The Legislative and Policy Gaps in the National HIV and AIDS, STI Policy, 2004-2014, Ghana

Ishmael D. Norman^1,2*, Margaret Kweku¹, Gideon Kye-Duodu¹, Joyce Der¹, Blandina M. Awiah², Fred N. Binka³

¹School of Public Health, University of Health and Allied Sciences (Hohoe Campus), Hohoe, Volta Region, Ghana.
²Institute for Security, Disaster and Emergency Studies, Sandpiper Place, Langma, Central Region, Ghana.
³University of Health and Allied Sciences, Ho, Volta Region, Ghana.

DOI: 10.4236/blr.2015.64027                

Abstract

By 2003, 350,000 persons lived with HIV/AIDS in Ghana with an average drop of 15,640 over 8 years. In 2011, approximately 224,878 persons lived with HIV/AIDS, which is expected to drop to 221,884 by 2015. We think the estimated 2994 drop over 4 years is pedestrian. We attribute the lackluster performance to the haphazard HIV and AIDS, STI Policy from 2004 through 2013. We considered the Ghana HIV/AIDS and STI Policy published (NACP/GHS, 2013) “as is” to isolate the gaps in the policy, looking at the provision of judicial and legal mechanisms for testing, treatment and counseling. We also investigated the national policy on partner notification, names reporting, and expedited partner therapy, in the case of MSM and young people as provided for in the policy. Finally, we looked at issues affecting stigmatization and discrimination. The investigation consisted of the review of the Revised National HIV and AIDS, STI Policy of August 2004 through 2013. We also undertook a documentary review of publications on the topic. There are systemic problems in the policy design, which has weakened the thrust of the national control program. The policy is unsystematic and inconsistent with international best practice in combating communicable diseases. It may not maximize the number of persons who are aware of their HIV status. It may not increase the number of HIV infected persons who receive care, and may not prevent new infections. It is unlikely that by 2015 even the low 2994 drop over four years would be sustained particularly with the current rationing of ART drugs in the nation. Recommendations are made to, perhaps, inform policy.

Keywords

HIV/AIDS, Legislative and Policy Gaps, Partner Notification, Names Reporting, Expedited Partner Therapy, MSM, Ghana

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Abelard, P., & Alexander, S. (2003). Anglo-American Ethics (20th Century). A History of Western Ethics, 173.
[2]	Atrash, K., & Carpentier, R. (2012). The Evolving Role of Public Health in the Delivery of Health Care. Revista Brasileira de Crescimento E Desenvolvimento Humano, 22, 396-399.
[3]	Bayer, R. (1991). Public Health Policy and the AIDS Epidemic: An End to HIV Exceptionalism? New England Journal of Medicine, 324, 1500-1504. http://dx.doi.org/10.1056/NEJM199105233242111
[4]	Bowtell, W. (2005). Australia’s Response to HIV/AIDS 1982-2005. Lowy Institute for International Policy. http://m.lowyinstitute.org/files/pubfiles/Bowtell,_Australia’s_Response_to_HIV_AIDS_logo.pdf
[5]	Brachman, P. S. (2003). Infectious Disease—Past, Present and Future. International Journal of Epidemiology, 32, 684-686. http://dx.doi.org/10.1093/ije/dyg282
[6]	Burris, S. (1999). Studying the Legal Management of HIV-Related Stigma. American Behavioral Scientist, 42, 1229-1243. http://dx.doi.org/10.1177/0002764299042007012
[7]	Burris, S., Finucane, D., Gallagher, H., & Grace, J. (1996). The Legal Strategies Used in Operating Syringe Exchange Programs in the United States. American Journal of Public Health, 86, 1161-1166. http://dx.doi.org/10.2105/AJPH.86.8_Pt_1.1161
[8]	Centers for Disease Control and Prevention (CDC, P., & Others) (2007). Rapid HIV Testing in Emergency Departments—Three US Sites, January 2005-March 2006. MMWR. Morbidity and Mortality Weekly Report, 56, 597.
[9]	de Zwart, O., Sandfort, T., & van Kerkhof, M. (1998). No anal Sex Please: We’re Dutch: A Dilemma in HIV Prevention Directed at Gay Men. The Dutch Response to HIV: Pragmatism and Consensus, 135-152.
[10]	Georgia Department of Public Health (2015). Georgia’s HIV/AIDS Epidemiology Surveillance Section. http://dph.georgia.gov/georgias-hivaids-epidemiology-surveillance-section
[11]	Ghana AIDS Commission (2005). The National Monitoring and Evaluation Plan for HIV/AIDS in Ghana 2006-2010. Ghana AIDS Commission.
[12]	Ghana Country AIDS Progress Report (2012). UNAIDS Global AIDS Response Progress Report, 2010-2011.
[13]	Ghana Public Health Act (2012). Ghana Public Health Act 851. Government Printer, Assembly Press, ACCRA. GPC/A753/ 350/11/2012.
[14]	Hanson, F. (2011). Australia and the World: The Lowy Institute Poll 2010. Sydney: Lowy Institute for International Policy.
[15]	Henriksson, B., & Ytterberg, H. (1992). Sweden: The Power of the Moral(istic) Left. In D. L. Kirp, & R. Bayer (Eds.), AIDS in the Industrialized Democracies—Passions, Politics and Policies (pp. 317-338). New Brunswick: Rutgers University Press.
[16]	Hodge Jr., J. G., Pulver, A., Hogben, M., Bhattacharya, D., & Brown, E. F. (2008). Expedited Partner Therapy for Sexually Transmitted Diseases: Assessing the Legal Environment. American Journal of Public Health, 98, 238-243. http://dx.doi.org/10.2105/AJPH.2007.113381
[17]	Jacobson v. Massachusetts, 197 US 11 (1905).
[18]	Kates, J. (2004). Trends in US Government Funding for HIV/AIDS.
[19]	Mathers, B. M., Degenhardt, L., Phillips, B., Wiessing, L., Hickman, M., Strathdee, S. A. et al. (2008). Global Epidemiology of Injecting Drug Use and HIV among People Who Inject Drugs: A Systematic Review. The Lancet, 372, 1733-1745. http://dx.doi.org/10.1016/S0140-6736(08)61311-2
[20]	Ministry of Health (2014). National Guidelines on Prevention of Mother to Child Transmission of HIV. NACP, Accra, Ghana.
[21]	National AIDS Control Program/Ghana Health Service (NACP/GHS 2013). HIV Sentinel Survey Report 2013.
[22]	National AIDS Control Programme. (2013). National HIV and AIDS, STI Policy.
[23]	Norman, I. D., Aikins, M., & Binka, F. N. (2012). The Legis-lative and Policy Gaps in the National HIV/AIDS and STI Policy, 2004-2012. White Paper, School of Public Health, University of Ghana, and the Office of the President, Ghana Government.
[24]	Slack, J. D. (1998). HIV/AIDS and the Public Workplace: Local Government Preparedness in the 1990s. Tuscaloosa, AL: University of Alabama Press.
[25]	Wolitski, R. J., Valdiserri, R. O., Denning, P. H., & Levine, W. C. (2001). Are We Headed for a Resurgence of the HIV Epidemic among Men Who Have Sex with Men? American Journal of Public Health, 91, 883-888. http://dx.doi.org/10.2105/AJPH.91.6.883
[26]	Yazdanpanah, Y., Sloan, C. E., Charlois-Ou, C., Le Vu, S., Semaille, C., Costagliola, D. et al. (2010). Routine HIV Screening in France: Clinical Impact and Cost-Effectiveness. PLoS ONE, 5, e13132. http://dx.doi.org/10.1371/journal.pone.0013132