International bioethics, Ubuntu and HIV testing in Sub-Saharan Africa: an evaluation of Zambia's HIV testing policy

International bioethical principles place considerable weight on individual rights and autonomy. They require informed consent for both treatment and diagnostic testing. Although individual rights are widely valued, in some non-Western contexts, they receive relatively less weight than other moral values. In particular, the communitarian African philosophy of Ubuntu places a greater emphasis on the collective good of the community than it does on individual rights. In this paper, we explore differences between an Ubuntu-based bioethics and international bioethical principles through the lens of Zambia's Universal Routine HIV Testing Services Policy. We find that both the written form of the testing policy and its practical implementation violate standard international bioethical principles of informed consent. However, we show that the policy and its implementation are compatible with an Ubuntu-based bioethics. We conclude with a suggestion that Ubuntu-based bioethics also better capture actual clinical practice in Western contexts than standard bioethical principles based on autonomy and individual rights.