While several countries have legalized same sex marriage, few have provided explicit and full anti-discrimination provisions in their constitutions. With the ratification of its new constitution, Nepal joins South Africa and Ecuador as the third country in the world to provide full protections for LGBT people in its national constitution.  This marks a significant step toward reducing discrimination and violence against LGBT individuals and communities across Asia. Countries across the region should look to Nepal as a leader in protecting the rights of LGBT people, and should seek to enact similar national anti-discrimination legislation. Such measures will help to advance the rights of all people, and will mitigate the spread of epidemics that disproportionately affect the LGBT community, including HIV.

Thailand’s new Gender Equality Act is an equally important, though imperfect, measure advancing the rights of the country’s LGBT community. Loopholes concerning the law’s application in regards to “religion or national security” remain troubling, but as Thailand’s first national legislation to specifically protect against discrimination on the grounds of gender expression, it has the potential to increase acceptance of LGBT communities in the country, particularly for transgender men and women.  Increased awareness and dialogue on these issues is crucial to sway public opinion on the universality of rights, reduce stigma, and help end discrimination. The Gender Equality Act will prove a useful platform for Thai and other regional actors to educate society on the lived experiences of LGBT people, and to advocate for improved rights protections across the board.

The new WHO policy will increase the number of people eligible for ART from 28 million to all 37 million people currently known to be living with HIV (PLHIV) globally. UNAIDS estimates the policy change has the potential to avert more than 21 million deaths and prevent 28 million new infections by 2030. 

Globally, HIV prevalence is decreasing among the general population. However, the epidemic is becoming concentrated and thriving in several highly marginalized communities—such as sex workers, people who use drugs, and men who have sex with men. In low- and middle-income countries, the average HIV prevalence among sex workers is estimated to be approximately 12%, with a high odds ratio for HIV infection of 13.5% compared to all women ages 15-49.  

Among the estimated 12.7 million people who inject drugs globally, approximately 1.7 million (13%) are living with HIV.  In this landscape, the WHO’s recommendation that anyone at “substantial risk” be offered PrEP to prevent contracting HIV—including,  for the first time, sex workers and people who use drugs—is a major step forward in ending the epidemic. It is not, however, the only step needed.

As the New York Times article notes, it is unclear where the money will come from to turn the new guidelines into reality. Although the WHO issues guidelines, each country sets its own policy on when treatment starts, depending on how many citizens the country’s health budget can afford to treat. Only fifteen million people are on treatment now, fewer than half of the 37 million people infected worldwide, and significantly less than the 28 million eligible under previous WHO guidelines.

Analysis:

This summer’s impassioned debate surrounding Amnesty International’s decision to support the decriminalization of sex work illuminated a global gap in knowledge on sex work issues. The Global Sex Work Law Map provides accessible and accurate information about the laws and policies that govern the global commercial sex industry. It allows for a wide range of people to draw evidence-based conclusions on the effects of various regulatory frameworks.  

As the world seeks to address challenges associated with the criminalization of commercial sex work, policy-makers must look past moral arguments and sensationalist headlines to focus on strong evidence. Appropriate responses to the needs and experiences of sex workers must take into account local cultural, political, and social realities. This can only be done when policy-makers consider the lived experiences of sex workers when developing strategies, and research the best and worst practices in similar contexts.  As such, this resource will inform ongoing global debates on sex work policy and regulation. Without such due diligence, policy-makers worldwide will continue to perpetuate the status quo and to stall progress, doing little to improve protections for sex workers.