Clinton calls for mandatory AIDS testing while UN discourages Goa

Bill Clinton is suggesting that mandatory testing for HIV/AIDS be used in countries with high infection rates and the means to provide lifesaving drugs.

The former U.S. president says countries where there is no discrimination against people with the illness and where anti-AIDS drugs are available should now consider universal testing.

Twenty years ago, at the start of the AIDS epidemic, mandatory testing was frowned on because of the stigma attached to the deadly illness and the lack of treatment for those infected.

Clinton says that position now needs a total rethink and support from the AIDS community.

It is estimated that over 40 million people worldwide are living with HIV/AIDS but many do not know they are infected.

Clinton says that now people's lives can be saved and the stigma is reduced, the only way to reduce the spread of the epidemic is with more testing because 90 percent of the people who are HIV positive don't know it.

Clinton's foundation has been working hard to bring quality medical care and cheaper drugs to sufferers in poor countries, and Lesotho will this year become the first country to do universal testing.

Clinton regards Lesotho as a test case to determine whether rapid tests, costing 49-65 cents each, and drugs, can reduce the 27 percent infection rate in the southern African country.

A budget of $100 million would pay for 200 million tests.

Clinton says the idea is to treat it as a major public health problem rather than some source of shame or disgrace and to keep as many people alive as possible.

He says the first aim is to stop infections and the second is to save the lives of those who are infected.

Clinton is prepared to back whatever accomplishes those objectives.

He believes the question is not whether a country is rich or poor but its infection rate.

He says when the level of infection reaches a critical point it threatens the public health structure and social stability, making it more difficult to bring rates down.

Since leaving office Bill Clinton has devoted much of his energy to getting anti-AIDS drugs to poor countries at the cheapest possible prices through the Clinton Foundation HIV/AIDS Initiative (CHAI).

The Foundation is working with 22 countries in Africa, the Caribbean and Asia to provide anti-AIDS drugs to more than a quarter of a million patients through special drug deals.

Meanwhile the United Nations is urging the state of Goa to abandon controversial plans to force marrying couples to undergo compulsory testing for HIV.

India is estimated to have more than 5 million people with HIV/AIDS and the legislation would make Goa the first state in India to insist on premarital testing.

In India the stigma associated with the disease and the high cost of the drugs used to treat the disease, mean few voluntarily come forward for testing.

Opponents of the bill say it contradicts national AIDS policy, which encourages voluntary testing based on informed consent, and would reflect the lack of co-ordination between various state agencies.

They also say it would violate privacy, stigmatise entire families and create a black market in false HIV-test results.

Civil rights groups say that permitting mandatory testing in one context increases the risk that it will become a requirement for employment and access to healthcare.

Compulsory HIV testing before marriage has been proposed before in several Indian states but, so far, never applied.

India, could soon overtake South Africa as the country with the largest number of HIV cases.