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- Immediately amend the implementing norms for Law 584/2002
on Measures to Prevent the Spread of AIDS in Romania and to Protect
Persons Infected with HIV or Suffering from AIDS to include effective and
appropriate sanctions for discrimination against people living with HIV in
relation to access to and enjoyment of services or goods. Sanctions should
be enforceable against all civil servants and medical, social, and
educational personnel who breach confidentiality.
- Amend the Labor Code and Ministry of Health and Ministry
of Labor and Social Solidarity Joint Order 508/2002 to prevent mandatory
HIV testing as a condition of employment, and ensure that persons living
with HIV are not unnecessarily prevented from working or attending
vocational school.
- Ensure that children and young adults living with HIV are
fully informed about how their rights and benefits will change after
turning eighteen and that those who need it receive assistance in
transitioning to adult services. In particular, the National Authority for
the Protection of the Rights of the Child, Directorates of Child
Protection and the National Authority for Persons with Handicap should
ensure that HIV-positive children and youth are prepared for independent
living, and provide appropriate continuing services to young adults who
may need them. Special attention should be given to the needs of children
and youth at risk of becoming homeless, including those in institutions,
foster care, and extended family placement.
- Repeal article 384 of the Criminal Code, which
criminalizes the knowing transmission of HIV. In those exceptional cases
involving deliberate and intentional transmission of HIV where general
criminal provisions apply, ensure that the elements of forseeability,
intent, causality and consent are clearly and legally established to
support a guilty verdict and/or harsher penalties under the Criminal Code.
- Reform the working methods and membership of the National
Committee for HIV/AIDS Surveillance, Control and Prevention to ensure that
it is able to fulfill its mandate, as provided under Law 584/2002. In
particular, establish a clear timetable for meetings for the Committee,
and expand membership to include all relevant actors, including
representatives of the National Committee on the Fight against AIDS and
the National Council for Combating Discrimination.
- Preserve the status of the National Committee on the Fight
against AIDS as a distinct medical committee within the Ministry of Health
mandated to oversee the national HIV/AIDS database, analyze developments
and needs for the treatment of HIV in Romania, and propose national
policies.
- Create and publicize effective, child-friendly mechanisms
to investigate and intervene in cases of abuse and neglect. Such
mechanisms should be easily accessible to children and youth living in all
parts of Romania, to young children, and to children and youth with
educational deficits or physical or mental disabilities. Data on the kinds
of complaints and the outcome of investigations, including any protection
measures issued and any disciplinary actions or criminal proceedings,
disaggregated by district, should be made public on an annual basis.
- Ensure that General Directorates for Social Assistance and
Child Protection have sufficient trained staff and resources to monitor
children and youth at risk of abuse or neglect, including conducting
regular visits to children and youth living with HIV in birth families,
extended family placement, foster care, public and private group homes,
and placement institutions. The National Authority for the Protection of
the Rights of the Child should set standards for DPC and municipal social
worker caseloads and should clarify minimum standards and methods for NGO
and municipal social worker to facilitate the sharing of information on
children at risk of abuse and neglect.
- Ensure that HIV-positive children and youth with mental
and physical disabilities enjoy the right to special care suitable to
their condition, including adequate access to outpatient mental health
care. Wherever possible, children and youth with mental and physical
disabilities should be cared for in existing family structures or
family-type care, and institutionalization should only be a measure of
last resort.
- Ensure that Romanian anti-discrimination legislation
provides effective and accessible protection to victims of discrimination
based on HIV status, including adequate sanctions and remedies.
- Ensure that the National Council for Combating
Discrimination has adequate staffing and resources to fulfill both its
mandate to investigate individual complaints and to develop policies and
programs to address widespread patterns of discrimination against persons
living with HIV. To that end, the Council should expand its in-house
expertise on HIV, and open branch offices and other mechanisms to receive
complaints and conduct investigations. It should also develop and
publicize written standards and procedures for its work, as well as
guidelines for NGOs and individuals on how to document cases of discrimination,
with priority given to developing guidelines on documenting health,
employment, and educational discrimination against persons living with
HIV.
- Ensure that individuals ongoing access to antiretroviral
medications (ARVs) is not compromised by bureaucratic delays or distance
from dispensing centers. To this end, the National Health Insurance House
should review its contracting procedures and consider allowing infectious
disease hospitals to maintain a buffer supply of ARVs to ensure that
therapy is not interrupted by short-term shortages.
- Ensure that persons living with HIV have adequate access
to medications needed to treat common opportunistic infections and related
conditions. To this end, the National Health Insurance House should ensure
that hospitals and private pharmacies receive timely reimbursement for
providing covered medications.
- Ensure that children and youth living with HIV have
adequate access to necessary routine and emergency medical care, including
mental health care and palliative or hospice care for persons with
terminal-stage AIDS. Investigate and sanction medical personnel who
discriminate against persons living with HIV or breach confidentiality.
- Ensure that all children and youth living with HIV have
access to information on their diagnosis and confidential counseling on
HIV prevention and treatment, including information on sexual health,
consistent with their evolving capacities. In particular, ensure that
childrens right to informed consent and their right to information on
their diagnosis are effected even in the absence of parental consent to
inform them of their HIV status.
- Ensure that local authorities properly implement
legislation providing subsidies to persons living with HIV, and that
bureaucratic delays, burdensome reporting requirements, and breaches of
confidentiality do not act as barriers to children and youth receiving the
nutritional and financial support they are entitled to by law.
- Ensure that children and youth living with HIV have access
to education that is appropriate to their needs, including by adopting
measures to combat drop-out of children living with HIV and to promote
their integration into the formal education system. Special attention
should be given to the needs of children who may require additional
assistance to overcome deficits caused by having dropped out of school or
attended substandard educational programs in state institutions, or who
have developmental or mental disabilities.
- Train teachers and headmasters on HIV, including
information on the special needs of children living with HIV, how to
prevent transmission of the disease, and how to intervene effectively to
stop bullying.
- Amend Law 584/2002 to include educational staff among
those required to keep confidentiality, and to provide effective sanctions
against those who breach confidentiality, discriminate against children
and youth living with HIV, or fail to protect them from harassment by
others.
- Ensure that children and youth living with HIV have access
to accurate information on reproductive health and HIV, including
information on how to prevent the transmission of HIV and other sexually
transmitted diseases. This information should be compulsory in all schools
and also be available to children and youth living with HIV who are not
attending formal education programs, should begin at an early age, and
should be monitored to ensure that the content is accurate and complete.
- End the practice of including HIV diagnoses on medical
prescriptions, and ensure the confidentiality of information about HIV
status on disability certificates, medical certificates, court records,
and other documents. To this end, the National Authority for Persons with Handicap
should ensure that the key for its disability codes is separate from its
certificates of disability.
- Amend Law 584/2002 to provide clear and adequate sanctions
for breaches of confidentiality of information on HIV status and
treatment, with particular attention to breaches of confidentiality in
schools, hospitals and clinics, the postal service, national and local
government offices, and official documents. The law should include
accessible mechanisms for reporting, investigating, and enforcing these
sanctions.
- Conduct an information campaign among all relevant
professional groups to clarify their obligation to maintain privacy unless
instructed by a judge to provide information for the prosecution of a
crime.
- Insist that the Romanian government take steps to enforce
the protections against discrimination on the basis of HIV status and
provide an appropriate remedy to victims of such discrimination.
- Ensure that adequate implementation of
anti-discrimination legislation with regard to HIV status forms an
integral part of broader EU efforts to promote equality and
non-discrimination in Romania.
- Encourage the Romanian government to adopt all necessary
legal and policy measures set out in the recommendations above as soon as
possible, making clear that accession to the EU will not mean an end to
active EU pressure in this regard. In cooperation with the Romanian
government, formulate concrete benchmarks for the reform steps that are
required to meet the recommendations above, with specific timelines for
their fulfillment.
- Prioritize health sector reforms in future funding to Romania, including funding for nongovernmental organizations providing services for persons
living with or affected by HIV.
- Prioritize funding for the labor and social integration of
adolescents aging out of Romanias child protection system, with an
emphasis on the needs of adolescents living with HIV. Such funding should
be conditioned on a clear set of benchmarks and on legal and policy
change.
- Urge the government of Romania to act quickly to fulfill
its commitment to take over Phare and Global Fund to Fight AIDS, Tuberculosis,
and Malaria projects on HIV currently being implemented by NGOs. Consider
giving bridge funding to NGOs providing crucial services to persons living
with HIV to ensure that their beneficiaries are not left without these
services during the transition.
- International financial institutions such as the World
Bank and the European Bank for Reconstruction and Development should
incorporate language reflecting the concerns expressed in this report in
their next country strategies for Romania, and encourage the Romanian
authorities to pursue reforms to address them.
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