Kenya

Michael Onyango rises before dawn in his Nairobi apartment and catches a train eight hours east to Kilifi, a coastal town north of Mombasa. Resorts populate Kilifi’s sandy beaches and narrow wooden boats dot the water. Onyango heads inland to meet with the Kilifi County health management team, before dashing to an assembly of peer outreach workers from across the districts of Kaloleni, Malindi and Kilifi North.

Onyango runs the Movement of Men Against HIV in Kenya (MMAHK), spearheading a community-led monitoring initiative in the region to address the high numbers of men and boys who lack access to HIV services. In Kenya, only 65 percent of the men and boys over 15 years of age who are living with HIV are on antiretroviral therapy, compared to 80 percent of women and girls. The trend is mirrored globally: in 2024, the WHO and UNAIDS released data that men lagged on progress in achieving the 95-95-95 targets. Worldwide just 83 percent of men living with HIV know their status; 72 percent are on treatment and only 67 percent are virally suppressed.

MMAHK, in collaboration with the Masculinity Institute (MAIN), the International Network of Religious Leaders (INERELA+Kenya) and the UNAIDS Kenya country office, came together to tackle these service gaps in Kilifi County, which surrounds the town of the same name. The area, home to around 1.5 million residents, extends westward from the Indian Ocean and supports livelihoods through fisheries, factories, cashew nut mills, and farming.

In Kilifi, peer data collectors have identified that health facilities need to change their opening days and hours to accommodate the work and school day.

Community organizers are also working to challenge harmful prejudices that assert that men visiting a health facility or seeking an HIV test are “weak”.

As they rapidly roll-out peer support groups to challenge these beliefs, Onyango has had flashbacks to the pandemic’s earlier phases, when in the 1990s he worked as a counselor in a Nairobi hospital. HIV treatment was not yet available. “Many men I met who found out they were positive would resign from their jobs, go to their rural homes, sell their property, and wait to die,” Onyango said.

In 2001, Onyango and others started MMAHK to create a safe space for men to talk about their health needs. MMAHK also ran community testing, workplace outreach and targeted advocacy with religious and cultural leaders. As grassroots initiatives challenged harmful gender norms, Onyango saw social stigma and self-stigma among men decrease across Kenya. But the past few years have seen a resurgence of harmful norms around masculinity.

Onyango shares that the shift in funding away from many community initiatives, which were seen as harder to measure than biomedical interventions, has hampered community engagement efforts. Both are needed, he says. For example, although HIV treatment and voluntary male circumcision are now available in Kenya, cultural factors prevent some men from accessing these services.

A regional strategy developed in 2022 by UNAIDS, WHO, UN Women and partners –“Male Engagement in HIV Testing, Treatment and Prevention in East and Southern Africa” – outlines four key approaches: Improve access to health for men and boys and decrease vulnerability; prevent HIV among men and boys; diagnose more men and boys living with HIV; and increase the proportion of men and boys accessing and adhering to antiretroviral therapy.

“Tackling harmful masculinity also has a ripple effect,” reflects Lycias Zembe, a UNAIDS advisor in Geneva. “Harmful gender norms affect everyone, and changing these norms creates a better environment for women and girls and for men and boys.”

Community initiatives like MMAHK remain key. To challenge gender norms, MMAHK positions service access as courageous, and educates men that discussing emotions is a sign of strength. At 63, Onyango shows no signs of slowing down: “We’re going to keep addressing self-stigma and figure out how to help men access the services that they need to stay healthy,” he said. “We don’t have any other option.”

Holy Disrupters: Interviews with Religious Leaders and advocates on HIV and Compassion

Professor Mohamed Karama, working with Islamic Relief on the HIV programme, Kenya

UNAIDS speaks to Professor Mohamed Karama about confronting stigma and his concerns for the future

How has the faith community engaged in the response to HIV?

I am a researcher with the Kenya Medical Research Institute and my background is from the Muslim community. Faith communities have become increasingly engaged, first with HIV then with COVID, and now the faith community are part and parcel of not only health but many other government programmes.

How big of a problem is HIV-related stigma among the Muslim community and how do you deal with that?

Stigma has been very high amongst Muslims because for many years there has been a misconception that HIV is one of the punishments for wrongdoing.  

To address the challenges of stigma we have had to address it from the Islamic scriptures and from the teachings of faith. This is what we have been doing for the last few years, and although stigma still remains, we have been able to break down some of the barriers this way.

“For many years there has been a misconception that HIV is one of the punishments for wrongdoing”

We have been teaching how God prohibits judgement of others, we should never see ourselves as holier than others and we should support the sick. From the Islamic scriptures God says, “I was sick, you didn’t visit me, I was hungry, you didn’t feed me, I was undressed, you didn’t clothe me.” And the people reply, “but you are God how can we do that?”

God says “Your brother was sick, you never visited him, if you had visited him you would have found me there. Your brother was naked, if you had clothed him you would have found me there, your brother was hungry, if you had fed him you would have found me there.” Allah says have mercy on those who live with you on earth so that he the great can have mercy on you as well.

These teachings are very strong, they discourage stigmatization, they discourage looking negatively at the sick, any sickness, HIV included.

What’s the biggest challenge you are facing in Kenya at the moment?

Young people 15 to 24 are sexually very active and increasingly liberalized, unlike before where social containment was very heavy, now it’s no longer the case. So we have to reactivate our HIV prevention programmes and re-strategize how to deal with these new dynamics.

What concerns you about the future?

I want to start with PEPFAR (the United States President's Emergency Plan for AIDS Relief), I’m an epidemiologist and I think that if we slack a little we are likely to lose the momentum, and losing the momentum might be too expensive to rebuild—too expensive to rebuild the motion and to sustain the momentum. The progress we have made in the last 40 years cannot be lost, so much has been achieved to date we mustn’t lose it.

“Losing the momentum might be too expensive to rebuild”

(concerning the reauthorization of PEPFAR)

What can the United Nations do better?

The United Nations also needs to work more closely together as partners with the faith-based community, the technical experts and the researchers. That way not only can we address HIV, but we can also address other pandemics that are likely to come in the future.

GENEVA, 20 December 2022—UNAIDS welcomes the judgement by the High Court of Kenya at Nairobi recognizing that coerced sterilization of women living with HIV is a violation of their human rights.  

The judgement follows a case brought forward in 2014 by a Kenyan woman living with HIV who was coerced by professionals at a health facility to undergo tubal ligation thus taking away her ability to have children. The High Court found that the performance of this operation without consent amounted to a violation of her rights to non-discrimination, to dignity, to health and to family.  

“This decision is an important step in protecting the sexual and reproductive health and rights of women living with HIV,” said Winnie Byanyima, Executive Director of UNAIDS. “UNAIDS stands ready to work with all governments to ensure such practices are eliminated completely and that women living with HIV are able to access health services without stigma or discrimination.” 

UNAIDS intervened in this case with an amicus curiae (friend of the court) brief that informed the Kenyan High Court on the health guidelines and human rights standards that each country must follow to respect, protect and guarantee the human rights of people living with HIV, and the impact that such involuntary practices can have on the HIV response. The Kenyan Legal and Ethical Issues Network on HIV/AIDS (KELIN) and the African Gender and Media Initiatives Trust (GEM) were also petitioners in this case.  

HIV-related stigma and discrimination has a significant impact on the health, lives and well-being of people living with or at risk of HIV. Stigma and discrimination hinders the HIV response by limiting access to broader sexual and reproductive health and other health services. UNAIDS continues to work daily to ensure that governments invest in preventing and responding to violations linked to the forms of intersectional discrimination to which people living with HIV have been subjected. 

The plaintiff in the case stated, “This was never about the money. I wanted to fight for justice for myself and all women who have had this experience, and to ensure this does not happen to other women who are living with HIV who need access to reproductive health services.”  

“This case is an important moment for reproductive justice and the feminist movement. Coercive sterilization of women living with HIV is a violation of women’s most fundamental human rights and undermines effective HIV responses,” said UNAIDS Country Director for Kenya, Medhin Tsehaiu. “It is only through a human rights approach that we will end AIDS as a public health threat.” 

A rights-based approach includes the right to start a family and have children, the right to decide the number and spacing of their children, the right to reproductive autonomy and the right to access quality services to support their reproductive health choices, based on their informed, safe and voluntary consent. These are fundamental human rights that belong to all women, regardless of HIV status, and are guaranteed in global and regional treaties.  

“We welcome the court’s decision and although it took a long time, we are happy that the court found the client’s rights had been violated, and particularly the finding of discrimination on the basis of sex and HIV status,” said Allan Maleche, Executive Director, KELIN. 

The Global AIDS Strategy 2021–2026: End Inequalities, End AIDS includes a central role for the promotion of human rights, gender equality and dignity, free from stigma and discrimination for all people living with and affected by HIV. It is a commitment by UNAIDS to an ambitious vision to end gender inequalities and realize human rights, including the right to health, calling on all partners and stakeholders in the HIV response in all countries to transform unequal gender norms and end stigma and discrimination.

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.

By David Chipanta, UNAIDS Senior Adviser, Social Protection

Joe Muriuki was a son of the African soil, born and raised in Kenya, a local, national and global advocate for the right of people living with HIV to access life-saving HIV treatment free from stigma and discrimination. In 1987, he became the first Kenyan and among the first of all people living with HIV in Africa to share publicly that he was living with HIV.

Mr Muriuki died from oesophagus cancer-related complications on 14 February 2022, having lived a healthy life with HIV for more than 36 years, thanks to his access to life-saving HIV treatment and through living his life with a sense of purpose.

Mr Muriuki fought against AIDS-related stigma and discrimination in his native Kenya at a time when an HIV diagnosis was thought to mean imminent death. He offered a testimony that a healthy life with HIV was possible. He formed the first support group of people living with HIV in Kenya, the Know AIDS Society, to encourage people living with HIV to overcome fear, stigma and discrimination and to advocate for changing policies and laws to remove AIDS-related stigma and discrimination.

After his HIV diagnosis, stigma and discrimination forced Mr Muriuki to leave his job, and he returned to his home city, Nyeri, to await his death. In Nyeri, the stigma and discrimination he experienced stopped him from opening a bank account. However, he overcame the obstacles in his path and decided to dedicate his life to a crusade against HIV. His courage and conviction to openly disclose his HIV status, and to fight AIDS-related stigma and discrimination, were heroic.

His campaigning also formed the foundation of Kenya’s national AIDS response, prompting the government to declare AIDS a national disaster before establishing the National AIDS Control Council in 1999. Mr Muriuki was also active globally, advocating for access to life-saving HIV treatment for people living with HIV in Africa and their greater involvement in the AIDS response. He served in the Network of African People Living with HIV, the Global Network of People Living with HIV, the International Treatment Preparedness Coalition and the Pan African Treatment Movement, among other organizations, advocating with candour for equitable access to HIV treatment for people living with HIV in Africa.

Although Mr Muriuki’s HIV was virally suppressed, from 2018 he struggled with cancer, eventually dying from its complications. He was worried that the AIDS response was ignoring noncommunicable diseases and in his work with Kenya’s HIV Tribunal he pushed for noncommunicable diseases to be brought to the forefront of the AIDS response.

Mr Muriuki will be sorely missed by his family, friends and colleagues in Kenya and around the world.

Kenyan AIDS activist Inviolata Mbwavi died on 29 July 2020 in Kakamega, Kenya, at the age of 48 years. 

Ms Mbwavi was the first Chief Executive Officer of the National Empowerment Network of People Living with HIV in Kenya. At the time of her death she was the National Coordinator of the International Community of Women Living with HIV, Kenya Chapter (ICW-Kenya). ICW-Kenya exists to support an enabling human rights environment, promote gender equality and address the HIV-related vulnerabilities and needs of women and girls. ICW-Kenya also works to respond to HIV among gay men and other men who have sex with men and transgender people, supports legal frameworks enabling trade and intellectual property legislation for improved access to affordable essential medicines and commodities and campaigns against violence and discrimination against key populations.

For Ms Mbwavi, the responses to HIV and to other underlying social, economic and legal factors were equally important. She was uncomfortable with an HIV response that does not question why more girls than boys and more women than men are living with HIV in Kenya and the wider African continent decades after the advent of the epidemic.

Ms Mbwavi was an active member of a civil society coordination group on HIV and tuberculosis and collaborated with UNAIDS in pushing for an HIV response that values and recognizes the contribution of civil society and affected communities.

“Inviolata Mbwavi was a fierce advocate for gender equity, safety and dignity. She was a passionate activist and leader who broke barriers for women and for civil society and was one of the first women living with HIV to serve in a Country Coordinating Mechanism. Her leadership qualities and desire to serve were further demonstrated when she twice ran to be a member of parliament,” said Medhin Tsehaiu, UNAIDS Country Director for Kenya. “We give our condolences to her family and all who loved her.”

UNAIDS has embarked on a project to support communities in Kenya during the COVID-19 pandemic.

The project has a two-pronged approach to provide short-term, urgent assistance and long-term, structural interventions to empower communities to respond to the immediate and extended impacts of COVID-19.

It also seeks to strengthen advocacy efforts aimed at government and partners to include the needs of vulnerable communities, including people living with HIV, key populations, adolescent girls and young women and pregnant and breast-feeding women, in COVID-19 response plans.

In the short-term, UNAIDS, in partnership with The National Empowerment Network of People living with HIV/AIDS in Kenya (NEPHAK) and Women Fighting AIDS in Kenya (WOFAK), is distributing food and hygiene packs to people living with HIV in informal settlements. 

WOFAK is distributing food vouchers across six counties in Kenya, targeting 450 women and girls in all their diversity. The two organizations are together distributing hygiene packs, consisting of a three-month supply of soap and disinfectant, as part of a partnership between UNAIDS and Reckitt Benckiser, to 10 000 people living with HIV across Kenya.

Furthermore, UNAIDS is supporting community organizations with a grant of Kes. 7 400 000 (USD 69 256). These funds will not only purchase food vouchers, but also will support communities to meaningfully engage in the Global Fund application process, assess the impact of COVID-19, including human rights and gender violations during the pandemic, and support civil society organizations to develop key messages and consolidate their strategies while linking them to Kenya’s Ministry of Health.

During the more than a decade that Carolyne Njoroge worked as a sex worker, she never saw such violence against her peers. Now working full time for the Kenya Sex Workers Alliance (KESWA), she said that the COVID-19 lockdown threw everyone into disarray.

“At the outbreak, no one was prepared for the coronavirus,” she said. “It’s not like the rains that we know and can prepare for.”

The government’s lockdown measures to limit the spread of the virus—a dusk-to-dawn curfew and shutting of bars and nightclubs—have left sex workers in Kenya to either work during the day and be very visible or to break the curfew at night.

So far, KESWA has reported that more than 50 sex workers have been forcefully quarantined during the early days of the pandemic, and women have been arrested for not adhering to the social distancing rules and obligatory mask-wearing.

“How do you expect women to adhere to these measures when they cannot feed themselves and their families and many of them don’t even have homes?” Ms Njoroge asked.

Kenya does not criminalize sex work. However, the law forbids “living on the earnings of sex work” and “soliciting or importuning for immoral purposes,” which Ms Njoroge said means that the women work in a grey area. “It’s a very hostile work environment and sex workers are the first to be violated because they say our work is not work,” she said.

Phelister Abdalla, a sex worker living with HIV and KESWA’s National Coordinator, said, “Sex workers need to be protected, but if we are told to stay at home we need to be given food.” 

The government has not released funds or directed aid to sex workers, so KESWA started a fundraiser to dispatch hygiene packs, which include hand sanitizer, masks and menstrual pads, as well as food baskets.

Ms Njoroje said that 100 sex workers from the informal settlements had benefitted. “Our challenge is keeping up with demand, so we are reaching out to others for help,” she said.  

Ms Abdalla said that fighting the pandemic together is key. “If we want to end COVID-19, we should not be judged by the type of job we do,” she said. “We are first and foremost Kenyans, so treat all of us equally.”

Fifty-seven Kenyan civil society and nongovernmental organizations, including KESWA, drafted an advisory note to the Kenyan Government to urge it to put in place safety nets to cushion the communities and people who cannot afford to not work. They also urged them to stop security forces from enforcing measures around social distancing and curfews. The note adds, “We cannot use a “one size fits all” approach for COVID-19” and calls upon the United Nations leadership to help safeguard the progress.

The Kenyan Government, through the National AIDS and STI Control Programme (NASCOP), in partnership with county governments, implementing partners and donors continues to work to ensure the continuity of KP service delivery during the confinement measures. NASCOP issued technical guidance to all services including information, education and communication materials e.g. posters, setting up virtual coordination platforms, capacity building of service providers on HIV in the context of COVID-19 and they have instituted advocacy efforts to raise resources to ensure that service providers, including outreach teams, and Key Population led groups have personal protective equipment (PPE) and sanitizers. Mobile dispensing services for people who use drugs and tailored outreaches have been established to enhance service delivery along with the formation of virtual psychosocial support groups distribution of food baskets to the very vulnerable and help/hotlines for violence response have been sustained.

UNAIDS collaborates with governments to ensure that international human rights law are respected, protected and fulfilled, without discrimination, in line with state obligations, including in times of emergency.

“Peace is not merely the absence of war—it is when people have access to resources that enable them to meet their basic needs so they can live their life with dignity. If people have no nutritious food, if children do not go to school, if there is a conflict, then they are not at peace. COVID-19 came to remind us about it,” said Karambu Ringera, the founder and President of the International Peace Initiatives in Kenya.

Ms Ringera says that peace is holistic—even though her organization focuses on women living with HIV and AIDS-related orphans, she believes that it is also working for peace.

Her work started back in the early 2000s, when Ms Ringera was a student in the United States of America. When she returned to her home town in Kenya, Meru, for the summer holidays, she met a group of women, some of whom had recently lost their husbands. Most of the women didn’t know the cause of death of their husbands, but since AIDS-related deaths in Kenya were at their peak then, Ms Ringera suspected the reason. She encouraged the women to find out their own HIV status so as to not follow in their husbands’ footsteps.

Moved by the plight of many of the women she met, many of whom couldn’t afford to send their children to school or access HIV treatment, when back in the United States Ms Ringera arranged a cultural event, at which Kenyan food was served and people could learn about African culture. She collected US$ 400—enough to send seven children to school.

“I love the proverb about not just giving a person a fish, but teaching them how to fish,” she said. She wanted to help more children at home in Kenya, but, said Ms Ringera, “I wanted to go beyond just being someone who came to study poor women, create a solution for them and ask them to implement it.” For her, it was important for the women to understand that they could help themselves.

The women decided that they would make jewellery, which could be sold at her cultural fundraising events. At the same time, women started developing more skills, such as weaving and catering, so they could start their own businesses and support themselves.

Nearly two decades later, Ms Ringera runs a nongovernment organization that provides sustainable initiatives for orphans, women living with HIV, survivors of violence and communities with the tools and resources they need to move on from violence, poverty and crisis to stability and self-reliance.

In the beginning, many of the women who work at the International Peace Initiatives couldn’t afford a US$ 3 school uniform for their children. Today, Ms Ringera is proud that many have put their children through university. “People even in vulnerable circumstances can transform their lives. We have women and children, young people, to show that this is possible. We need to create interventions that inspire people to save themselves,” she said.

In the time of COVID-19, though, Ms Ringera is worried.

“We will need a good strategy to survive as a family,” she said. “Since 2009, when our children’s home was opened, this is the first time that we closed its doors to visitors. We did this immediately after hearing the news about the new coronavirus.”

The children’s home is home to 76 children, who need to be fed three times a day. Ms Ringera thinks that sustainability is key—Ms Ringera and her team are planting crops, keeping chickens and trying to collect a store of food for at least three months. “I feel that more and more, people need to create their own sustainable systems where they are, so that during challenges like this, at least they can have their own food locally,” she said.

Cabinet Secretary, Acting Governor James Nyoro, colleagues from the United Nations system. Jambo!

Community health volunteers, you are my heroes. I am so happy to be here with you today in Kiambu County, Kenya.

And I thank you for the warm welcome from the heart of your community at the launch of the UNAIDS report, Power to the people.

Thank you, young people. Especially the young person with a disability who just spoke to us, who reminded us that not all people living with HIV are the same—they are all different, and we must be inclusive. We will remember it. We will act on it.

I want to express my sincere condolences and solidarity with the people of West Pokot on the tragic loss of life and property following the torrential rains and landslides. I hurt with you.

Launch of Power to the people

I am here because Africa is the continent still most affected by the HIV epidemic.

More than 25 million people are living with HIV in sub-Saharan Africa—more than two-thirds of the global total of 37.9 million people living with HIV.

I am also here because many countries in Africa are leading the way to end AIDS. We are heroes, fighting the epidemic.

In Kenya, AIDS-related deaths have fallen by more than 50% since 2010, and new HIV infections are down by 30%. This is a great achievement. Great progress in a short time.

Today, I can announce that 24.5 million people living with HIV around the world now have access to life-saving treatment. Great news and great progress.

Joining the marathon to end AIDS

This is a special day for me.

I am launching my first UNAIDS report.

With this new report, I am paying tribute to the families and communities devasted by AIDS, the women’s grass-roots groups and the communities that have mobilized and transformed the AIDS response. I congratulate you. We owe you a lot.

In my country, women got together in villages, bought saucepans and blankets, looked after each other, buried the dead, didn’t let anyone suffer alone. It was the women in our communities who did that.

Today, I am committing UNAIDS to take some big steps in a new direction.

Fight inequality and poverty

The first step is to address inequality and the injustices that fuel the HIV epidemic.

AIDS hurts people who live in poverty. This is a problem for everyone, but a big problem for the poor.

We have to address inequality. It cannot be right that some people get treatment and live long lives, while others cannot access health care and die.

We must fight inequality, lift all people up out of poverty.

We need to provide more services—education, health, social protection. That is how we will end AIDS.

Gender equality and women’s rights are key

We must advance women’s rights if we are to end AIDS, so our second big step in the race to end AIDS must be to tackle gender inequality.

Despite progress in prevention and treatment, HIV remains the leading cause of death for women aged 15–49 years worldwide.

Every week, 6000 young women aged 15–24 years are newly infected with HIV.

Across sub-Saharan Africa, young women and girls face rates of HIV far higher than men and boys.

Young women in sub-Saharan Africa aged 15–24 years are twice as likely to be living with HIV than men of the same age.

These are numbers that shame us all.

This is a gender injustice with tragic repercussions. Why are young women more vulnerable?

If we are going to keep our promises, we must end the gender power imbalances that are driving HIV risk and vulnerability.

We need to champion gender equality and empower young women and girls to transform our societies.

Worldwide, one in three women will experience physical or sexual abuse in her lifetime.

In too many of our communities, a women’s first experience with sex is violent, is forceful. That is the reality.

Yesterday, we launched 16 days of activism against gender-based violence. Every day we should commit to achieve equality for women and girls, so their vulnerability to violence can end.

Here in Kenya, I am concerned about the rate of femicide.

Every week, we read a media report of a woman, often a young woman, killed by her partner.

We need to speak up for these women, call for justice and an end to impunity. The world must be a safe space for all of us.

UNAIDS will pay more attention to fighting those laws, traditions, cultures and practices that enable and perpetuate gender-based violence. A woman’s body is her body.

It is our urgent duty to ensure that all women and girls, of all ages, have unrestricted access to sexual and reproductive health services.

We cannot accept that millions of women still cannot get access to contraceptives, because we know that their right to contraception is core to their empowerment across every aspect of life.

We are doing an injustice to millions of young people who still cannot access the simple health services they need: free condoms, an HIV test without parental consent and pre-exposure prophylaxis.

Keeping girls in school reduces their risk of HIV. We need to ensure that all young people can stay in school, and that every school provides quality comprehensive sexuality education—to know about their bodies, their health.

UNAIDS, together with our Cosponsors—the United Nations Population Fund, the United Nations Entity for Gender Equality and the Empowerment of Women, the United Nations Educational, Scientific and Cultural Organization and the United Nations Children’s Fund—will step up for women and girls, especially in Africa.

Human rights

The third step I ask us to take today is on human rights.

The human rights and citizen rights of women and girls, gay men and other men who have sex with men, transgender people, sex workers, people who use drugs and prisoners are being denied.

Without judgement, we must ensure that they can access HIV services, so this disease can end. We must treat them as equal citizens, so they can enjoy their right to health and get services to protect themselves and their partners from HIV.

One third of key populations do not know their HIV status.

In many countries, we still have laws that criminalize key populations or discriminate against people living with HIV, so they go underground and hide, and when they hide they can’t enjoy their right to health.

The crackdowns and restrictions on gay, bisexual, transgender and intersex groups and campaigns are unacceptable.

Young people are being judged and punished for who they are and who they love.

We will not end AIDS unless we guarantee the human rights of all people, especially key populations.

Funding and resources

Despite progress in recent years, there are still not enough resources available to end the AIDS epidemic. Poor countries are struggling to pay for everything they need—health, education, roads, water, sanitation.

Health should be a top priority. Without healthy people, we will not make progress.

Two-thirds of countries in Africa still charge fees for health care, and millions of people are just one sickness away from falling into extreme poverty.

Despite the world’s commitment to implement universal health coverage, the percentage of people paying catastrophic health costs out of their pocket has only increased in the past five years. Health cannot be a privilege for the rich—it should be a right for everyone.

Public debt has climbed above 50% of gross domestic product in half the countries in sub-Saharan Africa. In a constrained fiscal space, governments must find pathways to a sustainable long-term financing of their HIV responses. We want to work with governments to see how to create fiscal space and manage their priorities within budgets reduced by debt repayments.

During the recent replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria, countries and foundations made a historic down payment to advance the end of AIDS. But more work is also needed to ensure that every dollar, euro and shilling is being used effectively.

In many middle-income countries, governments are still paying thousands of dollars more for the same quality medicines that are available to low-income countries for just pennies a day. This is unacceptable. We will try hard to see that prices come down.

Universal access to quality health care is not a commodity—it is a human right.

Conclusion

I do not underestimate the challenges ahead, but I feel a lot of excitement about what can be achieved for people. We are standing on the shoulders of people who fought—how can we fail to finish?

What I have called for today requires some urgent changes.

Changes in how we think what is possible.

Health care for each and every person—this is not impossible.

Changes in how quickly we act.

Changes in how we work as UNAIDS—we need to look at ourselves in the mirror.

But let us be in no doubt, we can end AIDS.

I’ve lost loved ones.

We can go into a future of health for all.

Cabinet Secretary and all the activists here today, I wish you all the best in your endeavours. UNAIDS is right behind you.

GENEVA, 24 May 2019 — UNAIDS deeply regrets the decision of the High Court of Kenya to maintain key provisions of Sections 162 and 165 of the Kenyan Penal Code. Those provisions criminalize certain private sexual acts and lead to discrimination and violence against lesbian, gay, bisexual and transgender (LGBT) people in Kenya.

“Today’s ruling is a missed opportunity for Kenya to uphold human rights and to restore privacy, respect and dignity to the lesbian, gay, bisexual and transgender (LGBT) community,” said Gunilla Carlsson, UNAIDS Executive Director, a.i. “I share the deep disappointment and frustration felt by LGBT people in Kenya and I want to assure them of UNAIDS’ continued support in reaching justice and equality for all.”

UNAIDS has been working together with the National Gay and Lesbian Human Rights Coalition and other LGBT groups as well as civil society organizations and other partners to promote a more enabling legal environment in Kenya.

There are indications that the judgement will be appealed.

Criminalization of consensual same-sex sexual relations is a violation of human rights and legitimizes stigma, discrimination and violence against LGBT people. Criminalization stops people from accessing and using HIV prevention, testing and treatment services and increases their risk of acquiring HIV.

“The failure to decriminalize consensual same-sex relations will undermine Kenya’s aim of reaching universal health coverage,” said Ms Carlsson.

Globally, the risk of acquiring HIV is 28 times higher among gay men and other men who have sex with men than among the general population and 13 times higher for transgender women. Prohibitive legal and policy environments and a lack of tailored services for key populations increase their vulnerability to HIV. UNAIDS urges countries to ensure the full respect of the human rights of all people, regardless of their sexual orientation, through repealing laws that prohibit sex between consenting adults in private, enforcing laws to protect people from violence and discrimination, addressing homophobia and transphobia and ensuring that crucial health services are made available.

“We need to move towards a more humane, compassionate and rights-based approach towards same-sex relations worldwide. This decision entrenches unjust laws that criminalize same-sex sexual relations and block people’s access to essential services, including to health care,” said Ms Carlsson.

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.