Friday, 4 March 2011

Global Commission: HIV programs can only be truly effective if sexual minorities are decriminalised

by Laurindo Garci, Fridae’s HIV Programs Manager and Manila-based correspondent.

Over 200 participants from 22 Asia-Pacific countries gathered in Bangkok for a historic dialogue hosted by the Global Commission on HIV and the Law. As of now, 90 percent of countries in the Asia-Pacific region still have laws and practices that obstruct the rights of people living with HIV and those at higher risk of HIV exposure.

Delegates watching a video message from UNDP Administrator,
Helen Clark in the main conference room at the UN
Conference Centre, Bangkok. Watch Helen Clark's video message.
All photos courtesy of UNDP Regional Centre, Bangkok.Members of the Asia-Pacific LGBT community, public health workers and civil society came face-to-face with lawmakers, judiciary and police during a rare opportunity to air their grievances and share stories in hopes that a frank discussion on the core issues around HIV might change hearts and ultimately change laws.

The first of six regional dialogues for the Global Commission on HIV and the Law was held in Bangkok on February 16 and 17. The event comes almost midway through the 18-month lifespan of an independent commission, convened with the support of the United Nations Development Program (UNDP), and tasked to analyse the critical legal and human rights challenges of the HIV epidemic and recommend remedial policies.

Work started for the Commission in June 2010 and its 14 Commissioners – which include former presidents and members of international judiciary in its line-up – are working towards the goal of delivering key findings and recommendations by December 2011.

Panel discussion during the Asia-Pacific Regional Dialogue
Press Conference (left to right) UNAIDS Executive Director,
Michel Sidibé is the Executive Director of UNAIDS; HIV & the Law
Commissioners Hon. Michael Kirby and Jon Ungphakorn.


Observers believe that the credentials and political clout of this independent commission – which count Former President of Brazil, Fernando Henrique Cardoso, Parliamentarian Dame Carol Kidu from Papua New Guinea, the Honourable Michael Kirby, former Supreme Court Judge from Australia and Jon Ungphakorn from the Thai Senate among its members – could help convince governments and judiciaries that laws and law enforcement should support, rather than block, effective HIV responses.

During the dialogue, the Commissioners assigned to this first session and their legal counterparts from the region, heard that the burden of HIV is rests on the shoulders of Asian and Pacific Islander gay or bisexual men and other MSM. If current trends prevail, 50-percent of new HIV infections will be among by MSM by 2020, according to a Commission on AIDS in Asia report released in 2008. It is for this reason that various community groups who presented for the Commission advocated so stridently for the decriminalisation of same-sex behaviour.

This localised understanding is timely as scientific evidence released at the 2010 International AIDS Conference supports models of targeted prevention and treatment services for those most-as-risk of HIV infection. The research found that focusing on key-affected populations can result in a decline in on overall HIV prevalence in the general population. Hence governments and public health workers are being urged to “know their epidemic” and provide care and support for those who need it the most.

A preparation session for MSM civil society delegates (left to right)
Hisham Hussein and Raymond Tai from PT Foundation Malaysia;
community representative from Vietnam; Aung Thein, Burnett Institute,
Myanmar; representative from Sangama, India; Edmund Settle,
UNDP Regional Centre Bangkok;
Paul Causey, APCOM; Stuart Koe, Fridae & APCOM.

Dr Stuart Koe, CEO of Fridae and Vice-Chair of the Asia Pacific Coalition on Male Sexual Health (APCOM) attempted to spell out the conflict that is suffered by men who have sex with men and transgender people in the face of HIV.

“Discriminatory actions by public authorities threaten recent progress in addressing the HIV epidemic among these particularly vulnerable populations,” Dr Koe said. "During the past year, police and public security authorities across the Asia Pacific region have increasingly targeted men who sex with men and transgender people with physical and sexual assault, harassment, extortion and sometimes forced blood testing.”

Dr Koe and other community spokespeople from around the region recounted stories of human rights abuses against gay or bisexual men and other men who have sex with men with clear repercussions on HIV risk and access to treatment. Reports from China and the Philippines reveal how police often use charges of sex work as means to harass MSM and transgender people. Charges are often dropped in exchange for extorted money or sexual favours. There are several cases where on-duty HIV outreach workers have been snared by police in South Asia on suspicion of sex work. Possession of condoms was used as evidence of the charges.

Many laws in the region are preventing the distribution of MSM-specific safer sex education information on the basis that these materials contravene strict pornography laws, for example in Sri Lanka and Indonesia. Or similarly in Malaysia and Singapore where censorship codes prohibiting the promotion of homosexuality in the public domain hinder the scaling-up of MSM-specific HIV and sexual health outreach.

As the issue of homosexuality was raised, a Supreme Court Judge from Sri Lanka implored the Asian LGBT community to come together in solidarity because HIV is not just “gay or MSM issue”. Justice Shiranee Tilakawardane said that many lesbians were at risk of HIV as acts of rape and sexual violence was commonly used to “cure” lesbians of homosexuality. This reporter, who’s also Fridae’s HIV Programs Manager, made the point that while solidarity among LGBT people was likely to be common goal, laws need to be changed so that LGBT groups within the region can be recognised, thus enabling the community to organise and engage in public discourse. Violence and discrimination as demonstrated by religious fundamentalists across the region highlighted the urgent need for protection of sexual minorities under the law.

Dr Koe noted that while some instances exist where governments have learned to turn a “blind eye” and allowed MSM-targetted HIV programs to run freely despite criminalisation of same-sex acts, true progress can only be made when “champions” from within governments and civil society work together and advocate for change.

Of equal concern during the Dialogue was the way in which the law navigates issues for transgender people. “In the eyes of the law we don’t exist,” Khatini Slamah of the Asia Pacific Transgender Network said bluntly in reference to the failure of many governments to recognise gender identity. “And if we don’t exist,” Slamah explained during the Commission meeting, “how can we stand here and talk to you about rights if you don’t see us.”

Khatini Slamah of the Asia Pacific Transgender Network
addressing delegates during the Town Hall discussion.

Gender reassignment is not legally recognised in many countries in the region, though there are glimmers of progress in India, Nepal and Pakistan. This creates problems for transgender people in day-to-day life when their outward appearance does not match that of the person recorded on national identity cards, passports and other official documents. The consequence is that many transgender people disengage from conventional safety nets and health services set-up for the community. Transgender people are left to fend themselves at the margins of society, with limited options for livelihood. This kind of marginalisation becomes a structural barrier to access care, treatment and support, fanning the flames of HIV risk and transmission among transgender people.

The tension between intellectual property laws, free trade agreements and providing affordable treatment was another hot issue brought before the Commissioners and the region’s lawmakers. Issuing compulsory licenses to free up production of generic HIV medication has been a political lightening rod for the Thai government since the turn of the century. A similar scenario is now playing out within free trade agreement negotiations between India and the European Union. If left unchecked this new bilateral agreement could affect millions of people throughout the Asia-Pacific region who depend on cheap generics for treatment of HIV and other diseases.

The Asia-Pacific Regional Dialogue covered several topics relevant to those most affected by HIV in the region: men who have sex with men, transgender people, sex workers, people who use drugs, women, children and young people. As the Dialogue continued it was clear there were more issues that could fit in one session.

Discussions about protecting people living with HIV from discrimination came late in the day. Activists waited patiently for the chance to share their stories that were charged with emotion and frustration. One story from Princey, a single mother in Sri Lanka who faces intense harassment from health workers and fellow villagers on the sole basis of her HIV status. Other stories came from migrant workers of Sri Lanka and the Philippines who discovered their HIV status during mandatory testing required by visa regulations. These workers were swiftly deported, often in harsh conditions and with little support upon arriving home. For some, their ordeal was compounded by breaches in confidentiality and news of their HIV status and sexual orientation were leaked to others without consent. The Commissioners and their legal colleagues were reminded that all people living with HIV are impeded by restrictions on travel and migration by many countries.

Several commentators from the community repeated the adage that “the laws of the street and the laws on the books are two different things” throughout the session’s proceedings. This acute dichotomy is clearly felt for all the groups most-at-risk of HIV in Asia and the Pacific. A handful of countries have successfully passed laws and policies which recognise the rights sexual minorities, sex workers, people who use drugs or people living with HIV, and yet bigotry and intolerance remain unchecked in offices, villages, schools and clinics within the same jurisdictions.

It was fitting that the Regional Dialogue ended with a civil society representative for young key-affected populations who demanded a place for young people in any debate over laws, human rights and HIV. Skand Amata, Program Officer for the Coalition of Asia Pacific Regional Networks on HIV/AIDS’ Youth Lead Project, reminded the Commissioners that the legacy of HIV is being passed on to a generation who was born in the midst of a global epidemic, and many young people in Asia below the age of 25 – particularly MSM, are living with HIV. He said youth does not mean one is except from infection of HIV, nor should they be denied the right to sexual health. Amata said that if progress is to be had in the fight against HIV then young people need to be involved in the process because the future is in their hands.

The Regional Dialogue was hosted by the Global Commission on HIV and the Law, is jointly organised by UNDP and UNAIDS in partnership with the United Nations Economic and Social Commission on Asia and the Pacific (ESCAP).

The next Regional Dialogue for the Global Commission on HIV and the Law is scheduled for the Caribbean in the coming months, with dates for other regions to be announced soon. For further information on the Global Commission on HIV and the Law visit the official website at: A Fact Sheet on the Commission’s Asia-Pacific Dialogue is available for download in PDF format.

Laurindo Garcia is Fridae’s HIV Programs Manager and Manila-based correspondent. All photos courtesy of UNDP Regional Centre, Bangkok.

Related Links
UNDP: Global Commission on HIV and the Law Reviews Legal Barriers Obstructing Progress on AIDS in Asia-Pacific
Punitive and Discriminatory Laws Limit Access to Hiv Prevention And Care Services For Men Having Sex With Men In Asia Pacific
Transgenders Assert Identity At AIDS Meet
NGOs rally against patent law changes: Call on US to stop pressuring Thailand (Bangkok Post)
HIV protesters tell India to defy EU drug demands (AFP)
Asia HIV prevention programmes fail to reach sex workers (Reuters)
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