Let communities lead: HIV law and policy reform by and for key populations in Africa

New SCALE Initiative grants are supporting 17 key population-led organizations to remove barriers to HIV services across Africa

November 30, 2023

Nobody knows how to overcome barriers better than communities themselves. The AIDS response will succeed if communities are empowered and supported to lead.


More than four decades since the first cases of HIV were diagnosed, progress would not have been possible without the leadership, advocacy and passion of communities. This year’s World AIDS Day theme “let communities lead” is a call to action: the leadership of people living with HIV and other key populations, including gay men and other men who have sex with men (MSM), transgender people, people who inject drugs and sex workers, must be funded, strengthened and prioritized in the HIV response. 

Eastern and southern Africa, the region most heavily impacted by HIV, has seen a substantial reduction in new HIV infections and AIDS-related deaths since 2000. But progress has varied between countries and communities, with key populations continuing to bear the brunt of the epidemic across the continent. Many countries also continue to criminalize same-sex sexual relations, sex work or drug use, which exacerbates stigma and discrimination and blocks access to care. 

Nobody knows how to overcome these barriers better than communities themselves. Rights-based approaches provide a means of empowering all people to make decisions about their own lives rather than being the recipients of choices made on their behalf.

In November, UNDP announced US$1 million in Law & Access grants through the SCALE Initiative to key population-led organizations around the world, including seventeen organizations across Africa. The SCALE Initiative: Removing Barriers to HIV Services is a two-year partnership led by UNDP that scales up key population-led efforts to counter discriminatory laws and HIV-related criminalization. The Law & Access grants recognize the critical role communities play in both connecting their peers to HIV services and challenging harmful laws, policies and social norms standing in the way of progress. 

Though more countries are moving toward decriminalization of same-sex sex, removing structural barriers remains articularly important for the LGBTI+ community in many African countries. Out-Right Namibia is conducting advocacy campaigns to create favorable environments to promote the repeal of colonial era laws criminalizing same-sex sex in their respective countries. Latu Human Rights Foundation is improving access to HIV services for key populations in Zambia, while increasing public awareness and enhancing dialogue. Rainbow Reflections of Namibia is raising awareness on laws and practices targeting key populations given an uptick in human rights violations against LGBTI+ people in Namibia since the recognition of foreign same-sex marriages in May 2023.

"We look forward to forming meaningful collaborations and partnerships with key stakeholders in Namibia through this grant so we can advance policies and laws that take care of all, especially LGBTQI people in the country,” said Rita Moyo, Programmes Officer, Rainbow Reflections of Namibia.

Though data is limited, in some parts of Africa HIV prevalence among transgender women has been estimated to be as high as 42.8 percent. Diversity LGBTITQ Human Rights and Advocacy Association of Namibia is using its Law & Access grant to help realize legal recognition for transgender communities and advance the provision of life-saving gender affirming health services. Positive Vision in Cameroon is aiming to contribute to a more enabling environment for transgender people to improve care while reducing stigma, discrimination and violence against the community. 

Community-led action is necessary to accelerate progress, including through mobilizing and strengthening the leadership of marginalized people. Humanity First Cameroon Plus is working to improve the rights of sexual and gender minorities, including through community-led hate speech monitoring and strengthening support systems for victims. The Lotus Identity is helping improve cooperation among local key population-led civil society organizations in Zambia. The Rock of Hope is focused on community mobilization in order to better equip LGBTI+ people to become self-advocates for improved access to health care, justice and social services. 

In South Africa, the Sex Workers Education and Advocacy Taskforce (SWEAT) aims to establish a community-led advice office, which will provide legal advice to sex workers, LGBTI+ people, homeless people and migrants, many of whom are also living with HIV and/or drug users, while Access Chapter 2 is enhancing legal support to promote the human rights of LGBTI+ people through both legal literacy training for the community and sensitization of duty bearers.

Though the pathway to law reform is complex and varies by country and community, a common tactic across the organizations is to help create safe space for community engagement with decision-makers. Sisonke National Movement aims to build bridges between relevant government departments and key populations in South Africa, while Health Plus 4 Men in ang and Affirmative Action in Cameroon both aim to establish new key population consortiums to help engage with policymakers. 

Many organizations are leveraging their grants to either challenge or help enforce current and new laws. Through training and education programmes regarding the legal issues surrounding Angola’s HIV Law 8/04, the Arquivo de Identidade Angolano (AIA) in Angola aims to empower female key populations, including LBTIQ+ women, female sex workers and women living with HIV. IRIS Association and Human Action Association will also help address the current legal framework in Angola, including by training duty bearers on the fair and just application of law and engaging with parliamentarians. In Côte d'Ivoire, Paroles autour de la Santé is promoting a new rights-based law on narcotics, with a particular focus on training paralegal units made up of former drug users and sensitizing law enforcement agencies.

These communities do not need to be told what to do or how to do it – they have been on the frontlines for decades. To achieve the 10-10-10 targets set out in the 2021 Political Declaration on HIV/AIDS and end AIDS by 2030, we all must do our part to strengthen and scale up the work of people living with HIV and key populations. UNDP and partners support countries and communities to put people first and leave no one behind, on this and every day.