The Crisis of Confidentiality in the Control of the HIV/AIDS Pandemic in Botswana

This paper looks at the recent challenges to the confidentiality of the status of HIV patients in Botswana, the country with the highest rate of infection in the world. The nature and scope as well as the legal and ethical basis of confidentiality are examined. It is argued that this concept is not only an aspect of the fundamental human rights of patients but is also crucial in any effective strategy to halt the spread of the virus by encouraging voluntary disclosure which should help in eliminating the stigma, ostracism, and discrimination against people living with HIV/AIDS. Although widely recognised as sacrosanct, confidentiality has never been an absolute principle. The derogations to it reflect a compromise, which balances the patient’s right to his privacy and confidence, and the protection of persons exposed to the risk of infection by the patient. Therefore, it is argued that, any radical measures which undermine the principle of confidentiality will discourage rather that encourage the candour that is essential in controlling the spread of the HIV virus.