Ethical perspectives on surveillance and preventive strategies for HIV/AIDS in South Africa

[摘要] ENGLISH ABSTRACT: It is a well-known fact that the sub-Saharan Africa is a continent most affected by HIV/AIDS.The HIV/AIDS pandemic has in other words become our disease. For many of us, this factmay be difficult to fully accept. There are elements of prejudice in our reactions. Ignoranceand intolerance can be found around the world. Therefore, by presenting the facts aboutHIV/AIDS, this assignment challenges the misconceptions and focuses on the profounddilemmas confronting society.I think the success in combating the HIV/AIDS pandemic could be found in President ThaboMbeki's terminology Partnership against HIV/AIDS. In his speech, the President appealedto both the private and public sectors and all South Africans to work together with greaterdetermination than before to fight against HIV infection and AIDS. Arguably, this was thebest speech President Thabo Mbeki ever made on HIV/AIDS on October 9, 1998. Back then,the government seems to have had a direction and led from the front in the battle againstHIV/AIDS.The title of this thesis reads: Ethical perspectives on surveillance and preventive strategiesfor HIV/AIDS in South Africa. Presently, the South African Government through theMinistry of Health is seriously considering making AIDS a notifiable medical condition. Thisis a serious and a controversial move that has serious ethical and legal implications that willbe discussed. Should partners of HIV-infected individuals be informed? If the answer is onthe affirmative, who should inform them? I am also looking at the ethical obligation of healthcare workers to treat HIV/AIDS patients despite the fear of being accidentally infected. Toughquestions need to be asked. Should health workers be informed of the HIV status of everypatients they treat? On the other hand, some patients have some fears too that HIV-infectedhealth professionals may infect them. Again, the fundamental ethical concerns related toconfidentiality, privacy, the right to treatment will also be discussed. The country is dividedon this issue. Ethical principles are directly involved in such a decision, for instance, theprinciple of confidentiality, respect for autonomy and informed consent. How can thegovernment go about implementing this without disregarding these fundamental ethicalrequirements?Another ethical issue that comes to mind regarding HIV/AIDS concerns AIDS vaccine trials,which are so far dominantly manufactured in 'developed countries' while subjects of thesetrials are from 'third world' or 'developing countries '. The ethical concerns here are: Howwill informed consent be protected, especially where subjects of the trials are not educatedand do not understand the terms used? What are the cost-effects or benefits of such trials?What are the risks involved? Together with this, other issues include ethical debatesconcerning market prices of drugs, which are too expensive for poorer countries andaffordable for richer countries.Finally, this work does not treat everything that needs to be dealt with insofar as HIV/AIDS isconcerned. However, I hope that this thesis will contribute (in a small way) in making peopleappreciate the ethical dilemmas that are presented by HIV/AIDS.

[发布机构] Stellenbosch University