Zambia deletes 'sexual' from SRHR in blow to LGBTQ+ and rights groups

A move by Zambia to take the word “sexual” out of “sexual and reproductive health and rights” as part of an LGBTQ+ crackdown has raised the eyebrows of activists and donors, with some warning that this could lead to an “entrenchment of patriarchal norms” and particularly impact HIV service provision. The attempt was recently outlined in a letter dated Sept. 21 by professor Christopher Simoonga, permanent secretary in the Ministry of Health, and sent to all provincial health directors in the southern African country. In the memo, Simoonga claimed that the second joint Africa-European Union Ministerial meeting that was held in Kigali in October 2021 “rejected the use of the term ‘sexual and reproductive health and rights’” — despite denials from the European Union. “This is because the inclusion of the words ‘sexual’ and rights in the same phrase is inclusion of Lesbian, Gay, Bisexual, Transgender and Queer rights,” Simoonga said in the letter, explaining the reasoning behind the move. “Zambia was party to the decision by the African Union and does not support LGBTQ rights.” “The addresses are, therefore, advised to avoid using the term in public pronouncements and speeches and only refer to ‘Reproductive Health and Rights,’” Simoonga continued. He finished off by saying that the collaboration and support of provincial health directors was greatly appreciated. The memo was later posted on X, formerly Twitter, by activists. When contacted, Simoonga told Devex that he could not comment in a personal capacity on the letter, but confirmed that he had written and signed it. However, he added that a “response will need input from all those concerned.” Several requests by Devex for a response from the health ministry, as instructed by Simoonga, were however ignored. The letter has been the subject of some derision and eye-rolling. An activist in the country, who is wanted by the police in relation to protesting and did not want to be named, told Devex that the memo was “not just illogical, but also unlawful” and pointed out that the issue would affect everyone. “The government is so desperate to prove a point that they’ll even go to (target) the basic rights of everyone to access health services regardless of their sexual orientation or gender.” They pointed out that various articles of the country’s Constitution underpinned nondiscrimination. Villy Sitali Nawa Jr., a Lusaka-based activist, said on X: “The use of the word Sexual and Reproductive Health and Rights is now illegal in Zambia. Apparently, it’s Gay to use SRHR. Our government really has a lot of time to waste.” Under Zambia’s penal code, same-sex relationships are banned, with “offenses” punishable with a maximum of 14 years in jail. In March, four members of the feminist group Sistah Sistah Foundation were accused of promoting homosexuality in the country. Gay rights activist Paul Kasonkomona was acquitted on the same charge in a court in Zambia in 2014. “Zambian queer people are scared to even go to hospital because people will out them,” Zambian gay rights activist Anold Mulaisho told Devex. “Once they find out they’re queer the community doesn’t want to have anything to do with them and will even report them to the police.” He fled the country in 2017 after a warrant was issued for his arrest and now lives in Canada. The memo which came incidentally before the International Workshop on HIV & Adolescence held in Zambia between Oct. 4-6, with the theme “Out of the Box SRHR and HIV Innovation for, with, and by Adolescents," has also prompted serious concern. The conference site that foreshadowed the event spoke about “improving SRH,” among other issues. “Removing reference to sexual health and rights has real-world implications for people, especially women, and girls, including an entrenchment of patriarchal norms.” --— Marie-Evelyne Petrus-Barry, Africa regional director, International Planned Parenthood Federation Richard Lusimbo, national director of Uganda Key Population Consortium, based in Kampala, said that he had seen the document circulating on social media and told Devex that it could create a precedent where LGBTQ+ people would be locked out of access to services along with other members of the general population. This could include countries such as Uganda, where HIV progress is now expected to stall after the Anti-Homosexuality Act 2023 was recently approved. “It shows the kind of excuse that many homophobic individuals and governments are starting to use all possible ways of marginalizing LGBTQ plus persons at the expense of putting every citizen at risk,” Lusimbo said. “Every individual (is) supposed to have access to sexual reproductive health rights information, also services.” There was also outrage in other countries including Kenya, with one activist writing on X: “Do these people even know the work that goes into SRHR advocacy? Menstrual health? Contraceptives? Safe abortion? HIV and AIDS? Cervical cancer???? Y’all sat down and once again reduced queer folks to sex?” An EU spokesperson told Devex in an email: “There was no decision taken at the 2nd Joint Africa-European Ministerial in October 2021 to move away from using the term ‘sexual and reproductive health rights.’” The EU and its members were committed to implementing obligations arising from the Convention on the Elimination of all Forms of Discrimination Against Women, or CEDAW; the Beijing Platform for Action; the Cairo Declaration on Population and Development, or ICPD, and their respective outcome reviews; and the Sustainable Development Goals, or SDGs, they said. “Upholding and ensuring the full enjoyment of sexual and reproductive health and rights (SRHR) is an essential part of realising human rights and guides the EU’s external action as outlined in the EU’s new Global Health Strategy, Youth Action Plan and Gender Action Plan III,” the spokesperson said. “As an illustration, the EU and African partners launched a flagship initiative to enhance sexual and reproductive health and rights in December 2022.” This was developed by the EU Commission and EU members, the East African Community, the West African Health Organization of the Economic Community of West African States, and the Southern African Development Community. It was focused on increasing the implementation of continental and regional commitments on SRHR in the health and education sectors, improving the availability, affordability, and acceptability of quality-assured SRHR goods for all, especially women and girls, and strengthening advocacy and accountability to ensure SRHR needs were met. The African Union did not respond, despite several requests for comment from Devex. But the International Planned Parenthood Federation, or IPPF, expressed “concern” about the move. In an Oct. 12 statement, they stressed that “sexual rights are constituted by a set of entitlements related to the sexuality of all persons regardless of their gender, gender identity and/or expression, that emanate from the rights to freedom, equality, privacy, autonomy, integrity and dignity of all people — and like all rights, sexual rights are interconnected, indivisible, and applicable to all.” “Removing reference to sexual health and rights has real-world implications for people, especially women, and girls, including an entrenchment of patriarchal norms and a framing of people’s bodies as useful for reproductive purposes only,” said IPPF Africa Regional Director Marie-Evelyne Petrus-Barry. “This has far-reaching negative implications that are demonstrated by an increase in female genital mutilation and child marriage, and forced treatments, including sterilisation, virginity examinations, and abortions. Removal of sexual rights could also lead to the subjecting of women’s access to sexual health services to external approval, for example from a husband or male relative.” As sexual health and rights were closely linked to HIV/AIDS prevention and treatment, this could also adversely impact service provision to and the rights of HIV-positive people needing treatment and other services, Petrus-Barry said. Staggeringly, nearly all of the world’s 4.3 billion people who have reached a reproductive age will lack proper sexual and reproductive health services during their lives, according to research from The Lancet. Zambia has an HIV prevalence rate of 11% for adults aged 15 years and over, according to the Zambia Population‐based HIV/AIDS Impact Assessment 2021. Although there has been some progress, the virus disproportionately affects women with about 26,000 new infections among them compared to 19,000 for men in 2019. The country has guaranteed the sexual and reproductive health and rights of its population by ratifying 11 international law instruments, as highlighted by the Population Council. With Lusaka set to host the AU/UNECA ICPD+30 Africa Region Consultation next month, it was also important to remember that the 1994 International Conference on Population and Development, or ICPD, affirmed that sexual and reproductive health rights are human rights, added IPPF. “If we are to achieve these commitments 30 years later, it is critical that Zambia recommits to the attainment of sexual and reproductive health and rights for all,” they said. ICPD is considered groundbreaking in recognizing that sexual and reproductive health must be guided by the human rights of individuals and couples. This reframed population issues from an emphasis on population numbers to highlight human rights. Reproductive health is not possible without sexual health and comprehensive sexual and reproductive health requires access to human human rights, including bodily autonomy, said the World Health Organization. “Sexual health and rights are interconnected with reproductive health — whether this be protecting against infections, ensuring access to information and education relating to sexual health, or supporting agency over sexual activity and fertility,” WHO spokesperson Tarik Jašarević told Devex in an email. WHO and HRP, the U.N.’s Special Programme on Human Reproduction, were working to ensure that there was access to sexual and reproductive health services and rights which include menstrual health, information to negotiate consent, appropriate contraception and fertility care, safe and comprehensive abortion care, the highest standard of maternal, and perinatal health services.