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Premier Helen Zille is so worried about the spread of HIV and its cost to the government that she wants men who have multiple sexual partners and refuse to use condoms to be charged with attempted murder.
Zille told a wellness summit hosted by the provincial health department in Newlands yesterday that it was time the government shifted its exclusive focus from treating diseases to preventing them and promoting wellness.
But Aids activists slammed Zille’s remarks as “careless and misleading”, warning that criminalising HIV/Aids infection went against international guidelines and would create an incentive for people not to get tested.
Zille said HIV treatment alone cost the provincial government close to R2 billion a year. She said shifting the emphasis to prevention would free up more resources for unpreventable conditions which were often seriously underfunded because of the “burden of disease”.
While increasing wellness required the state to meet people’s rights, it also required individuals to take responsibility for their lives and avoid preventable conditions such as certain types of diabetes, hypertension, obesity and cholesterol, and those linked to abuse of substances such as tobacco, alcohol and drugs.
“... the Western Cape will continue to provide the most comprehensive HIV/Aids treatment in the country. …But it will also ask the necessary questions and make appropriate demands for behavioural change,” she said.
Zille said while many believed South Africa had emerged from the era of Aids denialism under Thabo Mbeki, it had in fact sunk even deeper into denialism.
“President Zuma’s lifestyle epitomises the Aids Superhighway: inter-generational sex with multiple concurrent partners. Because it was politically incorrect to challenge this, the country remained in denial about the root of the problem.
“Which part of ‘Use a Condom’ do some men not seem to understand?”
Men who persisted in this kind of behaviour and put women at risk should be charged with attempted murder, Zille said.
Mark Heywood, director of Section 27, formerly the Aids Law Project, said although Zille was correct to identify HIV infection as it was a talking point, her suggestions were not the solution.
“I would caution against any politician that suggests criminalisation of HIV... it goes against what (the joint UN HIV/Aids programme) UNAids stands for as it considers it counter-productive.
“Zille’s statement is careless and misleading. What we need to do as a country is to empower people, particularly women, to negotiate with their partners to wear condoms.
“If men refuse to wear condoms and force themselves on their partners then this should be reported as rape. Charging men with attempted murder will not address HIV transmission and it will not be workable as it will be difficult to prove this in court,” he said.
Zille said irresponsible sexual behaviour that led to the spread of HIV/Aids should be stigmatised, not people who were HIV-positive.
UCT constitutional law professor Pierre de Vos said Zille’s statement was criminalising people’s behaviour and would create an incentive for people not to get tested.
“It is a fundamental principle of criminal law that you can only be found guilty of a crime you have committed, so to say people have multiple sexual partners and don’t use protection without knowing their status will just be flying in the face of what any country’s criminal law should be about. Without being able to impute the intention, you can’t criminalise behaviour,” he said.
Anyone who knowingly endangered the life of another should face prosecution, but proving such intention in the case of HIV-positive persons would be difficult, he added.
According to Dr David Pienaar, a public health specialist from the provincial health department who also addressed yesterday’s summit, it was estimated there would be 14 000 new HIV infections in the province next year to add to the existing 270 000.
A paradigm shift on behaviour was needed. “The missing link is to effect behaviour change within those high-risk communities...”
Richard Delate, MD of Johns Hopkins Health and Education SA, said there had been a lot of behavioural change. In some areas “condom distribution is so inadequate that there’s less than 10 per sexually active man per year. Maybe Helen Zille needs to look at those shortcomings and engage with communities. Then we can talk about any policy changes”. – Additional reporting by Janis Kinnear