Compulsory HIV Testing, Sterilization of Disabled Violate Rights
July 1, 2009
Compulsory HIV testing and forced sterilization are counterproductive to the Rwandan government's goal of improved reproductive health.
Joe Amon, health and human rights director at Human Rights Watch

(New York) - The Rwandan Parliament should remove provisions in a draft law that would mandate compulsory HIV testing and require the sterilization of all individuals with intellectual disabilities, Human Rights Watch said today. The organization said that the provisions, in a reproductive health bill, are deeply flawed and violate the government's obligations to uphold and protect human rights.

"Compulsory HIV testing and forced sterilization are counterproductive to the Rwandan government's goal of improved reproductive health," said Joe Amon, health and human rights director at Human Rights Watch. "Provisions in the current bill that increase stigma, rely on coercion, and deny individuals their reproductive rights should be removed."

Human Rights Watch said that the reproductive health bill, drafted by the parliamentary committee whose duties include promoting social welfare, contains three particularly troublesome provisions related to HIV/AIDS testing. First it provides that all individuals who plan to marry must undergo HIV testing and provide a certificate beforehand. Second, married individuals are required to be tested for HIV/AIDS upon the request of their spouses. Third, if a physician finds it "necessary" for a child or an incapacitated person to be tested for HIV/AIDS, he or she may conduct the test without seeking consent and may show the result to the parent, guardian, or care provider.

Ensuring that all HIV testing is confidential, conducted with informed consent, and accompanied by counseling is widely recognized as integral to effective HIV prevention and treatment strategies. Mandatory HIV testing and disclosure have been condemned by the Joint United Nations Programme on HIV/AIDS, the World Health Organization, and the UN's Office of the High Commissioner of Human Rights as violations of the right to privacy and counterproductive to effective HIV/AIDS control.

These organizations have also stated that mandatory testing and compulsory disclosure can put women at increased risk of abuse and undermine public trust in the health care system. Research by Human Rights Watch on HIV testing has documented significant abuses associated with coercive testing programs.

The proposed bill also obligates the Rwandan Government "to suspend fertility for mentally handicapped people." Systematic, forced sterilization has been recognized as a crime against humanity by the Rome Statute of the International Criminal Court.

In May 2008, Rwanda ratified the Convention on the Rights of Persons with Disabilities. The convention upholds the rights of persons with disabilities, including intellectual disabilities, to equal rights. Human Rights Watch said that laws on sterilization, including for persons with disabilities, must respect both a person's right to bodily integrity and informed consent to medical procedures. Decision-making about sterilization must take into account each individual's capacity to give informed consent, and where such capacity is lacking an individualized consideration must be made of the best interests of the person concerned.

"While Rwanda has made notable progress in fighting stigma and responding to the AIDS epidemic, and has pledged to advance the rights of persons with disability, forced sterilization and mandatory HIV testing do not contribute to those goals," Amon said. "These elements of the bill undermine reproductive health goals and undo decades of work to ensure respect for reproductive rights."