Latest news with #SexualHealthwithEquity&Rights
Scoop
7 days ago
- Health
- Scoop
Prevention Revolution And Policy Harmonisation Are Critical To End AIDS
SHOBHA SHUKLA – CNS Despite having science-based tools for HIV combination prevention, there were 1.3 million people who A collage of people with text AI-generated content may be newly diagnosed with HIV in 2023 - and also in 2024 - hardly any decline between the two years. Despite having science-backed lifesaving antiretroviral therapy to help every person living with HIV healthy and well (and virally suppressed - which also ensures there is zero risk of HIV transmission because treatment works as prevention), 630,000 people died of AIDS-related illnesses in 2023 - and also in 2024 - hardly any decline between the two years. We clearly need a prevention revolution to drastically bring down new HIV infections as well as a lot more needs to be done to reduce AIDS-related deaths. 'Business as usual' is clearly not an option. In sub-Saharan Africa, one in four (~25%) of new HIV infections occur among key populations, but in Asia Pacific region, four in five (79%) of new HIV infections occur among key populations (such as men who have sex with men, sex workers, transgender people, persons who inject drugs, among others). In 2024 alone, there were an estimated 800,000 new HIV infections in sub-Saharan Africa, and women and girls accounted for 63% of them. Adolescent girls and young women aged 15-24 are more than twice as likely to acquire HIV as their male peers. These numbers remind us that HIV remains a public health crisis. But HIV is not just a medical or health issue—it is deeply intertwined with social, economic, and legal factors. To truly end HIV as a public health threat, we must look beyond the virus itself and address the broader context in which it thrives," said Letlhogonolo Mokgoroane, Legal Representative and Head of Strategic Litigation and Research, OurEquity, South Africa; member of Johannesburg Society of Advocates. "Sexual and reproductive health, rights and justice (SRHRJ) is about more than access to contraception or maternal care. It is about the right of every individual to make informed decisions about their bodies, free from violence, coercion, or discrimination. When people - especially women and girls - are denied these rights, they become more vulnerable to HIV and other health risks. For example, only 40% of young women in sub-Saharan Africa have comprehensive knowledge about HIV prevention. In some countries, less than 50% of women have access to modern contraception. Gender-based violence remains alarmingly prevalent: in South Africa, a woman is killed every three hours, and one in three women has experienced intimate partner violence," said Letlhognolo. Letlhogonolo was speaking in SHE & Rights (Sexual Health with Equity & Rights) session co-hosted by Global Center for Health Diplomacy and Inclusion (CeHDI), International Conference on Family Planning (ICFP 2025), Family Planning News Network (FPNN), International Planned Parenthood Federation (IPPF), Asian-Pacific Resource and Research Centre for Women (ARROW), Women's Global Network for Reproductive Rights (WGNRR), Asia Pacific Media Alliance for Health and Development (APCAT Media) and CNS. Survivors of violence are at a 50% higher risk of acquiring HIV "Criminalisation of same-sex relationships and sex work drives key populations underground, away from essential health services. In 31 African countries, same-sex relationships are still criminalised, making it difficult for LGBTQIA+ individuals to access HIV prevention and care. Sex workers, who are 13 times more likely to be living with HIV than the general population, often face harassment and violence, further increasing their vulnerability. Justice is central to this conversation. Laws and policies that discriminate against people living with HIV, LGBTQIA+ individuals, sex workers, and other marginalised groups, not only violate human rights but also fuel the epidemic," said Letlhogonolo. "For example, in Nigeria, the Same Sex Marriage (Prohibition) Act has led to a 41% decrease in access to HIV services among men who have sex with men. Justice means ensuring that everyone—regardless of who they are or whom they love—can access the information, services, and support they need to live healthy, fulfilling lives," added Letlhogonolo. If HIV funding is not fully restored, new infections and AIDS deaths can increase alarmingly "Recent global funding cuts could send the world back to levels of HIV infections and AIDS-related deaths not seen since the early 2000s. Next 5-years projection show that new HIV infections and AIDS-related deaths globally can dangerously rise if the lost funding (both this year and in recent years) does not return. Many countries have reduced their investments and domestic funding is often inadequate to fully fund the AIDS response – which has been relying on external support," said Eamonn Murphy, UNAIDS Regional Director for Asia Pacific, and Central Asia and Eastern Europe. 'Nine countries in Asia and the Pacific region have rising new HIV infection rates. 9 countries in the region have too low coverage of lifesaving antiretroviral treatments. Moreover, the region has been hit with funding crisis – and – overall HIV prevention crisis too. Between 2010 to 2024, there were 9 countries in Asia Pacific which reported an increase in newly diagnosed people with HIV. Fiji has the world's fastest growing epidemic, new HIV infections increased by over 3091% in Fiji,' said Murphy. 'Along with Fiji, other countries in Asia Pacific where there was an upswing in the number of people newly diagnosed with HIV between 2010-2024 are: 562% rise in Philippines; 187% rise in Afghanistan; 84% rise in Papua New Guinea; 67% rise in Bhutan; 48% rise in Sri Lanka; 42% rise in Timor-Leste; 33% rise in Bangladesh; and 16% rise in Lao PDR. Between 2010-2024, there were 9 countries in Asia Pacific which are also treating less than half of the people living with HIV, such as Afghanistan (11%), Pakistan (16%), Fiji (24%), Philippines (40%), Bangladesh (41%), Indonesia (41%), Mongolia (41%), PNG (46%), and Maldives (48%),' said Murphy of UNAIDS. Between 2010-2024, there were 9 countries in Asia Pacific which are also treating less than half of the people living with HIV, such as Afghanistan (11%), Pakistan (16%), Fiji (24%), Philippines (40%), Bangladesh (41%), Indonesia (41%), Mongolia (41%), PNG (46%), and Maldives (48%). 'Compared to the decline in the number of people newly diagnosed with HIV between 2010-2024 worldwide (40%), the decline in Asia Pacific is far behind (17%),' said Eamonn of UNAIDS. In Eastern and Southern Africa, new HIV infections declined by 57% during the same period. Pam Ntshekula calls for rights and safety of sex workers "Our mission is clear: sex workers deserve dignity, protection, and full recognition of their human rights. We are calling for the full decriminalisation of sex work because sex workers deserve to work in safe, free, and dignified spaces. Right now, criminalisation puts sex workers at risk - it makes them more vulnerable to violence, police abuse, stigma, and poor health access. Decriminalisation would mean sex workers can report crimes without fear, access healthcare without judgment, and work without hiding. It is not just a legal issue —it is about human rights, health, and safety. Every sex worker deserves to be protected, respected, and free to choose how they live and work," said Pam Ntshekula is a dedicated advocate for the rights and safety of sex workers and Lobbyist Officer, Sex Workers Education and Advocacy Taskforce (SWEAT), South Africa. "Many sex workers avoid clinics due to stigma and mistreatment. Full decriminalisation ensures safe, respectful access to SRHR services. Criminalisation limits condom use, outreach, and health education. Decriminalisation creates safer environments for prevention and care. Constant fear of arrest, violence, and shame harms mental wellness. SDG3 includes mental health - sex workers deserve safety and peace of mind," Pam added. "Sex workers face high levels of rape, assault, and abuse - often from police or clients. Decriminalisation allows them to report violence and access justice. Gender equality means protecting all genders and identities. My message is: There is no health without rights. There is no equality without decriminalisation. Decriminalising sex work is the single most powerful move to remove legal barriers to health access, justice, and human dignity. It also lets peer educators and health organisations do their work without fear," said Pam. "We also need to tackle poverty and unemployment by linking sex workers to job training, housing support, and social grants if they choose to exit. Empowerment means choices, not pressure." SDG goals and targets are not standalone but interconnected "Each of SDG goals and targets are interconnected. For example, studies show that countries with higher gender equality have lower rates of HIV infection among women. In Botswana, legal reforms to protect women's property rights have led to increased economic independence and better health outcomes. We cannot achieve health without justice. We cannot achieve justice without upholding rights. And we cannot uphold rights without addressing the root causes of inequality and exclusion," said Letlhogonolo. "It means we must break down silos. HIV programmes cannot operate in isolation from broader sexual and reproductive health services. Legal reforms must go hand in hand with public health initiatives. We must listen to and empower those most affected—young people, women, LGBTQIA+ communities, and people living with HIV—to lead the way," they added. "It means investing in education, not just about HIV, but about consent, healthy relationships, and bodily autonomy. In Uganda, the DREAMS initiative, which combines HIV prevention with education and economic empowerment for adolescent girls, has reduced new HIV infections among participants by 25%. Supporting community-based organisations is crucial: in Kenya, peer-led outreach among sex workers has doubled the uptake of HIV testing and treatment. It means holding governments accountable for their commitments to human rights and the SDGs," stressed Letlhogonolo. "In 2023, out of 54 African countries, only 16 African countries had fully funded their national HIV responses. We must advocate for increased domestic investment and international solidarity. And it means recognising that justice is not just a legal concept—it is a lived reality. When a young woman can access contraception without fear, when a gay man can seek HIV testing without shame, when a sex worker can report violence without risking arrest, we are moving closer to justice," rightly said Letlhogonolo. "Essential health services must include sexual and reproductive health services - including safe abortion and post-abortion care, menstrual health hygiene, and mental health services, with particular attention to women, adolescent girls, persons with disability, indigenous peoples, gender diverse communities, older people, young people, migrant workers, refugees, people living with HIV, sex workers, people who use drugs, among others. They must also include all health and social support services for survivors of sexual and gender-based violence," said Shobha Shukla, Lead Discussant for SDG-3 at the United Nations High Level Political Forum 2025 (HLPF 2025) in New York. "We have to ensure that health responses are people-centred, gender transformative and rights-based for all, without any condition or exclusion." She rightly called upon the government leaders who had assembled at the UN: "With less than 5 and a half years left to deliver on SDG3, we appeal to governments to step up their actions on gender equality and right to health - where no one is left behind." Shobha Shukla – CNS (Citizen News Service) (Shobha Shukla is a feminist, health and development justice advocate, and an award-winning founding Managing Editor and Executive Director of CNS (Citizen News Service). She was also the Lead Discussant for SDG-3 at United Nations High Level Political Forum (HLPF 2025). She is a former senior Physics faculty of prestigious Loreto Convent College; current President of Asia Pacific Regional Media Alliance for Health and Development (APCAT Media); Chairperson of Global AMR Media Alliance (GAMA received AMR One Health Emerging Leaders and Outstanding Talents Award 2024); and coordinator of SHE & Rights (Sexual Health with Equity & Rights). Follow her on Twitter/X @shobha1shukla or read her writings here
Scoop
13-05-2025
- Health
- Scoop
During Conflicts And Humanitarian Crises, Women And Gender Diverse Persons Face More Brunt Of Gender-based Injustices
With 78th World Health Assembly of the UN health agency, the World Health Organization (WHO) being held later in May 2025, The Lancet Commission on Gender and Global Health has launched an important multi-disciplinary report that shows how gender and health nexus can be better understood and addressed to serve equity and social justice goals. Dr Ravi Verma who is one of the Commissioners of The Lancet Commission on Gender and Global Health and Executive Director, International Centre for Research on Women (ICRW), Asia, said that 'To understand why gender presents such challenges for the global health sector The Lancet Commission reviewed massive amount of literature - social, political, legal and economic literature to find and assess how some of these forces are at work in the gender domain and how intertwined are the issues of capitalism, imperialism and capitalism in their effects on people's health and well-being. We see this humanitarian crisis emerging out of all this history of colonisation, imperialism and capitalism which has been brought out so lucidly.' He was speaking in SHE & Rights (Sexual Health with Equity & Rights) session which is hosted by Global Center for Health Diplomacy and Inclusion (CeHDI) and CNS with IPPF, ARROW, APCAT Media and WGNRR. 'Bringing gender justice in health policies and programmes and practices is important. The report has highlighted how in various countries if programmes have promoted gender equality, they have had much better and wider positive outcomes than just about dealing with the illnesses,' said Dr Verma. Ground realities of gender diverse peoples in Afghanistan Parwen Hussaini of Afghanistan is at risk of her life along with her lesbian lover Maryam (Maryam is under arrest). Parwen serves as a Programme Associate at Roshaniya, a LGBTQI+ rights group in Afghanistan. Parwen was born in Gazhni province of Afghanistan and identifies as a lesbian and Afghan. She narrowly escaped persecution and arrest by the Taliban on 20th March 2025 and she is now in Iran. 'I have endured hardships my whole life until this point. Since the current Taliban regime has come to power, we basically had no options, we have no hope; there is nothing to live for gender diverse people. The situation for Afghan women is deplorable. They cannot leave their house for work or for any other reason,' said Parwen. 'We had no rights, we were criminalized then and we are criminalized now. The only difference is that back then there was some space and some room for us.' Parwen and her lover were engaged to get married when they tried to escape. Her lover (Maryam) is being tortured and imprisoned by the Taliban and in prison for over one and a half months (as on 10 May 2025). They are devastated since that day on 20th March 2025 when Parwen, Maryam and Maeve (a transgender person) tried to come to Iran. But on that day, everything backfired because the Taliban apprehended and detained Maryam and Maeve and they have been in captivity since then. Luckily Parwen was able to get through the airport security. Parwen was lucky that her brother agreed to sign off as a male chaperone to give permission so that she can reach the airport and get on board. But Mariam was not able to get a male relative chaperone because her family refused, and got arrested. After several failed attempts, she eventually got support from 'Roshaniya' group, which reached out to Amnesty International, Human Rights Watch, UN special Rapporteur in Afghanistan and others but no relief came through. However, Peter Tatchel Foundation UK stepped forward to support them. Right now, Parwen faces an uncertain future in Iran because if her visa expires, they will deport her back to Afghanistan and if that happens, she will be imprisoned and tortured and possibly face a death penalty. Gender justice is a fundamental human right and it is critical to advance progress towards all sustainable development goals. Nemat Sadat, CEO of 'Roshaniya' (an advocacy network dedicated to assisting LGBTQI+ Afghans) and one of the first Afghans to have openly come out as gay and to campaign for LGBTQI+ rights, gender freedom and liberty, said: 'We have a list of over 1,000 LGBTQI+ peoples who still remain in Afghanistan. To this date, we have supported the safe evacuation of 265 people to different countries and we hope that Parwen will also get to a safe place. Right now, her future looks very uncertain because it is very difficult for someone to leave Iran to go to another country as Iran is under sanctions. There are 7 million Afghans in Iran and many of them are trying to secure humanitarian visa to go to a western country. So, it could take years and Parwen does not have that kind of a time frame.' South Sudan conflict and women and other marginalised persons 'The ongoing conflict in South Sudan has disempowered a lot of excluded and marginalised peoples including women, LGBTQI+, people living with HIV, persons with disabilities, sex workers, among others. So, when it comes to gender justice the issue of gender-based violence becomes central. There is physical violence, domestic violence, and sexual harassment and sexual abuse. They are raping women rampantly. Due to the conflict there is also increased risk for the displacement of women and girls in South Sudan (which puts them at greater risk of violence). There is also limited access to justice and support for young women, women with disability, and people with HIV because of their condition,' said Rachel Adau, Executive Director of the Women's Empowerment Centre South Sudan. 'Our healthcare system is breaking down and affecting reproductive health of young women and girls. The maternal and child healthcare is at its worse because the health facility itself has no services to offer. We advocate for pregnant women to go to the hospital to deliver, but the health facilities have no gloves, no beds, no midwives, and other essential supplies. So, they cannot deliver their child safely. This discourages women from going to the health facilities, which again is very risky for their lives,' added Rachel. Lebanon, women, gender diverse and other marginalised persons 'Since the Gaza war, 4000 people in Lebanon have been killed and 1.3 million have been displaced mainly from the areas that were affected by the war - that is South Lebanon. The war has caused an estimated US$ 11 billion in damage and 9% decline in the Lebanon's GDP. Hospitals and healthcare facilities were bombed, and the local organisations played the main role in providing shelter, food, medical and even mental health support. However, it is the vulnerable and marginalized groups - mainly the LGBTQI+ individuals, refugees, people living with HIV, people with disabilities, elderly and others that are paying the price more than anyone else in society,' said Bertho Makso, Regional Community Engagement & Networks Lead at the International Planned Parenthood Federation at its Arab World Regional Office. Across the Global South we face a lot of humanitarian crises: Why? 'Across the Global South, we continue to face a lot of humanitarian crises. We face floods, hunger, war, conflicts, and women and girls continue to be the most affected, the most at risk, and more importantly the LGBTQI+ community are most at risk and most affected. When we think about all the inequities then it is them that suffer the most. We see alarming gender-based violence, disrupted access to essential services like education and health care, and we also have heightened risk of women and girls facing sexual exploitation, early marriage and displacement,' said Nelly Munyasia, Executive Director, Reproductive Health Network of Kenya. Kenya's Constitutional Promise on gender equality threatened by regressive GCD 'Kenya has not only signed the regressive Geneva Consensus Declaration, but this month Kenya would be hosting the so-called 'family values conference'. This is more problematic because this creates an environment for the anti-rights movement to penetrate deeper into policy spaces in Kenya. We continue to call out collectively and speak against this regressive group of individuals who purport to be ensuring that they are restoring African 'values', but what they are trying to preach is not African when they talk about killing of the LGBTQI+ community and when they spread hatred,' said Nelly Munyasia. 'Kenya as a country does recognize the intersex persons. We are focusing on ensuring that we implement the constitution, we hold the government accountable and support the government too, to deal with the anti-rights groups that are well funded and well-coordinated. But we are not going to be gagged, we are not going to stop, and we are going to ensure that everyone enjoys their rights not only in Kenya but Africa as a whole.' Gender inequality is in itself a perpetual humanitarian crisis which girls and women and gender diverse peoples have been facing on an ongoing daily basis historically 'Perhaps there may not be a single girl or woman or gender diverse person on this planet who can say that he or she or they have never ever faced any type of violence or abuse or threat. The threat and danger of sexual and other forms of gender-based violence haunts so many of us every moment - sometimes even inside our homes. Wars and conflicts, extreme climate events, religious bigotry, or other forms of humanitarian crises exacerbate gender inequality and violations of human rights manifold,' said Shobha Shukla, Coordinator, SHE & Rights (Sexual Health with Equity & Rights) initiative and Executive Director, CNS. To quote The Lancet Commission on Gender and Global Health report, 'We are in 'the fight of our lives' against the anti-gender rhetoric and a rollback of gender rights. Now is a crucial moment in time to turn the tide on the rise of anti-gender rhetoric and to increase understanding of the importance of gender in public health'. 'Arriving at gender justice in global health is not a technical exercise- this is an exercise in understanding people's lives, their history, the politics, the economy, their culture and their local relations and context. This means we must identify those spaces where power and privileges are exercised inequitably and find some ways to disrupt that. The report calls for disrupting those spaces where the power dynamics are being played out and people are taking that for granted. That means it requires a lot of tactics and strategies at multiple levels,' said Dr Ravi Verma, one of the Commissioners (and authors) of The Lancet Commission report. Let us work together and support each other for a feminist and gender just inclusive world order where everyone has equal rights, equal dignity and equal access and control of resources, irrespective of their caste, creed or gender identity. Gender inequality and toxic masculinity must end with us.
