By September this year, the world will have a new set of sustainable development goals, but can these goals help cut HIV infections – especially among the most marginalised communities?
This year, the world will gain a new set of sustainable development goals, but can these goals help cut HIV infections – especially among the most marginalised communities?
In September, the UN General Assembly will host the 193 member states of the United Nations to agree on the new set of 17 goals and 164 targets, which will take over from the Millennium Development Goals.
In the new set of goals, which will be active until 2030, health is placed under goal three: “ensuring healthy lives and promoting wellbeing for all at all ages”.
In a more specific approach towards HIV and AIDS, clause three of the goal states that by 2030 the UN aims to: “end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases”.
Stigma still entrenched
Optimists say that the Millennium Development Goals made progress in areas such as access to treatment and care, as well as voluntary testing and counselling for people living with HIV. Yet stigma towards those infected with the disease ranks high among the issues that are stalling the fight against HIV and AIDS.
For instance, some communities in developing countries still hold that the disease is caused by witchcraft, while others argue that its spread is due to “moral decay”.
In a recent assignment to Northern Kenya I found that girls who are living with HIV are considered outcasts by their families. It seems this stigma is driven by retrogressive cultural beliefs as well as low civic education regarding HIV and AIDS.
It is widely accepted that religion is expected to bond the society together, even in times of hardships. Yet, in Northern Kenya religion has been used to ostracize the girl child, through accusations they are unchaste if found to be HIV positive.
As a result, girls are fleeing their homes to scratch a living in the rapidly growing urban centres. Oftentimes, the jobs are hard to find. Some end up turning to sex work.
Although I believe progress has been made towards HIV treatment and care through the Millennium Development Goals, as long as stigma remains entrenched in society it will undermine future targets and goals.
Human rights must be respected
While chatting with Hassan Omar, a civic leader from Kenya, he shared with me his dislike for the continued discrimination of minorities like sex workers, men who have sex with men, injecting drug users and transgender.
I agree with the legislator when he insists that public campaigns against stigma and discrimination should be prioritised in a post 2015 scenario, since they have proved to be effective in the past.
That might be possible under goal 16, which censures HIV-related stigma, discrimination and criminalisation. But I doubt whether the targets can be met if there is no goal that specifically addresses HIV and AIDS beyond 2015.
In the latest Universal Periodic Review, a report by Kenya’s Civil Society Coalition identifies stigma and discrimination towards lesbians, gay, bisexual, transgender and intersex as a major issue that prevents them from accessing health services.
Informed by the findings of the report, human rights institutions argue that cutting HIV infections among marginalised people begins with respecting the rights of individuals. This means not using a moral platform as a basis for granting protection.
That is a test that countries like Kenya are still weighing up. The country’s sex workers have petitioned the government to legalise the profession, a call that has won them both friend and foe in equal measure.
Leaders should focus on health
The three UNAIDS sub targets of ‘ending the AIDS epidemic’ are fighting against retrogressive forces such as stigma. The sub targets champion the post 2015 agenda to achieve zero new infections, zero stigma and discrimination, as well as zero AIDS related deaths. I am hopeful that by setting these targets, the UN can challenge legal and social discrimination against sexual minorities.
In the run up to the UN General Assembly in September, it is vital that African leaders maintain a clear focus on protecting the health of their people and not be distracted by unnecessary politics. At the January African Union Summit in Addis Ababa it was disappointing that politics about Africa pulling out of the International Criminal Court carried the main agenda of the meeting.
Our leaders must not lose sight of major health challenges affecting the people they represent. With this in mind, they should lobby for the post-2015 development agenda to include a specific goal on HIV and AIDS.
Read Zeinab’s story about becoming a sex worker and setting up a peer support group