On 10 June, representatives of the United Nations, Member States, young women’s movements and civil society laid out strategic pathways for advancing gender justice and women’s rights and agency at a thematic panel, Advancing Gender Equality and Empowering Women and Girls in the AIDS Response, held during the United Nations High-Level Meeting on AIDS.

Despite significant progress in the HIV response, the epidemic continues to take a heavy toll on women and girls. This was an opportunity to reflect on the realities of women and girls in all their diversity in the context of the HIV response and to share forward-looking recommendations on gender equality.

The event came on the heels of a new global pledge by world leaders to reduce the annual number of new HIV infections and AIDS-related deaths, eliminate new HIV infections among children, end paediatric AIDS and eliminate all forms of HIV-related discrimination by 2025. Governments missed the targets made in 2016 to reduce the number of adolescent girls and young women aged 15–24 years becoming newly infected with HIV to 100 000 per year by 2020.

Phumzile Mlambo-Ngcuka, the Executive Director of UN Women, noted the enormous work yet to be done, especially with the challenging convergence of gender-based violence, COVID-19 and HIV, with increased levels of violence against women and girls during lockdowns, spiking by up to 500% in some countries.

Nadine Gasman, President of the National Institute for Women, Mexico, shared best practices from Mexico, where municipal authorities and civil society have worked together to improve access to comprehensive quality HIV services for left-behind populations, such as transgender people, and integrated HIV and sexual and reproductive health services for women living with HIV as well as for gay men and other men who have sex with men and people who inject drugs.

The panel noted that many women, girls and gender-diverse communities at higher risk of and living with HIV are being left behind in HIV testing, treatment and care services. Women and girls continue to face intersecting forms of discrimination, stigma, violence and criminalization.

Particular concern was raised about adolescent girls and young women in sub-Saharan Africa, who remain at intolerably high risk of HIV. In 2020, six in seven new cases of HIV among adolescents between the ages of 15 and 19 years in the region were among girls. The participants stressed the importance of leveraging education, particularly girls’ completion of quality secondary education, as a powerful entry point for accelerating HIV prevention, gender equality, an inclusive environment free of stereotypes, economic empowerment and preventing gender-based violence.

Education Plus, a bold new initiative co-led by the heads of UNAIDS, UN Women, the United Nations Population Fund, the United Nations Educational, Scientific and Cultural Organization and the United Nations Children’s Fund that is calling for high-level political action for the empowerment of young women and girls in sub-Saharan Africa to urgently reduce HIV was hailed as a timely and much needed response. Many emphasized the need to put gender justice at the heart of the HIV response and the sustained meaningful engagement and inclusion of adolescent girls and young women in decision-making at all levels.

The calls to action stressed the importance of scaling up investments in gender-transformative interventions and support for young people’s movements and leadership in the HIV response, legal and policy reforms in parental consent requirements that undermine the right to health of adolescents, the protection of the sexual and reproductive health and rights of all women and adolescent girls and urgently scaling up comprehensive HIV prevention programmes as well as engaging men and boys in transforming harmful gender norms and promoting positive masculinities.

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HIV outcomes rely on far more than the availability of services or treatment.

According to the 2020 Jamaica People Living with HIV Stigma Index, more than one third (38%) of respondents delayed HIV testing due to fears about how others would respond if they received a positive diagnosis. And 30% were slow to start treatment because of concerns that people might learn about their status.

Many of those fears are founded.

Almost half of the study’s respondents (48%) had experienced stigma or discrimination related to their HIV status. Members of key population communities reported even higher rates of prejudice and worse mental health than other people living with HIV.

“More needs to be done to get those living with HIV, and communities impacted by HIV, to live in a country and society where they are accepted and appreciated. That will also make their health outcomes better,” said Jumoke Patrick, the Executive Director of the Jamaica Network of Seropositives.

To accelerate progress towards that goal, in 2020 Jamaica became one of the first countries to join the Global Partnership for Action to Eliminate all Forms of HIV-Related Stigma and Discrimination. The initiative combines the power of governments, civil society, donors, academia and the United Nations. It reaches beyond the health sector to address ignorance and bias in education, the workplace, the justice system, families and communities.

On 4 June, the Jamaica Partnership to Eliminate HIV-Related Stigma and Discrimination launched its first annual report, Enabling environment and human rights.

The State Minister in the Health and Wellness Ministry and Chair of the Partnership, Juliet Cuthbert Flynn, reiterated the government’s commitment to addressing the social and legal issues that are barriers to an effective HIV response. She called for political leadership across party lines to recognize their role in helping to create an enabling environment.

“This is an imperative as we strive to allow every individual—regardless of their occupation, socioeconomic status, sexual orientation, gender identity, age, health status, disability and other status—to enjoy their human rights,” Ms Cuthbert Flynn said.

“We strongly believe that AIDS in Jamaica is not over, but it can be,” said the UNAIDS Country Director for Jamaica, Manoela Manova,

She noted that the new UNAIDS report, Global commitments, local action, showed that while dozens of countries had achieved the 2020 targets, many, including Jamaica, are entirely off track.

“HIV remains driven by inequality. The countries with progressive laws and policies as well as strong and inclusive community and health systems have the best outcomes. New HIV infections and AIDS-related deaths reduce faster. That is what we would like to achieve for Jamaica,” Ms Manova said.

Jaevion Nelson, a UNAIDS consultant, detailed the achievements of stakeholders in the national HIV response in Jamaica. A national human rights public education campaign was led by the National Family Planning Board. Sensitization exercises were conducted with police and correctional officers, health-care workers and faith leaders and congregants. People living with HIV received legal support, with several securing resolutions such as being reinstated in their jobs and receiving settlement costs. A National Transgender Health Strategy was launched, and nongovernmental organizations collaborated to develop model antidiscrimination legislation. 

The next steps for the initiative include strengthening monitoring, evaluation and learning for its human rights agenda, increasing the engagement of legislators and creating a more sustainable framework for sensitizing health-care workers, law enforcement officers and other duty-bearers.

The UNAIDS Deputy Executive Director, Programme, Shannon Hader, delivered the feature address at the virtual event. “Societal enablers and HIV outcomes are linked,” she said. “We will only end AIDS if we strive to respect, protect and promote the rights of everyone, everywhere. It is the evidence-based thing to do.” 

Patson Manyati cuts an awkward and lonely figure in a room bustling with young people in their twenties. His elegant poise, greying beard and baby blue shirt place him at least 40 years too old for this scene.

Mr Manyati is on one of his first visits to the drop-in centre of Gays and Lesbians of Zimbabwe (GALZ) in Mutare, in eastern Zimbabwe. GALZ is a membership-based association that promotes, represents and protects the rights of lesbian, gay, bisexual, transgender and intersex (LGBTI) people in Zimbabwe.

While Mr Manyati may look out of place, being at GALZ is the most “comfortable” he has ever felt as a gay man living in Zimbabwe in his 60 years.  

“When I see people like me, I feel very happy,” says Mr Manyati in his musical, soft-spoken voice. His eyes don’t stop shimmering while he talks. Remarkable for someone who has grown up around pervasive homophobia. The kind of homophobia that, as recently as 2017, saw the former president describe gay people as, “worse than dogs and pigs.”

GALZ maintains that the hatred and fear caused by the late president’s particular brand of homophobia, “is still being felt in Zimbabwe today.”

While being at GALZ makes him happy, as soon as Mr Manyati ventures out beyond the gates of the premises, he must be guarded and vigilant. Beyond the insults, the threat of jail is real, as Zimbabwe punishes same-sex sexual relationships with up to 14 years imprisonment.

Beyond jail, there is the everyday lived experience of discrimination, violence and hate crimes with which LGBTI people must contend—not only in Zimbabwe, but also in the 69 countries worldwide that criminalize same-sex sexual relationships.

And even in countries that don’t, like neighbouring South Africa. While same-sex marriage is legal and LGBTI rights are constitutionally enshrined, being gay is dangerous. In the first half of 2021, there has been a spate of murders of young gay men and an outcry from the LGBTI community for the government, media and public to take hate crimes more seriously.

Under these conditions, it is an act of defiance just to exist and, even more so, to be deliberately happy.

Happiness is something Mr Manyati has tried to carve out for himself, despite the odds.

Born in Mutoko, a small town in Zimbabwe’s Mashonaland East Province, Mr Manyati says his parents expected him to get married in his twenties to a woman and to carry on the family name as one of the seven Manyati sons.

While his parents insisted on marriage for some time, Mr Manyati stood his ground. As the sole caregiver for his parents and siblings, they eventually gave in and he lived his life single, never coming out to his parents. 

“I couldn’t get married because I have the body of a male but, inside, I feel like a female. I know I am … I feel … like a female. So why should I marry a female?”, he says, visibly grappling with complex concepts about his gender identity without the vocabulary to do so.

Here at GALZ, everyone tells him “who they are,” says Mr Manyati. Perhaps with a few more visits and more interaction with the young people around him, who are so much more self-assured in their sexual orientation and gender identity, it may not be too late for Mr Manyati to give name to his feelings.

GALZ is a lifeline for its members. It offers regular clinic days at its Harare drop-in centre and referrals at its other drop-in centres, in Mutare and Masvingo, for a range of health-care services, including HIV prevention and treatment. It also provides critical counselling services and safe spaces for LGBTI people to socialize and relax, away from the “harsh” streets.

The leadership at GALZ says that things are slowly getting better for LGBTI people in Zimbabwe.

In 2017, GALZ was included as an official participant in the funding proposal developed for the Global Fund to Fight AIDS, Tuberculosis and Malaria. This helped to secure US$ 2 million for programmes that serve gay men and other men who have sex with men, the largest investment ever in an HIV and sexual and reproductive health response for the community. The funding resulted in the three GALZ drop-in centres.

The National AIDS Council (NAC) of Zimbabwe has a key populations forum, supported by UNAIDS, and of which GALZ is a member. The NAC is visibly working to improve the health and well-being of key populations even while their activities remain criminalized.

Despite progress, the lingering stigma and discrimination that the LGBTI community faces in Zimbabwe has resulted in Mr Manyati and people of his generation leading an isolated life. 

“It makes me feel safer to rather stay by myself,” says Mr Manyati, adding that all his peers and friends from the LGBTI community have since died. “Sometimes I cry,” he sighs.

When Mr Manyati’s friends were alive, they would live their lives to the fullest, even though the law was a constant threat and they remained unlucky in love with the men they encountered. 

“[You would know] he doesn't really like you because he has another love somewhere and you are just one on the side. In the end, he gets married and leaves you,” says Mr Manyati of these encounters.

Mr Manyati is adamant that he is “too old” to look for love now, and that he would rather focus on looking after his health as one of the estimated 1.4 million Zimbabweans living with HIV.

Mr Manyati discovered he was living with HIV when he developed a cough five years ago. He went to a local nongovernmental organization, New Start, for an HIV test and after a course of tuberculosis treatment he was initiated immediately onto HIV treatment. His health is his main priority.

“I continue with HIV treatment. That’s how I’m looking healthy now,” Mr Manyati concludes, eyes still shimmering.

* Not Yet Uhuru is a quote by the Kenyan freedom fighter Oginga Odinga. Uhuru is a Swahili word meaning “freedom”; thus, it loosely means “not yet free”. It is a hashtag routinely used by GALZ in its social media posts.

GENEVA, 6 May 2021—UNAIDS is deeply concerned by the Ugandan parliament’s decision earlier this week to adopt the Sexual Offences Bill 2019, which includes provisions that further criminalize entire groups of people, such as the lesbian, gay, bisexual and transgender community, sex workers and people living with HIV. The bill criminalizes same-sex sexual relations, extends the criminalization of sex work and imposes mandatory testing for HIV and harsher sentences on people living with HIV than the general population accused of some similar crimes.

Although UNAIDS welcomes some aspects of the bill, such as the extension of protection from sexual harassment, violence and sexual exploitation to groups of people such as people in detention and migrant workers, it urges parliamentarians to reconsider the provisions that discriminate against some people.

“I am deeply troubled by the Ugandan parliament’s adoption of portions of this bill that further criminalize and marginalize vulnerable groups of fellow citizens and deny them their human rights, including their right to health,” said UNAIDS Executive Director, Winnie Byanyima. “Targeting people living with HIV, lesbian, gay, bisexual and transgender communities and sex workers increases stigma and discrimination and undermines the HIV response by preventing people from receiving the HIV treatment, prevention and care services that they so urgently need.”

UNAIDS recognizes the good progress that Uganda has made in recent years in reducing the impact of HIV. The number of AIDS-related deaths has fallen by 60% since 2010, with 1.2 million people out of 1.5 million people living with HIV on medicines to keep them alive and well. In addition, the number of new HIV infections has fallen by 43% since 2010. However, many vulnerable groups of people, such as gay men and other men who have sex with men and sex workers, continue to be less likely than the general population to receive the HIV treatment, prevention and care services they need.

UNAIDS urges Uganda to join the growing number of countries in Africa and globally that are removing unjust laws from their penal codes. The Ugandan parliament’s adoption of the new law comes just weeks before the United Nations General Assembly High-Level Meeting on AIDS, which will take place from 8 to 10 June 2021.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

GENEVA, 30 April 2021—Norman Fowler, the pioneering United Kingdom Secretary of State for Health, human rights campaigner and respected Lords Speaker, will champion law reform, health for all and girls’ education worldwide to help end HIV as an ambassador for UNAIDS. 

Lord Fowler, who steps down as Lord Speaker at the end of April, will take up his new role as an advocate on AIDS in May 2021. 

In his new role, he will focus on engaging leaders across the world in advancing three transformational shifts that are central to ending AIDS: ending punitive laws against and stigmatization of lesbian, gay, bisexual, transgender and intersex (LGBTI) people; ensuring universal access to health care; and ensuring the empowerment and education of all girls so that they finish secondary school and benefit from a dramatically reduced risk of acquiring HIV. 

Lord Fowler served as the United Kingdom’s Secretary of State for Health from the beginning of the HIV epidemic. He has decades of service at the highest levels of government and has been a champion for people affected by HIV and for the human rights of LGBTI people. 

The UNAIDS Executive Director, Winnie Byanyima, said, “We can beat AIDS, but only through bold action by leaders. Lord Fowler is respected as a great parliamentarian and courageous leader across the world. He has delivered bold change to fight AIDS, and can help other leaders to do the same. We are so grateful to Lord Fowler for supporting us in this way.” 

Lord Fowler said, “As I said when I announced that I was stepping down as Lord Speaker, I am not retiring, only resigning. I am determined to see the end of AIDS, and to see the end of the inequalities that stand in the way of the end of AIDS. We have come so far but this last mile is the most challenging one. The COVID-19 crisis is not a reason to step back but a reason to step up and beat AIDS.”

This is a key year for the HIV response, which marks the fortieth anniversary of the discovery of HIV. This year will also see the United Nations High-Level Meeting on AIDS, at which leaders will set out the steps they will take to achieve the end of AIDS by 2030.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Effective HIV responses require legal, policy and social environments that empower people living with HIV, those at higher risk of HIV infection and others affected by the epidemic to claim their rights and receive redress when those rights are violated.

Those who are responsible for enabling such legal, policy and social environments need to be properly trained. However, country reporting to UNAIDS in 2020 shows that training programmes on human rights and non-discrimination legal frameworks applicable to HIV are operating at scale at the national level for police and other law enforcement personnel in only 40 out 102 reporting countries, for members of the judiciary in 36 out of 100 reporting countries and for lawmakers and parliamentarians in 30 out of 97 reporting countries.

By Patrick Eba, UNAIDS Country Director for the Central African Republic

Tributes have been pouring in since the announcement of the sudden passing of Christof Heyns, the South African human rights academic and expert. For Amnesty International, he was, “A baobab in the human rights world. A giant in his field, [who] fought hard for a just world.” For Edwin Cameron, a former judge of the Constitutional Court of South Africa and a leading global voice on HIV and human rights, “[Christof] was a meticulous, conscientious, persistent, courageous fighter for justice and human rights.”

A former member of the United Nations Human Rights Committee (2017–2020), Mr Heyns served as the United Nations Special Rapporteur for Extrajudicial Execution from 2010 to 2016 and as a member of the Working Group on Death Penalty, Extra-Judicial, Summary or Arbitrary Killings and Enforced Disappearances in Africa of the African Commission on Human and Peoples’ Rights. In 2015–2016, he chaired the United Nations Independent Investigation on Burundi.

Mr Heyns was one of the world’s most prominent experts on the African human rights system. He was the Director of the Centre for Human Rights at the University of Pretoria from 1999 to 2006 and Dean of the Law Faculty from 2007 to 2010. He later helped to establish and led the Institute for International and Comparative Law in Africa at the same university.

To many of his students, colleagues and partners, he was an accessible lecturer, a trusted ally and a thought leader who embodied the values of excellence with ubuntu (humanity). I first met Mr Heyns in August 2001 as a third-year law student representing the University of Abidjan in Côte d’Ivoire at the 10th African Human Rights Moot Court competition in Pretoria, South Africa. It was an exhilarating opportunity. This was my first-ever air travel. And It took me to no other place than South Africa, the land of Nelson Mandela, the (then) vibrant beacon of human rights optimism. The theme for the continental oratory joust that year focused on human rights violations against people living with HIV—how fitting.  

Some two years later, I was privileged to be awarded a scholarship to join what is arguably one of Mr Heyns’s most enduring legacies, the Centre for Human Rights’ master’s programme on human rights and democratization in Africa. Since 2000, this programme has trained a generation of human rights scholars, practitioners and activists from across Africa and other parts of the world. During his tenure as the Director, Mr Heyns enabled the transformation of the Centre for Human Rights into a world-class academic and activist institution that took an active role in education, advocacy and litigation.

As he later became involved as a member of United Nations human rights mechanisms, Mr Heyns took with him the values of dialogue and academic generosity that he had honed in South Africa. In a world that overemphasizes uniqueness, he was an internationalist who championed experience-sharing and cross-fertilization across human rights systems. It was thus naturally that UNAIDS and the Office of the United Nations High Commissioner for Human Rights turned to him when we were seeking allies for a joint dialogue on the human rights norms and practice relating to sexual orientation and gender identity between the African Commission on Human and Peoples’ Rights, the Inter-American Commission on Human Rights and the United Nations from 2015 to 2018. Mr Heyns was at the time the United Nations Special Rapporteur on Extrajudicial Executions and I was working as the Senior Human Rights and Law Adviser with UNAIDS in Geneva, Switzerland. Throughout the process, Mr Heyns was generous with his ideas, and, as ever, courteous and considerate with his peers as well as with support staff.

This year will mark 30 years since the creation of the African Human Rights Moot Court competition. We will miss Mr Heyns but his spirit will be with us as we mark this milestone. Across Africa and globally, his legacy will live on with those he defended as a human rights expert, and in the continued fight for justice and democratization of the thousands of students, academics, practitioners and activists that he has supported and nurtured.

Au revoir professor, the struggle approach to human rights shall continue.

“It is argued that legitimate resistance is the conceptual and historical counterpart and the ultimate guarantor of human rights. Human rights = legitimate resistance … The ongoing nature of history is emphasized, as well as the creative potential of members of the present generation to influence history, and as such the nature of human rights, through their struggles.” Christof Heyns, 10 January 1959–28 March 2021.

Christof Heyns, third from left (front row) with other participants during the joint thematic dialogue on sexual orientation and gender identity between the African Commission on Human and Peoples’ Rights, the Inter-American Commission on Human Rights and the United Nations, 3 November 2015, Kairaba Hotel, Banjul, the Gambia. Credit: UNAIDS