these overpopulated areas, mandatory testing will be a plus.
Even if I’m not a medical professional, I know for certain that with mandatory testing, there will be a shorter period for patients to be introduced to life saving drugs. I don’t have to be prophetic to see a drop in the prevalence rate and saving of many lives through prompt testing and quicker medical uptake.
Mwanza squared and others cautious about this move should prod Government on service provision. The move needs support in the areas of medicines, medical staff, equipped testing centres, modern rural health facilities, quick referral systems, equipment, counsellors and related personnel and facilities.
The President is on firm ground if these are going to be met. It is high time we removed the stigma of ignorance; most of my kith and kin who have succumbed to HIV and AIDS died before their time due to ignorance. Test and be free.
As long as you go to the hospital and the medical staff suspect that you could be infected, be ready for that test. We need to reduce infection for our populace through this wise move.
I’m all for mandatory testing if it is part of a cure package; generally speaking, patients who do not know their status usually take up medication meant for others. If you know your status, the medical regime will be pointedly given to you.
As I wind up, I hope mandatory testing will not discriminate in regard to job applicants, since we all agreed that HIV and AIDS has equal status with other ailments like malaria.
The author is a social and political commentator.