Disability rights in the context of HIV and AIDS: a critical review of nineteen Eastern and Southern Africa (ESA) countries

Abstract

Purpose: Many Eastern and Southern African (ESA) states are obliged to review and amend their legal frameworks with regards to disability since signing and ratifying the UN Convention on the Rights of Persons with Disabilities (CRPD). The HIV epidemic is one of the main health concerns in the region and is becoming increasingly associated with causing disabilities. In addition, people with disabilities are particularly at risk of exposure to HIV. Despite this, HIV programming has not yet included the interrelationship of disability and HIV. The principles within the CRPD may create much-needed international pressure and so provide a platform for the integration and inclusion of disability into HIV policies and programs. Method: This paper is based on a review of the legal framework in relation to HIV and disability in 19 ESA countries. It identifies 12 key articles of the Convention, which are particularly relevant to the interrelationship of HIV and disability. The paper assesses how these are integrated in the region’s disability or HIV legal frameworks and identifies the main gaps within these legal systems. Results: While many country’s constitutions, disability and HIV laws protect certain key rights, such as the rights to equality and nondiscrimination, employment and health, there are clear gaps in the legal responses to disability and HIV. In particular, legal frameworks fail to provide adequately for accessibility, mobility and access to justice and protection from violence for people with disabilities. This results in limited protection for people with disabilities from HIV exposure and access to services to address HIV-related health and welfare needs. Conclusions: The paper identifies the gaps and makes recommendations for implementing steps toward the integration of disability into HIV-related laws, policies and programs.

Implications for Rehabilitation

• Rehabilitation in Eastern and Southern Africa has to cater for an increasing number of people living with HIV who experience disability.

• The legal obligation of Article 25 in the Convention on the Rights of Persons with Disabilities (CRPD) obliges African states to provide appropriate rehabilitation and access to health care services for people with disabilities.

Keywords::

• Africa
• Convention on the Rights of Persons with Disabilities
• HIV/AIDS
• legal obligations

Acknowledgments

The authors would like to acknowledge the work of Leisl Gerntholtz (Human Rights Watch) during the review of the 19 ESA countries, which is a major contribution to the background of this paper. The authors would also like to thank Janet Whelen for her editing work.

African covenants

African Charter on Human and People’s Rights, Organisation of African Unity, 1981.

African Charter on the Rights and Welfare of the Child, Organisation of African Unity, 1989.

Protocol to the African Charter on Human and People’s Rights on the Rights of Women in Africa, Organisation of African Unity, 1995.

Declaration of Interest: The analysis input from Kitty Grant and Jill Hanass-Hancock was supported, in part, by HEARDs JFA funding. The writing process was supported by SIDA funding for Jill Hanass-Hancock’s position and Kitty Grant’s and Ann Strode’s personal time. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.