Power to the people: repressive laws hamper grassroots response to HIV, report warns
Government clampdowns on marginalised groups are hampering the response to the HIV/Aids epidemic, a new report has warned.
The United Nations HIV agency, UNAIDS, has highlighted the vital role played by community groups in fighting Aids but warns that repressive laws, such as bans on gay sex and drug prohibition, are threatening their existence and efforts to control the disease.
In an interview with the Telegraph to launch the report Winnie Byanyima, the new executive director of UNAIDS, said that since the beginning of the Aids epidemic community groups have played a crucial role in the fight against the disease.
“Community organisations have been delivering services on the ground, counselling people, taking them for testing and supporting them through treatment. But more importantly they have been challenging governments and speaking up and demanding the right to health,” she said.
The report, published in advance of World Aids Day on December 1, warns that HIV is becoming concentrated in girls and young women and what are known as “key populations” – gay men, sex workers, drug users, transgender people and prisoners.
In 2018, more than half of all new infections were among these groups but these are also the very people who face the most stigma and discrimination, the report says.
The report highlights how in all 21 countries in eastern and Southern Africa – which has one of the highest rates of HIV in the world – sex between same sex partners is criminalised and is punishable by the death penalty in more than half.
And it is a criminal offence to to fail to disclose HIV diagnosis to employers or others in around half of east and south African countries.
Other repressive policies include mandatory HIV testing for marriage, work or residence permits for certain groups.
The report warns: “Where people fear discovery and arrest – and where violence, discrimination, aggressive law enforcement and harassment are enabled by national and local legislation – the people most in need of services cannot access them.”
The report warns that civil society organisations in many countries face legal constraints, funding restrictions and regulatory hurdles and operate in hostile, authoritarian environments.
A study published in the Lancet last month showed that anti-gay laws were linked to low knowledge of HIV status among gay men.
The report highlights the success of gay rights groups in Botswana where, after four years of legal challenges, one group, the Lesbians, Gays and Bisexuals of Botswana, won legal recognition. Earlier this year it helped to get the country’s high court to decriminalise same sex relations.
Ms Byanyima said that while a country such as Uganda was seeing the number of new infections decrease – from 92,000 in 2010 to 53,000 in 2018 – it would not end Aids if same sex relations continue to be punishable by life imprisonment and gay people live in fear.
“In a country like Uganda most of the infections are transmitted through heterosexual sex and you see that women and girls are among the most infected. If you focus on women and girls you will drive down infections pretty fast but Uganda will not end the epidemic unless it also delivers on the human rights of gay people,” she said.
She added that in Russia, HIV rates were increasing among drug users.
“It’s important to address the epidemic you have in your own country,” she said.
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