Official figures indicate Sri Lanka to be a low prevalence country but numerous factors could contribute towards the possibility of an outbreak of HIV / AIDS. These factors include poverty, lack of awareness, low condom use and the presence of numerous vulnerable groups. This coupled with the high levels of stigma and discrimination prevents many from coming forward to obtain assistance including necessary health care. It is compounded by a legal and policy framework that criminalises and subjects vulnerable communities to further harassment. This paper discusses and comments on the legal and policy dimension and the obstacles it poses to a sustainable and effective response to HIV/AIDS as many do not come forward to obtain medical services for fear of violence, stigma and discrimination. The paper highlights that low prevalence levels are underestimated due to the existing legal and policy framework that is out-dated and in need of reform and recommends specific steps to be taken to address the situation.
The post war period has witnessed escalated development and rehabilitation across Sri Lanka. Most of the conflict affected areas in the north and east of Sri Lanka have been demined with thousands of internally displaced persons (IDPs) returning to their lands and rebuilding their lives and livelihoods. While there continue to be IDPs and affected communities, there has been development in the areas with much needed infrastructure rehabilitated or built new including hospitals in the areas.[1] Although development in Sri Lanka has been rapid, poverty still persists.[2] Sri Lanka prides itself on a high literacy rate and attributes this number to free education. Yet, conservative values are interwoven into the fabric of society alongside still impoverished rural areas of the country – a key reason for children dropping out of school. The lack of resources is an on-going battle for those living below the poverty line[3], as they require basic services such as health, education, water and sanitation. This has further marginalised vulnerable groups such as women and children.
Health care provided by the Government is free and accessible to all. There is also health care financed and managed by the private sector. Due to various factors including poverty, many are unable to afford private health care, and rely on public health care. Although public health care is meant to be accessible to all, there are issues such as lack of resources, staff and training. This has led to those who are able to afford it to seek private health care. The present Government’s shift towards economic development, while having some benefits for poverty alleviation and the provision of infrastructural development, is not sufficient in addressing basic health care needs. It is therefore important to examine Government policy towards key sectors including health to understand how the present economic development model will contribute towards better services. This includes People Living With HIV/AIDS (PLWHA) being able to access and enjoy basic services such as health care.
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[1] Central Bank of Sri Lanka –Annual Report 2009, page 70, available at, http://www.cbsl.gov.lk/pics_n_docs/10_pub/_docs/efr/annual_report/ar2009e/PDF/7_chapter_03.pdf last accessed on 23 May 2013
Central Bank of Sri Lanka –Annual Report 2012, page 86 , available at, http://www.cbsl.gov.lk/pics_n_docs/10_pub/_docs/efr/annual_report/AR2012/English/7_Chapter_03.pdf , last accessed on 23 May 2013
[2] Wimal Nanayakkara, “Eradicating Poverty in Sri Lanka: Strong progress But much remains to be done” available at http://www.scribd.com/doc/96488153/TE-Special-Report-MPI-WN-Jun2012, last accessed on 23May 2013
[3] Palitha Abeykoon , “Case Study Sri Lanka” available at, http://www.who.int/chp/knowledge/publications/case_study_srilanka.pdf, last accessed on 23 May 2013