Infectious Diseases Act

The Singapore Infectious Disease Act (IDA) can be found here. I was looking through it to try and understand the various published Schedules. This was in the context of the recent rescheduling of TB to Schedule 6. Like many of our statutes, it requires a bit of detective work to try and figure out what's really happening. I must admit it took me quite a while (maybe because I don't have the the mind of a lawyer, or statut-ologist).

Essentially it seems to me that the distinctive feature of Schedule 6 was that it empowered the Director to disclose information to relevant authorities to enable him to take steps to prevent the spread of the disease. This of course includes the identification of the infected individual. Fair 'nuff, I thought. The only other disease identified under this Schedule was the Severe Acute Respiratory Syndrome (SARS) (also fair 'nuff!).

Then I wondered why only these two diseases? In today's press, there was quite a lot of publicity about the Human Immunodeficiency Virus (HIV). Then I wondered why HIV wasn't listed under Schedule 6? Surely HIV is much more of a problem compared to TB in Singapore. True, the absolute incidence was still lower than TB (In 2007, HIV was 118/million as compared to TB 351/million), but its incidence has been increasing at an alarming rate. Between 2006 and 2007, the incidence in Singapore rose by 18% . Even discounting for improved reporting, this is an alarming rate of increase. UNAIDS and WHO has identified it as one of the most destructive pandemics in recorded history, having killed more than 25 million people since 1981 when it was first diagnosed.

HIV is actually covered under Part IV of the IDA. There is a lot there prescribing procedures to limit the spread of the disease. But astoundingly, there is a specific Para (25/25A) that specifies the protection of the identity of the infected person. Disclosure is only allowed only under certain conditions, mainly when the patient consents, and to the exposed/infected person.

....duuuuhhhh.....

Why this double standard? Today's Straits Times carried an Op-ed by Salma Khalik arguing that HIV should be treated like any other infective disease thereby qualifying for subsidy etc... "How can the Government expect to fight the disease when it discriminates against HIV patients by not providing them with the treatment that they need?

This is not about giving special privileges to HIV/Aids sufferers. It is about treating them like all other citizens in the country, with the same right to basic medical care."

She's not wrong. But in the same vain, HIV should be treated like any other infectious disease so that it's spread can be effectively contained. Why the need for confidentiality? Why constrain the flow of information that may allow other relevant authorities to take measures to control the spread?
Why are HIV sufferers entitled to more human rights than the rest of us? Is TB placed under Schedule 6 simply because the ah pek TB patients do not have a voice as powerful as the AIDS/HIV lobby? Its not wrong to do so....just that HIV should also be on Schedule 6.

OK...'nuff said.