How Uganda's anti-gay law can undermine HIV and AIDS response

The outcry over Uganda’s anti-gay law is deafening: Donors are re-channeling and reviewing their assistance, and aid and advocacy groups are clamoring for the law to be repealed.

But although most critics are talking about human rights and the shrinking freedom of the LGBT community in Africa, another — for some, even more pressing — concern is how this can affect the HIV and AIDS response in the country, the brunt of which is funded by foreign aid.

Uganda had been an example for many in the fight against the disease. In recent years, a slowly but steadily rising number of people have been receiving antiretroviral drugs.

However, Enrique Restoy, senior advisor on human rights at the International HIV/AIDS Alliance, warned the country is now falling fast behind others on HIV incidence rates. In 2012, this shot up to 7.3 percent from 6.4 percent in 2005, according to the Joint U.N. Program on HIV/AIDS.

“It’s one of the very few countries where incidence rates are going up. New cases year on year [are on the] rise, as opposed to most other countries where new cases year on year are going down,” he explained.

Restoy gave several reasons for this, including scant resources, lack of investment and a simplistic strategy wherein people stick to one form of intervention such as abstinence or condom use. But one critical point is that the government response has often isolated key populations that have the highest HIV prevalence rates, such as men having sex with men.

With the passing of the anti-gay law, this can only get worse.

“When this particular population is criminalized, like it is the case in Uganda now that the anti-homosexuality bill has been passed, it drives these populations on the ground. They [start to] fear of coming out to get the services they need to prevent the HIV transmission … or to treat themselves,” he argued.

Restoy noted: “There will be less and less people who will be openly gay. There will be less and less people who will disclose their status to their female partners. And therefore, it would be much more difficult to control the transmission of HIV … We heard the Ministry of Health already saying that they will guarantee access to services for the LGBT community, which is fine. But at the same time, with this policy, they are actually making sure that access is not happening. And this has a traumatic effect on one of the serious problems the wider Ugandan society is facing, not just the LGBT community.”

Organizations ‘at risk’

But while the fear now rests largely on LGBT beneficiaries of HIV and AIDS services, the law’s ramifications go beyond them and could potentially include organizations providing the services.

These groups could be accused of abetting or promoting homosexuality by simply offering treatment to these groups, and, Restoy fears, “potentially be imprisoned.”

The Alliance has been in constant contact with their implementing partners on the ground in Uganda, mostly community-based NGOs, which are also beneficiaries — but this is becoming increasingly difficult since the passing of the law.

“We’re very worried about communications being tapped into; we know some means of communication have already been interfered with by the government. So right now, we are not inquiring too much on specific cases that might expose our partners further,” he said. “You can automatically see the impact it has on them. They don’t want to leave their houses, they are scared about being seen in public, they are trying to find ways in which they can be in safe places, where they can work from home, without being harassed. It is very difficult at this stage.”

The group is currently relying on other channels of information, but Restoy did not elaborate on what those other channels are.

Reallocating aid

A number of donors, like the Netherlands or Norway, have already decided to re-channel their bilateral aid to civil society organizations in Uganda, immediately after President Yoweri Museveni initially decided against international presure to sign the law.

For most implementing partners, this is better than cutting aid completely, which would be devastating for people relying on it, whether of HIV response or other needs.

Restoy however cautioned donors to choose well who they give their money to from now on.

“Civil society is very very wide. And there are many different kinds of civil society. Some of them can be every bit as homophobic and as damaging to the LGBT community as the government is … We should be careful about what’s happening with funding that might go to civil society,” he said.

The issue is clearly not limited to Uganda. Just this month, an NGO in Kenya has reportedly written to parliament to pass a bill outlawing homosexuality in the country, and Nigeria has already done so even before Uganda.

The Netherlands has already expressed concerns over CSOs that might have backed the Ugandan law and warned there would be implications for those receiving Dutch ODA.

Rising trend

Uganda’s current crusade against homosexuals is not new, and extends to other countries in Africa, Asia and the Caribbean. More than 70 nations around the world have anti-gay laws, or what Restoy more aptly describes as “unnatural offenses” — although the concern is not as heightened as many of these legislations he said “are not enforced.”

“It’s not always black and white — that if you have legislation, you cannot have access and people are criminalized, there’s nothing you can do with it. There are lots of countries where a lot can be done,” he said, such as calling for legal reforms in legislation, specifically to those that affect the HIV response and the LGBT population, which in several countries receive significant support from some levels of government.

Many of these laws have been around for a very long time, but what is worrying according to Restoy is the trend of “recriminalization” being introduced now by countries such as Nigeria, Uganda, India and some Caribbean nations.

“Basically what they’re saying is this is not an old issue; it’s an issue that is very much present and we’re actually going to go further in this criminalization. That is the most worrying — the countries reigniting these anti-homosexuality sentiments,” he said. “What’s happening with this legislation is not far from the Public Order Management Law for instance recently passed in Uganda. It’s not far from the other wider human rights context of Uganda, with the shrinking spaces for democracy and accountability and civil society participation.”

Restoy added: “[These] laws don’t come out of nowhere. They come because in our view they are being instrumentalized to divert attention to the issues of shrinking space of civil society, the mounting corruption issues that divert the attention of the public away from the misguided policies.”

Moving forward

The Alliance, according to its senior advisor, is working with various organizations, internationally and in Uganda, to advocate in countering the legislation. But their number one priority at the moment is ensuring the continuation of services, and the safety of partner organizations and beneficiaries.

On this front, though, they hope that donors will match their aid with their political statements — for instance by providing security for implementing partners — or adjust policies for those that would seek asylum in their own countries.

“Governments are already being vocal. This is good. But you have to put into practice what you preach … If you only say these things, but you’re not doing anything to protect this community, then you’ll be, I’m sorry to say, hypocritical,” Restoy said.

The battle is not yet over on the ground though. Now that the law can now be taken up by the judiciary — which the senior advisor said has been “pretty lenient” with the LGBT community before — aid groups are hopeful the law will be considered unconstitutional, or the very least be reviewed.

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