HIV/AIDS: Commonwealth Countries — Question for Short Debate

– in the House of Lords at 6:45 pm on 13th March 2013.

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Tabled By Lord Black of Brentwood

To ask Her Majesty's Government what assessment they have made of the impact of discrimination against gay men and women in Commonwealth countries on global efforts to halt the spread of HIV/AIDS, and what steps they are taking to tackle such discrimination.

Photo of Lord Black of Brentwood Lord Black of Brentwood Conservative 6:56 pm, 13th March 2013

My Lords, it is a privilege to lead this debate. I am indebted for the support of the organisations that work tirelessly in this area, including the Human Dignity Trust, the HIV/AIDS Alliance, the Kaleidoscope Trust and the Terrence Higgins Trust.

It is a while since this House debated the issue of HIV/AIDS, so let us first remind ourselves of the scale of the problem. While in the developed world, where HIV is now a chronic condition, not a death sentence, we sometimes become blasé about the subject, in much of the world HIV and AIDS remains a catastrophe. In three decades, AIDS has claimed 30 million souls. Last year, 1.8 million died. More than 34 million people are living with HIV and many of them will perish. Although new infections have declined by 21% in the past decade, still 7,400 people are infected each day.

HIV and AIDS remains a global health catastrophe-the worst pandemic in modern history. The good news is the enormous advance in treatment. Today, there is no reason why anyone receiving it should live any shorter a life than someone without HIV. Crucially, we also have the tools radically to slow new infections through education and prevention measures. However, that ability to prevent the spread of HIV is being seriously compromised. The Global Commission on HIV and the Law concluded that,

"punitive laws, discriminatory and brutal policing and denial of access to justice for people with and at risk of acquiring HIV are fuelling the epidemic".

At the heart of international efforts to deal with this pandemic is a crisis of human rights law, not medicine. There is now overwhelming evidence of the link between criminalisation of homosexuality and the rate of HIV infection.

Why does criminalisation matter? What is the link between bad law and this public health disaster? The UN Development Programme's Global Commission on HIV concluded that criminalisation of homosexuality "both causes and boosts" the rate of HIV among men who have sex with men, or MSM. Evidence is incontrovertible. In Caribbean countries where homosexuality is criminalised, almost one in four MSM are infected with HIV. In the absence of such laws, the prevalence is one in 15-a shocking disparity. A report in The Lancet in 2012 reaffirmed:

"The odds of HIV infection in black MSM relative to general populations were nearly two times higher in African ... countries that criminalise homosexual activity than for those living in countries where [it] is legal".

Why is that?

Criminalisation breeds stigma and marginalisation. Where this exists, homosexual behaviour is driven underground. Those at risk do not want to talk about their sexuality, receive information about prevention or, crucially, get tested, for to do so may mean prosecution and severe punishment. That has a terrible impact on homosexual behaviour. As The Lancet report I just mentioned concluded, where it is impossible for gay men to found lasting, loving relationships because the law prohibits it, they adopt non-monogamous, anonymous, unsafe sexual practices that fuel infection. There is nothing to warn them not to do so. It is after all almost impossible to mount HIV prevention campaigns where homosexuality is outlawed. A study in 2010 commissioned by the UNDP focusing on Asia and the Pacific found that such laws are regularly used by police to prohibit HIV prevention activities, confiscate condoms and censor educational material on HIV. Yet as studies in Cameroon, Senegal and Kenya have found, there is a strong correlation between the lack of these programmes and the likelihood of MSM having unprotected sex, simply out of ignorance of the basic facts.

Then there is the impact on the care of those infected. The threat of criminal sanction is an overwhelming disincentive to seeking access to HIV services-if, of course, they are available. In a recent case in Kenya where the penalty for,

"carnal knowledge of any person against the order of nature", is 21 years in prison, the Medical Research Institute had its HIV work disrupted after church leaders claimed that it was providing "counselling services to criminals". There are similar horror stories from Uganda, Cameroon and Singapore, where health providers, who are key to preventing the spread of HIV, refuse to do so because of the threat of dreadful criminal sanctions.

The issue is not one that impacts just on gay men. HIV does not respect sexual orientation and statute in a neat and tidy manner. Because of these laws, many homosexuals inevitably maintain heterosexual relationships alongside a relationship with a man. The result is that innocent wives and children, often blissfully unaware of the fate that awaits them, also die as a result of criminalisation. So let us be very clear: criminalisation of homosexuality kills. It kills gay men. It kills women and children, and it kills them needlessly in their tens of thousands, with no end to this in sight. It begets a grotesque waste of human life on an unimaginable scale. Of course, criminalisation is an issue of fundamental human rights-one that I, as a gay man, feel profoundly. But it is also, overwhelmingly, an issue of public health. In the name of saving lives, it has to end.

To our shame, many Commonwealth countries stand in the dock. As we heard last October in a debate led by my noble friend Lord Lexden, their record on criminalising homosexual behaviour is shameful: 42 out of 54 Commonwealth countries criminalise same-sex relations. Punishments range from life in Sierra Leone to 20 years in prison, with flogging, in Malaysia. The record of the Commonwealth on HIV and AIDS is a pitch perfect underlining of my argument. While the Commonwealth represents 30% of the world's population, it contains more than 60% of people living with HIV globally. That is a damning statistic. We will never be able to tackle the global AIDS epidemic until Commonwealth countries take action to dismantle cruel, degrading, outdated laws criminalising homosexuality.

That point was rightly recognised by the Commonwealth Eminent Persons Group, which in 2011 concluded that decriminalisation had been successful in reducing cases of HIV infection and recommended that steps be taken to procure repeal of these laws. But, in the interest of saving human lives, words need to be met with action. Let me suggest some. There are some things that this House can do. Our committees can play a vital role by providing oversight of Commonwealth institutions and scrutinising progress made by the UK in delivering its LGBT rights strategy. There are things that the Church of England, which has great sway in the Commonwealth, can do by condemning criminalisation specifically because of the way it squanders human life. I am delighted to see the right reverend Prelate here this evening.

There are challenges for the Government. I recognise that they have already done a great deal and I applaud the work of DfID and the leadership of the Prime Minister. I also recognise the enormous personal commitment of my noble friend Lady Northover, but there is more. The UK needs actively to support legal reform across the Commonwealth-an issue that should also be a high priority for CHOGM later this year. I ask my noble friend for an assurance that we will press to make this happen. I hope that the Government might also make decriminalisation and HIV prevention, which is crucial to it, a policy commitment for the FCO and DfID.

The Government should also press the Commonwealth Secretariat and the Commonwealth Foundation for action in this area. It is very worrying, given the sheer number of people at risk across the Commonwealth, that the secretariat has not included LGBT rights, legal reform or HIV in its new strategy. I would ask my noble friend to take this up with these institutions, which could play a vital role here. I also hope that the Government will look at introducing a specific funding mechanism for LGBT organisations working for legal or social reform within their own countries, or delivering services to LGBT people.

All these are important steps in beginning to tackle the tragedy-it is a tragedy-of criminalisation. It is an affront to human rights, an affront to human dignity and a legacy of 19th century colonialism that is killing tens of thousands of people in the 21st century. It is an extraordinary monument to man's inhumanity to man. I shall listen with huge interest to our debate. We discuss many important issues in this House but it is not often that we get the chance to talk about a subject which, over time, could make the difference between life and death for many who are alive now but sick or at risk, and many yet to be born. This is one of those occasions and I am sure that we will rise to it.

Photo of Baroness Gould of Potternewton Baroness Gould of Potternewton Deputy Speaker (Lords) 7:07 pm, 13th March 2013

My Lords, I thank the noble Lord, Lord Black, for introducing such an important debate. As he says, it is the sort of issue that we do not discuss very often. I should declare an interest as co-chair of the Sexual Health Forum and a patron of the parliamentary group on transgender issues.

Part of the British Empire legacy to Commonwealth states 150 years ago was our then legal system, which we passed on and which regrettably included the old colonial draconian laws on homosexuality. These laws were not repealed when the former colonies won their independence, and they continued to ban gay sex between consenting adults. A consequence has been that the Commonwealth countries make up 30% of the world's population but 60% of the level of HIV. It is interesting that the countries that were colonised by France under the Napoleonic code, which does not concern itself with homosexuality, do not have anti-gay laws or high levels of HIV. In the Commonwealth countries, however, laws are myriad, and with them come violence, murder, fear, stigma, rejection, impunity, the criminalisation of identity and persecutions. As the noble Lord, Lord Black, says, of the Commonwealth countries, 42 still criminalise same-sex relationships for men, women or both, with dire penalties. I find it unbelievable that the situation is getting no better. In fact, in some countries, it is getting worse.

If I may, I shall repeat some of the horror stories because the more often they are told the more people might listen. In Uganda, the anti-homosexuality Bill is repeatedly brought forward to impose the death penalty for men living with HIV. In Zambia, the maximum penalty has been increased from 10 years to 15 years in prison. Penalties in Trinidad and Tobago include 25 years in jail, and there is legislation to ban the entry into the country of known homosexuals. In Malaysia, the penalty is 20 years and flogging. In Malawi, there are prison terms of up to 14 years hard labour. And there is life imprisonment in Sierra Leone, Tanzania, Bangladesh, and Pakistan, which also imposes imprisonment for private same-sex intimacy.

These so-called civilised countries defend these criminal sanctions as an authentic expression of indigenous national culture and tradition: that they are breaches of public morality, public health issues and sexual normality. But those conditions do not apply to the 12 Commonwealth countries that currently do not criminalise same-sex acts. It is encouraging that some of those countries also have laws that protect LGBT people from hate crimes and prohibit discrimination against them. Botswana, for instance, amended its Employment Act in 2010 to prohibit discrimination on the grounds of sexual orientation. There is no question that legal penalties for homosexuality encourage public persecution. In Jamaica, gay men are so hideously and violently socially persecuted that many countries now accept gay asylum seekers from Jamaica into their own countries.

Again, in Uganda, tabloid newspapers have conducted witch hunts naming gay men and encouraging violence against them. In both those countries, the result was gay men being killed. All this shows that obstructive legislation contributes to the inability of HIV sufferers to claim their rights and increases the level of HIV stigma and discrimination. HIV sufferers face persecution and violence from employers, hospitals and community organisations. These draconian laws drive gay people underground, away from effective HIV prevention, treatment, care and support. As the noble Lord, Lord Black, said, it must follow that if you have to hide being gay, HIV-prevention agencies cannot give appropriate advice and may find it hard to reach you at all.

Additionally, where men or women have acquired HIV through gay sex, they are less willing to go for testing, so they pass the virus on. This situation is not helped by the continual harassment of HIV outreach workers by police who prohibit HIV-prevention activities on the grounds that they aid and abet criminal activities. Government agencies may be forbidden from working with illegal minorities. The situation, therefore, is that gay people face a double whammy: first, the risk of acquiring HIV, but at the same time being unable to ask for advice or support because they would have to admit to committing an illegal act.

Last year, the Ugandan authorities shut down a workshop bringing together advocates for the rights of LGBT people and providing information on how to avoid HIV transmission. In Cameroon, armed police broke up a planned three-day meeting on HIV/Aids and sexual minorities, organised by the Association for Adolescents Health against HIV/Aids. All that support and help therefore is not going to the people who need it.

Tackling homophobia can encourage gay men to be tested for HIV and other sexually transmitted diseases. There is no question that homophobia continues to be a major barrier to ending the global HIV and AIDS epidemic. The Commonwealth Heads of Government say that the fight against HIV is a high priority, adding:

"we are committed to accelerating action to implement the objectives outlined in the 2011 UN Political Declaration on HIV/AIDS".

Nevertheless, only this week, when discussing the future Commonwealth Heads meeting, there was talk about the theme being democracy and human rights. If their goals on HIV/AIDS are really genuine, they have to tackle this situation. At the same time, the Commonwealth Secretariat-again, as the noble Lord, Lord Black, said-has not included LGBT rights, legal reform or HIV in its new strategy. The Commonwealth Foundation's new strategy does not include any plans to support LGBT organisations or others working towards law reform.

Gay men and women are not the only people who suffer because of their sexuality. Illegality is also likely to be extended to transgender people and sex workers, who are similarly marginalised, hard to reach and often subject to legal sanctions. For instance, the high prevalence of HIV in Africa is driven by cultural, religious and political unwillingness to accept LGBT people, so the prejudice, harassment and isolation means lack of access to HIV prevention, including the availability of condoms.

This is a particular problem for transgender women because their identity as women is not recognised in many Commonwealth countries. Denial of their gender identity in law exacerbates the discrimination and marginalisation that transgender people experience. They often are the targets of violent hate crimes, are denied healthcare and education and struggle to find employment, so they are forced into sex work, all of which increases their HIV risk.

Finally, I follow the same theme as the noble Lord, Lord Black. How should the UK exert its influence? What should we be doing? The UK should actively support legal reform that decriminalised consensual sex between adults of the same sex and prohibited discrimination on the basis of sexual orientation and gender identity. We should be calling for targets on law reform and equality in the post-2015 development framework as a means to ensuring access to health and other services for LGBT people and other excluded groups. The Government can play a vital role by providing a more critical oversight of the Commonwealth institutions and by scrutinising progress made in delivering on their LGBT rights strategy, thereby reducing the level and the spread of HIV and AIDS.

Assumptions that criminalising sexual minorities will prevent the spread of HIV and AIDS are ill-founded, based purely on ignorance and long-standing prejudice. The global evidence is clear that public health is best served by removing discrimination and prejudice against all LGBT persons, giving them-the people who need it most-access to HIV prevention and treatment. Removing stigma through the decriminalisation of private, adult, consensual, same-sex sexual relations is the first step in promoting, health and tolerant societies.

Photo of Baroness Brinton Baroness Brinton Liberal Democrat 7:16 pm, 13th March 2013

My Lords, I start with an apology. I am afraid that the speed of the previous business meant that I arrived just after the beginning of the speech by my noble friend Lord Black of Brentwood. I realise that was a discourtesy to the House and I hope noble Lords will allow me to continue. I also thank my noble friend Lord Black for instigating this debate, which is very important. We have already heard from both him and the noble Baroness, Lady Gould, the important strategic reasons.

The continued spread of HIV and AIDS in the Commonwealth of Nations has had devastating effects on the lives of the ill and their families, and on the nation as a whole, which suffers the loss of a young population. Although many nations have been able to minimise transmission of the disease through education and public health initiatives, cultural barriers persist that make containment of the disease particularly challenging. We have all followed the progress of the Anti-Homosexuality Bill in Uganda, which, in criminalising homosexuality and all educational content regarding homosexual behaviour, makes it nearly impossible to educate the Ugandan LGBT community about safe sex practices.

As we have heard already, this problem is not isolated to a single nation, but is part of a widespread culture of homophobia that bars education and marginalises gay men and women around the world. Although it might be awkward to acknowledge, we recognise that the homophobic attitudes that exist in statute today in parts of the Commonwealth originated in whole or in part from a legacy of colonial British prejudices. Over the past half-century, we have taken steps to change our own culture to one of tolerance and support for all people, regardless of sexual orientation or gender identity. Today, we must take those lessons that we ourselves have learnt to encourage and support some of our Commonwealth family to make similar strides towards the equal protection of all people, regardless of sexual orientation or HIV status, and towards a culture that encourages education and public health awareness.

While the spread of HIV and AIDS in the LGBT community has devastated lives around the world, this evening I would like to focus on Zambia, which is an interesting case study in the ways in which HIV and AIDS prevention can be effective, but also the ways in which it can fail. Zambia is one of the nations hit hardest by the HIV and AIDS epidemics and currently suffers the sixth highest rate of HIV in the world. Today, more than one in seven adults live with HIV. As a result, average life expectancy has dropped to a mere 49 years. Although hit hard by this disease, the Zambians rallied to become one of the most willing African nations to confront the epidemics by the start of the millennium. In 2004, President Mwanawasa declared HIV and AIDS a national emergency, promising to provide antiretroviral drugs to 10,000 people by the end of the year. Not only did the President meet this goal, but he exceeded it, and promised to provide the drugs for an additional 10,000 people by the end of 2005. Former President Kaunda, who in the 1980s attempted to cover up the magnitude of the AIDS epidemic, is now one of Zambia's foremost AIDS activists. In 2008, UNAIDS reported that the epidemic in the region was stabilising.

Political attitudes towards the virus are changing now that politicians in Zambia are willing to talk about it. In light of International Women's Day, it is important to congratulate Zambia on the steps taken to protect women and children against the disease by educating women about healthy relationships and safe sex practices, and leading a national campaign to dispel the "virgin cure" myth. Condom use is increasing, and with it the negative stigma associated with condoms is slowly waning. Heterosexual couples are learning through many education initiatives about abstinence and marital fidelity as means of stopping the spread of AIDS and HIV.

However, despite these positive steps forward, the LGBT community in Zambia remains marginalised, unable to access education and abused. As the noble Baroness, Lady Gould, has already told your Lordships' House, homosexuality is a crime in Zambia, punishable now by up to 15 years in prison. Cultural attitudes express widespread disapproval of homosexuality. In a 2008 survey by the Pew Research Center, the number of respondents who indicated that they felt homosexuality was morally wrong was the highest in any country in Africa, at 98%. American journalist Linda Villarosa described her experiences in Zambia on the Huffington Post blog last summer after travelling with the Global Fund to report on HIV and AIDS. While in Zambia, she wrote, she met Lundu, an openly gay man and an HIV and AIDS activist. When he told his family he was gay, they turned to medicine men to try to cure him. Lundu told Linda that:

"The first day, they cut my skin in 200 places and rubbed herbs and ash in the cuts. The second day they tied me to a tree in the bush and left me there overnight. On the third day, they put me in a shallow grave wrapped in a white shroud".

Despite the hellish experience that Lundu suffered at the hand of his own family, he recognises the cultural barriers and widely held beliefs that feed into homophobia and consequently contribute to the spread of HIV and AIDS. The criminalisation of homosexuality in Zambia makes it difficult for public health organisations to disseminate information about safe sex and almost impossible for homosexual Zambians to seek access to these materials and to support networks. Many people in Zambia, both heterosexual and homosexual, do not know their HIV status for fear of stigmatisation because of the virus.

The UK Government have come forward in the past and asked the Zambians to protect the LGBT community and legalise homosexuality, but we know that this was met with resistance. In 2011, we expressed our disapproval for these policies by channelling aid directly to the people rather than through the Government. However, the policies remain unchanged and, sadly, so does the state of the virus. Although Zambia continues to receive millions of pounds in international aid, the prevalence of the virus has not dropped significantly since it stabilised in 2008. If through this debate your Lordships' House continues to take the view, which I hope our Government will continue to take, that one of our foremost priorities in the world is to stop the spread of HIV and AIDS, in Zambia in this instance, we must consider other means of helping to change the culture of homophobia in Zambia through channels other than purely by increasing or changing international funding. There is still a lot that we can do.

We can continue to support online resources, such as Rainka in Zambia and Behind the Mask in South Africa, which use blogs to disseminate information about sexuality and safe sex for homosexual couples in nations where the Governments are not willing to support this type of education. We can continue to engage in a dialogue with the nations most affected by the AIDS epidemic about the public health reasons to decriminalise homosexuality. We can set an example by continuing to stand for equal rights regardless of sexual orientation or gender identity. Perhaps most importantly, we can be the voice that connects health with respect for all people, promoting a new cultural attitude that will help nations like Zambia continue efforts to conquer HIV and AIDS.

Photo of The Bishop of Newcastle The Bishop of Newcastle Bishop 7:25 pm, 13th March 2013

My Lords, I am very grateful to the noble Lord, Lord Black, for his powerful, moving and, indeed, sometimes bleak speech, which spelt out so strongly and persuasively the link between the criminalisation of homosexuality and the rate of HIV infection and death from AIDS. This timely debate is taking place in the week when the charter has been agreed and signed up to by all the Commonwealth nations. It expresses that it is,

"implacably opposed to all forms of discrimination, whether rooted in gender, race, colour, creed, political belief or other grounds".

I take "other grounds" to mean also on grounds of sexuality, although the charter does not spell that out, which suggests there is still a very great deal of work to be done.

Noble Lords may remember that it was almost 50 years ago now, in 1967, that the then Archbishop of Canterbury, Michael Ramsey, spoke in this House to support the decriminalisation of homosexuality in this country. We sometimes underestimate how brave a stance that was from him at that time. By doing so, he made the distinction in British law between a moral and a criminal matter. One of the problems today is that no such distinction has been made in many parts of the Commonwealth and, as a result of criminalisation, people continue to suffer terrible abuse-sometimes death-and the scourge of HIV/AIDS continues unchecked. Indeed, as the noble Baroness, Lady Gould, said, in recent years in some countries there has been an increase in stigmatisation, discrimination and criminalisation, which of course threatens to undermine all the good work that has been done with HIV/AIDS.

It is very well known that on matters to do with homosexuality the churches in general, and the Anglican communion in particular, are deeply divided. However, there are not, and cannot be, any grounds for denying the equality before the law of every single human being, whether they are homosexual or heterosexual. Many of us in this country value and indeed treasure our links with particular dioceses around the Anglican communion. In my case, over the past dozen years or more, that has been with the diocese of Botswana. HIV/AIDS was a disaster for that country, although things are now improving significantly. The Botswana Government have been actively providing public health education and public healthcare and the HIV/AIDS rate is in decline. There has been a much more positive response in Botswana than in some other neighbouring African countries.

Few have spoken out of southern Africa as clearly as Archbishop Desmond Tutu, who said to a United Nations panel in 2010:

"All over the world, lesbian, gay, bisexual and transgender people are persecuted. They face violence, torture and criminal sanctions of how they live and who they love. We make them doubt that they too are children of God-and this must be nearly the ultimate blasphemy ... Our lesbian and gay brothers and sisters across Africa ... are living in fear. And they are living in hiding-away from care, away from the protection the State should offer to every citizen and away from health care, when all of us ... need access to essential HIV services".

The noble Lord, Lord Black, issued a challenge to me in his opening speech. He believes, he says, that the Church of England has got great sway within the Commonwealth. If only that were so. Much more importantly than that, he challenged me to condemn criminalisation specifically because of the way in which it endangers and squanders human life. I will say as clearly as I can that criminalisation is wrong. I know when I say that that I speak not just for myself but for other members of this Bench, and I want to say it as clearly as the right reverend Prelate the Bishop of Leicester did in a previous debate a few months ago. If criminalisation leads, as it evidently does, to gay people concealing their identity, that is wrong. If criminalisation leads to many living in fear, that is wrong. If criminalisation leads to the prospect of persecution, arrest, detention and death, that is wrong. If criminalisation means that LGBT people dare not turn to the state when facing violence and hate crimes, that is wrong. If criminalisation hinders the treatment of people with HIV/AIDS, that is wrong.

It is within the lifetime of most of us in this House that the law in this country was changed to decriminalise homosexual acts. We need to seek to bring change and a completely new climate in those many countries of the Commonwealth where same-sex relations are still criminal offences. I very much hope that this debate will assist and serve that cause. Let the last words again come from Africa and Desmond Tutu:

"Exclusion is never the way forward on our shared paths to freedom and justice".

Photo of Lord Lexden Lord Lexden Conservative 7:32 pm, 13th March 2013

My Lords, like my noble friend Lady Brinton, I must apologise for not being in the Chamber at the very start of this debate, having lingered outside for too long after the debate on the Succession to the Crown Bill, in which I was involved. After a friendship of some 27 years, I think my noble friend Lord Black will probably forgive me.

As my noble friend reminded us in his powerful speech, this House has debated HIV/AIDS from time to time, most recently on the initiative of our noble friend Lord Fowler, whose continuing interest and commitment took him recently to Uganda. It is a matter of great regret that he cannot be with us this evening. Last October I opened a debate, to which kind reference has already been made, on the criminalisation of homosexuality, which, shockingly, remains widespread in the developing world in general and the Commonwealth in particular, breaching fundamental human rights.

This debate brings those two grave issues together. They are by common consent among the most important challenges confronting the world today. My noble friend Lord Black has shown conclusively that the spread of HIV/AIDS and the retention of harsh criminal punishments for homosexual conduct are inextricably linked. As my noble friend reminded us, after a detailed inquiry the UN Development Programme's Global Commission on HIV and the Law found that criminalisation of homosexuality "both causes and boosts" HIV among men who engage in sexual activity with other men.

As we have heard, the records of most Commonwealth countries-which in so many respects are our closest associates and most valuable friends-testify with particular bleakness to the malign link between criminalisation and HIV/AIDS. Sadly, the majority of Commonwealth countries defy international human rights obligations by treating homosexuals as criminals; as a result, those countries suffer disproportionately from the incidence of HIV. The Commonwealth contains some 30% of the world's population; it also contains twice that figure-60%-of all people living with HIV across the globe.

John Wesley once said:

"No circumstances can make it necessary for a man to burst in sunder all the ties of humanity".

The same goes, perhaps even more strongly, for societies, communities and countries. The heart bleeds at this spectacle of suffering and injustice in countries of the Commonwealth, of which my noble friend Lady Brinton has given such a harrowing example. How thankful we should be, therefore, for the sensitive yet determined work of the organisations that have come into existence to combat it: the Terrence Higgins Trust, Kaleidoscope, Stonewall, the Human Dignity Trust and the International HIV/AIDS Alliance prominent among them, all of them working in the name of our common humanity without regard to politics, religion or ideology. They are becoming increasingly well known for their work and that, too, is a cause for thankfulness. They deserve the fullest possible support from all those within the Commonwealth who want to overcome the sundering of the ties of humanity. This great cause must be among the highest priorities of the Commonwealth as a whole-I repeat, as a whole-so that ill intentioned people blind to the ties of humanity cannot decry and belittle it as some neo-colonial plan by Britain and a few others.

In this connection, it was extremely heartening to finds words of the highest wisdom in the report of the Commonwealth Eminent Persons Group two years ago, which recommended:

"Heads of Government should take steps to encourage the repeal of discriminatory laws that impede the effective response of Commonwealth countries to the HIV/AIDS epidemic, and commit to programmes of education that would help a process of repeal of such laws".

How good it would have been if these fine sentiments had been fully reflected in the new Commonwealth charter, which was described last week by my noble friend Lord Wallace of Saltaire as,

"one of the most important outcomes from the Commonwealth modernisation process. The charter conveys clearly the values that the Commonwealth stands for".-[Hansard, 7/3/13; col. 1674.]

As we have already heard in the extremely moving speech of the right reverend Prelate the Bishop of Newcastle, the charter-of which so much is being made -does not include any specific rejection of discrimination based on sexual orientation or gender identity, nor does it make reference to the decriminalisation of homosexuality. I understand that some officials of the Commonwealth Secretariat interpret the phrase "on other grounds" in the passage of the charter that covers the rejection of discrimination as a condemnation of anti-gay laws. If so, they should be encouraged by our own and other Governments to make this more explicit.

To that end, as my noble friend Lord Black requested, our Government should make decriminalisation a specific policy priority, with the Foreign and Commonwealth Office and the Department for International Development working together with equal resolution and tenacity to promote it. Operating in close association with other countries, our Government should also monitor closely the progress of central Commonwealth institutions in carrying forward agreed plans throughout this unique association of nations.

It is not enough simply to back the general interests of LGBT people throughout the world, as the Government now do; decriminalisation should be made an explicit goal of government policy for the sake of humanity as a whole, and in particular for the thousands of young people-teenagers even-who at the moment face great suffering and then death as a result of HIV/AIDS. I ask, too, that the Government review their policy on asylum to provide full and equal protection to those throughout the Commonwealth on whom inhumane laws bear so heavily, destroying their hopes and ambitions in their own countries. In addition, many have asked the Foreign and Commonwealth Office to update its dossier of information and advice, the "toolkit" about promoting the human rights of LGBT people, which I understand has remained unchanged since the previous general election.

Sixty-five years ago, the newly formed United Nations issued its Universal Declaration of Human Rights. Its first article states:

"All human beings are born free and equal in dignity and rights".

For the good of all its peoples, the Commonwealth today should pledge itself to bring those of LGBT identity fully within the scope of that great promise to mankind made to straight and gay alike.

Photo of Lord Watson of Invergowrie Lord Watson of Invergowrie Labour 7:40 pm, 13th March 2013

My Lords, I am grateful to have the opportunity of speaking in the gap, and I apologise to the House, to the Lord Speaker and to the noble Lord, Lord Black, for missing the beginning of the debate due to its unexpectedly early start.

Section II of the Charter of the Commonwealth, signed three months ago, states:

"We are implacably opposed to all forms of discrimination, whether rooted in gender, race, colour, creed, political belief or other grounds".

I cannot add anything to what the noble Lord, Lord Lexden, has just said in describing how empty those words, "other words", are.

It is important to note that the Commonwealth Heads of Government adopted the recommendations of the Eminent Persons Group on repealing of laws in 2012, indicating that member Governments should identify which, if any, laws are considered discriminatory and what steps should be taken to address them.

None the less, the Commonwealth Secretariat has not included, as other noble Lords have said, LGBT rights, legal reform or HIV in its new strategy, and the Commonwealth Foundation's new strategy includes no plans to support LGBT organisations or others working towards law reform. The secretariat should offer technical support to members to revise and amend their legislation, and the foundation should support civil society organisations working to promote LGBT rights. To address these gaps, I hope that the UK Government will continue actively to promote LGBT rights within the Commonwealth, particularly at the upcoming Commonwealth Heads of Government Meeting-if they attend; it is suggested that they may not-and in the work of the Commonwealth Secretariat and Foundation.

It is important that deeds match the words. LGBT people throughout the Commonwealth-indeed, wider, but the Commonwealth contains such a large proportion of those suffering from HIV and AIDS-deserve to see stigma removed through the decriminalisation of private, adult, consensual and same-sex sexual relations. It seems to me self-evident that, if that were done, it would be so much easier to treat the many people who are afraid to come forward and seek medical assistance with HIV and AIDS. I hope that that would be seen as a first step towards the tolerant and respectful societies that the Commonwealth should promote.

Photo of Lord Collins of Highbury Lord Collins of Highbury Shadow Spokesperson (Work and Pensions), Opposition Whip (Lords) 7:43 pm, 13th March 2013

My Lords, I, too, thank the noble Lord, Lord Black, for initiating this debate. The level of cross-party support that has been shown in the debate makes me incredibly proud of this House and of our country. During the past 20 years the situation for lesbian, gay and bisexual people in Britain has changed significantly. I am also proud that much of that progress was made under the previous Government. That is not to say that we should be complacent about the problems that remain, in particular the level of homophobia in our schools.

In the same period, remarkable efforts have been made in combating the HIV and AIDS epidemic. No longer a death sentence, HIV is now a long-term chronic condition. Britain can rightly claim to be a beacon to the world of equality for gay people and in the forefront of the fight against HIV and AIDS. However, domestic progress is not enough. If we are serious in our belief in equality we should speak up for those beyond our borders. This country has led and should continue to lead the EU and the wider international community in ensuring that the rights of LGBTI people are recognised and protected. Challenging homophobia, promoting equality and pressing other Governments to introduce measures to ensure equality for LGBTI people should be-as the noble Lord, Lord Lexden, said-a priority for the Foreign and Commonwealth Office.

Sadly, as we have heard in all the examples cited in the debate, progress in our country is not reflected in many parts of the world. Same-sex sexual conduct between consenting adults continues to be criminalised in more than 80 jurisdictions in the world, and 42 of the 54 countries of the Commonwealth of Nations criminalise same-sex relations for men, women or both. A lot of these laws, as we have heard, are a hangover from British colonial rule. While they remain on the statute book, they have a continuing impact of fear, stigma, rejection, violence and, far too often, murder.

However, this systematic persecution and criminalisation of identity can also decimate efforts to halt the spread of HIV. It often results in gay people not being able to access the healthcare, education and employment that they need, preventing access to HIV testing and treatment. A global online survey of 5,000 men who have sex with men found that only 36% were able easily to access treatment and that less than a third had easy access to HIV education materials.

As we have heard, men who have sex with men have a significantly heightened risk of HIV infection. They are 19 times more likely to be infected with HIV than other adult men. Criminalisation of homosexual activities both causes and boosts those numbers. As we heard from the noble Lord, Lord Black, UNAIDS reports that in the Caribbean countries where homosexuality is criminalised, almost one in four men who have sex with men is infected with HIV. In the absence of such criminal laws, the prevalence is only 1 in 15 among men who have sex with men. As my noble friend Lady Gould said, Commonwealth countries comprise more than 60% of people living with HIV globally, despite representing about 30% of the world's population. As we have heard, a recent meeting of the Commonwealth Foreign Affairs Ministers adopted a recommendation proposed by the Eminent Persons Group within the Commonwealth to tackle laws that undermine effective responses to HIV. As the right reverend Prelate said, the signing of the new Commonwealth charter is great news, too, as it underpins the commitment of the Commonwealth to human rights, gender equality and democracy.

However, whether the vague terms of the charter against discrimination based on "other grounds" really include sexual orientation and gender identity, drug use, sex work or HIV status presents a real test for the Commonwealth. It is therefore imperative that the commitment to repeal all discriminatory legislation which hampers the HIV response is honoured in the Commonwealth.

Today's debate presents a real opportunity for the UK Government to underpin the steady support that they have given to reform and modernisation of the Commonwealth and to ensure that the Commonwealth Secretariat takes a proactive and supportive role in promoting the reform of bad laws across the Commonwealth, starting with those that still criminalise gay men.

As both the noble Lord, Lord Black, and my noble friend Lady Gould stated, the global evidence is clear that public health is best served by removing discrimination and prejudice against LGBTI persons, ensuring that the widest possible information regarding safe sex practices, health services and HIV prevention and treatment measures is accessible to the people who need it most.

There are some Commonwealth countries-for example, India and Pakistan-where, if it were not for the Global Fund to Fight AIDS, Tuberculosis and Malaria, the response to tackle HIV among men who have sex with men would be inadequate. Will DfID stick to the commitment made by the former Secretary of State for International Development substantially to increase the amount of resources given to the fund to ensure that those essential programmes are able to continue? Will the Minister outline how the UK Government will work with other leading countries ahead of the G8 this summer, to harness as much financial support for the fund as possible?

I welcome the way-which the noble Lord, Lord Black, referred to-that the Government are now working closely with organisations such as the Human Dignity Trust, Stonewall and the Kaleidoscope Trust on how we oppose human rights abuses of gay people worldwide. Real progress on gay equality will ultimately come from grass-roots movements, but we need to help create the conditions where those local gay rights movements can emerge. May I ask the Minister what direct assistance the Government will provide, either financially or politically, to support the development of lesbian, gay and bisexual movements worldwide, in particular in the Commonwealth countries that we have been talking about?

Finally, we cannot pretend that this does not affect us here. Gay people around the world look to Britain to offer them refuge from this discrimination. I ask the Minister if the Government will ensure that, through the UK Borders Agency, lesbian and gay people are provided with a real safe haven when they flee from persecution? Is it also not time that the existence of these laws should be sufficient to establish persecution?

Photo of Baroness Northover Baroness Northover Baroness in Waiting (HM Household) (Whip), Lords Spokesperson (Department for International Development) 7:51 pm, 13th March 2013

My Lords, I, too, thank my noble friend Lord Black for introducing so effectively this important debate on the stigma and discrimination facing gay men and women in Commonwealth countries, and the additional stigma of HIV/AIDS. My noble friend Lord Black makes clear that the criminalisation of homosexuality in 42 Commonwealth countries can indeed lead to death, possibly not only of the person in question but of partners and children. We are reminded, both by him and the noble Baroness, Lady Gould, and others that the laws that criminalise are a colonial legacy. We heard a powerful account from my noble friend Lady Brinton about the situation in Zambia, where homosexuality is criminalised and where families and communities take severe measures to "cure" homosexuals of their apparent illness.

Homosexuality is criminalised and homosexuals suffer terrible discrimination. Those with HIV also suffer discrimination. As my noble friend Lord Lexden said, we have here two grave issues-and they can be literally grave. It is appalling that HIV-related stigma and discrimination in the family, community and workplace is still so widespread around the world and in the Commonwealth. Unless stigma and discrimination are addressed, as the noble Baroness, Lady Gould, and others said, we will not meet our global commitment to halt and reverse the spread of HIV. The noble Lord, Lord Collins, outlined the particular risk in the Caribbean and elsewhere. Our response cannot neglect these populations who are most marginalised and today I hope to highlight areas where the UK Government will do more.

Legal barriers create a climate of fear that prevents people accessing the prevention, treatment and care they need. In many countries, including many Commonwealth countries, rather than providing protection, as we have heard, the law-and the law of the street-dehumanise sex workers, men who have sex with men, people who use drugs, transgender people, prisoners and migrants. This drives these key populations underground and hinders their access to information and services, which in turn promotes risky behaviour that makes them even more vulnerable to HIV infection and fuels the epidemic further.

In defiance of international human rights standards, 78 countries, half of them in the Commonwealth, make same-sex sexual activity a criminal offence, as we have heard. When we have specific concerns about a government's failure to protect its citizens' rights-for example, through the persecution of lesbian, gay, bisexual and transgender people-we raise these directly at the highest levels of the Government concerned. My noble friend Lord Black asked whether the UK Government will make decriminalisation a stated policy commitment for the FCO and DfID. The UK's LGBT action plan includes an international commitment to advocate changing discriminatory practices and laws that criminalise homosexuality and same-sex behaviour, and to work with international institutions to oppose the introduction of new anti-homosexual legislation. We work with our embassies and high commissions and through international organisations, including the UN, the Council of Europe and the Commonwealth, to promote tolerance and non-discrimination and to address discriminatory laws, in particular those that criminalise homosexuality.

We see the Commonwealth and its networks as a potentially valuable partner in protecting and promoting human rights globally. However, the rights of homosexual men and women remain a very difficult and controversial issue in the Commonwealth. Like the right reverend Prelate the Bishop of Newcastle and others, I am delighted with the positive outcomes from the Commonwealth Foreign Affairs Ministers' meeting in New York last September, including agreement on the outstanding recommendations of the Eminent Persons Group, now reflected in the Commonwealth charter signed by Her Majesty the Queen on Monday on Commonwealth Day. This sets out the Commonwealth's core values and aspirations, including that discriminatory laws that impede access to HIV treatment should be addressed. Protecting human rights is a core value of this unique organisation and endorsement of the charter reiterates its commitment to opposing all forms of discrimination on any grounds.

I will read certain elements of the Commonwealth charter. Various noble Lords have referred to this and quoted from it, but it is worth reading again, for the reasons that my noble friend Lord Lexden gave. In the section on human rights, it states:

"We are committed to equality and respect for the protection and promotion of civil, political, economic, social and cultural rights, including the right to development, for all without discrimination on any grounds as the foundations of peaceful, just and stable societies. We note that these rights are universal, indivisible, interdependent and interrelated and cannot be implemented selectively ... We are implacably opposed to all forms of discrimination, whether rooted in gender, race, colour, creed, political belief or other grounds".

If noble Lords read on, they will see under "Tolerance, respect and understanding" the emphasis on,

"the need to promote tolerance, respect, understanding, moderation"; under "Separation of powers",

"the promotion and protection of fundamental human rights"; and under "Access to health",

"emphasise the importance of promoting health and well-being in combating communicable and non-communicable diseases".

It is worth emphasising those, because I urge noble Lords to take heart from these words. They are the words that citizens can use to hold their Governments to account; and for countries to hold other countries to account. As my noble friend Lord Lexden will know, international human rights may seem to make slow progress historically, but it is often through these statements that gradually things move forward.

My noble friend Lord Black asked why the Commonwealth Secretariat has not included LGBT rights, legal reform or HIV in its new strategy. The draft Commonwealth Secretariat's strategic plan is quite high-level and does not go into much detail about proposed activities. It foresees a role in health, human rights and justice, which are all relevant here. We will continue to work with the secretariat and the foundation to see what more they could do in this important area. To address a question from the noble Lord, Lord Watson, we in the UK do not ourselves set the agenda for the CHOGM, but we will continue to raise these issues in Commonwealth fora. It is extremely important that countries have signed up to the language that I have just cited.

I hardly need to draw noble Lords' attention to the fact that policies, programmes and resources for HIV for key populations are grossly inadequate, despite the growing infection rates in the groups that we have talked about. For example, in 2009, only 18% of countries had established HIV prevention goals for reaching men who have sex with men.

That is why, in the Government's position paper on HIV in the developing world, Towards Zero Infections, published in May 2011, we committed to build on our track record as a voice for a public health approach-as emphasised by the noble Lord, Lord Collins, and the noble Baroness, Lady Gould-to the key populations affected by HIV that respects human rights and addresses stigma and discrimination. The world must work much harder to empower those groups whose life circumstances place them at increased risk of HIV.

I could draw on many examples to demonstrate DfID's support, which echoes the approach that we have taken in the Department of Health within the United Kingdom. I shall mention three. The Global Network of People Living with HIV has been conducting policy research in South Africa on the criminalisation of LGBT. The Global Forum for Men who Have Sex with Men is engaging in international policy dialogue to promote laws, regulations and policies that improve HIV prevention programmes for men who have sex with men. I hope that my noble friend Lord Black and others will be pleased that, last July, my right honourable friend the Minister of State for International Development, Alan Duncan, announced new resources for the Robert Carr fund to support global and regional networks to improve HIV responses reaching key populations, and this new funding is being disbursed.

My noble friend Lord Black asked whether the UK Government will consider introducing a specific funding mechanism for LGBT organisations working for legal or social reform in those countries. The UK funds a number of programmes in that area. For example, 21% of the networks that the Robert Carr fund, to which I just referred, is supporting involve work for legal or social reform in those countries, so that is being addressed. My noble friend Lady Brinton made the point that there are new ways of promoting equality, such as through social media. She is surely right about that; there are a number of ways to do that.

My noble friend Lord Lexden asked about the FCO rights toolkit. We are very pleased that NGOs feel that it is a world reference and that the United States have used it as a basis for developing their own toolkit, but we take his point that it is now somewhat dated. We plan to update it this year and will be happy to receive suggestions from anyone on how to strengthen it further.

The noble Lord, Lord Collins, asked about support for the global fund. The United Kingdom remains a strong and reliable supporter of the global fund. I am writing to my noble friend Lord Fowler with an update on the situation because, as the noble Lord will know, the global fund went through something of a difficult time, but the United Kingdom is on track to meet our £1 billion commitment to the fund by 2015. I am happy to copy the noble Lord into my letter to my noble friend Lord Fowler. We are working with others to ensure that there is successful replenishment.

It is clearly critical in all our support for local civil society organisations to empower those most at risk from HIV, so that they understand and can advocate for their rights, and to challenge HIV-related discrimination and criminalisation. Without grass-roots support to tackle legal barriers that hamper the HIV response, and without the ability to hold Governments to account, change will not be sustained. People living with or directly affected by HIV understand their needs better than anyone. Involving those communities is not just their right; it is essential to an effective response to the epidemic that their voices are heard in policy, decision-making and budgeting processes.

This has been a very important debate linking the terrible discrimination against homosexuals in many Commonwealth countries with the terrible discrimination against those who suffer HIV/AIDS. As the noble Lord, Lord Collins, the noble Baroness, Lady Gould, and others said, public health is assisted by promoting the rights of homosexuals, but it is right in itself, as others have said.

I assure noble Lords that we recognise those challenges and how important it is to support the rights of all, especially those who are the most vulnerable around the world.

House adjourned at 8.06 pm.