Despite high risk, HIV services don’t reach 9/10 MSM and transgender people. By Bobby Ramakant


Despite of AIDS programmes prioritising men-who-have-sex-with-men (MSM) and transgender people as high risk communities, not only the existing services are reaching appalling low numbers of MSM and trangender people, but also the funding for programmes targeting these communities is shockingly, namesake. “Funding for programmes that address sexual health needs of MSM people in Asia Pacific is left to 4% of total HIV-related funding” said Shivanand Khan, who was conferred upon the Order of British Empire (OBE) by the British Queen in recognition of his contribution to HIV prevention among MSM. Shivanand Khan is also the Chief Executive Officer (CEO) of Naz Foundation International (NFI).
This is very serious concern because according to the Commission on AIDS in Asia report 2008, more than 50% of new HIV infections will occur in MSM and transgender people.
“Nine out of ten MSM or transgender don’t receive any service at all” said Shivanand Khan OBE.
Shivanand Khan was speaking at the launch of a UN study at the XVIII International AIDS Conference in Vienna, Austria. The study report “Legal Environments, human rights and HIV responses among MSM and transgender people in Asia and the Pacific” is co-published by the UNDP and Asia Pacific Coalition for male sexual health (APCOM).
“With this year’s XVIII International AIDS Conference on the theme ‘Rights here, right now’, this study we worked with UNDP on, is very pertinent and very important because it talks about right to health, right to social justice, and right to well being” said Shivanand Khan.
It becomes more poignant reality as Shivanand Khan is speaking in the year (2010) by when ‘Universal Access’ to comprehensive HIV prevention, treatment, care and support services should have been achieved globally. If service coverage for one of the key populations for AIDS response is 10%, that is undoubtedly, and shockingly, alarming.
With extensive experience in AIDS care and sexual health services among MSM people, Shivanand Khan identified four key areas to address the urgent shortfall that exists:
1) We need to increase investments in HIV services for MSM and transgender people in the region. It can no longer be at 4% level
2) We need a rapid scale-up of services for MSM and transgender people. 10% service coverage is unacceptable. It is a form of a genocide in a sense, said Shivanand
3) Need to move the bias that stops those services being developed
4) We need a positive legal and social environment that our sense of self can be strengthened enough to engage in responsible sexual behaviour
“We certainly didn’t have the lot of evidence on how the legal environments actually influence the health outcome. Now we have the evidence before us, in form of this UNDP-APCOM study, we are all compelled to act on that evidence” said Shivanand Khan.
Shivanand Khan calls upon the governments to address the legal framework for three reasons:
1) “Basic human rights principle, because we want the governments to save money, we want to save money, money is being wasted. When HIV money goes to populations that are not affected by HIV, the kind of dissidence between health and AIDS policies and traditional policies, like two arms of governments working against each other and wasting resources
2) We do need more resources for the global response to AIDS but we could certainly do better work for the resources we now have if we get the legal environment right, and
3) If we align all of the necessary government policies, this is about rights, this is about health and this is also about saving money” said Shivanand.
“We have launched the Global Commission on HIV and law to build on this evidence and other evidence and to make sure we are pointing to good practices” said Shivanand Khan.
This UNDP-APCOM study report “Legal Environments, human rights and HIV responses among MSM and transgender people in Asia and the Pacific” adds to the existing body of evidence that points out how legal environments affect HIV responses among MSM and transgender people. Let us hope that the governments of countries in Asia-Pacific, take this report in cognizance and harmonize their policies so as to benefit public health and social justice. (CNS)

Bobby Ramakant – CNS
(The author is a CNS Policy Adviser and is the Director of CNS Stop-TB Initiative. He is a World Health Organization (WHO) Director-General’s WNTD Awardee (2008) and writes extensively on health and development issues for Citizen News Service (CNS). Website:, email: )

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