GENEVA, 4 April 2019—UNAIDS and UNFPA, the United Nations sexual and reproductive health agency, are seriously concerned by new criminal law provisions that came into force yesterday, 3 April 2019, in Brunei Darussalam. The provisions, which impose the death penalty for same-sex sexual activity, adultery and for having a child outside of marriage, breach a number of international human rights norms, including the right to be free from torture and from cruel, inhumane or degrading treatment. The provisions will have a significant negative impact on overall health and well-being.  

“These extreme and unjustified punishments will drive people underground and out of reach of life-saving HIV treatment and prevention services,” said Michel Sidibé, Executive Director of UNAIDS. “I strongly urge Brunei Darussalam to suspend or repeal the amendments to the Syariah Penal Code and I offer UNAIDS’ support to ensure that laws are grounded in human rights, based on evidence and protect the most vulnerable.”

Laws that punish sexual orientation, same sex relations and reproductive health care are discriminatory, and have a disproportionate impact on women, creating barriers to accessing health information and services, which in turn increases vulnerability to HIV and other health concerns. Impeding access to sexual and reproductive health and rights, including HIV services, negatively affects public health.

“Every person, without any distinction on any grounds, has an equal right to live free from violence, persecution, discrimination and stigma of any kind. Human rights are universal. Cultural, religious and moral practices and beliefs, and social attitudes must not be invoked to justify human rights violations against any group regardless of gender or sexual orientation,” stated Natalia Kanem, Executive Director of UNFPA.

Criminalization of same-sex sexual conduct has been shown to increase stigma and give license to discrimination, violence and harassment. Evidence shows that where communities are criminalized, they are more vulnerable to violence, less likely to access necessary HIV and other health services, and less able to protect themselves against HIV infection. Criminalizing people also works against reaching the Sustainable Development Goals agreed by the United Nations General Assembly.     

UNAIDS and UNFPA are concerned by increasing conservative and discriminatory policies and rhetoric in a number of countries, which may potentially give rise to violence, stigma and discrimination against people on the basis of gender, gender identity and sexual orientation. Recent discussions with governments in the Asia–Pacific region and beyond have highlighted the need to put evidence-informed and human rights-based laws and policies in place. 

Last December, Brunei Darussalam called for more and better data on its key affected and higher-risk populations in order to ensure more effective outreach. The production of those data, which would help improve Brunei Darussalam’s health-care provisions for key affected and higher-risk populations, will be undermined by the Syariah Penal Code.

UNAIDS and UNFPA support the calls of the United Nations High Commissioner for Human Rights and the open letter of the five United Nations human rights mandate holders to suspend the implementation of the revised penal code and urge all governments to protect the human rights of all people. This includes repealing criminal laws against adult consensual sexual conduct and decisions on reproduction, implementing laws to protect all people from violence and discrimination and ensuring that adequate health services, including sexual and reproductive health services, are accessible, affordable and acceptable to address their needs.

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.

UNFPA

UNFPA is the United Nations sexual and reproductive health agency. Our mission is to deliver a world where every pregnancy is wanted, every childbirth is safe and every young person's potential is fulfilled. Learn more at www.unfpa.org.

The second annual Global Health 50/50 report was launched on 7 March in Addis Ababa, Ethiopia. The report reviews progress made over the past 12 months by organizations active in the health sector to implement policies that promote gender equality, non-discrimination and inclusion in the workplace.

This year’s report, Equality works, reviews the gender-related policies and practices of almost 200 organizations. The sample includes organizations from 10 sectors, headquartered in 28 countries across the world that together employ an estimated 4.5 million people.

The report provides a comprehensive guide to how far global organizations active in health are taking steps to promote gender equality across four areas: commitment, evidence-informed policy content, equitable outcomes in power and pay and gender-responsive programming.

The Global Health 50/50 review identifies 14 organizations as very high scorers across these four areas, including UN Women, the United Nations Development Programme and the United Nations Population Fund. UNAIDS is included in a list of a further 17 organizations identified as high scorers.

However, the report stresses that even among good performers, there remains an urgent need for organizations to live up to and put into practice their stated policies on equality, non-discrimination and inclusion.

Ethiopia’s President, Sahle-Work Zewde, was the keynote speaker at the launch and spoke of the need to promote female leadership to implement policies and programmes that foster gender equality.

Ms Sahle-Work is Ethiopia’s first female head of state and currently the only female head of state across Africa. Ethiopia’s Prime Minister, Abiy Ahmed, has ensured gender parity among his cabinet ministers.

Speaking at the launch of the report, Michel Sidibé, UNAIDS Executive Director, said it was fitting that the event was taking place in Ethiopia and spoke of the importance of reaching gender equality as a matter of social justice.

“Women continue to be left behind and are more likely to face harassment and discrimination and slower career progression,” said Mr Sidibé, “It is an outrage that on average women today earn 20% less than men for no reason other than their gender. This must change.”

Mr Sidibé said UNAIDS had made progress on gender parity but acknowledged there was more to be done. He said that UNAIDS had increased the proportion of female country directors from 26% in 2013 to 48% today. He also pointed to the introduction of a single parental leave policy and the expansion of the UNAIDS Leadership Programme to all women in the organization as examples of its commitment to reaching gender equality.

Colour my HIV is an HIV prevention and empowerment campaign led by and focused on young people in South Africa. It was launched on World AIDS Day 2018 in Johannesburg, South Africa.

The aim of the campaign is to create an information platform to debunk myths and misconceptions about HIV in order to reduce HIV-related stigma and discrimination, increase knowledge of HIV by presenting new findings by experts and researchers, promote human rights, advocate for political commitment and accountability by policy-makers and other partners and highlight issues around HIV prevention among young people.

UNAIDS sat down with Sibulele Sibaca, the founder of the campaign, to ask her a few questions.

Question: Describe Colour my HIV in five words

Vibrant. Youthful. Life-changing. Futuristic.

Hopeful in all that we do. We hope that by 2030 we will end AIDS. With Colour my HIV we’re hopeful that young people themselves will change the course of HIV.

Question: What do you want to achieve with Colour my HIV?

Firstly, I want get to a point in South Africa where being HIV-positive is like having any other chronic disease—diabetes, high blood pressure—in that it’s a manageable illness.

Secondly, to change the narrative where people think that when you contract HIV it is a death sentence. It’s no longer that at all. South Africa has one of the most well-implemented HIV treatment programmes in the world. I remember when a very close person in my life contracted HIV, the doctor said, “You should be so glad you got HIV in South Africa. This is the country to be in when you have HIV. In other countries people are still crying for HIV treatment and you have it here; all you have to do is adhere to it.”

Thirdly, the stigma around testing for HIV is that if I test positive I am going to die, so people must know that they will not die when they are HIV-positive. It’s one of the reasons I have called the campaign Colour my HIV. We must own it. We must celebrate how far we’ve come with HIV as a country. Let’s not discriminate or stigmatize, instead we must go out and get tested for HIV.

Question: Why the focus on young people?

Primarily, we were thinking of adolescent girls and young women between the ages of 15 and 24 years, because they are the most at risk of HIV infection in South Africa. In this age group, nine girls contract HIV every hour in South Africa. My question is, how and why? Where are they? What are the circumstances that lead to the moment they contract HIV? Are they hungry? This group can be influenced. The messages planted in their heads are critical, as they are still growing. So, Colour my HIV looks to be that voice of reason, to teach and educate them about why they should get tested, to prevent themselves from contracting HIV.

However, it is difficult to focus on girls in isolation. We can’t solely speak to girls, we have to engage boys as well. Men and boys hardly visit the clinic, test or take medication. They have to be included in the narrative, which is why Colour my HIV focuses on young people in general.

Question: Where do you see Colour my HIV in five years?

In the short term, we are looking to start touring South Africa from April until the next World AIDS Day, going into communities and really just spreading HIV awareness. As HIV is not only an issue on World AIDS Day, we are looking to engage communities on how they can embrace HIV and live in colour.

We actually need to end AIDS by 2030. We have 11 years to go. So, the question is what are we doing now? Hopefully this year we are going to take Colour my HIV countrywide. In the next three years, I want to see it journey from the Cape to Cairo. When they talk about ending AIDS by 2030, I want Colour my HIV to be part of the narrative.

Ahead of Zero Discrimination Day, young people came together in Cairo, Egypt, to learn how to respond to HIV-related stigma and discrimination and to hear about how the HIV epidemic affects Egypt and the role that young people can play in the AIDS response.

“The burden of the epidemic is higher on young people. In Egypt, it is for young people to lead the HIV response,” said Walid Kamal, Egypt’s National AIDS Programme Manager.

During a discussion on stigma and discrimination, people living with HIV shared some of their testimonies and experiences, helping to give the participants a deeper understanding of how stigma and discrimination affects people living with HIV.

“It is our responsibility to help people living with HIV feel part of the community,” said one of the participating young people.

“It is not only about AIDS, it is about social justice, equality, the empowerment of women and promoting healthy gender norms,” said Ahmed Khamis, the UNAIDS Country Manager for Egypt.

The participants also learned how to plan, design and implement online awareness and advocacy campaigns on social media.

At the end of the meeting, organized by UNAIDS and the National AIDS Programme and held on 21 February, the young people agreed to lead social media campaigns to highlight the harm caused by stigma and discrimination. Starting on 1 March, Zero Discrimination Day, and running for three weeks, the campaigns will be supported by the UNAIDS country office in Egypt and are endorsed by Egypt’s Ministry of Health and Population.

On the night of 6 February 2009 in Georgetown, Guyana, seven transgender women were rounded up by the police and detained for the weekend. The following Monday, in the Georgetown Magistrates Court, they learned that they had been charged with cross-dressing. They pleaded guilty, were convicted and were each ordered to pay a fine. But not before being admonished by the Magistrate that they were “confused about their sexuality.”

With support from the Faculty of Law University of the West Indies Rights Advocacy Project, U-RAP, the group challenged the nineteenth century Guyanese law that bars men from dressing like women, and women from dressing like men “for an improper purpose”. On 13 November 2018, Guyana’s final court of appeal, the Caribbean Court of Justice (CCJ), ruled unanimously that the law violates the Constitution of Guyana and is therefore void.

“No one should have his or her dignity trampled on, or human rights denied, merely on account of a difference,” CCJ President, Adrian Saunders, said.

For U-RAP Co-Coordinator and law lecturer Tracy Robinson, this was a step towards addressing the unequal power and unequal life chances of many Caribbean people. 

"Laws do not apply evenly to everyone: those with the least resources and those marginalized are at greatest risk. Trans women are not the only ones who face lives which are cut short by state action and state inaction. There are many other instances in which we leave out and exclude those who are integral and part of our societies,” Ms Robinson said.

HIV is one manifestation of the way vulnerable communities are left behind. In the region, HIV prevalence among key populations is much higher than among adults generally. For example, among transgender women in Guyana—one of the few Caribbean countries with data on this population—the HIV prevalence is 8.4%, compared with 1.7% among all adults. Relevant Caribbean data indicate that HIV prevalence among gay men and other men who have sex with men ranges between 1.3% and 32.8%. The combination of discriminatory laws, stigma and discrimination and the relative lack of friendly services for members of key populations drives people underground, blocking them from HIV prevention and treatment services.

But in some countries, partners are acting to challenge the constitutionality of discriminatory laws held over from the colonial era. Through a case also supported by U-RAP, Caleb Orozco challenged the law in Belize that made “carnal intercourse against the order of nature,” which includes anal sex, a crime punishable by up to 10 years imprisonment. On 10 August 2016, Belize became just the second independent Commonwealth Caribbean country to decriminalize sex between men, and the first to do so through its courts.

And in Trinidad and Tobago the High Court ruled in favour of Jason Jones on 12 April 2018, finding that sexual activity between consenting adults should not be criminalized. This ruling was cited in the landmark Indian Supreme Court decision in 2018 decriminalizing gay sex.

UNAIDS is contributing to community engagement and communication around these issues, including supporting public forums in Belize and Trinidad and Tobago and the sensitization of journalists reporting on the transgender community in Guyana.

For the litigants, these victories are one step forward in a long journey towards equity.

“It forces communication between families and their lesbian, gay, bisexual and transgender relatives. It encourages people who are lesbian, gay, bisexual or transgender to come out the closet. It forces institutions to think about their administrative practices and the discrimination they justified based on that law. It forces homophobic people to acknowledge that the constitution covers everyone,” Mr Orozco said.

Litigant and co-founder of Guyana Trans United, Gulliver Quincy McEwan, said “It was very important for us to be heard and get justice.”

Every day, 460 adolescent girls become infected with HIV and every week 350 adolescent girls die of AIDS-related illnesses

GENEVA, 8 March 2019—On International Women’s Day, UNAIDS is urging countries to step up and protect young women and adolescent girls from HIV.

AIDS-related illnesses remain the leading cause of death for women aged 15–49 years globally. In 2017, 66% of new HIV infections among 10–19-year-olds were among females globally—in eastern and southern Africa, 79% of new HIV infections among 10–19-year-olds were among females.

“There is a vicious cycle of gender inequities, gender-based violence and HIV infection in many parts of the world,” said Michel Sidibé, Executive Director of UNAIDS. “Oppression and power imbalances must be redressed and harmful masculinities addressed in order to ensure that women and girls have full control over their sexual health and rights.”

Much more needs to be done to reach young people with HIV prevention, treatment and care. Young women and adolescent girls are especially being left behind. Gender-based violence, sexual exploitation and drug use are among the many factors that can increase the vulnerability of young women and adolescent girls to HIV.

Efforts to end AIDS are undermined where the human rights of young women and adolescent girls—especially their sexual and reproductive health and rights—are not supported. Countries must therefore enact laws and policies that enable access to services, including health and social protection, by young women and adolescent girls, helping them to claim their right to health.

International law gives people, including young women and adolescent girls, the right to access services to protect their sexual and reproductive health. However, 45 countries worldwide still have laws that require people under the age of 18 years to obtain the consent of their parents in order to be tested for HIV.

Social protection, education—including comprehensive sexuality education—and HIV prevention services that are integrated with sexual and reproductive health services have been shown to improve the health of, and empower, young women and adolescent girls. A South African study showed that HIV prevalence among girls who had finished high school was about half that among girls who had not (8.6% versus 16.9%). Children who access universal primary education in Botswana, Malawi and Uganda have been shown to have similar outcomes.

Investing in education. Investing in HIV and other health services. Preventing and protecting women and girls from violence. Eradicating harmful practices such as early, forced and child marriage. Promoting women’s rights. Through these actions young women and adolescent girls can be protected from HIV and the world can build towards ending 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.

On Zero Discrimination Day, UNAIDS calls on countries to examine discriminatory provisions in their laws and policies and make positive changes to ensure equality, inclusion and protection

GENEVA, 1 March 2019—In 2018, a number of countries made landmark decisions to change discriminatory laws and bills. The Supreme Court of India struck down Section 377 of the Penal Code, which criminalized same-sex sexual relations, the Philippines lowered the age of consent for voluntary HIV testing without the need to obtain consent from a parent or guardian to 15 years and Malawi removed provisions from a draft bill that would have criminalized HIV non-disclosure, exposure and transmission.

On Zero Discrimination Day, UNAIDS recalls the equal dignity and worth of every person, as enshrined in the Universal Declaration of Human Rights, and is calling for action to change discriminatory laws and practices, which are a significant barrier for access to health and other services.

“Human rights violations are happening all over the world because of discriminatory laws and practices,” said Michel Sidibé, Executive Director of UNAIDS. “Laws must protect, not cause harm. All countries must carefully examine their laws and policies in order to ensure equality and protection for all people, without exception.”

Raising awareness, mobilizing and taking action are essential. On Zero Discrimination Day, UNAIDS is proposing specific actions that individuals, civil society organizations, parliamentarians and donor organizations can take to change discriminatory laws. These range from being an ally to someone affected by a discriminatory law to joining a nongovernmental organization, tabling amendments to laws and calling for reviews of legislation.

Making a positive change is possible and there are many ways a law can be amended or abolished. These include:

• Reforming or removing laws through parliamentary processes and the votes of parliamentarians.
  • Raising awareness among parliamentarians is therefore essential, as was done in the revision of the HIV laws in the Philippines and bills in Malawi.
• In many countries, courts have the power to strike down laws that are discriminatory. This can be done if an individual or organization affected by the law takes legal action and wins the case for change.
  • The case of India’s Supreme Court, which removed Section 377 in 2018, was a striking example.
• In some countries, people or politicians can propose law reform through a petition and request a national vote or referendum.
  • This is a standard method of legislating in Switzerland.

UNAIDS has identified a range of laws that are discriminatory, impede access to health and social services, restrict freedom of movement and violate human rights.

In 2018:

• At least 20 countries imposed travel restrictions of some form against people living with HIV.
• Around 29 countries reported that they require the consent of a woman’s husband or partner to access sexual and reproductive health services.
• Fifty-nine countries reported mandatory HIV testing for marriage, work or residence permits or for certain groups of people in the law, regulations or policies.
• Seventeen countries criminalized transgender people.
• Forty-five countries had laws that impose the need for parental consent for adolescents and young people below 18 years to access HIV testing services.
• Thirty-three countries imposed the death penalty for drug offences in law.
• Same-sex sexual relations were criminalized in at least 67 countries and territories worldwide.

UNAIDS is actively working with United Nations partners, governments and civil society organizations to change those laws as part of the Global Partnership for Action to Eliminate all Forms of HIV-Related Stigma and Discrimination. 

Zero Discrimination Day campaign 2019—act to change laws that discriminate.

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.

“The HIV epidemic is a human rights epidemic. An epidemic of human rights loss, denial, derailment and in some instances abuse and violation.” With these words, Kate Gilmore, the United Nations Deputy High Commissioner for Human Rights, opened the Consultation on Promoting Human Rights in the HIV Response.

But while there are commitments, treaties and agreements, action is needed—this was the call from the consultation, held in Geneva, Switzerland, on 12 and 13 February, which sought to share regional and subregional strategies and best practices.

The consultation heard that stigma and discrimination, poor access to justice and punitive laws, policies and practices are barriers to the most vulnerable people accessing HIV prevention, testing, treatment and care.

Throughout the event, there was a central theme of removing harmful criminal laws, funding human rights and working closely with the community, through a call for national and regional institutions to listen, act, lead, reform and fund.

While the traditional human rights barriers—for example, stigma and discrimination and criminalization—persist, new problems are emerging. Questions of how to ensure that criminalized populations are included in universal health coverage, or that human rights and key populations programmes continue to be funded as a country transitions to middle-income status, was raised. A number of speakers, including Michaela Clayton, Director of the AIDS and Rights Alliance for Southern Africa, endorsed a top-down, bottom-up approach to promoting human rights, drawing on the actions of both political leaders and civil society together. 

“This isn’t easy. We can only do this by working in partnership: governments, civil societies, accountability mechanisms, human rights groups and health professionals,” said Tim Martineau, UNAIDS Deputy Executive Director, Programme, a.i.

“If I am meant to be a leader, I needed to be truthful,” said Lloyd Russell-Moyle, British Member of Parliament, reflecting on his bold move to reveal his HIV-positive status in the House of Commons in late November 2018, days before World AIDS Day.

He explained that for years he would honour people for their outstanding work in the HIV field and yet he never opened up and was honest with people about living with HIV.

“The more people don’t talk about it, the harder it is for everyone. As a Member of Parliament my job involves speaking out, being an advocate and helping people in their journey,” Mr Russell-Moyle said.

In his speech to the House of Commons, he described the sense of fear he had when he learned that he was living with HIV nearly 10 years ago. In his view, there is internal stigma, which kept him from speaking about his status for fear of “spreading” what used to be a deadly disease and the fear that people may reject him if they knew he was living with HIV.

“All that stigma makes a treatable disease life-threatening due to the impact on an individual’s mental health and access to medication,” he said in his emotional 28 November speech. In a telephone interview with UNAIDS, he specified that, “In no way should we glorify HIV, but it is liveable and manageable.” And living with HIV should not hold anyone back in any way, shape or form, he stated.

He desperately wants people to understand HIV better. “I want to get to the stage where I don’t have to explain that if you take one pill a day, you [have a viral load that is] undetectable and if you become undetectable you cannot pass the virus on to anyone,” he said. 

That’s why, with the leading British association representing professionals in HIV care, BHIVA, Mr Russell-Moyle wants to reform certain laws. One European Union law forbids people living with HIV from obtaining a full pilot licence.

“It’s outdated considering that HIV treatment now involves a pill a day with no side-effects,” he said.

He also has been vocal about the British Government’s public health spending cuts. “We are at a crossroads right now, having made so much progress,” Mr Russell-Moyle said. “We are in danger of lifting our foot off the pedal so close to the finish line.”

Not funding vaccine research and reducing sexual health screening and prevention will cost the government in the long run and ruin lives, he predicted. “It’s a race against the disease, and if we slow down at this stage we will likely see a rebound,” he said.

According to Public Health England, 12% of people living with HIV in England are unaware of their diagnosis. A Brighton-based foundation launched a Making HIV History campaign to improve knowledge and encourage people to come forward for testing—Mr Russell-Moyle noted that the Stigmasaurus video animations were a great tool to correct stereotypes.

“We have got the drugs, the tools to allow everyone to live happily, so for those who don’t know their status: get tested, get treatment, it will be okay.” He concluded, “It is okay.”