Human Rights Protection and Access to Essential Treatment for People Living With Hiv/Aids in Uganda A Case Study of Makindye Division Kampala District

TABLE OF CONTENTS

DECLARATION .......................................................................................................................................... i

APPROVAL ..................................................................................................................................................... ii

DEDICATION ........................................................................................................................................... iii

ACKNOWLEDGEMENT ......................................................................................................................... iv

LIST OF' ACRONYMS .............................................................................................................................. v

ABSTRACT ................................................................................................................................................ ix

TABLE OF' CONTENTS ......................................................................................................................... xi

CHAPTER ONE ......................................................................................................................................... 1

1.0 Overview ............................................................................................................................................. 1

1.1 Background of the Study .................................................................................................................... 1

1.2 Statement of the Problem .................................................................................................................. 5

1.3 Worl

1.4 Scope of the Study .............................................................................................................................. 8

1.5 General Objective of the Study ........................................................................................................... 8

1.5.1 Specific objectives ........................................................................................................................ 8

1.6 Research Questions ............................................................................................................................. 9

1.7 Related Literature ............................................................................................................................... 9

1.8 Relevance/ Importance of the Study ................................................................................................ 14

1.9 Research Methodology .................................................................................................................. 14

1.10 Limitations .................................................................................................................................... 15

1.11 Chapterisation ................................................................................................................................. 16

CHAPTER TWO ............................................................................................................................................. 17

2.1. lntroduction .................................................................................................................................. 17

2.2. Human Rights Response to HIV/AIDS and Access to Treatment .................................................. 17

2.3. The right to access essential treatment as part and parcel of the right to health ..................... 19

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2.3.1. The right to health within the framework of social, economic, and cultural rights ................. 19

2.3.2. The right to access essential treatment as part of the core content of the right to health

under the ICESCR ................................................................................................................................. 20

2.3.3. The right to health as interpreted in other Human Rights instruments ................................... 21

2.4. The right to access essential treatment and its relationship with other human rights .............. 24

2.5. Implications of the right to access essential treatment for state and non-state actors ............. 26

2.5.1. Implications for the state .......................................................................................................... 26

2.5.2. Implications for non-state actors .............................................................................................. 28

2.6. Conclusions ...................................................................................................................................... 28

CHAPTER THREE .......................................................................................................................................... 30

3.1. lntroduction .................................................................................................................................. 30

3.2. The State's Response to the Right to Access Essential Treatment in Uganda ............................ 30

3.2.1. The National Legal Framework ................................................................................................. 30

3.2.2. The National Policy Framework .................................................................................................... 33

3.2.2.1. The National Health Policy (NHP) and the Health Sector Strategic Plan (HSSP) ................ 33

3.2.2.2. Revised National Strategic Framework for HIV/AIDS activities (NSF) ................................ 35

3.2.2.3. The Antiretroviral Treatment Policy (ATP) ......................................................................... 36

3.2.2.4 Makindye Case study .............................................................................................................. 38

3.2.2.4. The policy for reduction of MTCT ....................................................................................... 39

3.2.2.5. The Uganda National Drug Policy ....................................................................................... 40

3.2.3. Judicial and Other Appropriate Remedies Relating To Access to Essential Treatment ................ 41

3.2.3.1. Justifiability of the right to access essential treatment in Uganda ........................................ 41

3.2.3.2. Other remedies available with regard to the right to access essential treatment.. .............. 44

3.3. The Response Of Non-State Actors to the Right to Access Essential Treatment in Uganda ....... 46

3.4 Conclusion ......................................................................................................................................... 48

CHAPTER FOUR ........................................................................................................................................... 50

4.1 Introduction ...................................................................................................................................... 50

4.2 Impact of the Globalisation Process on Access to Essential Treatment ........................................... 50

4.2.1 Conceptualisation of the Globalisation Process .................................................................. 50

4.2.2 The role of the policies of international financial institutions (IFIS) on barriers to access

essential treatment ............................................................................................................................. 51

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4.3 Lack of Accountability Mechanisms and Good Governance ............................................................. 54

4.4 Lack of Awareness of the Right to Access Essential Treatment.. ...................................................... 55

4.5 Gender Relations as a Barrier to Access Treatment ......................................................................... 55

4.6 Conclusion ......................................................................................................................................... 56

CHAPTER FIVE .............................................................................................................................................. 57

5.1. Conclusions ...................................................................................................................................... 57

5.1.1. Scope Of Access To Essential Treatment For PLWHA Under International Law ....................... 57

5.1.2. Implementation of the Right to Access Essential Treatment in Uganda .................................. 57

5.1.3. Obstacles to the Realisation of the Right to Access Essential Treatment in Uganda .............. 58

5.2. Recommendations ........................................................................................................................... 59

5.2.1. Recommendations for the government ....................................... Error! Bookmark not defined.

5.2.2 Administrative measures ........................................................................................................... 61

5.2.3. Judicial protection ..................................................................................................................... 62

5.3. Recommendations to non-state actors ............................................................................................ 62

5.3.1. Recommendations to the international organisations and the donor community .................. 62

5.3.2 Recommendations to the civil society ....................................................................................... 63

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TRODUCTION

1s research examines the effectiveness of the Laws providing for human rights Jtection and Access to Essential Treatment for People Living with HIV/ AIDS in  ;anda through looking at how these laws have been applied in matters concerning atmcnt, healthcare, and government support among others. Although the 1995 constitution of the Republic of Uganda and other international Conventions to which ;anda ratified give protection to PLWHA among other persons against abuse of their  hts enforcement of those statutory provisions is difficult as they conflict on specific )visions towards such persons. Therefore the nationals should be sensitized about  :ir legal rights and obligations to enable them see legal redress where they have  ~n denied their rights to essential treatment, protection and discrimination.