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Africa

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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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

Lorato ke Lorato: marriage equality, democracy, and the unfinished work of justice in Botswana

High Court considering marriage equality case

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As Botswana prepares for the resumption of a landmark marriage equality case before the High Court on July 14–15, the country finds itself at a critical constitutional crossroads.  

At first glance, the matter may appear to be about whether two women, Bonolo Selelelo and Tsholofelo Kumile, can have their love legally recognized. At its core however, this case is about something far more profound: the dismantling of patriarchy, the decolonization of law, and the integrity of Botswana’s constitutional democracy. 

Beyond marriage: a question of power 

Marriage, as a legal institution, has never been neutral. It has historically functioned as a  mechanism for regulating women’s bodies, sexuality, and social roles within a patriarchal  order. To deny LBQ (lesbian, bisexual, and queer) women access to marriage is not merely to exclude them from a legal benefit, it is to reinforce a hierarchy of relationships, where heterosexual unions are deemed legitimate and all others invisible. This case therefore challenges the very foundations of who gets to love, who gets to belong, and who gets to be protected under the law. 

As feminist scholars have long argued, patriarchy is sustained through institutions that  appear ordinary but are deeply political. The law is one such institution. And it is precisely  here that this case intervenes: by asking whether Botswana’s legal system will continue to uphold exclusion, or evolve to reflect the constitutional promise of equality. 

A constitutional journey: Botswana’s courts and human dignity

This is not the first time Botswana’s courts have been called upon to affirm the dignity of  LGBTQI+ persons. Over the past decade, the judiciary has built a progressive body of  jurisprudence grounded in equality, nondiscrimination, and human dignity. 

In Attorney General v. Rammoge and Others (Court of Appeal Civil Appeal No. CACGB 128-14, 2016), the Court of Appeal upheld the right of LEGABIBO to register as an organization. The court affirmed that: 

“The refusal to register the appellant society was not only unlawful, but a violation of the  respondents’ fundamental rights to freedom of association.”

This was followed by the ND v. Attorney General of Botswana (MAHGB-000449-15,  2017) case, where the High Court recognized the right of a transgender man to change his gender marker. The court held: 

“Gender identity is an integral part of a person’s identity … and any interference with  that identity is a violation of dignity.” 

In Letsweletse Motshidiemang v. Attorney General (MAHGB-000591-16, 2019), the High Court decriminalized same-sex activity, declaring sections of the Penal Code unconstitutional. Justice Leburu powerfully stated: 

“Human dignity is harmed when minority groups are marginalized.” 

This decision was affirmed by the Court of Appeal in Attorney General v. Motshidiemang (CACGB-157-19, 2021), where the court emphasized: 

“The Constitution is a dynamic instrument … it must be interpreted in a manner that gives effect to the values of dignity, liberty, and equality.” 

These cases collectively establish a clear principle: the Constitution of Botswana protects all persons, not just the majority. 

The marriage equality case now asks a logical next question: If LGBTQI+ persons are entitled to dignity, identity, and freedom from criminalization, why are their relationships still denied recognition? 

Decolonizing the law: What is truly ‘UnAfrican’? 

Opponents of marriage equality often argue that homosexuality is “unAfrican.” This claim, while politically powerful, is historically inaccurate. Same-sex relationships and diverse gender identities have existed across African societies long before colonial rule. What is foreign, however, are the laws that criminalize these identities. 

Botswana’s anti-sodomy laws were inherited from British colonial legal systems, not from  indigenous Tswana culture. As scholars of African history have demonstrated, colonial  administrations imposed rigid Victorian moral codes that erased and suppressed existing  sexual diversity. To claim that homosexuality is unAfrican, while defending colonial-era laws, is therefore a contradiction.

A truly decolonial approach to the law requires us to ask: Whose morality are we upholding? And whose history are we erasing? 

Marriage equality, in this sense, is not a Western imposition: it is part of a broader project of reclaiming African dignity, plurality, and humanity. 

Democracy on trial: the question of separation of powers

This case also raises important questions about the health of Botswana’s democracy. 

Following the 2021 Court of Appeal decision affirming the decriminalization of same-sex  relations, Botswana witnessed public demonstrations, including marches led by groups such as the Evangelical Fellowship of Botswana (EFB), opposing the judgment and calling for the retention of discriminatory laws. 

While public participation is a cornerstone of democracy, these events raise deeper concerns about the separation of powers. Courts are constitutionally mandated to interpret the law and protect fundamental rights, even when such decisions are  unpopular. When judicial decisions grounded in constitutional principles are publicly resisted on moral or religious grounds, it risks undermining the authority of the courts  and the rule of law itself. 

Democracy is not simply about majority opinion: it is about the protection of minority rights within a constitutional framework. 

Botswana is not a theocracy 

It is also important to clarify a recurring misconception: Botswana is not a Christian nation. 

Botswana is a secular constitutional democracy and more accurately, a pluralistic society that recognizes and respects diversity of belief, culture, and identity. The Constitution does not elevate one religion above others, nor does it permit religious doctrine to  dictate legal rights. The law must serve all citizens equally, regardless of faith. 

To frame marriage equality as a threat to Christianity is therefore misplaced. The question before the courts is not theological, but constitutional: Does the exclusion of same-sex couples from marriage violate the rights to equality and nondiscrimination?

Love, equality, and the future of justice 

At its heart, this case is about love, but it is also about power, history, and justice. It asks whether Botswana is prepared to move beyond colonial legal frameworks and patriarchal  norms, and to embrace a future grounded in equality, dignity, and inclusion. 

It asks whether the Constitution will continue to be interpreted as a living document, one that evolves with society, or remain constrained by outdated moral assumptions. Ultimately, it asks whether Botswana’s democracy can hold true to its founding promise: that all persons are equal before the law. 

As the High Court prepares to hear this case in July 2026, the nation has an opportunity to affirm not only the rights of two individuals, but the broader principle that love, in all its diversity, deserves recognition, and protection. 

Lorato ke lorato.  

Love is love. 

Justice, if it is to mean anything at all, must make space for it.

Nozizwe is the CEO of LEGABIBO (Lesbians, Gays and Bisexuals of Botswana)

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State Department

Report: US to withhold HIV aid to Zambia unless mineral access expanded

New York Times obtained Secretary of State Marco Rubio memo

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The State Department is reportedly considering withholding assistance for Zambians with HIV unless the country’s government allows the U.S. to access more of its minerals.

The New York Times on Monday reported Secretary of State Marco Rubio in a memo to State Department’s Bureau of African Affairs staffers wrote the U.S. “will only secure our priorities by demonstrating willingness to publicly take support away from Zambia on a massive scale.” The newspaper said it obtained a copy of the letter.

Zambia is a country in southern Africa that borders Tanzania, Malawi, Mozambique, Zimbabwe, Botswana, Namibia, Angola, and the Democratic Republic of Congo.

The Times notes upwards of 1.3 million Zambians receive daily HIV medications through PEPFAR. The newspaper reported Rubio in his memo said the Trump-Vance administration could “significantly cut assistance” as soon as May.

“Reports of (the) State Department withholding lifesaving HIV treatment in return for mining concessions in Zambia does not make us safer, stronger, or more prosperous,” said U.S. Sen. Jeanne Shaheen (D-N.H.), the ranking member of the Senate Foreign Relations Committee, on Tuesday. “Monetizing innocent people’s lives further undermines U.S. global leadership and is just plain wrong.”

The Washington Blade has reached out to the State Department for comment.

Zambia received breakthrough HIV prevention drug through PEPFAR

Rubio on Jan. 28, 2025, issued a waiver that allowed PEPFAR and other “life-saving humanitarian assistance” programs to continue to operate during a freeze on nearly all U.S. foreign aid spending. HIV/AIDS service providers around the world with whom the Blade has spoken say PEPFAR cuts and the loss of funding from the U.S. Agency for International Development, which officially closed on July 1, 2025, has severely impacted their work.

The State Department last September announced PEPFAR will distribute lenacapavir in countries with high prevalence rates. Zambia two months later received the first doses of the breakthrough HIV prevention drug.

Kenya and Uganda are among the African countries have signed health agreements with the U.S. since the Trump-Vance administration took office.

The Times notes the countries that signed these agreements pledged to increase health spending. The Blade last month reported LGBTQ rights groups have questioned whether these agreements will lead to further exclusion and government-sanctioned discrimination based on sexual orientation and gender identity.

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Botswana

The rule of law, not the rule of religion

Bonolo Selelo and Tsholofelo Kumile are challenging the Botswana Marriage Act

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Botswana was in a whole frenzy as religious and traditional fundamentalists kept mixing religion and constitutional law as if it were harmless. It is not. One is a private matter of belief between you and God, while the other is the framework that protects and governs us all. When these two systems get fused, the result is rarely justice. It results in discrimination. 

The ongoing case brought by Bonolo Selelo and Tsholofelo Kumile challenging provisions of the Botswana Marriage Act has reignited a familiar debate in Botswana. Some commentators insist that marriage equality violates religious values and therefore should not be recognized by law. It is a predictable argument. It is also fundamentally incompatible with constitutional governance.

Botswana is not a Christian state. It is a constitutional democracy governed by the Constitution of Botswana. That distinction matters. In a constitutional democracy, laws are interpreted in accordance with constitutional principles such as equality, dignity, protection, inclusion and the rule of law, rather than the doctrinal beliefs of any particular religion.

Religion has no place in constitutional law and democracy

The central problem with religious arguments in constitutional disputes is simple in that they divide, they other, they contest equality and they are personal. Constitutional law by contrast, must apply equally to everyone.

Botswana’s Constitution guarantees fundamental rights and freedoms under Sections 3 and 15, including protection from discrimination and the right to equal protection of the law. These provisions are not conditional on religious approval. They exist precisely to protect minorities from the preferences or prejudices of the majority.

Legal experts, such as Anneke Meerkotter, in her policy brief in Defense of Constitutional Morality, point out that constitutional rights function as a safeguard against majoritarian morality. If rights depended on whether the majority approved of a minority’s identity or relationships, they would not be rights at all. They would merely be privileges.

This principle has already been affirmed in Botswana’s jurisprudence. In the landmark decision of Letsweletse Motshidiemang v Attorney General, the High Court held that criminalizing consensual same-sex relations violated constitutional protections of liberty, dignity, privacy, and equality. This judgment noted that constitutional interpretation must evolve with society and must be guided by human dignity and equality. The court emphasized that the Constitution protects all citizens, including those whose identities, expressions or relationships may be unpopular. That ruling was later upheld by the Court of Appeal of Botswana in 2021, reinforcing the principle that constitutional rights cannot be restricted on grounds of moral disapproval alone. These decisions were not theological pronouncements. They were legal determinations grounded in constitutional principles.

The danger of religious majoritarianism

When religion is used to justify legal restrictions, the result is what constitutional scholars call “majoritarian moralism.” It allows the dominant religious interpretation in society to dictate the rights of everyone else. That approach is fundamentally incompatible with constitutional democracy. Botswana is religiously diverse. While Christianity is the majority faith, there are also Muslims, Hindus, traditional spiritual communities, Sikh and people who practice no religion at all. If the law were to follow the doctrines of one religious group, which interpretation would it adopt? Christianity alone contains dozens of denominations with different views on love, equality, marriage, sexuality, and gender. The moment the state begins to legislate on the basis of religious doctrine, it implicitly privileges one belief system over others. That undermines both religious freedom and constitutional equality. Ironically, keeping religion separate from constitutional law is what protects religious freedom in the first place.

Judicial independence is the cornerstone of Botswana’s governance system

The current case involving Bonolo Selelo and Tsholofelo Kumile is before the judiciary, where it belongs. Courts exist to interpret the Constitution and determine whether legislation complies with constitutional rights. Political and religious lobbying, as well as public outrage, must not influence that process.

Judicial independence is the cornerstone of Botswana’s governance system. According to the International Commission of Jurists, judicial independence ensures that courts can make decisions based on law and evidence rather than political or social pressure.

When governments, political, religious, or traditional actors attempt to interfere in constitutional litigation, they weaken the rule of law. Botswana has historically prided itself on having one of the most stable constitutional systems in Africa. The judiciary has played a critical role in safeguarding rights and maintaining legal certainty. The decriminalization case demonstrated this. Despite strong public debate and political sensitivity, the courts assessed the law according to constitutional principles rather than moral panic. The same standard must apply in the current marriage equality case.

This article was first published in the Botswana Gazette, Midweek Sun, and Botswana Guardian newspapers and has been edited for the Washington Blade. 

Bradley Fortuin is a consultant at the Southern Africa Litigation Center and a social justice activist.

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