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World Bank must boost fight for gay rights

Leaders should fund progress, not discrimination

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Jim Yong Kim, World Bank Group, gay news, Washington Blade
Jim Yong Kim, World Bank Group, gay news, Washington Blade

World Bank Group President Jim Yong Kim (Photo by MONUSCO/John Bompengo)

The World Bank blocked a $90 million loan to Uganda last year because of its anti-LGBT laws, the first time it has explicitly linked a loan to the rights of sexual minorities. Has this had an impact? In a recent BuzzFeed interview, World Bank President Jim Yong Kim implied that it has — it seems to have slowed the passage of anti-gay laws in other countries. “Everyone knows now that I will do this and so everyone is watching very carefully,” Kim told the site.

That may be true. But the fact is that the Bank, and other international organizations, could still do a lot more to help LGBT individuals who are being criminalized and sometimes killed in their own countries, and the time to start doing that is now.

In 2014, when the Bank withheld the loan from Uganda, it did so because the country planned to deny gay men and men who have sex with men access to hospital HIV services provided by through Bank funding. This policy is rooted in the Anti-Homosexuality Law in Uganda, but the Bank did not say a word against it while it was being drafted even as the United Nations, UNAIDS and other institutions were warning Kampala to not pass the measure. Amid rising pressure from civil society groups the Bank finally moved to block the funding. But these people who risked their lives to protect human rights were not even acknowledged by President Kim in his interview.

Uganda is not the only country seeking to criminalize LGBT individuals, yet the Bank has remained largely silent as country after country moves to restrict gay rights or vilify gay people. Where has the Bank been when The Gambia, a country ruled by Yahah Jammeh, one of the most notorious modern day autocratic leaders, passed its anti-gay law and began the current practice of hunting LGBT individuals? Why is it silent when Democratic Republic of Congo proposed a bill similar to that of Uganda, and what does the Bank have to say now when lawmakers in Kenya, a country seen as one of the most liberal in Africa, are discussing presenting a similar bill to its legislature? Where is it on Cameroon, which has been in the news with increasing attacks on LGBT people?

All of these moves against the LGBT community have come since Uganda passed its anti-gay law. And yet the World Bank has remained silent.

The Bank may hope to avoid taking public political stances and stick to the work of infrastructure projects, but that work is not happening in isolation. In perhaps the starkest case, Nigeria passed an anti-gay law similar to Uganda’s and yet Bank projects are still funded there, including an HIV surveillance initiative, which is a direct threat to the safety of gay people. This program collects data on how many people are living with HIV, and in order to participate people have to state their sexual orientation. In Nigeria, being openly gay is illegal so either people jeopardize their safety by participating or they do not take part, limiting the impact of the Bank’s program.

The Bank is already under fire following a new report that says some 3.4 million people have been physically or economically displaced by various World Bank-funded projects over the last 10 years, violating its own pledge to protect the poor.

Kim has talked about a proposal for updated “safeguards” for human rights that is being drafted to guide the Bank’s lending policies. But the safeguards will still be rooted in the local laws of each country. So, in the case of Nigeria, the Bank has put itself in a very difficult position because it will still be dealing with a domestic legal framework that justifies criminalization of homosexuality. So there is clearly more work to go on crafting the protocol so that the Bank does not simply put its stamp of approval on local laws that facilitate discrimination.

I am not completely dismissing the efforts of the World Bank and I think what Kim did in Uganda was important. I am asking the Bank to be consistent in its policies and to treat all countries the same and to pull funding for projects that similarly exclude LGBT individuals.

Further, I am not dismissing the hard work of President Kim to restructure the World Bank and I commend him for creating a Sexual Orientation and Gender Identity Advisory Group on which I serve.

But the fact is the Bank, and other major international organizations, could do a lot more to help the activists across the world who are paying with their lives to make their countries a better place to live and to the LGBT individuals whose lives are in jeopardy every day because of the restrictive laws. The Bank should be funding progress, not discrimination.

 

Adebisi Alimi is an LGBT advocate, an HIV activist, and the first person to come out as gay on Nigerian television. He is a 2014 Aspen New Voices Fellow at the Aspen Institute.

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Speaker Kevin McUseless calls for Biden impeachment inquiry

Stunt will backfire on Republicans in 2024

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House Speaker Kevin McCarthy (Washington Blade file photo by Michael Key)

Congress has joined the world of the insane with Republicans calling to impeach any Democrat they disagree with. It is happening in Wisconsin to the new Supreme Court justice, and now lily-livered Kevin McUseless, facing threats from his MAGA members, announced an impeachment inquiry of President Biden.  

He could name no reason, and in fact during the nine months of Republicans investigating Biden, they have found none. Two weeks ago, he said he wouldn’t do this without a vote of the House, but moderate Republicans rightly figure this will all backfire on them, so wouldn’t agree to vote for it. Meanwhile the country is waiting for House Republicans to do their job and pass a budget, which they are unable to do. The result could close the government again. That will also backfire on them, as it will hurt so many people. 

So, what better time for Democrats, thinking independents, and any sane Republican left, those willing to put the country above their own party, and in the case of Liz Cheney (R-Wyo.) and Adam Kinzinger (R-Ill.), even their own reelections, to just vote all these Republican clowns out of office? 

Oversight and Accountability Committee Chair James Comer (R-Ky.), who will lead the inquiry on Biden, has for the nine previous months come up with zilch — nothing meriting impeachment or even further investigation. The IRS whistleblowers’ testimony he touted was contradicted by the FBI in sworn testimony. But then it isn’t Comer asking for this impeachment inquiry, it is Marjorie Taylor Greene and Matt Gaetz, and the MAGAs holding McUseless hostage. Those two should be arrested for criminal behavior, charged with being an embarrassment to the country. They are joined by the likes of Lauren Boebert (R-Colo.), recently thrown out of a Denver theater for groping her boyfriend, vaping, taking pictures, and recording a show, Beetlejuice. This is today’s Republican Party. 

Clearly, most elected Republicans are not willing to stand up to these jokers; all afraid of the Trump cult, aka the Republican Party. They are being threatened with a primary by Trump if they do. They would lose the primary, part of the reason Sen. Mitt Romney (R-Utah) just announced he would not run again. The Trump cult controls roughly 35% of the party and you can’t win without them. But Trump-supported primary winners have shown they lose general elections. 

I am more confident than some in a Trump/Biden replay, Biden will win by 10 million votes this time, but not get one more electoral vote. It will again be about seven or eight states. If Republicans go ahead with this impeachment Democrats will win in 2024.

As to Hunter Biden, he should be punished for anything he did wrong, like any private citizen; whether it is not paying his taxes or lying on a gun permit application. President Biden should stop inviting Hunter to the White House, and curtail his public embrace of his son. It hasn’t helped his son, and is clearly not helping his own campaign, or for that matter any other Democrat. What he does in private is his business. The president has two homes, one in Wilmington, and one in Rehoboth Beach, where he can meet with, and entertain his son. I think the president owes that to the people he is asking to support him. He owes it to the party to not put himself in positions his opponents can take advantage of. 

Joe Biden has been a public servant since he was 28 years old, starting on the New Castle County Council, in Delaware, in 1970. He ran and won his Senate seat in 1972. He has never been accused of any impropriety until the Republicans decided they could make unfounded accusations for political gain. He has shown himself a decent and honest man. A man with empathy for those less fortunate; and a president with one of the most successful administrations in modern times. 

So McUseless, do your worst. Bend over for the MAGAs and get screwed. Hope it hurts. You have no balls as depicted in a recent funny meme where Barbie is shown on her knees in front of Ken, saying she finally understood; McUseless was the model for Ken. 

The country will survive McUseless and the congressional Trump cult and be stronger for it. The decent people of the country will end up winning and McUseless, Marjorie Taylor Greene, Matt Gaetz, and their cronies, will be relegated to the dustbin of history with nary an asterisk to their names. If there is an asterisk it will read that they were useless, venal, and screwed up.

Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist. He writes regularly for the Blade.

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Impact lingers 22 years after that bright September morning

Religious zealotry that led to 9/11 can be seen in far right politics

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The Pentagon in Arlington just across the Potomac River from Washington D.C. on the morning of September 11, 2001, approximately 10 minutes after terrorists flew American Airlines flight 77, which had taken off from Dulles International Airport, into the southwest side of the building killing 184 people. (Screenshot/YouTube Archival news footage)

Tuesday, September 11, 2001, a point in time that forever altered the world in a series of events, terrorist attacks, that would linger on politically, spiritually, culturally, and leave an indelible mark on those alive at the time who experienced that day.

A human being born that day celebrates their twenty-second birthday this week, having grown up in a world where security measures — some draconian — dominate and where a certain sense of collective innocence has been lost.

Perhaps the ultimate irony is that lessons of peaceful diplomacy that could have possibly been gained from that day were instead lost to the sense of paranoia and nationalistic ideology and messaging as governments reacted, and in the case of the United States, commencement of a war that became the longest in American history.

The number of American service members who died fighting the wars in Iraq and Afghanistan had passed 7,000 at the end of 2021. The ‘War on Terror’ as it was known spanned 20 years, saw the expenditure of $6 trillion, 900,000 lives lost around the globe and at least 38 million people who have been displaced. 

9:37:46 AM, The Pentagon in Arlington, Va., just across the Potomac River from Washington, D.C.: American Airlines Flight 77, which had taken off from Dulles International Airport, struck the southwest side of the building killing 184 people.

This reporter was in the Pentagon that fateful morning, having agreed to substitute for a sick colleague. I witnessed the utter disbelief on the faces of every one of my colleagues as we were clustered around a television set watching the events unfolding in New York City at the World Trade Center and then suddenly it was our turn as the entire building shook as Flight 77 crashed into the southwestern face of the Pentagon.

The next 16 hours are still a vignette of sounds, smells, and sights from that day that have never left me. The events of that day would later define my career and set me on a path of being far more cynical than I was previously as I viewed a changed world.

Here, two decades later, I reflect still on what could have been and yet still remain optimistic even in the face of greater turmoil, widespread authoritarianism, a global climate crisis exacerbated by war, and then too of war itself as evidenced by the illegal incursion into the sovereignty of Ukraine.

The rise of nationalism, especially of the white supremacist variety tied to religious fundamentalism, is the primary danger and the direct linear descendent of the terrorism that was seen on that Tuesday morning 22 years ago. It is not just an American issue, it is a global issue, one that needs to be exposed and then dealt with.

The religious zealotry that fed the extremist ideology that led to the acts of terrorism that bright September morning can be seen again manifesting in the extremist actions of the far right beyond politics. Book bans, the war on trans and queer people, stifling of free speech and ideas, promotion of anti-immigrant, anti-LGBTQ and racist ideas all contribute to a society that is rapidly becoming very unsafe and a petri dish for the next 9/11.

This is the lingering impact of that long ago day and must be mitigated, before history repeats itself.

Brody Levesque is editor of the Los Angeles Blade. 

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There’s a good chance you’re overpaying for medication

New policy lets worst offenders behind high drug prices off the hook

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(Photo by Vitalii Petrushenko/Bigstock)

In its push to lower the cost of medicine, Congress has focused on giving Medicare the authority to negotiate drug prices with manufacturers. Officials just announced the first 10 medicines up for negotiation under the Inflation Reduction Act (IRA).

Unfortunately, all of the attention given to that policy lets some of the worst offenders behind high drug prices off the hook: pharmacy benefit managers, or PBMs — companies that function as powerful drug-industry middlemen.

Acting on behalf of insurers, PBMs use their buying clout to obtain discounts and rebates from drug makers. In theory, these savings should be passed on to patients at the pharmacy counter. But in fact, while PBMs extract billions of dollars in profit for themselves each year, patients see little to no benefit.

It’s time to change this system. Thankfully, lawmakers now have PBMs in their sights in a proposed bipartisan reform bill.

The fundamental problem is that PBMs wield enormous influence over drug prices, with virtually no transparency or accountability. They’re able to wield such power because they control insurance company formularies — those lists that determine which drugs your insurer will cover, and on what terms.

PBMs have drug manufacturers over a barrel because (in a helpless position), in order to make sufficient sales, the manufacturers need their products on formularies on favorable terms. But even though PBMs are charged with obtaining discounts, their interests are not aligned with those of patients. In fact, just the opposite is true.

The PBM revenue model is linked to the list prices of drugs. The higher the list price, the bigger the discount they can obtain. That means that PBMs make more money off more expensive medicines, giving them a perverse incentive to offer better formulary placement to pricier treatments. But that, in turn, pressures drug makers to increase list prices, on the expectation of offering larger discounts.

Meanwhile, the coinsurance obligations that patients pay continue to be calculated based on list prices — not the discounted prices insurers actually pay. By exploiting this difference, PBMs manage to charge two-thirds of patients for the full list price of a drug, even though they’ve negotiated deep discounts from the manufacturer.

Mergers and acquisitions among PBMs and insurers have given them even more power. Currently, just three PBMs make up 80% of the prescription drug market, and the top six control nearly the entirety, 96%. At the same time, the three biggest PBMs either own or are owned by the three biggest insurance companies. They also use their sway to steer patients to fill prescriptions at the pharmacies they likewise own.

Consider how this whole setup affects patients with HIV. While there are more than 30 FDA-approved medicines to treat the virus, a PBM can steer patients toward the most expensive options via their insurance coverage. Then, a patient can be required to pay a percentage of the list price out of pocket, rather than a percentage of the lower price the insurer actually paid.

There’s still more in the PBM-insurer bag of tricks. Drug makers often issue discount coupons to help patients with coinsurance requirements. But PBMs and insurers essentially steal the value of those coupons right back, by refusing to count them toward deductibles and annual caps on out-of-pocket spending.

Insurers and their PBMs are also behind the “utilization management” rules that patients increasingly face when seeking care. So-called “prior authorization” policies, for instance, require doctors to ask insurers’ permission before ordering certain drugs or tests. Such policies have been an obstacle to patients obtaining PrEP drugs, the pre-exposure prophylaxis that prevents HIV transmission.

As so many activists and lawmakers have observed, we need to bring down out-of-pocket medication costs. One-third of Americans report not filling a prescription because of price, and we know that when prescription costs increase, patients are less likely to adhere to their medication regimen. Their health suffers as a result, often requiring additional interventions and hospital stays.

But the new IRA plan for drug-price negotiations can’t solve all these problems. Lawmakers also need to rein in PBMs. Specifically, any new legislation should decouple PBM compensation from the list prices of drugs, so that the companies aren’t motivated to steer patients toward the most expensive treatments.

For the sake of patients, myself included, there’s no time to lose.

Guy Anthony is president and CEO of Black, Gifted & Whole.

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