African Civil Society Raises Concerns Over “Test and Treat” Model for HIV Elimination

On April 29, representatives of 30 human rights and AIDS organizations from throughout Africa met in Johannesburg to discuss the implications of a new HIV prevention model developed by World Health Organization scientists. The model calls for universal annual HIV testing and requires anyone who tests positive to begin immediate initiation of antiretroviral treatment.

The organizations—which came from Botswana, Kenya, Namibia, Mauritius, South Africa, Tanzania, and Uganda—released a joint statement expressing “fundamental concerns about the assumptions on which the model is based, its shortcoming from a human rights perspective, and its inattention to vulnerable and marginalized groups.”

In particular, the groups noted that the model focuses primarily on heterosexual sex and ignores drug users and gay, lesbian, and transgender people. It also fails to take into account any socioeconomic and cultural realities that create barriers to voluntary testing and access to treatment for vulnerable populations, including women, sex workers, and refugees and migrants.

The groups expressed concern that a universal testing and treatment model could lead to coercion, forced testing, and widespread human rights violations. 

"Based on our experience we have every reason to fear that the implementation of this model in its current form will in practice violate rights, including those to autonomy and bodily integrity," wrote the groups.

The joint statement recommends a transparent and inclusive process of civil society consultation in any country where the model might be tested as part of a pilot research study, in order to ensure that rights are not violated.

Organizations that signed the statement include the AIDS and Rights Alliance for Southern Africa, the Kenya Treatment Access Movement, and the Tanzanian Network of Women Living with HIV/AIDS.

The Johannesburg meeting was co-sponsored by the Public Health Program, the Open Society Initiative for Southern Africa, the Open Society Initiative for East Africa, and the AIDS and Rights Alliance for Southern Africa.

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