In India, HIV history repeats itself

By Sharon Ekambaram

Recently, Mumbai Aids activists took to the streets protesting the Indian government’s failure to protect people living with HIV from discrimination. More than 20 years after South African activists took up the same fight at home, the protests are a stark reminder that the battle for equality, dignity and access to life-saving care is not over.

The Mumbai protest last week was in response to the Indian parliament’s failure to ratify the country’s “HIV Bill.” This bill would, for instance, make it illegal to discriminate against anyone based on their HIV status, ensure the provision of free HIV treatment and care, and legalise HIV prevention services – like needle exchange programmes for injecting drug users – aimed at criminalised populations.

South Africa and India are alike in that they are facing large HIV epidemics. In South Africa, about 17% of people between the ages of 15 and 49 years are living with the virus. Although India’s HIV prevalence rate is much lower than South Africa’s at about 0.3%, the size of its population means that it remains one of the world’s largest epidemics in terms of numbers, only trailing South Africa and Nigeria globally.

However, unlike South Africa, India’s HIV epidemic remains concentrated among marginalised communities such as commercial sex workers, men who have sex with men and injecting drug users. This makes India’s HIV Bill all the more important.

Currently, India has no anti-discrimination legislation which would cover prejudice on the grounds of HIV. Marching alongside protesters, and feeling the anger and pain of people discriminated against because they have a virus reminded me of South Africa’s struggles to eliminate discrimination.

From words to action
In 1992, Judge Edwin Cameron helped draft South Africa’s Aids Charter. The charter was instrumental in raising awareness and addressing HIV stigma. The document would also guide the work of South Africa’s Aids Consortium, which Cameron co-founded, and the Aids Law Project where he served as director. These organisations challenged discrimination on the basis of a person’s HIV status, and won important victories in and out of court.

In 2000, the organisations legally challenged South African Airways’ discrimination against a potential job applicant based on his HIV status. In a case prepared by former Aids Law Project advocate Fatima Hassan, activists pitted science against stigma and won. In 2003, after both the Aids Consortium and the Aids Law Project received complaints against the insurance company AVBOB, public pressure and activism led AVBOB and other insurers to remove discriminatory clauses limiting benefits to people living with HIV.

Landmark cases such as these have formed the bedrock of the South African struggle for the dignity and respect for all irrespective of HIV status.

When words fail
India’s HIV Bill has its origins in a 2002 conference attended by high-level delegates from South Africa, Kenya and Nigeria among others. At this meeting, participants signed the “Deli Declaration”, which states:

“The HIV/Aids epidemic constitutes a global health emergency of unprecedented magnitude that impacts economic and social development worldwide and in particular the developing world. To combat this global tragedy, a comprehensive strategy is needed to focus on issues including health care, prevention, support, and treatment within a legal framework designed to protect human rights.”

Sadly, more than ten years later this text is worth no more than the paper on which it was printed.

Following the 2002 meeting, a national advisory group, chaired by India’s national Aids council, was formed. Comprised of representatives from civil society, people living with HIV and government, this group approached the Indian public interest law organisation, the Lawyers Collective to prepare a draft HIV law. A little more than one year after the Delhi Declaration, a draft bill was presented to government following months of consultation with people living with HIV, health care providers, trade unions and other representatives from Indian society.

However, the draft bill has languished in the Indian parliament since 2006. Seven years later, Indian civil society – spearheaded by the newly re-launched Mumbai Aids forum that Doctors Without Borders (MSF) helped established – has said, “enough is enough.”

India needs South African solidarity
Marching on the overcrowded streets of a city located in the world’s second-most populous country is indescribable. The high levels of poverty and poor living conditions of people in Mumbai’s slums – like those of New Delhi – pervade every part of this overpopulated city.

The struggle for survival facing India’s vulnerable plagued by serious socio-economic inequalities, is much the same as it is in South Africa – just on a much greater scale. Unofficial statistics suggest that more than 80 percent of the India’s sex workers are coerced into their work with few other job options.

With a fight before them that resonates with our history, South Africans must support Indians in their struggle to ratify the HIV Bill – and their broader fight for equality and humanity as people’s lives depend on it.

Sharon Ekambaram is the head of programmes for MSF South Africa. She has been an Aids activist in South Africa since the 1990s when she became the Treatment Action Campaign’s first provincial coordinator for Gauteng.