• Are rights enough?

Are rights enough?

This article, from the Bulletin of the World Health Organization (WHO), considers the ethical challenges of massive scale-up of HIV testing required in order to achieve ART (antiretroviral therapy) targets. The article outlines how the success of increasing access to ART is dependent on the identification of people who need treatment. Poor uptake of VCT (voluntary counselling and testing) means that the vast majority of people living in low income countries do not know they are HIV positive. The WHO and UNAIDS have recommended an "opt-out" testing policy, where routine HIV testing is justified and ethical if certain conditions are met.

The authors suggest that in settings marked by poverty, weak health-care and civil society infrastructures, gender inequalities, and persistent stigmatisation of people with HIV and AIDS, opt-out HIV-testing policies may become disconnected from the human rights ideals that first motivated calls for universal access to AIDS treatment. They leave open the ethical question of whether opt-out policies should be implemented. However, they do recommend that whenever routine HIV-testing policies are introduced in resource-poor countries, that their effect on individuals and communities should be the subject of empirical research, human-rights monitoring and ethical scrutiny. [adapted from author]

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