In community consultations in Nigeria, the descriptions of discrimination and violence shared by men who have sex with men and female sex workers were disturbing and extensive. ‘We were beaten up by a bunch of community boys’, ‘at some of our gatherings the police come and harass us’, ‘If I go to the police station, they will say, is she not a prostitute? […] I prefer dying in silence.’
The distressing experiences may differ, but the impact is the same. Those who are most vulnerable to HIV infection stop accessing life-saving treatment or reporting human rights violations due to fear, stigma, discrimination and the possibility they may face prosecution.
Nigeria has the second largest HIV epidemic globally, with an estimated 3.2 million people living with the disease, and particularly high HIV infection rates among key populations. HIV prevalence among adults is 2.9 percent, while HIV prevalence is 14.4 percent among sex workers and 23 percent among gay men and other men who have sex with men. A successful national HIV strategy must respond to the barriers key populations face in accessing HIV services.
This requires improving laws and policies in Nigeria that currently present significant challenges for key populations. Although anti-discrimination laws exist, they may not be comprehensively understood by the public or routinely enforced by the authorities. This perceived lack of legal protection can drive vulnerable people further underground, and away from health services
UNDP welcomes the theme of the upcoming 22nd International AIDS Conference: ‘Breaking Barriers, Building Bridges’. Putting human rights centre stage by drawing attention to the need for evidence and rights-based laws and policies is critical.
But progress needs more than just words. It requires direct action to address the laws and policies undermining public health efforts, and a partnership approach that engages key populations, government, legal and healthcare professionals.
The Nigerian government, supported by Enda Santé and UNDP, has developed the National Plan of Action for the removal of legal and human rights barriers in the HIV/AIDS response. Founded on the experiences of key populations, it draws on the collective wisdom of policy makers, health care providers, civil society organizations and development partners.
Gender equity and human rights are integrated into the National HIV and AIDS Strategic Framework and Plan, meaning these important issues can no longer be overlooked. Nigerian law enforcement officers, healthcare workers, lawyers, judges and parliamentarians have been sensitized on removing legal and human rights barriers to HIV services. Civil society organizations have received financial support to document human rights violations and train community-based groups on their rights, to facilitate access to justice for key populations and to enforce their rights.
More remains to be done, and the Nigeria national HIV plan sets ambitious targets, as it must, if we are serious about ending AIDS by 2030. To achieve these targets, human rights must take centre stage of HIV responses once and for all.
About the author
Deena Patel is a programme manager in the HIV, Health and Development Group at the United Nations Development Programme Regional Service Centre for Africa. Follow her on Twitter: @deenapatel1234
Together with the Global Fund, UNDP is working with 10 African countries and four leading African civil society organizations – the AIDS and Rights Alliance for Southern Africa, ENDA Santé, KELIN and the Southern Africa Litigation Centre – to support human rights programmes for HIV. The programme aims to remove legal and policy barriers by providing documentation of human rights violations, advocacy support, strategic litigation and capacity strengthening for key stakeholders.