The State Department on Tuesday announced PEPFAR has delivered the first doses of a groundbreaking HIV prevention drug to two African countries.

The lenacapavir doses arrived in Eswatini and Zambia.

The State Department in September unveiled an initiative with Gilead Sciences to bring lenacapavir “to market in high-burden HIV countries.”

Lenacapavir users inject the drug twice a year.

The State Department in its September announcement noted everyone who participated in Gilead’s clinical trials remained HIV negative. It also said lenacapavir “has the potential to be particularly helpful for pregnant and breastfeeding mothers, as it safely protects them during and after pregnancy to prevent mother-to-child transmission.”

“In our new America First Global Health Strategy, the Department of State is establishing a first-of-its-kind innovation fund to support American-led research, market-shaping, and other dynamic advancements in global health,” said PEPFAR on Tuesday in a press release.

“The arrivals of the first doses of lenacapavir in Eswatini and Zambia mark an important milestone in HIV prevention and reflect our commitment to supporting communities with the greatest need,” added Gilead CEO Daniel O’Day. “For the first time, a new HIV medicine is reaching communities in sub-Saharan Africa in the same year as its U.S. approval.”

The September announcement came against the backdrop of widespread criticism over the Trump-Vance administration’s reported plans to not fully fund PEPFAR and to cut domestic HIV/AIDS funding. The Washington Blade has previously reported PEPFAR-funded programs in Kenya and other African countries have been forced to curtail services or even close because of U.S. funding cuts.

“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.

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.