HIV and Human Rights in Nigeria
With an adult HIV prevalence of 2.8% and the second highest number of people living with HIV in the world, Nigeria’s HIV response is critical to the success of the global AIDS response. To coincide with the 22nd International AIDS Conference, UNDP spoke with Dr. Yinka Falola-Anoemuah, PhD, Assistant Director (Gender, Human Rights and Care Support Services) at the National Agency for Control of AIDS (NACA).
What are some of the key changes you’ve witnessed in the HIV response over the years?
There’s been a move away from general awareness campaigns, which is what everybody was doing at the beginning of the 1980s. Now the focus is on providing testing, treatment and comprehensive care and support services. There has also been a shift towards protecting human rights and a stronger focus on how to reform laws and policies, in order to reduce vulnerabilities to HIV.
Data has also become more and more important. We now know that Nigeria has a mixed epidemic, with very high HIV prevalence among certain key populations, including female sex workers, men who have sex with men, people who use drugs and transgender people. We also need to look at how best to support young women and girls.
There has also been a shift towards protecting human rights and a stronger focus on how to reform laws and policies, in order to reduce vulnerabilities to HIV.
Why is a human rights-based approach key to halting the HIV epidemic?
We know that to reach the SDG 3 target to end AIDS, we need to ensure that no one is left behind. Despite recent improvements in coverage of HIV services in many places, studies continue to show that certain groups are being left behind and may have poor access because of social, legal, cultural and political constraints. Sometimes regardless of supportive laws and policies, they are systematically excluded.
A lot of people still don’t understand how the virus is transmitted. There is an urgent need to address stigma and discrimination towards people living with HIV and other key populations, including the LGBTI (lesbian, gay, bisexual, transgender and intersex) community which is not officially recognized in Nigeria. It is critical that people have access to information and access to life saving services, and that programming efforts reach people in their own environments.
We know that for us to reach the SDG 3 target to end AIDS, we need to ensure that no one is left behind.
What are the main challenges that are currently hindering an effective response to HIV in Nigeria?
Reaching key populations with services and working with service providers to address stigma and discrimination in healthcare settings is crucial. We also need to work with the judiciary and parliamentarians. This includes investing and strengthening capacity of government institutions, including legal, law enforcement, public health and other practitioners, to programme for key populations using human rights principles.
There is significant intolerance towards key populations, especially for people with diverse sexual orientations and gender identities such as transgender people, both by members of the public and service providers. People must accept the fact that these are Nigerians and they have rights like every other person.
There is also a lack of understanding of human rights. There are many provisions that can be used within the Constitution, within the NACA Act, or the HIV/AIDS Anti-Discrimination Act 2014. But we need greater efforts to expand legal literacy and know-your-rights campaigns. Knowing your rights is critical to realizing them.
Knowing your rights is critical to realizing them.
What is the National Agency for Control of AIDS doing to reduce the impact of HIV on key populations?
The HIV Legal Environment Assessment we carried out in partnership with UNDP helped to identify key legal, human rights and policy issues that are acting as barriers for key and vulnerable groups to access services. Based on these recommendations, we developed the five-year National Plan of Action to facilitate reform of punitive laws and policies, enforcement of enabling ones, and strengthening legal literacy of stakeholders and key and vulnerable populations.
As part of this, we are implementing capacity building activities for government and non-government actors — law enforcement officers, lawyers, health workers, social workers, communities, etc. — on how to use human rights principles for programming for key and vulnerable populations. We are committed to ensuring the involvement of key populations in the planning, implementation, monitoring and evaluation of interventions.
We are committed to ensuring the involvement of key populations in the planning, implementation, monitoring and evaluation of interventions.
How are you helping people to report human rights violations?
We have a toll-free call centre where people can call in to report violation. We also work together with a civil society organization, the Coalition of Lawyers on Human Rights (COLaHR), on law reform, legal literacy, access to services, and specific issues to deal with key and vulnerable populations. Since the start of the call centre over 50 cases have been documented.
How are you supporting the transgender community?
We still have challenges in better understanding transgender issues and how to programme specifically for this group. One of the ways we’re addressing this is by engaging with the Gender, Human Rights and Care Support Services Unit to get gender and human rights, including transgender issues, integrated into the new strategic framework, which we’ve succeeded in doing. This is significant because the framework will direct what we’re going to do in the HIV response in our country for the next five years until 2021.
How are UNDP and the Global Fund supporting a human rights-based HIV response in Nigeria?
Nigeria is one of the countries included in the Africa Regional Grant on HIV: Removing Legal Barriers. It is a multi-year grant supported by the Global Fund and implemented by UNDP that addresses human rights barriers faced by vulnerable communities.
Nigeria has already benefited from a series of capacity building programmes for health workers, law enforcement officers, parliament, lawyers, judges and human rights institutions.
A number of Federal and State Parliamentarians have benefitted from regional trainings. This has resulted in having champions amongst them with a better understanding about the importance of gender and human rights in HIV and TB programming. They have helped to facilitate increases in health budgets.
Furthermore, Nigerian key populations themselves are benefiting because they are also part of the regional capacity building efforts and have been given a space for dialogue with stakeholders.
We’ve also been able to strengthen the capacity of three key populations-led civil society organizations, in understanding their rights; documenting and reporting human right violations experienced by community members; and supporting access to justice.
The regional trainings have also been very useful as countries are able to share their experiences. Meeting our counterparts from other countries helps us to learn from each other and work together.
We’re now taking forward the legal environment assessment in Nigeria, building on the recommendations and action plans developed and commencing implementation with relevant government institutions and civil society groups.
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Together with the Global Fund, UNDP is working with four leading African civil society organizations — the AIDS and Rights Alliance for Southern Africa, ENDA Santé, KELIN, and the Southern Africa Litigation Centre — through the Africa Regional Grant on HIV to address human rights barriers faced by vulnerable communities in Africa, and facilitate access to lifesaving health care. The programme aims to remove legal and policy barriers by providing documentation of human rights violations, advocacy support, strategic litigation and capacity strengthening for key stakeholders. For more information, click here .