ARTICLES

The Model Law on HIV in Southern Africa: Third World Approaches to International Law insights into a human rights-based approach

Robert Johnson

United Nations Advisor/Consultant

SUMMARY

Legislating in response to the HIV epidemic is a core element of the global HIV strategy. A human rights-based approach is essential in order to comply with international law as well as to ensure effectiveness. This stands in contrast to punitive measures and criminalisation provisions within HIV legislation. Third World states are entitled to be cautious about a purportedly human rights-based approach and an explicit conformity with international law that have their institutional origins in advancing Western hegemonic interests. The insights of Third World Approaches to International Law (TWAIL) are important in harnessing international human rights law as a necessarily transformative framework that is effective in meeting its globally equitable and social justice character. This is especially so for the Southern African model law on HIV. TWAIL provide critical guidance relating to context and strategy for Southern African states in this regard and the model law, in turn, offers important opportunities in advancing TWAIL objectives in its counter-hegemonic struggle for global equity and justice. The Southern African model law on HIV is strongly compliant with international human rights principles and obligations and relevant to effectively address the nature of the HIV epidemic in the region. The domestic adoption of the model law across Southern African states has the potential to fulfil a strategically crucial transformative role in advancing Third World resistance.

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* Dip Youth Work (ISW, Melbourne), BA (Politics) (Adelaide), M Public Policy, M Development Studies (Deakin), M Public and International Law (Melbourne); rj-bz@yahoo.com. The views in this article are entirely those of the author, and do not reflect the views or opinions of the SADC Parliamentary Forum, where the author undertook an internship in 2008 toward completion of post-graduate human rights law studies.
1 UNAIDS Report on the global AIDS epidemic 2008 (2008) 214 217 218 http://data.unaids.org/pub/GlobalReport/2008/JC1510_2008GlobalReport_en.zip (accessed 10 April 2009).         [ Links ]
2 UNAIDS (n 1 above) 13.
3 The SADC states are Angola, Botswana, Democratic Republic of the Congo, Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Swaziland, United Republic of Tanzania, Zambia and Zimbabwe. Madagascar was suspended by the Extraordinary Summit of the SADC Heads of State and Government (30 March 2009) until its return to 'constitutional normalcy'.
4 UNDP Human Development Report 2007/2008 (2007) Table 5 (2005 data).
5 UNAIDS (n 1 above).
6 UNICEF The state of the world's children 2008 (2007) Table 4 (2005 data).
7 JT Gathii 'Alternative and critical: The contribution of research and scholarship on developing countries to international legal theory' (2000) 41 Harvard International Law Journal 265.         [ Links ]
8 Gathii (n 8 above) 266.
9 M Mutua 'What is TWAIL?' (2000) ASIL Proceedings 2000 31.         [ Links ] Okafor locates TWAIL's origins in the pre-1940s decolonisation movements of Latin America. OC Okafor 'Newness, imperialism, and international legal reform in our time: A TWAIL perspective' (2005) 43 Osgoode Hall Law Journal 177.         [ Links ]
10 BS Chimni 'The past, present and future of international law: A critical Third World approach' (2007) 8 Melbourne Journal of International Law 500.         [ Links ]
11 Mutua (n 9 above).
12 DP Fidler 'Revolt against or from within the West? TWAIL, the developing world, and the future direction of international law' (2003) 2 Chinese Journal of International Law 31.         [ Links ]
13 Fidler (n 12 above) 74. For ways in which '9/11' was used - especially by the USA - to intensify pro-hegemonic international law and its institutions, see B Rajagopal 'Counter-hegemonic international law: Rethinking human rights and development as a Third World strategy' (2006) 27 Third World Quarterly 774.         [ Links ]
14 Okafor (n 9 above) 173.
15 Mutua (n 9 above) 36. 'Just like the Third World on which it focuses, TWAIL is not a monolithic school of thought' (Okafor (n 9 above) 176).
16 Mutua (n 9 above) 31.
17 OC Okafor 'Marxian embraces (and de-couplings) in Upendra Baxi's human rights scholarship: A case study' in S Marks (ed) International law on the left: Re-examining Marxist legacies (2008) 256-7.         [ Links ]
18 Okafor (n 17 above) 265-270.
19 Okafor (n 17 above) 266-267. For a coherent elaboration of the means by which international law is being used to advantage global capital and property interests over Third World states and peoples and, by association, human rights standards, see BS Chimni 'Third World approaches to international law: A manifesto' in A Anghie et al (eds) The Third World and international order: Law, politics and globalization (2003) 52-60.         [ Links ]
20 U Baxi 'What may the "Third World" expect from international law?' (2006) 27 Third World Quarterly 721.         [ Links ]
21 A Anghie Imperialism, sovereignty and the making of international law (2004) 271.         [ Links ]
22 Chimni (n 19 above) 62-63.
23 n 21 above.
24 Rajagopal (n 13 above) 768.
25 Chimni (n 19 above) 67.
26 Rajagopal (n 13 above). For the reader surprised by the notion that human rights discourse has served hegemonic purposes, see Rajagopal (n 13 above) 769-775 and, more vociferously, Mutua (n 27 below), including concerning the hegemonic role of Western/international human rights NGOs.
27 M Mutua 'Savages, victims, and saviours: The metaphor of human rights' (2001) 42 Harvard International Law journal 201 208 210.         [ Links ]
28 Mutua (n 27 above) 245.
29 As above.
30 n 21 above, 255-256. There is not uniform optimism about the capacity to reform from 'within'; see, eg, OC Okafor 'Poverty, agency and resistance in the future of international law: An African perspective' (2006) 27 Third World Quarterly 808.         [ Links ]
31 Rajagopal (n 13 above) 780-781.
32 B Rajagopal 'International law and Third World resistance: A theoretical inquiry' in Anghie et al (n 21 above) 151.
33 Okafor (n 30 above) 799. In the context of HIV and AIDS in Southern Africa, the issue of poverty is highly contested: it is briefly referred to in sec 4.2.
34 Okafor (n 30 above) 804.
35 Okafor (n 30 above) 809.
36 Rajagopal (n 13 above) 781.
37 SADC Treaty of the Southern African Development Community (SADC) (2001) http://www.sadc.int/index/browse/page/120 (accessed 10 April 2009).         [ Links ]
38 See, eg, the African Union http://www.africa-union.org/root/au/RECs/sadc.htm (accessed 10 April 2009).
39 As above.
40 African Union (n 38 above) http://www.africa-union.org/About_AU/Abrecs.htm (accessed 10 April 2009).
41 SADC Tribunal Protocol of Tribunal and the Rules of Procedure thereof arts 14 & 15 http://www.sadc.int/tribunal/protocol.php (accessed 10 April 2009).
42 See African International Courts and Tribunals http://www.aict-ctia.org/courts_sub-reg/sadc/sadc_home.html (accessed 10 April 2009).         [ Links ]
43 SADC Parliamentary Forum http://www.sadcpf.org/index.php?disp=about (accessed 10 April 2009).         [ Links ]
44 Inter-Parliamentary Union http://www.ipu.org/english/membshp.htm (accessed 10 April 2009).         [ Links ]
45 African Union http://www.africa-union.org/root/au/organs/Pan-African_Parliament_en.htm (accessed 10 April 2009).         [ Links ] Only two SADC member states (DRC and Seychelles) are not current members.
46 For the Abuja Declaration (2001), see http://www.un.org/ga/aids/pdf/abuja_declaration.pdf (accessed 10 April 2009).
47 SADC Declaration on HIV and AIDS (2003) http://www.sadc.int/sadcaidsinfo/docs/TechnicalDocuments/The Maseru Declaration on HIV and AIDS.pdf (accessed 10 April 2009).         [ Links ]
48 See, eg, SADC SADC HIV and AIDS business plans: Strategic 5-Year business plan 2005-2009 (2004) http://www.sadc.int/sadcaidsinfo/docs/Technical%20Documents/ Southern%20African%20Development%20Community%20(SADC)%20HIV%20 and%20AIDS%20Business%20Plan%202005-2009.pdf (accessed 10 April 2009).         [ Links ]
49 UN Declaration of Commitment on HIV/AIDS (2001);         [ Links ] for human rights, see paras 58-61 http://data.unaids.org/publications/irc-pub03/aidsdeclaration_en.pdf (accessed 10 April 2009). A subsequent UNDP-commissioned study in 2006 recommended that regional institutions be tasked 'with taking the lead in developing model legislation' on HIV and AIDS. UNDP A review of regional and national human rights-based HIV and AIDS policies and frameworks in Eastern and Southern Africa (2006) 75.         [ Links ]
50 National Development Institute for International Affairs and SADC Parliamentary Forum Survey of legislative efforts to combat HIV/AIDS in the Southern Africa Development Community (SADC) region (2004) http://www.sarpn.org.za/documents/d0001339/NDI_Nov2004_HIV.pdf (accessed 10 April 2009).         [ Links ]
51 By late 2008, the Forum's HIV/AIDS unit comprised five officers - co-ordinator, webmaster, information officer, training ('capacity development') officer and accountant - and the present author on a part-time voluntary basis. It has also recruited national HIV/AIDS researchers in seven of the 14 member parliaments: Botswana, Lesotho, Malawi, Mozambique, Swaziland, Zambia and Zimbabwe; see http://www.sadcpf.org/hivaids/page.php?pn=research%20assistants (accessed 10 April 2009).
52 These workshops led to the 2004 Cape Town Declaration on an Enhanced Parliamentarian Response to the Crisis of Orphans and other Children made Vulnerable by HIV/AIDS in Africa http://www.awepa.org/resources/cape-town-declaration-on-an-enhanced-parliamentarian-response-to-the-crisis-of-orphans-and-other-ch_en.html (accessed 10 April 2009).
53 UNICEF Africa's orphaned and vulnerable generations: Children affected by AIDS (2006) 35 http://www.unicef.org/publications/files/Africas_Orphaned_and_Vulnerable _Generations_Children_Affected_by_AIDS.pdf (accessed 10 April 2009).         [ Links ]
54 Established in 2005 as a collaboration between the University's Centre for Human Rights and Centre for the Study of AIDS; see http://www.chr.up.ac.za/centre_projects/ahrru/ (accessed 10 April 2009). Financial support to the PF for these purposes has come from the Swedish International Development Co-operation Agency.
55 SADC Parliamentary Forum Model law on HIV in Southern Africa: Position paper (2007) http://www.sadcpf.org/SADC PF model law on HIV_position paper.pdf (accessed 10 April 2009).
56 Primarily, but not only, the following PF workshops: 'HIV/AIDS Standing Committee and Policy Organs: Workshop on Consideration of Model Legislation on HIV & AIDS', Pretoria, South Africa (25-27 June 2008); 'Regional Consultation and Action Planning Meeting on Rights-Based Law in the Context of National Responses to HIV' (with UNAIDS and AIDS and Rights Alliance for Southern Africa), Johannesburg, South Africa (7 July 2008), and 'Regional Consultative Meeting of Experts on the Draft SADC PF Model Law on HIV' (with University of Pretoria AIDS and Human Rights Research Unit), Pretoria, South Africa (15-16 July 2008). For a final version of the Model Law on HIV in Southern Africa, see http://www.chr.up.ac.za/centre_projects/ahrru.
57 UN General Assembly Summary of the 2008 high-level meeting on the comprehensive review of the progress achieved in realising the Declaration of Commitment on HIV/AIDS and the Political Declaration on HIV/AIDS (United Nations Headquarters, 10-12 June 2008): Note by the President of the General Assembly, 62nd session UN Doc A/62/895 (3 July 2008) para 27.
58 n 55 above, 5-6.
59 n 55 above, 7-8. All SADC PF member states are parties to all of the relevant human rights treaties.
60 n 55 above, 12-14; UNDP (n 49 above) 73. For various legislation, policies and case law in the region, see UNDP Compendium of key documents relating to human rights and HIV in Eastern and Southern Africa (2008) Parts D2, D3 & D4, respectively http://content.undp.org/go/cms-service/download/asset/?asset_id=1704942 (accessed 10 April 2009).
61 n 55 above, 15.
62 n 55 above, 8.
63 n 55 above, 17. For a valuable discussion of the need for a rights-based approach to health services and care, in the specific context of HIV/AIDS, see P Farmer 'Global AIDS: New challenges for health and human rights' (2005) 48 Perspectives in Biology and Medicine 10.         [ Links ]
64 n 55 above, 27 29. For the inappropriateness, if not counter-productivity, of criminalisation approaches, see PM Eba 'Pandora's box: The criminalisation of HIV transmission or exposure in SADC countries' in F Viljoen & S Precious (eds) Human rights under threat: Four perspectives on HIV, AIDS and the law in Southern Africa (2007) 13.         [ Links ]
65 SADC Parliamentary Forum Deliberative Session for Members and Legal Drafters on the Model Law for HIV and AIDS in the SADC Region (including the final Communiqué) 10-14 November 2007, draft version.
66 SADC Parliamentary Forum Model Law on HIV in Southern Africa (Draft) (2008) sec 1. All references within this paper to the SADC PF model law are to the version presented to the Plenary Assembly in November 2008.
67 The model law has adapted provisions drawn from laws in place across eight different countries, of which seven are African states, as well as UN and AU instruments.
68 The person in a relationship to first ascertain their HIV status is often the female, with frequent reported instances of violence against her by her male partner when informed of her status (whether or not he transmitted the virus or knows his status). This thus seems to expose the woman to such additional risk and to place a substantial legal onus on the service provider in such circumstances. Nevertheless, this provision is consistent with UNAIDS's recommended language; see UNAIDS UNAIDS recommendations for alternative language to some problematic articles in the N'Djamena legislation on HIV (2004) (2008) 11-12 http://www.icw.org/files/Alternative language_280308.doc (accessed 1 November 2008).         [ Links ]
69 UNAIDS and Inter-Parliamentary Union Handbook for legislators on HIV/AIDS, law and human rights: Action to combat HIV/AIDS in view of its devastating human, economic and social impact (1998) Annex B.         [ Links ]
70 n 69 above, para 7.
71 UNAIDS International guidelines on HIV/AIDS and human rights (2006 Consolidated Version) http://data.unaids.org/Publications/IRC-pub07/jc1252-internguidelines_en.pdf (accessed 1 November 2008).         [ Links ]
72 AWARE-HIV/AIDS Project Regional Workshop to Adopt a Model Law for STI/ HIV/AIDS for West and Central Africa (2004) 3 http://www.awarehiv.org/images%5Cinserts%5CModel%20law% 20on%20HIV-AIDS%20.PDF.pdf (accessed 28 August 2008), but site http://www.awarehiv.org/ and this report unavailable by 1 November 2008 (copy of document with author).
73 ECOWAS is the regional counterpart to SADC, comprising 15 countries of West Africa, and similarly to SADC is a regional economic community of the AU.
74 UN (n 49 above) para 58.
75 n 72 above, 7. It is not clear whether this report was agreed to by the workshop partners to represent an official record of proceedings, or whether the absence of commentary on human rights aspects or dissenting views on the scope of the model law is an accurate representation of the workshop discussions.
76 West and Central Africa: Law # of 2004 on HIV/AIDS Prevention and Control in UNDP (n 60 above) 279-283. The version in this UNDP report is slightly amended from that annexed to AWARE (n 72 above) 9-19; but not with respect to human rights provisions.
77 n 68 above.
78 n 68 above, 15.
79 M Kirby 'The never-ending paradoxes of HIV/AIDS and human rights' (2004) 4 African Human Rights Law Journal 167.         [ Links ]
80 As above.
81 The seven legislating states are Benin (2005), Guinea (2005), Guinea-Bissau (2006), Mali (2007), Niger (2007), Sierra Leone (2007) and Togo (2005). The prospective legislating states are Cameroon, Cape Verde, Chad, Côte d'Ivoire, Mauritius and Senegal (R Pearshouse 'Legislation contagion: The spread of problematic new HIV laws in Western Africa' (2007) 12 HIV/AIDS Policy and Law Review 2/3,         [ Links ] 5 and n 1 http://www.aidslaw.ca/publications/interfaces/downloadFile.php?ref=1275 (accessed 10 April 2009). The inclusion of Mauritius - a SADC state - may mean to refer to Mauritania or simply be a geographic error. With the exception of Cameroon and Chad, all these states are ECOWAS members, except Mauritania, which left ECOWAS in 2000. The UNDP's 2008 Compendium only includes Benin's law. A subsequent report cites the AWARE model law as 'best practice' shaped by Benin's domestic adoption, followed by Burkina Faso, Cape Verde and Niger (suggesting nine legislating states), each with support from various UN agencies: Family Health International Disseminating and replicating best practices in West Africa: Strengthening West Africa's response to the HIV/AIDS epidemic (2008) 9-13.
82 Pearshouse (n 81 above) 9-10. Only Togo's law includes intent as a factor in wilful transmission.
83 Inter-Parliamentary Union The role of parliamentarians in advocating and enforcing observance of human rights in the strategies for the prevention, management and treatment of the HIV/AIDS pandemic (2005) para 14(c).
84 Inter-Parliamentary Union Final conclusions (2007) para 18.         [ Links ]
85 UNAIDS Policy brief: Criminalisation of HIV transmission (2008) 1 http://data.unaids.org/pub/BaseDocument/2008/20080731_jc1513 _policy_criminalization_en.pdf (accessed 10 April 2009).         [ Links ]
86 S Burris & E Cameron 'The case against criminalisation of HIV transmission' (2008) 300 Journal of the American Medical Association 5, http://jama.ama-assn.org/cgi/reprint/300/5/578 (accessed 10 April 2009).         [ Links ]
87 n 3 above; Prevention and Control of HIV and AIDS Act 2007 (Sierra Leone) sec 21 http://www.sierra-leone.org/Laws/2007-8p.pdf (accessed 10 April 2009); conviction carries a sentence of up to seven years' imprisonment and a fine.
88 S Lewis 'Keynote address at the closing session of the XVI International AIDS Conference' Toronto, Canada (2006) http://www.aids-freeworld.org/content/view/74/153/ (accessed 10 April 2009).         [ Links ]
89 n 85 above, 6. The figure for African states would be even lower.
90 n 72 above, 1 5, Annex 4.
91 Rajagopal (n 13 above) 780-781.
92 See, eg, 'Civil Society Statement on HIV-related Legislation in Southern Africa', signed by 15 civil society agencies across 10 countries of the region (14 July 2008) http://www.chr.up.ac.za/press%20releases/PRETORIA%20CIVIL %20SOCIETY%20STATEMENT%20ON%20HIV%20RELATED%20LEGISLATION.doc (accessed 10 April 2009).
93 The East African Community comprises the original member states of Kenya, Tanzania and Uganda, plus - since 2007 - Burundi and Rwanda. Tanzania is a member of both EAC and SADC.
94 'The Tribunal shall have jurisdiction over disputes between states, and between natural or legal persons and states' (art 15(1)), provided that the applicant 'has exhausted all available remedies or is unable to proceed under the domestic jurisdiction' (art 15(2)), and regardless of the consent of the other (state) party (art 15(3)); n 41 above.
95 Mike Campbell (PVT) Limited & Another v Republic of Zimbabwe (2/07) [2007] SADCT 1 (13 December 2007) http://www.sadc-tribunal.org/docs/CASENo207.pdf (accessed 10 April 2009).
96 Comments by the Tribunal's Registrar, Justice C Mkandawire (interview with author 8 April 2009).
97 Rajagopal (n 13 above) 781.
98 Okafor (n 30 above) 804.
99 This is an ongoing issue for the Forum with some of its key external partners which, eg, engage in training and policy development activities directly with Southern African parliaments in the absence of timely notification of SADC PF, let alone engagement.
100 n 21 above.
101 n 88 above.
102 n 65 above, para 36(1). All SADC member states are WTO members and are therefore bound by those instruments.
103 Okafor (n 30 above) 802-4.
104 n 55 above, 8.
105 Okafor (n 30 above) 809.
106 Declaration on the TRIPS and Public Health, Ministerial Conference, WTO Doc WT/ MIN(01)/DEC/2 (2001) para 7.
107 Agencia de Informacao de Mocambique 'Mozambique: Anti-retroviral factory by 2010, pledges Lula' (17 October 2008) http://allafrica.com/stories/200810171101.html (accessed 10 April 2009).         [ Links ]
108 JT Gathii 'The Doha Declaration on TRIPS and public health under the Vienna Convention on the Law of Treaties' (2002) 15 Harvard Journal of Law and Technology 317.         [ Links ]
109 Gathii (n 108 above) 297.
110 AO Sykes TRIPs, pharmaceuticals, developing countries, and the Doha 'solution' (2002) 10-12 http://www.law.uchicago.edu/Lawecon/WkngPprs_126-150/140.Sykes.TRIPs.pdf (accessed 10 April 2009).         [ Links ]
111 H Epstein The invisible cure: Why we are losing the fight against AIDS in Africa (2008) 57-58 61.         [ Links ] Epstein has strongly criticised the 2008 UNAIDS global report (n 1 above) for its failure to adequately treat evidence of the role of concurrent relationships in HIV transmission in Southern Africa, and a consequential inability to engage in appropriately informed policy dialogue on such a significant core of the issue. See H Epstein 'Open letter to the Lancet regarding UNAIDS 2008 Report on the Global AIDS Epidemic' (30 July 2008) (copy with author).         [ Links ]
112 Epstein (n 111 above) 62; n 1 above, 122. Male circumcision protects the male against infection. Women benefit from the reduced number of HIV-positive males (assuming continued safe practice) including the female's primary partner, especially where she is monogamous.
113 n 111 above, 255.
114 N Scheper-Hughes 'AIDS in South Africa: The invisible cure' (letter in response to book review: H Epstein) The New York Review of Books Vol 50, No 18 (20 November 2003) https://www.nybooks.com/articles/16809 (accessed 10 April 2009).         [ Links ]
115 P Farmer 'AIDS heretic: Paul Farmer reveals how the President of South Africa broke the AIDS establishment's inequality taboo' (2001) New Internationalist http://find-articles.com/ p/articles/mi_m0JQP/is_331/ai_30065280 (accessed 10 April 2009).         [ Links ] Farmer emphasises that, contrary to popular opinion, Mbeki 'has never denied that HIV is the etiologic agent of AIDS' and, at that conference, 'consistently referred to the disease as "HIV/AIDS"'.
116 Refer to, eg, n 115 above, 263-269.
117 Epstein (n 111 above) 65 167.
118 Conversely, western responses have often targeted messages to people in heterosexual relationships, when the need has been to primarily focus on those other elements. 'Aiming propaganda at heterosexual teenagers is (outside the special case of Africa) a waste of money. It is, however, often an easier course than tackling drugs, whores and buggery, which many politicians would prefer to pretend have no place in their countries' ('Getting the message: Good news on treatment. Bad news on propaganda' The Economist 5 June 2008 http://www.economist.com/science/dis-playstory.cfm?story_id=11487365 (accessed 10 April 2009)).         [ Links ]
119 n 115 above, 77.
120 n 115 above, 127; G Bertozzi 'Sugar daddies and garden boys: Relationships that increase infection risk for young adolescents' eforum posting (11 August 2008) http://www.healthdev.org/viewmsg.aspx?msgid=edee3cb4-a186-4bac-bd74-80102e3d8d8d (accessed 1 November 2008).         [ Links ]
121 n 55 above, 7; n 64 above, 32-7.
122 n 79 above, 164.
123 Cited in O Aginam 'The nineteenth century colonial fingerprints on public health diplomacy: A post-colonial view' (2003) 1 Law, Social Justice and Global Development Journal http://www2.warwick.ac.uk/fac/soc/law/elj/lgd/2003_1/aginam (accessed 1 November 2008).         [ Links ]
124 As above.
125 As above.
126 See also Farmer ( n 63 above).
127 n 76 above, art 6.
128 n 7 above, 26 6 275 (emphasis in original). Gathii notes Rajagopal's reference to international law not taking 'the local' seriously, and that TWAIL is more 'ambivalent' about the value of the national/domestic context than 'traditional Western approaches' which see it as a barrier to the 'emancipatory potential of universalist projects'.