A controversial US project that pays drug users and alcoholics to undergo sterilisation or long-term contraception, is setting its sights on women living with HIV in South Africa.
Founder of Project Prevention Barbara Harris has confirmed that they were making plans to offer similar services to women living with HIV in South Africa as well as drug users.
"We have had huge interest in South Africa from organisations and concerned citizens," said Harris, adding that they would be joining forces with local non-governmental organisations.
While she declined to identify them, she said "we have many wanting to work with us".
"How can anyone object to anything that can prevent innocent children suffering needlessly?" asked Harris.
However, Professor Eddie Mhlanga, Chief Director for Maternal, Child and Women's Health in the health department said they would approach the Human Rights Commission if the project started operating in South Africa.
He also warned that doctors found co-operating with the organisation in any medical interventions would be reported to the Health Professions Council of South Africa.
"We do not support it and we find it very worrisome," said Mhlanga.
Project Prevention is already operating in parts of Kenya, where it is paying women living with HIV U$40 to accept long-term contraception. A doctor is paid U$7 per patient.
In Kenya, Project Prevention is working in Nyanza province where they place woman in groups of between 10 and 15 and give them a pooled amount of money to begin income-generating activities in return for accepting intrauterine devices (IUDs) as long-term contraception. Each woman then receives around R280 in return.
A Project Prevention statement released in December last year said there was a need " to work on getting women living with HIV/AIDS on long term birth control to prevent future pregnancies that may result in suffering children."
It also stated that long term birth control was the "only way those numbers will become fewer."
Project Prevention co-ordinator in Kenya Willice Okoth also confirmed they were planning to work in South Africa and claimed they were teaming up with "individuals" from a doctor and medical insurance network.
Harris started the organisation in 1997 and has famously been quoted as saying in reference to drug addicts: "We don't allow dogs to breed. We spay them. We neuter them. We try to keep them from having unwanted puppies, and yet then women are literally having litters of children."
Harris' organisation started operating in the United Kingdom late last year, but her sterilisation attempts were met with stiff opposition from the British Medical Association. Project Prevention has since opted to offer payment for long-term sterilisation instead.
Women in the US are paid U$300 (R2 100).
Various medical interventions, some available to state patients in South Africa, enable women living with HIV to have perfectly healthy babies.
"We cannot accept a situation where organisations come and exploit poor and defenseless people and we find it unethical that they are asking people to for a certain fee give up their reproductive rights," said Mhlanga.
"Why are they specifically targeting people who are drug users or living with HIV? They are no less people," he said.
Professor Di Cooper, head of the Women's Health Research Unit at the University of Cape Town said the project went against the core of women's sexual and reproductive rights recognised in the South African Constitution which gives women a free, non-coercive choice in terms of reproduction.
"The offering of money could be seen as bribery and is effectively coercive."
She said the emphasis on "preventing innocent children suffering" and the "very derogatory" statement by Harris likening women to "breeding dogs" did not bode well.
"This has no place within the human and reproductive rights culture in South Africa, particularly given our history of human and reproductive rights abuse under apartheid," said Cooper.
Dr Eric Goemaere of Medecins Sans Frontieres South Africa said the analogy with dogs was "very unfortunate" as it tends to trivialise the issue while access to family planning is a real issue in rural SA and many countries in Africa.
"Key issues are of course the women's choice, steering clear of any form of irreversible sterilisation," he said.