Response to the Ugandan Anti-Homosexuality Act 2023
The Harvard Global Health Institute (HGHI) calls for a repeal of the Ugandan Anti-Homosexuality Act 2023. The Act is a violation of universal human rights and a threat to the health of its citizens, particularly the LGBTQIA+ community. While the Ugandan government has passed anti-LGBTQIA+ legislation over the past several decades, this bill is the most egregious and among the harshest anti-LGBTQIA+ laws in the world. HGHI firmly stands for equal rights and protections for all individuals, and for inclusive policies that foster a healthy environment for LGBTQIA+ individuals, and all individuals across the globe.
The Act fosters a climate of marginalization and punishment that will have far-reaching consequences for health. Stigma and discrimination of sexual minorities are associated with a higher likelihood of HIV infection and can lead to the avoidance of HIV testing and care (Gautier Ndione et al., 2022) (Levy et al., 2014) (Beyrer, 2014) (Mbeda et al., 2021) (Hladik et al., 2012). These challenges are likely to be exacerbated by the Act’s impact on health care providers, who may suspend important health-related work with sexual minorities out of fear for their own safety, as was observed in Senegal following the criminalization of same sex practices (Poteat et al., 2011). The Act calls for life imprisonment for same-sex behavior among adults, introduces the death penalty for what is referred to as “aggravated homosexuality,” and renders activities that “promote homosexuality,” punishable by up to two decades in prison. In these ways, despite decades of progress on HIV testing, treatment, and prevention in Uganda, the Anti-Homosexuality Act poses a risk of undoing these advancements and further marginalizing the health needs of the community.
In addition, the enactment of this legislation jeopardizes the integrity of healthcare systems that benefit all Ugandans. In a joint statement by the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund), the Joint United Nations Programme on HIV/AIDS (UNAIDS), and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), these global actors attribute the successful fight against HIV/AIDS in Uganda to the implementation of comprehensive healthcare programs that prioritize access for all individuals, without stigma or discrimination. With the passage of this legislation, not only will LGBTQIA+ individuals who depend on the program’s preventive, diagnostic, and therapeutic services be discouraged from seeking vital health services, but the entire population of Uganda, who have benefited from these robust healthcare systems during public health crises (Chamie et al., 2012) (Collins et al., 2023), will also bear the consequences of weakened healthcare systems. As seen during the COVID-19 pandemic, this infrastructure critically supported Uganda’s timely, efficient response by lending the laboratory network developed by PEPFAR for HIV and TB diagnostics to COVID-19 testing, amongst other forms of support (Walensky, 2022).
For Uganda’s LGBTQIA+ community, the weeks and months preceding the passing of this Act had already escalated apprehension surrounding engagement with the healthcare system. The threat of punishment may further prevent LGBTQIA+ individuals from openly discussing their health concerns and seeking necessary medical services (King et al., 2020). This will have dire consequences for well-being and contribute to the persistence of health disparities within the LGBTQIA+ community. These challenges are further intensified by other forms of structural violence, including biased attacks, housing insecurity, and social exclusion, which greatly impact both physical and mental health (AP News, 2023) (Human Rights Watch, 2023) (Amnesty International, 2014).
We call for a repeal of the Act. We encourage support for local organizations in Uganda advocating on behalf of gender and sexual minorities and in opposition to this legislation, including: