Minister explains mandatory HIV testing policy

Minister of Health Chitalu Chilufya says 81 per cent of admissions at the University Teaching Hospital which result in death are HIV related because of allowing voluntarism to take precedence over the need to know ones status to be protected from ill health.

And President Edgar Lungu’s press aide Amos Chanda says compulsory HIV testing policy is final and shall not be rescinded.

At a joint media briefing yesterday, Dr Chilufya said the Patriotic Front government wanted to ensure the health of citizens.

“81 per cent of admissions at UTH which result in mortality are HIV related, why? Because we allow voluntarism to take precedence over the need for us to know our status and be protected from ill health. So there are people who repeatedly come to UTH with optimistic infections and because they have said they will not test for HIV, they are not started on ART and the health systems have a burden, we create orphans and widows,” Dr Chilufya said.

“And very important to emphasis that the UNAIDS Global Fast Track strategy to ensure that everybody accesses HIV health services requires that we test all citizens, we test 90 per cent of citizens. We ensure that 90 per cent of those tested are on therapy so what we are doing is in alignment to the UNAIDS Global Fast Track strategy and that is how we are going to proceed and we already have adequate support from partners and all the people we will test will be on ART and will sustainably continue on ARTs.”

He revealed that infections in females aged between 15 and 24 had doubled.

“New infections in the age group 15 years to 24 years, females has doubled, that is a big threat to the development of this country and to the very existence of this country because if the females 15 to 24 years old have doubled new infections, then what we are going to see is a generation of older individuals who will be positive in the next five to ten years, that means that the nation will not have the healthy and productive citizens that are required to drive the social and economic agenda,” he said.
“The young man 35 to 45 years, infections have doubled. So government had to take decisions to protect the adolescents, to protect the youths and young adults to ensure that the very existence of this nation is assured. So for those who are worried about our human rights ‘I don’t want to know, I don’t want to know’, your partner also has a right not to get infected, your child also has a right not to get infected. And this responsible government will not allow smoldering guns on the streets just infecting innocent people. There are people who know their status today and they will go ahead and infect others and in other countries, that is a criminal offense.”

He insisted that President Lungu was determined to build a healthy nation.

“The shift from voluntary counseling and testing has been informed from the shift that we have gathered over the years. National building involves investment in the health of your people, protecting the people from ill health. The Patriotic Front party, and His Excellency Mr Edgar Chagwa Lungu is determined to build a nation of productive people from diseases including HIV. We have had HIV for many years and we have lost one million Zambians, celebrities, professionals, our fathers and mothers. We cannot continue doing the same things and expect different results so it is a responsible decision that government has made to ensure that we protect the lives of our citizens,” Dr Chilufya said.

“If you think it is your right not to know your status, how about the right of the partner you are going to infect? That partner doesn’t have the right to remain negative? How about the rights of a child who is not born? Doesn’t that child have a right not to be born positive? We cannot be selfish and focus on ourselves. So as a responsible government, we are going to protect all citizens. In our countries, infecting another person with HIV is a criminal offense. All we are saying is that know your status and if you are positive, we will start you on treatment. If we start you on treatment, we will reduce your viral load through that treatment and when it is reduced, the capacity to infect the next person is significantly reduced if not zeroed.”

He also said mandatory testing was not new as it had applied to pregnant women for some years.

“This is not even new, when we introduced the option B Plus programme for pregnant women in the prevention of mother to child transmission of HIV, what did we do? All pregnant women who were coming to antenatal clinics were tested for HIV and those who were positive were started on ART. Today, the infection rates from mother to child have plummeted to a level where we are saying we are in the elimination phase. So there is evidence to back the decision to enroll all who are positive on ART. Furthermore, if you look at other infectious diseases such as measles, way back, at the University Teaching Hospital we used to have an isolation ward where we used to admit children with measles, we used to certify not less than 30, 40 children every day from measles, we made a decision as a country to vaccinate children at a particular age to protect them from measles and today that ward is closed,” said Dr Chilufya.

“So these are public health decisions that must be taken. The testing that shall be done will be routine testing. If you get into a facility and you have pneumonia, and we think that that pneumonia is associated with HIV, we will test you for HIV. And if we find you positive, we will counsel you on the need and we will start you on ART. And we will reduce your viral load to a level where your partner is safe if your partner is not yet infected, we will reduce your viral load to a level where the pregnant woman will not have the capacity to transmit it to their child. So the hope in an HIV free generation lies in stopping new infections.”

Dr Chilufya also said government would place HIV test kits in public places to allow people to test themselves in the privacy of their homes.

And Chanda said the policy was final.

“This morning the President was going through the texts and reactions and he was saying, if we hear that in the next room you are preparing to commit suicide in the comfort of your home, we shall violate your right of privacy and independence of your home because suicide is an offense, it is one of those offenses where you are punished for not succeeding, it is like treason…so the President takes this AIDS thing in that context that if the age group 15-24 when the AIDS infection rates are going down and it is doubling, matters of public policy require that a democratically elected president like him will declare public policy measures that he deems suitable. Those people who will come and grant a democratic right for people to die will come then, for now, he has said that this is a matter of public policy and that’s what will happen,” said Chanda.

“It is a closed chapter, the policy has been proclaimed, we are now in the implementation phase and I think that very soon, the minister will be announcing to you the results of this. I thought I should say that because there are people who think that they can create a debate around that.”

         

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