Africa
Kenyan, Ugandan groups demand inclusive HIV programs to fill US funding gap
USAID contributed 80 percent of funding to sub-Saharan Africa programs
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.
Ghana
Ghanaian lawmakers approve anti-LGBTQ bill
Measure that would criminalize allyship awaits president’s signature
Ghanaian lawmakers on Friday approved a bill that would, among other things, criminalize LGBTQ allyship.
Reuters reported MPs approved the Human Sexual Rights and Family Values Bill, 2025, in a voice vote after parliament’s Constitutional and Legal Affairs Committee backed it.
MPs in 2024 approved a similar bill, but it faced legal challenges and then-President Nana Akufo-Addo didn’t sign it. Lawmakers last year reintroduced the measure after President John Dramani Mahama took office.
The bill awaits his signature.
Rightify Ghana, a Ghanaian LGBTQ advocacy group, in a series of social media posts notes MPs passed the bill days before the 4th African Inter-Parliamentary Conference on Family Values and Sovereignty will take place in Accra, the country’s capital.
Kenya
Kenyan High Court issues landmark transgender rights ruling
Government ordered to allow trans people to amend ID documents
Kenya’s High Court has ruled the country’s government cannot refuse requests to amend gender markers on birth certificates and other ID documents.
Audrey Mbugua, a prominent transgender activist, and two other people in 2020 sued Attorney General Dorcas Oduor, the Registrar of Births and Deaths, the National Registration Bureau, and Immigration Services Director General Evelyn Cheluget after they did not receive amended birth certificates.
The Washington Blade previously reported the three plaintiffs argued documents that do not correspond with their gender identity “has denied them opportunities and rights.” Oduor, for her part, in response to the plaintiffs’ claims argued “a person’s gender is based on fact — not feelings — and the plaintiffs at birth were registered and named based on their gender status.”
High Court Justice Bahati Mwamuye ruled on May 20.
“The silence and delay cannot defeat rights,” ruled the court, according to the Daily Nation, a Kenyan newspaper. “Constitutional rights cannot be delayed over administrative convenience.”
The court in 2014 ordered the Kenya National Examinations Council to change Mbugua’s name on her academic diplomas and to remove the male gender marker from them.
Kenya’s intersex rights law took effect in 2022. The government in February 2025 announced intersex people can receive birth certificates with an “I” gender marker.
The Daily Nation notes Mwamuye ordered the Registrar of Deaths and Births and other government agencies to “begin receiving and considering applications for gender-marker changes within” 60 days.
“Access to legal identity documentation is not just a human rights issue; it is a foundational pillar of socio-economic inclusion,” said the Initiative for Equality and Non-Discrimination, a Kenyan advocacy group, in response to the ruling. Without accurate IDs or passports, individuals face severe barriers to employment, financial systems, global business travel, and participation in governance and democratic processes.”
“This ruling marks a critical step forward in reducing administrative discrimination and fostering an inclusive environment where every Kenyan citizen’s legal identity aligns with their dignity,” added INEND.
Outright International, a New York-based global LGBTQ and intersex advocacy group, in a statement described Mwamuye’s ruling as “a meaningful shift towards aligning Kenya’s legal framework with constitutional guarantees of equality, privacy, and human dignity. Outright International also applauded Mbugua and other activists who fought for this change.
“Today, we celebrate a milestone — one achieved through resilience, solidarity, and an unwavering belief in justice,” said the group. “Outright International stands with transgender and intersex Kenyans in honoring this victory and reaffirming our commitment to advancing rights, recognition, and equality for all.”
Ghana
Intersex lives, constitutional freedom, and the dangerous future of Ghana’s Human Sexual Rights and Family Values Bill
Lawmakers continue to consider draconian measure
There is a dangerous silence surrounding intersex lives in Ghana — a silence shaped by fear, misinformation, cultural misunderstanding, and institutional neglect. Today, amid discussions around the possible passage of the Human Sexual Rights and Family Values Bill, 2025, that silence risks becoming law, reinforcing exclusion and deepening the marginalization of already invisible lives.
Much of the national debate surrounding the bill has focused on LGBTQ+ identities. Yet buried within it are implications for intersex persons that many Ghanaians do not fully understand because intersex realities remain largely invisible.
Intersex persons are born with natural variations in chromosomes, hormones, reproductive anatomy, and/or genital characteristics that do not fit typical definitions of male or female bodies. Intersex is not a sexual orientation or gender identity. It is a biological reality. Ghana’s Commission on Human Rights and Administrative Justice (CHRAJ) has clearly acknowledged this distinction.
Despite this distinction, the bill mistakenly collapses intersex realities into a legal framework linked to LGBTQ+ criminalization.
Although the bill contains only limited references to intersex persons, under certain medical exceptions, these references do not amount to recognition or protection. Instead, they frame intersex bodies as abnormalities requiring regulation, correction, and institutional management. This approach is inconsistent not only with Ghana’s constitutional guarantees of dignity, equality, privacy, and liberty, but also with emerging African and international human rights standards. The African Commission on Human and Peoples’ Rights Resolution on the Promotion and Protection of the Rights of Intersex Persons in Africa – ACHPR/Res.552 (LXXIV) 2023 affirms protections relating to bodily integrity, dignity, freedom from discrimination, and against harmful medical practices. Additionally, the United Nations has repeatedly condemned medically unnecessary and non-consensual interventions on intersex children. Rather than affirming the humanity and autonomy of intersex persons, the bill risks legitimizing systems of surveillance, coercion, violence, and institutional erasure.
This is not protection.
It is managed erasure.
A child born intersex in Ghana already enters a society shaped by secrecy and stigma. Families are often pressured to hide intersex children or seek “correction” to make their bodies conform to social expectations.
The bill risks intensifying this pressure.
Clause 17 creates space for “approved service providers” to support interventions relating to intersex persons, yet offers little protection around informed consent, bodily autonomy, confidentiality, or coercive treatment. Under the language of “correction” or “support,” harmful interventions may become normalized.
The intersex community has documented painful lived experiences of intersex Ghanaians that reveal the devastating consequences of stigma and invisibility.
One heartbreaking case involved intersex twins born in Ghana’s Eastern Region in 1993, who were repeatedly forced to move from village to village because of rejection and ridicule. After losing their father, their main source of protection and support, they became even more vulnerable and reportedly experienced severe emotional distress, including suicidal thoughts linked to years of stigma and exclusion. This is what invisibility looks like in practice.
Another painful example is the story of Ativor Holali, whose lived experience exposed the cruel realities intersex persons face in sports and public life. Ativor Holali endured invasive scrutiny, public humiliation, and social suspicion because her body did not conform to rigid expectations of femininity. Rather than being protected as a Ghanaian athlete deserving dignity and privacy, she became the subject of speculation, gossip, and institutional discomfort.
Her experience reflects a broader social crisis: when society insists that every body must fit a narrow binary definition, intersex people are forced to defend their humanity in spaces where dignity should already be guaranteed.
Intersex Persons Society Of Ghana (IPSOG)’s Ŋusẽdodo research further revealed that approximately 70 percent of intersex respondents reported depression, anxiety, trauma, or severe emotional distress linked to medical mistreatment, family rejection, bullying, and social exclusion.
The bill risks transforming these existing prejudices into institutional policy. Several provisions risk deepening surveillance, restricting advocacy, weakening confidentiality, and discouraging public education around intersex realities. Intersex-led organizations providing healthcare guidance, legal referrals, psychosocial support, and community services may face serious challenges.
This places IPSOG and other intersex-led organizations in Ghana at serious risk.
For many intersex Ghanaians, these spaces are not political luxuries.
They are survival mechanisms.
Governments derive legitimacy by protecting the natural rights of all persons, including dignity, liberty, bodily autonomy, and freedom from arbitrary interference. The bill raises concerns because it risks weakening these protections for intersex persons through surveillance, coercive interventions, and restrictions on advocacy.
Ghana’s Constitution declares that “the dignity of all persons shall be inviolable.” Articles 15, 17, 18, and 21 specifically protect dignity, equality, privacy, expression, and freedom of association. These protections should apply equally to intersex persons.
Intersex persons are not threats to Ghanaian culture.
Intersex children are not moral dangers.
Intersex bodies are not political weapons.
They are human beings deserving dignity, healthcare, safety, and constitutional protection.
The true measure of a democracy is how it protects those most vulnerable to exclusion. At this moment, Ghana faces a choice: deepen fear and silence, or uphold dignity, bodily autonomy, and constitutional freedom for intersex persons.
History will remember the choice we make.
Fafali Delight Akortsu is the founder and president of the Intersex Persons Society of Ghana (IPSOG).
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