On behalf of the International AIDS Society (IAS), we, the IAS Governing Council Africa Regional Representatives, express our grave concern regarding the reported anti-gay initiative underway in Tanzania.
On 31 October 2018, the Regional Commissioner for the capital city, Dar es Salaam, Paul Makonda, announced the creation of a task force to identify and arrest people suspected of being gay and he appealed to the public to identify and report them. This follows a broader pattern of arrests and state-sponsored harassment of LGBT Tanzanians that includes the forced closure of HIV clinics accused of promoting homosexuality. In the wake of this announcement, 10 people were unjustly arrested in Zanzibar on spurious charges.
These actions are contrary to Tanzania’s stated commitment to end the AIDS epidemic by 2030. In its National Guideline for Comprehensive Package of HIV Interventions for Key Populations from 2014, the government declares: “To ensure an effective and sustainable response to HIV there is a need to reach out to KPs (key populations) with a comprehensive package of prevention, treatment, care, support interventions and other public health services.” It goes on to acknowledge: “Public discussion of MSM elicits strong reactions of fear, hatred and disgust. MSM and transgender people have remained largely invisible to many of the ongoing interventions for HIV prevention, treatment and care.”
Key populations are particularly at risk of HIV infection. While national prevalence among adults in Tanzania is 4.5%, 17.6% of the country’s men who have sex with men are living with HIV.
Homophobia, “the irrational hatred, intolerance, and fear” of LGBT people, has been identified as a major barrier to ending AIDS according to the World Health Organization. Institutionalized discrimination, such as the public scapegoating now occurring in Tanzania, drives many people away from the services that can save their lives. The climate of fear created by such stigmatizing official actions undermines the ability of HIV programmes to reach those in greatest need. Barring vulnerable communities from specialized services that play a critical role in linking them to essential HIV services leaves them with few options for accessing lifesaving and medications and information.
We know from experience that Tanzania has the means to translate international public health recommendations into concrete actions and results. The country has made some important gains in its response to HIV, with new infections dropping by 22% from 2010 to 2016 and AIDS-related deaths dropping by 54%. Indeed, its national guidelines – based on the principle that “services and programmes implemented are non-stigmatizing, non-discriminatory, accessible, acceptable, affordable and equitable for all” and that “the legal, policy, and social environment [should] allow access by KP to available health services” – exemplify this capacity. The epidemic among key populations including gay men and other men who have sex with men, however, continues unabated.
Now is the time for Tanzania’s government to take seriously its human rights-related responsibilities as stewards of the public health. As colleagues in the global HIV response, we call on Tanzania to end this initiative that threatens to hobble the national HIV response at a moment of such promise. We plead that our colleagues in Tanzania heed their own government’s advice – stated so clearly in its national guidelines – and commit to providing equitable, unobstructed access to high-quality, non-stigmatizing prevention, treatment and care services to all communities, including gay and other men who have sex with men.
Signed
IAS Governing Council Africa Regional Representatives
Serge Paul Eholié
Unit of Infectious and Tropical Diseases
BPV3, Treichville
University Teaching Hospital
Abidjan
Côte d’Ivoire
Keletso Makofane
TH Chan School of Public Health
Harvard University
677 Huntington Ave
Boston, MA 02115
USA
James G. Hakim
Department of Medicine
University of Zimbabwe
PO Box A178
Avondale
Harare
Zimbabwe
Kenneth Ngure
School of Public Health,
Jomo Kenyatta University of Agriculture and Technology
PO Box 62000-00200 Nairobi
Kenya