This year on World AIDS Day 2018, it is important to acknowledge the positive changes that we are seeing in the Asia-Pacific region regarding the legal and policy environment for HIV, and to continue to push ahead for further reforms so that we can achieve our goals of once and for all ending HIV.
In South Asia in particular there have been a number of recent encouraging developments. On 6 September, in a historic ruling, the Indian Supreme Court struck down a key component of Section 377 of the Indian Penal Code, decriminalizing consensual same-sex adult sex. In May, Pakistan enacted the Transgender Persons (Protection of Rights) Act, which explicitly provides for legal gender recognition based on self-identification. In Nepal, the 2015 Constitution included protections for sexual minorities, including third gender recognition. Transgender people in Bangladesh and India are also now able to have their preferred gender on identity documents.
These reforms not only help to ensure more inclusive societies but will contribute to breaking down social and legal barriers that will improve the health outcomes of some of the most vulnerable and marginalized groups in society.
As the UN Development Programme (UNDP) administrator Achim Steiner so succinctly put it: “Equality, inclusion, and non-discrimination are at the heart of the 2030 Agenda for Sustainable Development. Laws and policies that protect rather than punish, combined with programmes that reduce stigma and discrimination, exist and need to be scaled up if we are to achieve our goal of ending the AIDS epidemic by 2030.”
We are seeing that legal and policy reform is possible.
Laws that criminalize HIV, same-sex behaviour, sex work, and drug use often have the unintended side effect of blocking access to HIV services for vulnerable ‘key populations’ – namely men who have sex with men, transgender people, people who use drugs and sex workers, and their partners.
These laws contribute to social exclusion, persistent poverty, and poor health outcomes, including elevated HIV risk.
While there has been overall strong progress in responding to HIV in Asia and the Pacific – with significant reductions in HIV infections between 2010 and 2017 across most of the region – we continue to see some worrying data. According to the latest UNAIDS figures, 84% of new HIV infections in 2017 were among members of key populations groups or their partners. And since 2010, the Philippines and Pakistan have seen new infections among young people (aged 15-24 years) increase by 170% and 29%, respectively.
These figures clearly show there is no time to be complacent.
Through our work at UNDP, we are committed to promoting a human rights-based approach to HIV prevention, treatment, care and support, together with an enabling legal environment to protect rights.
Across the region, we are working closely with civil society, governments and development partners, such as WHO, UNAIDS and the Global Fund. Efforts are now ongoing in several countries, including the Cook Islands, Malaysia, Pakistan, Viet Nam, amongst others, to review existing laws and policies, as well as propose new legislation to address barriers to services for people who need them most.
Research to build an evidence base for advocacy continues as well. Recently, UNDP and the Asia Pacific Transgender Network released a comprehensive review of existing laws, policies and practices related to legal gender recognition for transgender people in Bangladesh, China, India, Nepal, Pakistan, Philippines and Thailand. UNDP also partnered with International Center for Research on Women (ICRW) and APCOM Foundation on a report exploring the links between violence, mental health and HIV risk among men who have sex with men and transwomen in South Asia. Building on its 2012 report, the Global Commission on HIV and the Law also released a supplement highlighting the developments since 2012 in science, technology, law, geopolitics and funding affecting the global AIDS response.
This World AIDS Day, it is essential to recognize the need to ensure that human rights are protected, health disparities addressed and laws, policies and practices that impede the AIDS response are overturned. This is imperative if the inclusive mission of the Sustainable Development Goals to “leave no one behind” is to be achieved.
About the Author
Kathryn Johnson is a human rights and gender specialist in HIV, Health and Development at UNDP Bangkok Regional Hub. She is overseeing the Unified Budget, Results and Accountability Framework (UBRAF) portfolio, which is UNAIDS’ instrument to maximize the coherence, coordination, and impact of the UN’s response to AIDS by combining the efforts of the UN Cosponsors and UNAIDS Secretariat.