by Thanuri Jayodya
Published on Ceylon Today on 21st October 2024.
HIV/AIDS, which has taken 42.3 million lives to date (WHO 2024) since its first reported cases in 1981 (MHAF n.d.), is a major global public health issue which poses significant challenges to world society. Defined by the World Health Organization (WHO), Human Immunodeficiency Virus (HIV) is a virus that attacks the immune system of the body. Even though there is no chance to cure this, it can be controlled with Antiretroviral Therapy (ART). If it is untreated, it can lead to Acquired Immunodeficiency Syndrome (AIDS) which happens when an infection is at its most advanced stage. HIV spreads more easily from the body fluids of an infected person and it can also spread from a mother to her baby (WHO 2023).
According to global HIV statistics presented by WHO 2024, the total number of people living with HIV is approximately 39.9 million. Among them, 1.4 million are children and in 2023 approximately 630,000 people have died from the causes of this epidemic. Further, it also states that in the South-East Asian Region, approximately 4.0 million people were living with HIV. Among them, about 78 per cent are aware of their HIV status.
The Office of the High Commissioner for Human Rights (OHCHR) declared that AIDS has been identified as the sixth-largest cause of death worldwide. It further states that this epidemic’s overwhelming impacts mostly fall on developing countries and in most countries AIDS and poverty have become interconnected and generate more negative impacts.
The National STD/AIDS Control Programme of Sri Lanka (NSACP) states that 207 HIV cases were reported during the period of January to March of 2024. In this first quarter, male to female ratio of reported HIV cases is 7:1 and there are 13 deaths. Moreover, cumulative HIV cases at the beginning of the quarter are 5,705 and at the end of the quarter, it is 5,912. According to Adaderana 2024, NSACP has reported that within 2023, 40 children were diagnosed with HIV/AIDS and as stated by STD specialist Dr. Vino Dharmakulasinghe, the number of reported adults who present with HIV/AIDS is 3,169. Further, marking a 14 per cent rise in people who are living with HIV, the total cases has increased from 607 in 2022 to 694 in 2023. He has also highlighted an increase in the spread of AIDS among the age group of 15 to 24.
Impact of AIDS
Since the discovery of AIDS, it has affected people’s lives in different ways causing deaths, creating economic disruptions, violating human rights and creating social stigma. The implications are not just limited to HIV/AIDS-affected persons. It has implications for their children and families too. They face discrimination, social isolation, social exclusion and stigma. With these implications and because of the fast spread of AIDS, at present human rights concerns are becoming more important.
According to the United Nations, human rights are the rights inherent to all human beings regardless of their race, sex, nationality, ethnicity, language, religion, or any other status (United Nations 2023). Focusing on HIV/AIDS’s impact on human rights, it has implications for individuals’ economic, social, cultural, civil and political rights.
By facing isolation and discrimination in society, the AIDS-affected individual’s liberty and security are often ignored and their freedom of expression and opinion is being limited. Moreover, they will face difficulties when participating in public affairs and there is a possibility of them facing torture and inhuman treatment in different settings.
In addition to that, AIDS has been an obstacle to the right of education of children. A good example of this is, a few years ago, in Sri Lanka, a petition regarding violation of Fundamental Rights was filed for a mother whose child was refused admission to a school due to a rumour that his father had passed away from AIDS-related complications, leading to the assumption that the boy was HIV-positive. Even though it was confirmed after doing a test that he was HIV-negative, the denial for the enrolment was continued. In response to this case, on 28 April 2016, Sri Lanka’s Supreme Court gave its decision saying that children who are living with or affected with HIV have the full right to education and they must not face discrimination (Right to Education 2016).
People living with HIV/AIDS face various challenges in accessing healthcare and treatments too. This happens when they have a lack of access to affordable and quality healthcare services. In some cases, affected individuals who lack confidentiality and face discrimination within healthcare systems discourage them from seeking care and it will worsen this epidemic.
Due to fear or misconceptions of society, HIV/AIDS-affected individuals are likely to face denial of employment, workplace discrimination, unfair treatment and isolation. These conditions will violate their right to work and even harm their dignity and equality. Further, this will insecure their earnings and will worsen their economic security and their health. By leading them to poor health and nutrition conditions, this affects the living quality of both AIDS-affected people and their families.
This isolation and discrimination will further prevent them from participating in religious and cultural activities. The fear of social isolation and denial of the rights will lead the individuals to hide their health status and some will even step back from taking treatments. This will eventually increase the number of HIV cases in society and harm the affected individuals.
The challenges of this epidemic are not just limited to people. It poses numerous challenges to a country too. This rapid spread of AIDS creates an increased demand for healthcare services and it strains medical resources. Further, the healthcare system and staff have to cope with the rising number of patients who require antiretroviral therapy, long-term care, counselling facilities and other care facilities.
Implications of AIDS go beyond health security. It affects economic security and social security too. The high infection rates of HIV/AIDS can reduce the productivity of the workforce, especially in sectors such as governance and administration, health, education, economic, public, and social services. By that, AIDS weakens the social and economic stability of a country which finally leads towards poverty.
Reasons behind the rise in HIV/AIDS
The refusals of individuals for treatments because of the fear of social implications, such as discrimination and isolation give space for the spread of this virus. Limited education and awareness about the virus and how it is transmitted also allow HIV to spread. Unawareness of the updated statistics will also lead individuals to the danger of affecting AIDS. Moreover, not taking proper steps to maintain their health, such as not doing regular check-ups, makes people unaware of their health conditions and also increases the transmission of AIDS. Further, risky behaviours like having unprotected sex and sharing needles, especially by tattoo artists, also contribute to an increase in the number of AIDS-affected people. In addition, the failure to supply the necessary healthcare facilities such as testing and preventive measures for affected individuals is also a reason for the increase in AIDS cases. Finally, social inequalities such as poverty and gender disparity also make individuals, especially women and girls more vulnerable to this disease. In conclusion, social and behavioural factors can be given as the causes for the increase in HIV cases.
Way Forward
It is clear that AIDS is not just only a public health concern, but also a social and development challenge which threatens the stability of society. So, to fight against this challenge, collective efforts of individuals, communities and other parties such as government, non-government organisations and media are also needed. Especially the Government should enhance the policies related to this disease which ensure the safety of society and by that should ensure the rights of people are protected, promoted and respected. For this safety measures taken by developed countries against this epidemic also can be taken as examples.
Without taking a test, people cannot know whether they are infected by HIV or not. Some HIV-affected people have never been tested and do not know their health status. In this kind of situation, they can make an informed decision to be tested for HIV/AIDS of their own will by doing a Voluntary Counselling and Testing (VCT) (UNESCO n.d.).
Expanding existing testing facilities, antiretroviral therapy and other necessary healthcare facilities will help to prevent further transmission of this disease and mitigate the other implications to the health of the individuals and society. It is important to update people on statistics related to HIV/AIDS because it will help increase people’s awareness about the disease and will encourage them to adhere to the necessary safety measures.
Further, to protect vulnerable communities and fight against the rapid increase in HIV/AIDS and its implications, existing community programmes should be strengthened and awareness programmes about the disease, transmission and prevention should be carried out especially targeting schoolchildren and other vulnerable communities with the collaboration of NGOs who are interested in Human Immunodeficiency Virus and health. For this social media and media campaigns also can be used.
In addition to that, awareness should be raised of HIV/AIDS and its implications to society, the economy and human rights. It will contribute to the protection of human rights, economic development and strengthen social relations, reducing discrimination, and social isolation. This will also prevent people’s myths generated by their religious beliefs and culture.
Moreover, the educational rights of every child should be respected and protected and it should be ensured that HIV-affected children do not face discrimination in educational settings.
Adhering to the safety measures in healthcare settings and other environments like tattoo parlours, such as using gloves and disposable needles will also help to prevent the transmission of HIV to other people and healthcare staff.
Most importantly, both employers and employees should avoid carrying out workplace discrimination against HIV-affected individuals. This will help to mitigate the economic disparities in the work setting and will protect the individual’s right to work and live with dignity.
The above safety protocols and other necessary actions will prevent and mitigate the transmission of HIV/AIDS and will help individuals to live in a safe environment, where their rights are protected.
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* Ms. Thanuri Jayodya is an Intern (Research)at the Institute of National Security Studies (INSS), the premier think tank on National Security established and functioning under the Ministry of Defence. The opinion expressed are her own and not necessarily reflective of the institute or the Ministry of Defence.