Uganda’s debt to the gay community

Bloomberg NewsFebruary 25, 2014 

Explaining his decision Tuesday to sign a parliamentary bill making homosexual acts punishable by life imprisonment, Ugandan President Yoweri Museveni groused that Westerners had vexed the country by importing homosexuality into it.

It’s a laughable complaint, of course, and doubly wrong. Not only does Uganda have no legitimate grievance against Western homosexuals, it has reason to be hugely grateful to them. If it weren’t for Western homosexuals, hundreds of thousands of Ugandans alive today almost certainly would be dead. The anti-HIV drugs that keep them healthy were a direct result of gay activism, which also helped make the medicines accessible to Ugandans and others in developing countries.

Uganda was hard-hit by HIV in the early years of the pandemic. At the worst point, as much as 30 percent of the population was infected. Such a status meant almost certain death, as there was no effective treatment for HIV.

Gay activists in the United States pushed drug makers and government officials to accelerate research. They persuaded the Food and Drug Administration to make experimental drugs more available to the severely ill and to speed product review and approval.

By the mid-1990s, a new class of anti-retroviral drugs, used in combination, could turn HIV infection into a manageable, non-fatal condition. But only if patients had access to them. Very few did in Uganda, where the per capita GDP is about $1,400. Initially, the only Ugandans who received ARVs were those wealthy enough to travel to the West and pay for them. Slowly, the drugs became available within Uganda to a few thousand who could afford them.

In recent years, Uganda has benefited from the global movement to make ARVs accessible to everyone who needs them, a campaign in which gay Westerners have played an integral role. Reduced prices for poor countries and bulk purchases by governments and non-profit groups enabled some 9.7 million people in developing countries to receive ARVS in 2012. In Uganda, about 1.5 million people, or 7.2 percent of the adult population, are HIV-infected. Some 62 percent of the 575,000 who should be receiving treatment are getting it in Uganda, a relatively high percentage.

In middle-income countries with relatively liberal attitudes toward homosexuality, notably South Africa and Brazil, gay men have been instrumental in pressing their governments to ensure access to HIV treatment. Uganda’s homosexuals, on the other hand, are being silenced by fear.

It’s true, Uganda’s HIV epidemic isn’t characterized by homosexual transmission; fewer than 1 percent of infections in Uganda are attributed to gay sex. Nevertheless, gay men in Uganda are significantly more likely to be HIV-positive than their straight cohorts. This is not just a matter for gay men. Infections in this community are more likely to spread to the heterosexual community in a society such as Uganda’s in which gay men must pretend to be straight. In one study of Ugandan gay men, 78 percent had had sex with a woman, 20 percent were married to a woman, and 16 percent were living with a female sex partner.

In any case, wherever gay HIV activism has flourished, it has benefited all the victims of the pandemic. If Museveni and the parliamentarians who passed this awful law can’t be grateful for the Ugandan lives saved by Western activism, at least they should consider the advantages of allowing Uganda’s gays to live openly and advocate freely.

Lisa Beyer is a Bloomberg View editorial board member.

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