Insights from the SCALE Initiative regional conversations on HIV, law and access
By Kevin Osborne, Manager, SCALE Initiative, UNDP
Michael Akanji, moderator of the SCALE Initiative Africa Regional Conversation, asked panelists an unplanned question: “What was one ‘wow’ moment for you in your work on HIV and law reform?” The discussion that followed between Angela McBride (South African Network of People Who Use Drugs), Grace Kamau (African Sex Workers Alliance) and Jean Paul Enama (Humanity First Cameroon Plus) reminded me once again of the sheer passion and possibility that opens when you bring activists and advocates together for real conversation.
That’s what the SCALE Initiative - a new partnership between UNDP and PEPFAR - set out to do the week of 9 May, holding four regional conversations “Law and Access: Getting it right by and for key populations” to collect and share strategies to tackle discriminatory laws and HIV-related criminalization. These virtual dialogues were designed by and for people living with HIV, gay men and other men who have sex with men, transgender people, sex workers and people who use drugs; namely, the people who are disproportionately impacted by HIV. While each regional conversation reflected their contextual realities, the importance of ensuring the safety and security of key populations and their allies who are advocating for law reform was loud and clear.
In Eastern Europe and Central Asia, wartime considerations are front and center, given the urgent need to ensure continued access to care and services for marginalized communities and refugees. In Africa, a recent wave of harsh anti-LGBT legislation has led some communities to recalculate priorities and operating strategies in increasingly hostile environments. In Latin America and the Caribbean, strategies need to be calibrated to deal with both colonial heritage laws and rising populism fueled by religious conservatism. In Asia and the Pacific, the realities, especially for people who use drugs, are exacerbated by blunt criminalization policies.
Despite these differences and significant obstacles, people living with HIV and other key populations in these regions spoke to many similar challenges, opportunities and tactics on the pathway to improving legal and policy environments.
Three takeaways struck me across all the conversations:
When it comes to law reform, there is rarely a clearly defined beginning and end. From know your rights and media advocacy campaigns to strategic litigation and implementation activities, the work requires sustained effort before, during and after laws and policies change.
As Joel Simpson from the Society Against Sexual Orientation Discrimination in Guyana described, the non-legal work, including communications campaigns and community mobilization, “was important for shaping the policy environment for the legal change that was to come.”
More than 40 years into the HIV epidemic, this lesson continues to be affirmed and reaffirmed. No one understands both the barriers and the solutions that key populations face better than they themselves. Progress is therefore impossible without those most impacted in the driver’s seat.
It is also critical that key population-led organizations are supported and capacitated to leverage existing resources, which can be further encouraged through peer-to-peer learning opportunities and platforms. This must also include sustainable funding and any demand driven capacity building support from international organizations and donors. In the words of Angela McBride, there is “a wealth of knowledge across our movements that we should be leaning on...we need to see what is working for us as a community and we need sustainable funding to continue doing so – it really is that simple.”
A through line was clear across all four conversations – we cannot do this alone, especially in the face of continued discrimination, criminalization and widespread backsliding on democratic principles and human rights. Practically speaking, solidarity between groups can help amplify issues, protect the security of those most harshly criminalized and attract law and policymakers’ attention. The responsibility also falls upon international agencies and organizations to leverage their resources and influence to help promote the safety and security of those who are criminalized and under threat while carrying out HIV service, policy and law programming.
Solidarity among key populations also reflects the true intersectional nature of identity. LGBTIQ+ activists in the Eastern Europe and Central Asia conversation explained that even if a given community is not explicitly criminalized, the intersectional reality of key population identities means that authorities can find multiple ways to arrest any given individual. As Marcela Romero of RedLacTrans, Argentina, put it: “a trans person might have a disability, or use drugs. It’s not just one discourse for each issue. We must be united to make progress. We need a more comprehensive agenda where no one is left behind.”
With the safety and security of communities front of mind, the SCALE Initiative is committed to helping strengthen key population-led efforts, understanding and implementing the pathway to law reform and elevating new and emerging leaders. In the coming months, together with key population organizations and partners including PEPFAR, UNAIDS and the Global Fund, and informed by these regional conversations, the SCALE Initiative will be rolling out a digital learning hub and a small grant programme to support key population-led efforts on HIV and the pathway to law reform. As part of the learning hub, we will also be sharing key lessons from the conversations, thanks to reporting done by our fantastic moderators: Erika Suero, Tung Doan, Michael Akanji and Olena (Lena) Kucheruk.
UNDP and PEPFAR are committed to regaining lost ground on HIV and advancing an equitable, global response that leaves no one behind. PEPFAR's Five-Year Strategy outlines a clear commitment to reduce new HIV infections, particularly in priority and key populations. The UNDP HIV and Health Strategy 2022-2025 includes an emphasis on repealing discriminatory laws against key populations and promoting LGBTQI+ inclusion, underpinned by a commitment to leave no one behind and reach the furthest behind first.
If these conversations are any indication of what is to come, I remain hopeful. Hopeful that the SCALE Initiative can play a small role in helping to amplify, strengthen and scale up this kind of work. And hopeful that despite our differences and the challenges we face from those who wish to criminalize us, the principles of solidarity, human rights and equity will prevail.