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VI. Government Response

Jamaica acknowledges in its official policy documents the role that homophobia plays in driving the country’s HIV/AIDS epidemic, and lists as a key priority the development of legislation and policy to protect the human rights of people living with and affected by HIV/AIDS.183  Despite these stated commitments, there exist few policy or legal protections for people living with HIV/AIDS or people whose marginalized status puts them at high risk of infection.  The vast majority of people living with HIV/AIDS remain without access to lifesaving antiretroviral medicines.  While some ministries (such as the Ministry of Education) have drafted national AIDS policies, the lack of institutional commitment and intersectoral coordination among them hampers the government’s response to the epidemic.  And the lack of high-level political commitment to addressing homophobic violence further weakens efforts to fight HIV/AIDS.

Improving legal and policy protections

In 2001, the National AIDS Committee (NAC), a government-organized NGO established in 1988 to advise the Ministry of Health on policy issues, drafted a report reviewing legal, ethical, and human rights issues for people living with HIV/AIDS.184  The report identified a number of weaknesses within existing legislation and recommended changes to address them.  These included drafting comprehensive antidiscrimination legislation, strengthening legal protections for confidential information, and repealing the sodomy laws.185

The Office of the Attorney General reviewed the NAC report and in 2002 rejected its main recommendations, insisting that there be a national AIDS policy before any legislation was adopted.  As of this writing, the national policy document has not yet been completed.186  High-level officials at the National HIV/AIDS Control Programme, consistent with the NAC report and Ministry of Health policy documents, have advocated for the need to repeal discriminatory laws because they impede HIV prevention efforts and drive vulnerable groups from HIV services.  Minister of Health John Junor repeatedly has rejected these appeals, however.187  And in July 2004, Prime Minister P.J. Patterson reportedly announced that his government would not be forced by foreigners to repeal Jamaica’s sodomy laws, apparently ignoring government and NAC reports on their role in driving Jamaica’s HIV/AIDS epidemic.188

The U.N. Guidelines on HIV/AIDS and Human Rights specifically recommend that “an independent agency should be established to redress breaches of confidentiality.”189  Professional organizations governing certain health professionals are empowered to sanction physicians, nurses, and midwives for professional misconduct, including failure to protect confidential patient information.190  No independent agency exists, however, to redress breaches of confidentiality by other health workers, such as porters and ward assistants, who have access to patient dockets and may otherwise discover patients’ HIV status.191

Educating health personnel

Doctors, nurses, and other medical personnel who work with people living with HIV need training, both about the disease as well as how to ensure human rights protections for people living with HIV/AIDS, including ensuring confidentiality of HIV-related information and addressing discrimination.  The Jamaican government has acknowledged that many health care personnel are not adequately trained in HIV/AIDS care and treatment and has undertaken steps to address this problem.  The Ministry of Health has devoted a major portion of a World Bank loan to strengthening institutional capacity to respond to HIV/AIDS, including by providing training on AIDS-related stigma and discrimination for a range of health personnel (including doctors, nurses, nutritionists, and medical records workers).192  The Ministry has also specifically targeted individuals working with medical records for training on protecting confidentiality.193  These training sessions are optional, however.194  In addition, the Ministry also has begun work with domestic and international HIV/AIDS organizations to address problems with quality of care for people living with HIV/AIDS.195

These are laudable initiatives, but the findings of this report make it clear that considerable room for improvement remains.  HIV/AIDS training, including basic information addressing HIV transmission, must extend to all hospital personnel, including porters and laundry workers, and it must be mandatory.  In addition, sanctions must be available and imposed for disclosing confidential information about HIV status and other HIV/AIDS-related discrimination.

In May 2004, Jamaica signed an agreement with the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) that should enable it to address some of the major gaps in its national response.  The bulk of the funds is intended to scale up availability of antiretroviral medications, with the goal of providing access to all Jamaicans living with HIV/AIDS within five years.  The agreement also prioritizes efforts to complete and implement policies and a legislative framework to protect the human rights of people living with and at high risk of HIV/AIDS, including by “address[ing] the repeal of discriminatory laws and policies that make it difficult to reach vulnerable high-risk communities (especially MSM, CSWs [commercial sex workers], and incarcerated populations).”196  The findings of this report underscore the importance of enacting into law and enforcing human rights protections for vulnerable high-risk groups, especially men who have sex with men, to ensure the success of its AIDS treatment program.  If the Jamaican government fails to do so, men who have sex with men will be denied access to AIDS treatment in the same ways that they have long been denied access to other health care services.

Efforts to address police abuse and provide HIV/AIDS education to police

It is widely acknowledged that there is a crisis in policing in Jamaica, fueled in part by police failure to control high rates of violent crime or to be held accountable for crimes they commit.197  Human rights abuses by the Jamaican police have been documented and publicized by national and international organizations for over thirty years, and millions of dollars have been pledged toward efforts to reform police practices and improve security.198  The Jamaican government has undertaken important efforts to address these abuses, including by establishing mechanisms to investigate cases of police misconduct and to train police regarding the proper use of force.199  But serious problems with police abuse continue.

The Jamaican Constabulary Force (JCF) has only recently acknowledged HIV/AIDS as a workplace issue and drafted policy guidelines to address HIV/AIDS in its workforce.  These draft guidelines do not, however, address police conduct toward marginalized populations or toward HIV/AIDS outreach workers.  Nor has the government addressed police abuse based on sexual orientation and gender identity, apparently ignoring cases that have been documented by domestic and international human rights organizations and by foreign governments.200

Institutional mechanisms to address police misconduct

Complaints of police abuse can be lodged directly with the Jamaican Constabulary Force, with its Bureau of Special Investigations or with the Complaints Division of the Office of Professional Responsibility.  The Police Public Complaints Authority (PPCA), an independent body charged with monitoring and supervising civilian complaints of police misconduct, also is empowered to investigate cases of police misconduct.  Once an investigation has been completed, reports are sent to the Department of Public Prosecutions for a ruling on whether criminal or disciplinary proceedings, or a coroner’s inquest, should follow.201  Public access to police and independent complaint mechanisms is limited by lack of knowledge about them, distrust of the legal system, and fear of reprisals for making complaints against officials.202

The Bureau of Special Investigations, which investigates fatal shootings and other killings by police, has been criticized for its failure to conform with international standards in conducting investigations.  Failure to investigate incidents promptly or thoroughly, including failure to collect blood and other forensic evidence or to properly record crime scene information, compromises the chances for successful prosecution.203  The Office of Professional Responsibility, which investigates complaints of police misconduct that do not involve firearms, has been criticized for its lack of impartiality and thoroughness.204

The Police Public Complaints Authority has been criticized as “completely ineffectual” in carrying out its mandate to investigate, supervise, and monitor complaints of police misconduct.205  Jamaican and international human rights organizations have argued that the PPCA’s lack of independence and transparency and the Authority’s failure to make full use of its powers contribute to the inadequacy of its investigations.206  Justice Lloyd Ellis, PPCA Chairman, has stated, for example, that he did not consider it appropriate or possible to hold Jamaica to the same standards as other countries and that he was generally satisfied with the quality of police investigations.207

Little attention has been paid to police interference with HIV/AIDS outreach workers or other abuses against men who have sex with men and sex workers.  When asked about police conduct toward men who have sex with men and people living with HIV/AIDS, Justice Ellis said that he “would be surprised if anyone could prove that police would set up to abuse people who are homosexuals or, as you put it at high risk of HIV.  If that is done, it is done not by police acting qua police but as citizens.” 208  Ellis acknowledged that gay men might be targeted on the community level but suggested that they bore some responsibility for violence committed against them: “I have no evidence of police beating anyone for being gay.  You have people doing it in the community, doing it out of necessity.  You have it every day.  . . .  It happens in other countries too.  It’s not just a problem in Jamaica.”209

Police training on HIV/AIDS and related human rights issues

Percival Buddan, the officer in charge of HIV/AIDS training for the Jamaican police force, acknowledged that there was an urgent need for HIV/AIDS education in the police force to ensure protection against the disease as well as protection against HIV/AIDS-related discrimination.  He told Human Rights Watch:  “Until two or three years ago, police officers were more or less in the dark about HIV/AIDS, how the virus was contracted, about universal precautions [to protect against HIV transmission].  And people who have HIV/AIDS may want to keep it secret because of stigma and discrimination.”210  The Jamaican Constabulary Force has published a document addressing myths and facts about HIV/AIDS and has begun to include HIV/AIDS education in its training and in optional lectures given in preparation for annual first aid certification exams.  It is clear that these efforts are insufficient, however.  Human Rights Watch interviewed several police officers, including a high-level police officer in Kingston and constables in St. Ann’s Bay, who made comments indicating their confusion and incomplete knowledge about HIV transmission.  In St. Ann’s Bay, for example, police officers told Human Rights Watch that people living with HIV/AIDS should be confined in isolated areas for treatment, “so they will not be able to contaminate other people,” and that people living with HIV/AIDS were isolated from other detainees in the police lockup.211

As of this writing, the Jamaican Constabulary Force HIV/AIDS policy has been drafted but not approved.  Percival Buddan told Human Rights Watch that the draft policy did not address police conduct toward marginalized populations such as men who have sex with men and sex workers or toward HIV/AIDS outreach workers to these groups.212



[183] See, e.g., Ministry of Health, “Jamaica HIV/AIDS/STI National Strategic Plan 2002-2006,” January 2002, pp. 10-12 (identifying “discrimination and stigmatization around HIV/AIDS especially homosexuality” as among the factors driving the epidemic, and policy, advocacy, legal and human rights as a top priority area in its HIV/AIDS plan).

[184] The Minister of Health established the National AIDS Committee (NAC) in 1988 to coordinate a national multi-sectoral response to HIV/AIDS.  It has more than one hundred members, including representatives from public and private sector organizations and NGOs.  http://www.nacjamaica.com/about_nac/index.htm (retrieved September 16, 2004).

[185] See National AIDS Committee, “HIV/AIDS Legal, Ethical and Human Rights Issues in Jamaica,” http://www.nacjamaica.com/subcom/legal_ethical/index.htm (retrieved April 19, 2004).

[186] A draft National AIDS Policy is expected to be circulated for review in the fourth quarter of 2004.  Human Rights Watch telephone interview with Ruth Jankee, executive director, National AIDS Committee, Kingston, September 7, 2004.

[187] Human Rights Watch interview with Dr. Peter Figueroa, chief, Ministry of Health Epidemiology Unit, Kingston, June 23, 2004; see also Zadie Neufville, “Fear Among Gay Men Said to Fuel HIV/AIDS Cases,” Inter Press Service, March 5, 2002 (reporting that Minister Junor said that while the government is “committed to preventing the spread of the disease,” it had no intention of changing the laws).

[188] “PM Says Gov’t Will Not Change Anti-Homosexual Laws,” Jamaica Observer, July 2, 2004.

[189] U.N., HIV/AIDS and Human Rights: International Guidelines, para. 30(c).

[190] See, e.g., The Medical Act, section 11; The Nurses and Midwives Act, section 11.

[191] Patients can lodge complaints with the Ministry of Health within ten days after suffering a breach of confidentiality or discrimination by health workers.  Ministry of Health, “Client Charter,” http://www.moh.gov.jm/Standards.htm (retrieved August 27, 2004)

[192] U.S.$4.82 million, or 29 percent of a World Bank loan received for the 2002-2006 period is being used for HIV/AIDS-related projects, but it is unclear what portion of these funds are going to training.  Country Coordinating Mechanism for the Global Fund to Fight AIDS, Tuberculosis and Malaria, A Proposal to Scale UP HIV/AIDS Treatment, Prevention, and Policy Efforts in Jamaica, May 2003, http://www.theglobalfund.org/search/docs/3JAMH_661_0_full.pdf  (retrieved August 27, 2004), p. 26.

[193] Human Rights Watch telephone interview with Kevin Harvey, coordinator of treatment, care and support for people living with HIV/AIDS, Ministry of Health, Kingston, September 7, 2004.

[194] Ibid.

[195] In 2004, the Johns Hopkins Program for International Education in Gynecology and Obstetrics (JHPIEGO), a nonprofit organization affiliated with Johns Hopkins University that receives funding from USAID, and Jamaica AIDS Support provided training addressing stigma and discrimination against people living with HIV/AIDS and on infectious disease control to health care workers at Kingston Public Hospital, one of Jamaica’s highest-volume hospitals.  The National HIV/AIDS Program at the Ministry of Health provided oversight for this training, which did not address stigma and discrimination against men who have sex with men or other vulnerable groups.  JHPIEGO, “Project Proposal: Building the HIV/AIDS Capacity of Health Care Providers and Communities in Jamaica,” 2004; E-mail communication with Robert Carr, director, Jamaica AIDS Support, September 7, 2004.

[196] Country Coordinating Mechanism for the Global Fund to Fight AIDS, Tuberculosis and Malaria, A Proposal to Scale UP HIV/AIDS Treatment, Prevention, and Policy Efforts in Jamaica, May 2003, http://www.theglobalfund.org/search/docs/3JAMH_661_0_full.pdf  (retrieved August 27, 2004), p.25.

[197] See Anthony Harriott, Police and Crime Control in Jamaica: Problems of Reforming Ex-Colonial Constabularies  (Kingston, Jamaica: University of the West Indies Press, 2001); Horace Levy, They Cry ‘Respect’!  Urban Violence and Poverty in Jamaica (Kingston, Jamaica: University of the West Indies Press, 2001).

[198] See, e.g, ibid.; United Nations Special Rapporteur on Extrajuducial, Summary or Arbitrary Executions, “Report of the Special Rapporteur, Asma Jahangir, submitted Pursuant to Commission on Human Rights Resolution 2003/53.  Addendum.  Mission to Jamaica,” E/CN.4/2004/7/Add.2, September 26, 2003; Amnesty International, Jamaica: Killings and Violence by Police: How Many More Victims,” pp. 52-54; Amnesty International, “’Until Their Voices are Heard.’  The West Kingston Commission of Inquiry,” July 2003; Jamaicans for Justice, The Jamaica Justice Report, 2002; U.S. Department of State, “Country Reports on Human Rights Practices: Jamaica, 2003,” February 25, 2004.   International donors and agencies contributing to justice reform efforts include the Canadian International Development Agency (CIDA), the World Bank, the Inter-American Development Bank, the U.S. Agency for International Development (USAID), the European Union (EU) and the United Nations Development Program (UNDP). 

[199] See Police and Crime Control in Jamaica, pp. 121-182 (discussing reforms).

[200] See, e.g., Amnesty International, “A Summary of Concerns: A Briefing for the Human Rights Committee,” October 1997, p. 14. U.S. Department of State, “Country Reports on Human Rights Practices: Jamaica, 2003,” February 25, 2004; Robert Carr and Jamaica Forum for Lesbians, All-Sexuals and Gays, “Testimonies,” 2003.

[201] Coroner’s inquests are conducted before a judge and jury of the Coroner’s Court and the court’s verdict referred back to the Director of Public Prosecutions for a decision whether to continue to prosecute or to close the case.

[202] See ”Report of the Special Rapporteur on Mission to Jamaica,” September 26, 2003.

[203] See, e.g., ibid.; Amnesty International, Jamaica: Killings and Violence by Police: How Many More Victims,” pp. 52-54; Jamaicans for Justice, The Jamaica Justice Report, 2002.

[204] Ibid.

[205] Jamaicans for Justice, Jamaica’s Human Rights Situation, 2003, p. 6.

[206] Amnesty International, Jamaica: Killings and Violence by Police,  p. 55; Jamaicans for Justice, “Jamaica’s Human Rights Situation,” 2003, pp. 6-7.

[207] Amnesty International, Jamaica: Killings and Violence by Police , p. 55.

[208] Human Rights Watch interview with Justice Lloyd Ellis, executive director, Police Public Complaints Authority, Kingston, June 23, 2004.

[209] Ibid.

[210] Human Rights Watch interview with Percival Buddan, sub-officer in charge, Jamaican Constabulary Force First AID Center, Kingston, June 18, 2004.  “Universal precautions” are simple measures taken to reduce the risk of transmission of HIV and other bloodborne pathogens through exposure to blood or body fluids, including the use of protective barriers such as gloves for direct contact with blood or body fluids and careful handling and disposal of needles, waste, and other materials contaminated with blood or body fluids.  World Health Organization, “Universal Precautions, Including Injection Safety,” http://www.who.int.hiv/topics/precautions/universal/en/ (retrieved September 16, 2004).

[211] Human Rights Watch interview, St. Ann’s Bay, June 16, 2004.

[212] Human Rights Watch interview with Percival Buddan, sub-officer in charge, Jamaican Constabulary Force First AID Center, Kingston, June 18, 2004 and telephone interview, Kingston, October 26, 2004.


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