Tau­reef Mo­hammed

It's not about free­dom of speech, nor aca­d­e­m­ic free­dom. It's about fight­ing HIV/Aids through a com­pre­hen­sive ap­proach which in­cludes grant­i­ng hu­man rights to all groups in so­ci­ety.This was the view of sev­er­al stake­hold­ers in the cam­paign against HIV/Aids in the Caribbean as they weighed in on the con­tro­ver­sial fir­ing of Trinidad-born aca­d­e­m­ic Prof Bren­dan Bain by UWI, Mona.

What trig­gered the con­tro­ver­sy?

A re­lease from UWI on May 20 said Bain, a re­tired mem­ber of staff at UWI, was fired as di­rec­tor of the Caribbean HIV/Aids Re­gion­al Train­ing Cen­tre (Chart), a po­si­tion he had held since Chart's in­cep­tion in 2001.Chart is a re­gion­al or­gan­i­sa­tion man­aged by UWI, aimed at pre­vent­ing HIV/Aids in the re­gion and pro­vid­ing care, treat­ment and sup­port to peo­ple with HIV/Aids.

The is­sue arose in 2012 in a case in Be­lize in which Caleb Oroz­co, a gay man in Be­lize, chal­lenged an 1861 law that crim­i­nalised men hav­ing sex with men (MSM).Bain pro­vid­ed a state­ment to the court that, ac­cord­ing to UWI, sup­port­ed ar­gu­ments for re­ten­tion of the law.

UWI's ac­tion caused out­rage among some in Ja­maica, who de­scribed UWI as a "spine­less" or­gan­i­sa­tion that had bowed to pres­sure from pow­er­ful gay lob­by groups.But in state­ments re­leased last week, re­gion­al health agen­cies came out in UWI's de­fence, say­ing UWI's ac­tion was based on main­tain­ing prop­er lead­er­ship and a sound pub­lic health strat­e­gy to end the HIV/Aids epi­dem­ic in the re­gion.

Dr Ed­ward Greene,

UN Sec­re­tary Gen­er­al's

Spe­cial En­voy for HIV

in the Caribbean

Bain's sub­mis­sion to the court was "aimed at up­hold­ing a law that, in the opin­ion of pub­lic health ex­perts and mem­bers of civ­il so­ci­ety, re­in­forced stig­ma and dis­crim­i­na­tion­a­gainst MSM," Dr Ed­ward Greene said.He said laws and poli­cies that crim­i­nalised cer­tain pop­u­la­tions pre­vent­ed them from seek­ing in­for­ma­tion, treat­ment, and sup­port ser­vices, mak­ing it dif­fi­cult to mount an ef­fec­tive re­sponse to HIV/Aids in the re­gion."These laws are dis­crim­i­na­to­ry and coun­ter­pro­duc­tive. They must be re­pealed or at least mod­i­fied.""The protests against the uni­ver­si­ty's de­ci­sion un­for­tu­nate­ly mis­char­ac­terise it as a threat to free­dom of speech and to aca­d­e­m­ic free­dom."On the con­trary, it is sim­ply a lack of cred­i­bil­i­ty to lead Chart, giv­en the or­gan­i­sa­tion's goals sur­round­ing the elim­i­na­tion of stig­ma and dis­crim­i­na­tion to­ward MSM and oth­er com­mu­ni­ties that are vul­ner­a­ble to HIV."

He said rec­om­men­da­tions will be pre­sent­ed to Cari­com heads of gov­ern­ment in Ju­ly on ways to strength­en the re­gion's re­sponse to HIV/Aids, which in­clude: "To ac­cel­er­ate the process for re­peal of laws crim­i­nal­is­ing sex­u­al acts in pri­vate be­tween con­sent­ing males and fe­males and re­plac­ing them with pro­vi­sions crim­i­nal­is­ing sex­u­al acts be­tween per­sons in pub­lic or with the use of force."

Dr Ernest Mas­si­ah, UN­AIDS

Lost in the pas­sion­ate pub­lic de­bate sur­round­ing Bain's fir­ing was the re­al­i­ty of HIV/Aids in the re­gion, Dr Ernest Mas­si­ah, UN­AIDS Caribbean Re­gion­al Sup­port Team di­rec­tor, said.

"At the end of 2012, UN­AIDS es­ti­mat­ed that there were 260,000 peo­ple liv­ing with HIV in the re­gion. In many coun­tries, ap­prox­i­mate­ly one in three new cas­es is among MSM. How do we deal with this as we work to end the epi­dem­ic in the Caribbean?"Point­ing out that HIV was a virus and not a crime, Mas­si­ah said laws that crim­i­nalised sex­u­al be­hav­iours and ori­en­ta­tions made it dif­fi­cult to end the HIV/Aids epi­dem­ic in the re­gion."Per­sons who know their sex­u­al be­hav­iour or ori­en­ta­tions are il­le­gal are less like­ly ei­ther to go to health ser­vices or to speak open­ly about their sex­u­al be­hav­iour while there, thus lim­it­ing their treat­ment op­tions and pre­ven­tion ef­forts.

"Our laws should help cre­ate an en­vi­ron­ment in which there is no im­ped­i­ment to de­liv­er­ing tar­get­ed pre­ven­tion and treat­ment ser­vices to a pop­u­la­tion par­tic­u­lar­ly af­fect­ed by HIV."

There­fore, re­mov­ing laws that crim­i­nalised sex­u­al be­hav­iours and ori­en­ta­tions was recog­nised by glob­al and re­gion­al agen­cies as a key step to de­feat Aids, he said.Laws that crim­i­nalised sex­u­al be­hav­iours and ori­en­ta­tions, he added, re­in­forced stig­ma and dis­crim­i­na­tion.A re­cent in­ter­net sur­vey by UN­AIDS found that in two Caribbean coun­tries, about ten per cent of doc­tors and nurs­es would rather not pro­vide ser­vices to MSM.Pan Caribbean Part­ner­ship against HIV and AIDS (PAN­CAP)"Prof Bren­dan Bain's tes­ti­mo­ny in the Oroz­co v AG Be­lize (2012) case is not con­sis­tent with the stat­ed goals of Pan­cap to re­duce stig­ma and elim­i­nate dis­crim­i­na­tion and is in dis­so­nance with Pan­cap's on­go­ing work to re­move dis­crim­i­na­to­ry laws and af­firm hu­man rights.

"In adopt­ing an ac­tive po­si­tion of op­pos­ing the de­crim­i­nal­i­sa­tion of anal sex be­tween two con­sent­ing male adults in pri­vate, Prof Bain has un­der­mined the pub­lic health and hu­man-rights goals of Pan­cap." The re­lease not­ed that the Glob­al Com­mis­sion on HIV and the Law found that coun­tries that crim­i­nalised same-sex sex­u­al ac­tiv­i­ty have high­er HIV preva­lence rates among MSM than coun­tries that do not.Pan­cap said a "mul­ti-sec­toral" ef­fort to re­move le­gal, so­cial, and cul­tur­al bar­ri­ers that pre­vent­ed uni­ver­sal ac­cess to health care was need­ed to move to­ward an Aids-free Caribbean.

Prof Rose-Marie Belle An­toine, for­mer UWI lec­tur­er in the Fac­ul­ty of Law

The fir­ing of Bain has noth­ing to do with aca­d­e­m­ic free­dom and those who claim oth­er­wise are "mis­in­formed, with per­haps a few who are sim­ply be­ing op­por­tunis­tic," says for­mer UWI lec­tur­er Prof Rose-Marie Belle An­toine."At the core, it is about a pro­gramme leader pub­licly un­der­min­ing the very pro­gramme and prin­ci­ples he was man­dat­ed to sup­port."Re­spond­ing to those who said Bain's state­ment rep­re­sent­ed his per­son­al views, Belle-An­toine said: "The very rea­son au­thor­i­ties like Prof Bain are called up­on to speak is be­cause of their pro­fes­sion­al ca­pac­i­ty, which is in­ex­tri­ca­bly linked with the in­sti­tu­tion, the UWI. Thus, Prof Bain can­not sep­a­rate his per­son­al views from these com­ments that have come to rep­re­sent the in­sti­tu­tion that is the UWI, which is why they are viewed as harm­ful and ir­re­spon­si­ble."Belle-An­toine said it was a fact that "the elim­i­na­tion of dis­crim­i­na­tion on the ground of sex­u­al ori­en­ta­tion is a key in­gre­di­ent of the UWI's HIV pro­gram­ming, which Prof Bain had the ho­n­our to lead for many years."

Col­in Robin­son,ex­ec­u­tive di­rec­tor, Coali­tion Ad­vo­cat­ing for In­clu­sion of Sex­u­al Ori­en­ta­tion (Caiso)

Lead­er­ship prin­ci­ples and an ef­fec­tive pub­lic health strat­e­gy are at the core of this is­sue, ac­cord­ing to Col­in Robin­son of the Coali­tion Ad­vo­cat­ing for In­clu­sion of Sex­u­al Ori­en­ta­tion (Caiso).

In an in­ter­view with the T&T Guardian, Robin­son said, "The out­come here is re­al­ly about in­tegri­ty in lead­er­ship and con­sis­ten­cy of prin­ci­ples, and about the fact that crim­i­nal­i­sa­tion of any group ought not be a part of an ev­i­dence-based HIV re­sponse."Hu­man rights, he said, had to be at the cen­tre of all pub­lic health pro­grammes, in­clud­ing the HIV re­sponse."You can't make peo­ple well and whole if you say that they aren't ful­ly hu­man."

HIV/Aids in the Caribbean–the facts

To­tal num­ber of adults and chil­dren liv­ing with HIV: be­tween 220,000 and 280,000.

Preva­lence of HIV (the ra­tio of in­fect­ed peo­ple to un­in­fect­ed peo­ple in a pop­u­la­tion) among adults: be­tween 0.9 and 1.1 per cent–the sec­ond high­est in the world. (With a preva­lence of 4.7 per cent, sub-Sa­ha­ran Africa is at num­ber one.)

� In 2012, there were be­tween 9,400 and 14,000 new cas­es of HIV.

� Ap­prox­i­mate­ly one in three new cas­es is among men who have sex with men (MSM).

� The preva­lence of HIV among MSM is 25.4 per cent–the high­est in the world.

� Men who have sex with men are at in­creased risk for HIV. This is be­cause un­pro­tect­ed anal sex has much high­er trans­mis­si­bil­i­ty than vagi­nal sex.

(Sta­tis­tics from 2013 UN­AIDS Glob­al Re­port; UN­AIDS Guide­lines on sur­veil­lance among pop­u­la­tions most at risk for HIV (2011); and The Lancet (2012))