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18 April 2017 Editorial


18 APRIL 2017

Legally enabling


The HIV/AIDS Bill provides a solid base for further empowerment and treatment access

The HIV and AIDS (Prevention and Control) Bill passed by Parliament does not guarantee access to anti-retroviral drugs and treatment for opportunistic infections, but there is no denying that it is a good base for an active health rights movement to build upon. Understandably, HIV-positive people in the country, estimated at over 21 lakh, are disappointed that the Centre's commitment to take all measures necessary to prevent the spread of HIV or AIDS is not reflected in the Bill, in the form of the right to treatment. The law only enjoins the States to provide access "as far as possible". Beyond this flaw, though, the legislation empowers those who have contracted the infection in a variety of ways: such as protecting against discrimination in employment, education, health-care services, getting insurance and renting property. It is now for the States to show strong political commitment, and appoint one or more ombudsmen to go into complaints of violations and submit reports as mandated by the law. Here again, State rules should prescribe a reasonable time limit for inquiries into complaints, something highlighted by the Standing Committee on Health and Family Welfare that scrutinised the legislation.

Access to insurance for persons with HIV is an important part of the Bill, and is best handled by the government. The numbers are not extraordinarily large and new cases are on the decline, according to the Health Ministry. Data for 2015 published by the Ministry show that two-thirds of HIV-positive cases are confined to seven States, while three others have more than one lakh cases each. Viewed against the national commitment to Goal 3 of the UN Sustainable Development Goals - to "end the epidemic of AIDS" (among others) by 2030 - a rapid scaling up of interventions to prevent new cases and to offer free universal treatment is critical. Publicly funded insurance can easily bring this subset of care-seekers into the overall risk pool. Such a measure is also necessary to make the forward-looking provisions in the new law meaningful, and to provide opportunities for education, skill-building and employment. As a public health concern, HIV/AIDS has a history of active community involvement in policymaking, and a highly visible leadership in the West. It would be appropriate for the Centre to initiate active public consultations to draw up the many guidelines to govern the operation of the law. Evidently, the requirement for the ombudsman to make public the periodic reports on compliance will exert pressure on States to meet their obligations. In an encouraging sign, the Supreme Court has ruled against patent extensions on frivolous grounds, putting the generic drugs industry, so crucial for HIV treatment, on a firm footing. The HIV and AIDS Bill may not be the answer to every need, but it would be a folly not to see its potential to make further gains.


Mr. Erdogan rising

Turkey referendum

The stage is set for Turkey's strongman to assume even more power

The path is now clear for Turkey to be transformed from a parliamentary democracy to a presidential republic, after a referendum on constitutional reforms proposed by the ruling Justice and Development Party (or AKP) gave the nod for handing sweeping powers to President Recep Tayyip Erdogan. The "Yes" campaign won by a relatively narrow margin, with a little more than 51% of the vote, and the opposition Republican People's Party (CHP) cited irregularities, including the use of unstamped ballot papers. The three biggest cities, Istanbul, Ankara and Izmir, voting "No" also indicates that much work remains to be done by the incumbents to bridge the rift within the polity. However, the head of the electoral body said the vote was valid. This remarkable turn of events, which will echo through the region and beyond, marks a step change from Turkey's historical tryst with representative democracy. The idea of major constitutional reforms of this sort has been in the making at least since 2014, when Mr. Erdogan became Turkey's first directly elected president. Nevertheless, many in Turkey and elsewhere, including anxious liberals across the EU, will watch with concern as the 18 major reforms on the table now will centralise power to an unprecedented extent in Mr. Erdogan's hands, raising valid questions about the separation of powers in the Turkish government.

The new executive powers that will accrue to Mr. Erdogan if he wins the 2019 elections, a very likely outcome, include the abolition of the post of Prime Minister and the transfer of that power to the President; authority to appoint members to the judiciary; and the removal of the bar on the President maintaining party affiliation. These changes could presage overwhelming AKP control of state institutions, which in turn could lead to, for example, a purge in the judiciary and the security forces. Mr. Erdogan has in the past accused the judiciary of being influenced by the U.S.-based Islamic preacher, Fethullah Gülen, besides attacking members of the security forces in the aftermath of the failed coup in July 2016. That these fears are not exaggerated is clear from the fact that tens of thousands of officials have been dismissed and dozens of journalists and opposition politicians arrested since that time, not to mention Mr. Erdogan's diplomatic spats with the Netherlands and Germany during the harsh campaign leading up to the referendum. Turkey today faces myriad problems, many stemming from the civil war in Syria. But the greatly empowered Mr. Erdogan would do well to design his future policies not only as a reaction to these forces but also as the means to enhance Turkey's unique effort in reconciling pluralist democracy with political Islam, and Western-style liberalism with populist nationalism.

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