On June 22 2016, the Ministry of Public Health of the Republic of Cameroon issued an information note on the new directives in the fight against HIV.
According to the note, the goal is to improve care for people living with HIV and the directives fit into the implementation of an antitretroviral therapy Acceleration Plan. They are in line with international guidelines pertaining to the fight against HIV, including WHO’s new directives and UNAIDS 90 90 90 targets. Besides the creation of new care centers, the deployment of psychosocial workers, the subsidized price of biological follow-up examinations, the note requires the systematic screening of each and every person coming to a hospital for consultation, no matter the disease.
Here is an excerpt of the document entitled 90-90-90, An ambitious treatment target to help end the AIDS epidemic issued by UNAIDS: “The only way to achieve this ambitious target is through approaches grounded in principles of human rights, mutual respect and inclusion. Coercive approaches not only violate fundamental human rights norms, but they will also hamper hopes for ending the AIDS epidemic. As experience throughout the world has repeatedly and conclusively demonstrated, coercive approaches drive people away from the very services they need.“
The information note is supposed to be in line with this document. However, the latter calls into question its validity. First of all, it is against Human Rights norms. Health is a private matter. Individuals should not be forced to know their serological status. Forcing someone to be screened or screening someone without informing them is a coercive method and, therefore, a violation. Furthermore, it undermines people’s trust in health workers.
Second, inclusion is a key term nowadays. No programme, no plan can be a success without the inclusion of populations. Sensitisation instead of coercion. People need to understand the rationale behind a programme to fully participate in and benefit from it. If they feel brutalised either physically or morally, they will not participate. In this case, we are exposed to a major negative impact: people will stop going to hospitals, fearing they will be informed they have HIV.
The positive outcomes of all the good work and improvements in the health sector in Cameroon will be null. People will be more vulnerable to illnesses considered minor because they will not seek treatment from a hospital. Contagious diseases which are easily treated today such as tuberculosis will become a major problem because everyone will be exposed. Not to mention women in need of maternal care. It will not even be possible for health workers to treat people at home because they will not be trusted anymore. The setbacks will be tremendous, especially in remote areas where information are not well shared and rumours take precedence.
When it comes to health, sensitisation about best practices is key. How is it that in Cameroon, a country with a good literacy rate, leaders feel the need to force people to do things for their own good? Sensitisation campaigns putting forward the benefits of knowing one’s serological status and the subsidized price of treatment will be a good way to attract people and achieve positive results. An information note stating the systematic proposition of HIV screening to every person coming to a hospital for consultation was issued on January 25 (see @NMNjamnsi tweet below). According to Cameroon Tribune (June 27 issue), the Minister of Public Health said last Friday that the screening will be systematically proposed to patients, but the information note of June 22 says otherwise. Citizens are sharing information and thoughts on the topic on social media.
Correct me if I misunderstand but I guess systematic screening = screening without someone's consent?
— Njamnsi (@NMNjamnsi) June 25, 2016
This is a BIG deal. Elsewhere this would warrant court action.
— Njamnsi (@NMNjamnsi) June 25, 2016
J'attends que quelqu'un me touche ils verront. Je suis trop jaloux de ma liberté. https://t.co/84K5YD45K5
— K. Éric (@KmtzEric) June 25, 2016
je lis pourtant dans le CT de ce matin que le dépistage sera obligatoire dans les hôpitaux publics 🤔 pic.twitter.com/vy4zq55MBH
— #TogoDebout (@petit_ecolier) June 27, 2016
— Njamnsi (@NMNjamnsi) June 27, 2016
dans les hôpitaux catholiques c'est obligatoire et "gratuit" depuis 3 mois pour les patients de o à 17 ans 🙂 @ek_Bamzok
— Nina Fleur NDENGUE (@NinaNdengue) June 27, 2016
July 12, 2016 : The Cameroon Radio Television or CRTV, the national television channel, broadcasted a coverage during the 8 pm news broadcast on the new measures adopted to fight HIV. Screening will not be compulsory, but it will be systematically proposed to every patient coming to a hospital.
Photo: Health Map
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