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Kenyan, Ugandan groups demand inclusive HIV programs to fill US funding gap

USAID contributed 80 percent of funding to sub-Saharan Africa programs

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(Photo by NASA)

Seven months since the Trump-Vance administration froze U.S global aid, African countries whose health programs have been seriously affected have devised new ways to address the funding challenge.

The governments’ urgent interventions, however, come with calls of inclusion from queer rights groups in Kenya and Uganda and elsewhere that have also been seriously impacted, warning their sidelining only implies a lack of seriousness to end HIV/AIDS.  

“We must fund, protect, and institutionalize community leadership to survive this moment and build systems that endure,” Richard Lusimbo, founder of Uganda Key Populations Consortium, said.

Lusimbo noted community-led organizations, including LGBTQ networks, not only implement public health programs but have co-designed them. They have created referral systems, peer support structures, and delivered medical clinics in remote areas that public systems cannot reach.   

We are not there to patch holes,” said Lusimbo. “We are there to lead. Our leadership must be recognized, resourced, and embedded within national systems, and not only consulted once programs are already designed.”

The queer community’s demand for the government interventions comes amid UNAIDS’s latest warning of a serious global HIV response crisis if U.S funding is halted permanently. The agency’s report said this gap would reverse decades-long gains of saving 26.9 million lives from the virus.

“UNAIDS projections show that a permanent discontinuation of support from the United States President’s Emergency Plan for AIDS Relief (PEPFAR) for HIV treatment and prevention could lead to more than 4 million additional AIDS-related deaths and more than 6 million additional new HIV infections by 2029,” its report states.

The annual UNAIDS reportreleased on July 10 notes the sudden dismantlement of the U.S. Agency for International Development — which was the world’s largest contributor to HIV programs for low- and middle-income countries in sub-Saharan Africa and elsewhere — has disrupted prevention and treatment programs.

USAID contributed 80 percent of the total funding for the aforementioned efforts.

The UNAIDS report also notes half of the 9.2 million people with HIV/AIDS around the world last year who needed treatment but were not receiving it lived in Kenya, Uganda, and other sub-Saharan African countries.

It notes the largest gaps are in diagnosing men living with HIV and linking them to treatment and care, while singling out men who are gay and are members of other key populations as the most affected because of discriminatory laws, violence, and stigma.

“In the absence of a cure for HIV, millions of people will continue to need HIV treatment for many decades to come, but funding losses are destabilizing many treatment programs and the efforts to make them more equitable,” UNAIDS warns.

Key populations, including gay men whose clinics, community-led health groups, and queer rights organizations depend largely on PEPFAR and other foreign aid programs, are reeling from the U.S. funding cuts. UNAIDS data notes around 25 percent of people from vulnerable populations in sub-Saharan Africa are denied access to HIV/AIDS programs, which causes new infections.

GALCK+, a Kenyan queer rights group, noted the freezing of PEPFAR funding has impacted most LGBTQ programs. The result has been fewer HIV testing clinics, queer mental health centers and safe spaces, and hospitals no longer offering gender-affirming care.

“Our lives are on the line, and we must fight for every life. Donate, volunteer, and uplift local LGBTQ+ organizations working on healthcare access and community support,” GALCK+ said.  

The queer lobby group also noted forging new partnerships with other international donors is crucial to address the new funding challenge.

Kaleidoscope Trust, a U.K.-based queer rights organization, has stepped in to support LGBTQ groups affected by the U.S. funding freeze.

Although the Global Fund has picked Kenya and Uganda as among the first sub-Saharan African countries to benefit from lenacapavir, a new long-acting injectable PrEP drug, anti-gay discrimination has prevented many people from accessing it.

“This long-acting option has the potential to revolutionize HIV prevention, especially for our community who continue to face stigma or barriers in accessing daily oral PrEP,” Lusimbo said.

Kenyan, Ugandan governments work to bridge funding gap

The PEPFAR funding cut has led to the closure of hundreds of HIV treatment clinics and disrupted the supply of antiretroviral drugs, forcing Kenya and Uganda to reconsider domestic financing through national budgets passed last month. 

Kenya, which received a total of $322 million in PEPFAR funding in 2024, increased its national budget for the health sector by $85 million, from $983 million in the previous financial year to $1.07 billion in the current one, in an attempt to bridge the shortfall.

The additional funding resulted from a joint high-level meeting of top officials from national and local governments, health sector players, and relevant communities in March to agree on a sustainable HIV response plan.

The plan entails redesigning medical service delivery to integrate HIV and other diseases in reproductive, maternal, newborn, child, and adolescent health programs. It also involves more domestic funding for HIV products, vaccines, and effective health management systems.

NEPHAK, a Kenyan national network that works with people living with HIV and those at risk of the virus, has called for immediate integration of HIV care into general health care. NEPHAK has also said HIV treatment should be included in the country’s universal health coverage plan.

Uganda also convened a high-level national health financing dialogue in May in response to the U.S funding pause to explore ways of increasing its health sector spending, which has stood between $52-$57 per capita, below the World Health Organization’s recommended $86 minimum.

“Organizations in Uganda are asking for more local money for health and SRHR (sexual and reproductive health rights), better use of budgets, and more community involvement and engagement in all the processes,” stated CEHURD Uganda, a local health social justice rights group. Uganda this financial year increased its health sector’s budget to 8.1 percent from 4 percent in the last financial year, a move lauded by CEHURD as the only way towards having a robust health sector.     

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Botswana

The first courageous annual Palapye Pride in Botswana

Celebration was a beginning rooted in courage, community, and love.

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The first Palapye Pride took place in Palapye, Botswana, on Nov. 1, 2025. (Photo courtesy of the AGANG Community Network)

“When the sun rose on 1 Nov., 2025, Pride morning in Palapye, the open space where the march was scheduled to begin was empty. I stood there trying to look calm, but inside, my chest felt tight. I was worried that no one would come. It was the first-ever Pride in Palapye, a semi-urban village where cultural norms, religious beliefs, and tradition are deeply woven into everyday life.

I kept asking myself if we were being naive. Maybe people weren’t ready. Perhaps fear was going to win. For the first 30 minutes, it was me, a couple of religious leaders and a handful of parents. That was it. The silence was loud, and every second felt like it stretched into hours. I expected to see the queer community showing up in numbers, draped in color and excitement. Instead, only the wind was moving.

But slowly, gently, just like courage often arrives, people started to show up with a rainbow flag appearing from behind a tree and a hesitant wave from someone standing at a distance.

That’s when I understood that people weren’t late, just that they were afraid. And their fear made sense. Showing up openly in a small community like Palapye is a radical act. It disrupts silence. It challenges norms. It forces visibility. Visibility is powerful, but it is never easy. We marched with courage, pulling from the deepest parts of ourselves. We marched with laughter that cracked through the tension. We marched not because it was easy, but because it was necessary,” narrates activist Seipone Boitshwarelo from AGANG Community Network, which focuses on families and friends of LGBTIQ+ people in Botswana. She is also a BW PRIDE Awards nominee for the Healing and Justice Award, a category which acknowledges contributions to wellness, mental health, and healing for the LGBTIQ+ community across Botswana.

Queer Pride is Botswana Pride!

Pride is both a celebration and a political statement. It came about as a response to systemic oppression, particularly the criminalization and marginalization of LGBTIQ+ people globally, including in Botswana at some point. It is part of the recognition, equality, and assertion of human rights. It also reminds us that liberation and equality are not automatically universal, and continued activism is necessary. A reminder of the famous saying by Fannie Lou Hamer, “Nobody is free until everybody’s free.”

The 2023 Constitutional Review process made one thing evident, which is that Botswana still struggles to acknowledge the existence of LGBTIQ+ people as full citizens. Instead of creating a democratic space for every voice, the process sidelined and erased an entire community. In Bradley Fortuin’s analysis of the Constitutional review and its final report, he highlighted how this erasure directly contradicts past court decisions that explicitly affirmed the right of LGBTIQ+ people to participate fully and openly in civic life. When the state chooses to ignore court orders and ignore communities, it becomes clear that visibility must be reclaimed through alternative means. This is why AGANG Community Network embarked on Palapye Pride. It is a radical insistence on belonging, rooted in community and strengthened through intersectionality with families, friends, and allies who refuse to let our stories be erased.

Motho ke motho ka batho!

One of the most strategic decisions made by the AGANG Community Network was to engage parents, religious leaders, and local community members, recognizing their value in inclusion and support. Thus, their presence in the march was not symbolic, but it was intentional.

Funding for human rights and LGBTIQ+ advocacy has been negatively impacted since January 2025, and current funding is highly competitive, uneven and scarce, especially for grassroots organizations in Botswana. The Palapye Pride event was not funded, but community members still showed up and donated water, a sound system, and someone even printed materials. This event happened because individuals believed in its value and essence. It was a reminder that activism is not always measured in budgets but in willingness and that “motho ke motho ka batho!” (“A person is a person because of other people!”).

Freedom of association for all

In March 2016, in the the Attorney General of Botswana v. Rammoge and 19 Others case, also known as the LEGABIBO registration case, the Botswana Court of Appeal stated that “members of the gay, lesbian, and transgender community, although no doubt a small minority, and unacceptable to some on religious or other grounds, form part of the rich diversity of any nation and are fully entitled in Botswana, as in any other progressive state, to the constitutional protection of their dignity.” Freedom of association, assembly, and expression is a foundation for civic and democratic participation, as it allows all citizens to organize around shared interests, raise their collective voice, and influence societal and cultural change, as well as legislative reform.

The Botswana courts, shortly after in 2021, declared that criminalizing same-sex sexual relations is unconstitutional because they violated rights to privacy, liberty, dignity, equality, and nondiscrimination. Despite these legal wins, social stigma, cultural, and religious opposition continue to affect the daily lived experience of LGBTIQ+ people in Botswana.

The continuation of a declaration

AGANG Community Network is committed to continuing this work and creating safe and supportive spaces for LGBTIQ+ people, their families, friend, and allies. Pride is not just a day of fun. It is a movement, a declaration of queer existence and recognition of allyship. It is healing and reconciliation while amplifying queer joy.

Seipone Boitshwarelo is a feminist, activist, social justice healer, and founder of AGANG Community Network. Bradley Fortuin is a social justice activist and a consultant at the Southern Africa Litigation Center.

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Opinions

The hidden struggle for LGBTQ refugees in East Africa and beyond

Those seeking refuge and safety are often silenced

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Kakuma Refugee Camp in Kenya (Courtesy photo)

I never imagined that fleeing my own country would not free me from fear. Yet, when I left Uganda, the place of my birth, my memories, and the source of both joy and pain I believed that the hardest part of my journey was behind me. I was wrong.

I had lived under the weight of persecution, where being queer was not only condemned but criminalized by laws and reinforced by the religious and cultural doctrines that shaped daily life. Every glance, every whispered insult, every hushed conversation reminded me that the very core of who I am was treated as a threat. In the end, I had no choice but to flee.

I arrived at Kakuma Refugee Camp in northern Kenya with hope in my heart, imagining that safety and relative freedom awaited me. Kakuma is one of Africa’s largest camps, home to hundreds of thousands displaced by conflict across the region. But what I found was a different kind of cage: the cage of silence. The fear I carried from Uganda followed me, threading itself into my interactions, my movements, my very breath. “You cannot say who you are,” a fellow refugee whispered one night as we huddled in the corner of a tent. “Even the walls have ears.”

For LGBTQI+ refugees across East Africa, silence is often the only shield against violence. But silence is also a heavy burden. In Kakuma, Malawi’s Dzaleka Camp, and Zambia’s Meheba settlement, we live in a constant negotiation between visibility and invisibility, between survival and authenticity. The promise of freedom is only partial; the moment you speak your truth, the risk of reprisal is real from fellow refugees, from camp authorities, and from the broader legal and social systems that criminalize us.

Freedom of speech is not merely the right to speak about politics; for us, it is the right to exist openly, to report threats, to seek help when we are attacked, and to be acknowledged as human. But in countries where same-sex relations are criminalized, even reporting a threat can become an act of extreme risk. Arrest. Deportation. Beaten for daring to ask for safety. Silence, then, becomes both our protection and our punishment.

In Kakuma, I have seen friends beaten for holding hands with someone of the same sex, harassed for wearing clothing that did not “fit” traditional gender expectations, and denied essential aid because our identities are deemed illegitimate. We are told to stay quiet, to blend in, to survive in shadows. And yet, survival in silence is a constant reminder that our rights exist only on paper.

The tension between hope and hostility is a daily reality. Humanitarian organizations like UNHCR and NGOs such as ORAM and Rainbow Railroad provide critical interventions, but safe spaces are limited and often inaccessible. Even interpreters people meant to help us navigate the bureaucracy of aid can inadvertently “out” us, putting lives at risk. Attempts at advocacy, such as peaceful marches within camps, are met with hostility, detention, or social ostracism.

Malawi and Zambia offer a similar narrative, albeit in different hues. In Dzaleka Camp, Malawi, LGBTQI+ refugees live largely underground, avoiding clinics or services for fear of ridicule or exposure. Even when protections are formally recognized, they are often overridden by national laws or local social norms. In Zambia, settlements like Meheba and Mantapala host tens of thousands of refugees, but restrictive legal frameworks and growing public hostility force many queer individuals to remain silent, invisible, and isolated.

Silence carries a cost far beyond fear of immediate violence. It fosters isolation, anxiety, and depression. It limits access to justice, healthcare, and advocacy. When we cannot speak openly, misinformation and stigma flourish. The very systems meant to protect us in camps, NGOs, and legal frameworks often fail to bridge the gap between policy and practice.

Yet, even within these constraints, resilience thrives. I have witnessed extraordinary courage: small networks of LGBTQI+ refugees who create discreet support groups, online networks that allow us to share information safely, and local NGOs that quietly provide legal aid and mental health support. Technology, especially encrypted communication tools, has become our lifeline. Even if we cannot speak openly in our physical spaces, our voices travel through digital networks, connecting us with allies and advocacy channels across the globe.

I think of Musa, a bisexual refugee from the Democratic Republic of Congo, who once told me, “Even if we can’t speak loudly here, we can be heard somewhere.” Those words linger, reminding me that freedom of speech is not just about talking it is about being acknowledged, being safe, and being human.

International organizations are slowly recognizing these realities. UNHCR’s 2024 Global Appeal emphasizes the need for safe spaces, community outreach, and equitable access to protection for LGBTQI+ refugees. Yet, progress remains uneven. Governments and donors must move beyond statements to tangible actions: confidential reporting channels, SOGIESC-sensitive training for camp staff and interpreters, funding for refugee-led initiatives, and legal reforms that at least protect asylum seekers under international protection.

Writing this from Gorom Refugee Settlement in South Sudan, I reflect on the journey I have taken from Uganda’s shadows of persecution, through Kakuma’s labyrinth of fear, to this temporary space of relative safety. I still carry the echoes of enforced silence, the whispers of caution, and the weight of being invisible. But I also carry hope, solidarity, and the knowledge that even small acts of courage ripple outward.

I write not just for myself, but for every queer refugee silenced by fear, for every friend who cannot report an assault, who cannot access medical care, who cannot simply say, “I am here. I am human. I exist.” Freedom of speech is more than words; it is the right to live authentically and safely. Every whispered story, every cautious disclosure, is a testament to our humanity and our resilience.

I did not come to Kakuma, or to any camp, to be a hero. I came to survive. I came to live. And I continue to write in shadows, in whispers, and now, finally, in a voice that reaches beyond the walls of fear. One day, I hope, we will no longer have to whisper. We will be able to speak, freely, openly, and safely. Until then, every word I write is a small act of defiance, a claim to my right to exist, and a reminder to the world that legal protection means little without the freedom to claim it.

Abrina lives in the Gorom Refugee Camp in South Sudan.

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South Africa

Transgender inmate sues South Africa prison officials

Nthabiseng Mokoena alleges mistreatment at Johannesburg Correctional Center

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(Photo by Rarraroro via Bigstock)

South Africa’s transgender community is eagerly anticipating a court ruling that could change their lives.

The Equality Court at the Gauteng High Court in Johannesburg on Sept. 12 reserved judgment for a case brought by Nthabiseng Mokoena, a trans woman who is an inmate at the Johannesburg Correctional Center (Sun City Prison) against the Department of Correctional Services and other officials.

According to Mokoena, who is being represented by Lawyers for Human Rights and others, the DCS commits systemic discrimination against trans inmates by refusing to recognize their gender identity and denying them basic gender-affirming rights.

Mokoena also argued the DCS has violated her rights by refusing her chosen name and pronouns, not allowing her to wear clothing and use cosmetics and toiletries that correspond with her gender expression, bullying her, and denying her gender-affirming healthcare.

“The transphobia within DCS’s senior management is undeniable,” said Mokoena. “There’s a clear difference in how heterosexual inmates are treated compared to members of the LGBTQI+ community. The LGBTQI+ community is often treated as less than human.”

Mokoena also said there is no recourse for her and other trans people when they are victimized; they are rather punished when they try to stand up for themselves.

“When we are hurt or attacked, no one speaks up or does anything to help,” said Mokoena. “Those who harm the LGBTQI community are never held responsible. What is worse, when we try to defend ourselves or speak out about the unfair treatment, we are the ones who get punished.”

Mokoena as a result wants the court to order the defendants to provide her with gender-affirming healthcare, assistance in legally changing her name and gender marker, and to be housed in a single cell or with other inmates who share her gender identity.

Letlhogonolo Mokgoroane, a nonbinary lawyer who represents Mokoena, said gender-affirming healthcare is recognized by medical professionals worldwide as essential healthcare.

“Gender-affirming care is not elective or optional, it is life-saving,” said Mokgoroane. “Denial of such care amounts to cruel and inhumane treatment, which is incompatible with the values enshrined in our constitution and international human rights standard. Trans rights are human rights.”

Access Chapter 2, a local LGBTQ organization which filed an amicus brief in support of Mokoena in the Equality Court, said it stands with her and all trans people who face systematic discrimination.

“Our submissions emphasized that gender-affirming healthcare is an essential component of primary healthcare, not an elective treatment. Denying access to gender-affirming healthcare violates the constitutional rights of transgender people to equality, dignity, and healthcare, especially those in detention facilities,” said Access Chapter 2.

Thabsie Mabezane, acting media and programs director at Lebo Basadi Foundation, an LGBTQ rights organization, said trans issues are complex and multifaceted and require a comprehensive approach that addresses legal discrimination, societal stigma, economic oppression, and healthcare access.

“Socially transitioning individuals who choose to live as their preferred gender without medical intervention, face unique challenges,” noted Mabezane. “They often lack access to essential services, including healthcare and social support, and may be excluded from projects aimed at uplifting LGBTQ+ individuals, hence the need to promote inclusivity, supporting advocacy efforts, and addressing the specific needs of transgender individuals.”

Even though South Africa has made strides in recognizing and advancing the rights of trans people, systematic and deeply-rooted transphobia in the country make it difficult for them to live openly and access gender-affirming health care.

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