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Blinded by Fear: How Politics Influenced Medical Policy in Greece

In her mugshot, she wore a faded pink hoodie emblazoned with a cartoon dwarf from Disney’s Snow White. Her hair was ruffled and her eyes dull. In 2012, the Greek media plastered this image of a woman at her lowest across the Internet. The police encouraged the public abuse, publishing her name, birthplace, and the names of her parents.

She was one of twenty-six young women whom Greek authorities had forcibly tested and diagnosed as HIV-positive. The women were subsequently imprisoned, accused of being prostitutes, and charged with risking “bodily harm” to others. Because of this and other incidents, the international community has accused Greece of mistreating and stigmatizing citizens with HIV over the last few years. There is no one particular reason for Greece’s stringent policies on HIV. Rather, the combination of political power plays, economic instability, and societal fear planted the seeds for criminalization of the disease.

Greece has historically had very low rates of HIV. However, The Guardian reported that new cases of HIV had risen by over 1,450% from 2011 to 2012. While the number of new cases was still relatively low for the nation (12,000 people in a nation of 11 million), the alarming spike left Greek officials and civilians scrambling to contain the disease. Unlike most Western countries, Greece lacked a clear policy on how to handle patients with HIV.

Edward Bernard, an expert in HIV/AIDS policy, explained, “Every country, even different jurisdictions within the same country, can have different laws and policies around what exactly is a crime in regards to HIV/AIDS. What [governments] have done is to try to fit different general laws around assault, bodily harm, or even attempted murder into being applicable to cases where people haven’t disclosed [that they have the virus] or transmission is […] alleged or a person is exposed. Through a series of court rulings in each country, that’s sort of what creates the law.” Greece, in particular, was one of those nations that lacked direct laws about HIV/AIDS until the recent spike in transmission forced officials to acknowledge the problem.

Increasing HIV rates resulted in the passage of Provision No 39A, which allows the police to detain and test people suspected of having HIV under the pretext of preventing bodily harm to others. It was under this law that the twenty-six women in 2012 were imprisoned. Zoe Mavroudi, a young Greek screenwriter and director, was particularly unnerved when she witnessed the personal lives of these individuals being paraded across the news. She went on to document the lives of those involved in the affair, creating the documentary, “Ruins: Chronicle of an HIV Witch-hunt.”

“Mandatory tests are a violation of a person’s human rights,” Mavroudi asserted in an interview with The Politic. “This is something that happens in conditions where the person is not in a position to offer an informed consent about the reasons behind the test. In many cases for the women, the diagnosis was given to the police officers. The women had no idea what was happening to them until a month after when they were already in prison. This is a grievous violation of their rights and their dignity, as well as their medical confidentiality.”

“Mandatory tests are a violation of a person’s human rights.”

Despite criticism from international actors such as UNAIDS and the European Human Rights Court, who called these tests a violation of international conventions, Greek officials did not change their policies. Former Health Minister Andreas Loverdos, who created and implemented Provision No 39A, claimed that he was protecting the Greek people. However, many believe Loverdos used the aggressive containment of HIV to gain public support for his reelection. After protests by NGOs and activist groups, Provision No 39A was repealed in 2013. Nevertheless, in the summer of the same year, newly-appointed Health Minister Adonis Georgiadis reinstated the policy.

“When the case in ‘Ruins’ happened, it was six days before the national elections in which a Neo-Nazi party was voted as the third largest party in Greece,” Mavroudi explained. In her documentary, Mavroudi closely examined the relationship between politics and the attitude towards HIV. “The far-right politicians and the three consecutive health ministers hold extreme, far-right views in all fronts, such as public health, immigration, HIV/AIDS, and human rights. They used the disease, which was becoming a real problem among certain vulnerable groups, particularly injecting drugs users in Athens, as a pretext to a political campaign.HIV/AIDS sort of offers itself as a modern plague that will allow these measures to be accepted by the population because of how easy it is for politicians to fearmonger and terrorize people with the threat of an epidemic.”

Golden Dawn

Far right groups such as Golden Dawn advocate for oppressive HIV/AIDS laws.

This political shift towards the right has been prompted by Greece’s struggling economy. In the past few years, the nation has seen a financial collapse, and subsequent austerity measures put pressure on its economy just as it was recovering. Thus, paradoxically, the international community has on the one hand pressured Greece to give up its stringent HIV policies, and on the other hand, it has imposed austerity measures on the nation, measures that have severely undercut public healthcare budgets. “The recession basically closed down a lot of the support and harm reduction tactics, such as needle exchange programs. That’s when there was a spike in HIV among people who used drugs in the last few years,” Bernard said. Several organizations have noted the relationship between the decrease in harm reduction programs and the increase in HIV transmission among drug users. The European Center for Disease Prevention and Control reported in 2012 that the outbreak in HIV infections among drug users was from a combination of a lack of needle exchange programs and methadone programs. It addressed the financial crisis as a key factor in the disruption of critical health programs and concluded, “The current economic turmoil will continue to have adverse effects on HIV prevention.”

The continued enforcement of the provision is also worrisome because of its strong language targeted towards minority populations, such as immigrants, homeless people, and sex workers. Policy 39A identifies these groups as a priority for

mandatory testing under the assumption that these populations have lower standards of hygiene. HIV/AIDS policy experts worry that this has created an ‘other-ing’ effect.

“That’s part of the stigmatization of HIV/AIDS, the ‘other-ing’ which is the idea that it only affects other people and certainly it doesn’t affect me,” Bernard explained. “The idea of using sex workers wasn’t the issue in 2012, as the men were never perceived to be the problem. Instead, it was the idea that these women with HIV were infecting the men who would then take back the disease to the unsuspecting Greek family.” The fight against HIV/AIDS often takes an accusatory tone, especially towards women.

Mavroudi agreed that the current laws around the disease have perpetuated stereotypes and discrimination against minority groups. “When you hear about the need to impose measures to protect the public, you have to be very suspicious of that kind of rhetoric,” she said. “The only way to prevent the spread of HIV/AIDS is to respect human rights and give these vulnerable groups support and proper care through outreach programs.”

The future of the population of Greek civilians with HIV/AIDS remains unclear. International bodies, such as Amnesty International, Human Rights Watch, and the European AIDS Treatment Group, swiftly decried Provision 39A as ineffective and a violation of basic human rights. Nikos Dedes is the president of Positive Voice, an activist organization composed of people with HIV living in Greece. In an interview with The Politic, Dedes discussed the work done by international organizations: “The international response was swift and harsh. The Health Regulation 39A has been universally condemned by local and international organizations, from human rights organizations, feminists, LGBTQ organizations to scientific societies and media.” Despite the mounting international pressure to respect the medical rights of targeted minorities, Greek politicians as well as the Greek public have made it clear that the issue is domestic. Furthermore, the current political landscape makes it unlikely that HIV/AIDS policies will become more progressive. Conservative, nationalist parties in Greece continue to gather momentum as austerity and bailouts from other European Union nations frustrate Greek citizens. Dedes explains that this radical, conservative nationalism has made individuals with infectious diseases, especially HIV, an easy scapegoat. “A society that has a thirty percent unemployment rate, a decrease of twenty-five percent in its GDP, and around forty percent in the salaries and pensions of citizens needs to blame someone for their ills and pain,” said Dedes.

This makes it unlikely that the government will find either the time or money to invest in a stronger health program to treat current HIV/AIDS-positive individuals and prevent transmission. Still, organizations and individuals remain hopeful that the current atmosphere around HIV/AIDS will become more accepting. Small victories are currently being won by individuals. For example, in 2013, the European Court of Human Rights ruled in favor of an HIV-positive Greek citizen who was fired after colleagues objected to his presence after finding out about his status. The ruling stated that the Greek state had violated the right to respect for one’s private life as well as the prohibition of discrimination, and Greece had to pay the man in question more than 14,000 euros. Cases such as these are small but crucial victories in the fight to change stringent policies and correct stereotypes about people with HIV/AIDS, and activists continue to play their part. As Bernard urged, “There are a lot of good people doing good work on procuring rights for individuals with HIV/AIDS, but there are always more people needed.”