Why the need to amend HIV confidential reporting form?

THE EDITOR, Madam:

This is an open letter to the Minister of Health and Wellness Dr Christopher Tufton.

The Civil Society Forum on HIV and AIDS was made aware of a press release issued by the Ministry of Health and Wellness (MOHW) stating that the ministry will be adjusting the HIV confidential reporting form. In the release titled, ‘Health Ministry to adjust HIV reporting form’, it states, “Based on an internal review initiated by the minister of health and wellness, Dr. The Hon. Christopher Tufton, it has been agreed that the form, while supporting a detailed epidemiological profile for public health, does not comply with existing constitutional and legal structures of the Government of Jamaica. It will, therefore, be amended with full compliance.”

We are concerned about this decision by the ministry and have the following questions:

• What prompted this sudden review and proposed adjustment of the HIV confidential reporting form?

• What on the HIV confidential reporting form violates the Jamaican Constitution?

• What legal structures of the government does the form fail to comply with?

We acknowledge the need for periodic review of data tools and processes to enhance our public health response. However, as civil society, we believe any such adjustment should take into account global best practices, informed by evidence from our technical public health partners and done with the full involvement of critical stakeholders in the response.

Current HIV data continue to show that HIV and AIDS disproportionately affect members of key populations. We believe any amendment which does not take these factors into account has the potential to erode the progress we have collectively achieved over the years in HIV prevention, treatment, and care. It might also force the individuals and communities back into the shadows.

The position of the MOHW that the reporting form in its current iteration is inconsistent with constitutional and legal provisions is a position with which we disagree. While we understand the importance of all government institutions, acting within legal and constitutional contours, we are concerned over the soundness of the legal position taken by the government on this matter without any detailed explanation being given. If indeed there are valid constitutional issues, it is important that these positions be properly and thoroughly ventilated before any major change in government practice is advanced. While cultural sensitivity is understood, one ought not to conflate the same with constitutional and legal structures to the extent that such conflation threatens our public health response.

The HIV response, over the years, has seen the MOHW collaborating with civil society organisations and working closely with those impacted by HIV/AIDS. It is disheartening that such a crucial matter, which has implications for all stakeholders, was decided without broader consultation with the HIV response community. The absence of dialogue with agencies who do provide HIV-related prevention, treatment and care, and would be well-positioned to offer input, can only erode decades of trust and consensus building that were critical underpinnings in the reduction of new HIV infections, which declined by 62 per cent between 2004 and 2021.

We urge the minister and the MOHW to reconsider the current stance and communication. This approach, in our view, stands at odds with the core principles of an evidence-based public health response.

THE CIVIL SOCIETY FORUM ON HIV