(Editor’s note: As the World Bank announces a landmark research project on the economic costs of homophobia, the Rev. Canon Albert Ogle reflects on what it feels like to be on the first-ever LGBT panel at the world Bank’s Spring Civil Society meetings this week.)
Five-hundred civil society organizations are gathering from all over the world this weekend at the World Bank in Washington, D.C. to engage in discourse with the World Bank staff.
The meetings coincide with a high level meeting of finance and health ministers convened by the International Monetary Fund (IMF) focusing on how developing countries can get value for money for health care expenditure, for example. At a time of recession for the developed world, there is also an opportunity for countries with natural resources to negotiate loans and investments to reduce dependence on foreign aid and become more self-sustaining.
The ambitious goal of reducing global poverty by 30% by 2030 is a noble benchmark and may allow billions of human beings who live on less that $2 a day to have a better life. For the first time in the history of civil society engagement with the World Bank, LGBT issues are now part of the discourse.
St. Paul’s Foundation, with support from the Ford and United Nations foundations, sponsored four panelists to share their stories and expertise on what LGBT poverty looks like and suggested specific ways to engage it.
Young gay men in poverty
A report on the needs of young gay men released this week by MSM Global Forum underscores one aspect of this largely invisible community. Surveying almost 6,000 men who have sex with men (MSM) from 165 countries illustrates the disconnections between service delivery, prevention and living in poverty.
The Global Men’s Health and Rights study (2012 GMHR) indicates that 20% of younger MSM surveyed had no income and 30% had no stable housing, which have both been linked to greater HIV vulnerability and reduced access to HIV services. Compared to older MSM in the 2012 GMHR sample, younger MSM experienced significantly higher levels of homophobia and violence. Among all MSM surveyed, homophobia was significantly associated with reduced access to condoms, lubricants, HIV testing and HIV treatment.
“This data shines light on our collective failure to ensure that YMSM have the resources they need to keep themselves healthy,” said Dr. George Ayala, executive director of MSM Global Forum. “Moreover, it is a powerful reminder that HIV among MSM is an international development issue, inextricably linked with housing, health, education, and security. Donors and policy makers must treat HIV among MSM of all ages with the same level of urgency afforded to other international development priorities, and they must take concrete steps to ensure that the unique needs of YMSM are accounted for.”
The cost of exclusion
As the larger framework of civil society discourse with the World Bank explores how the human family can maximize our resources, particularly how to get more value for money for healthcare, our four panelists used this particular lens as a context for LGBT issues, particularly as they relate to the prevention and care of HIV infected and affected populations.
Another perspective was to simply ask ourselves as an international community: “Can we afford not to include LGBT people in the creation of their own destinies, health care and wellbeing?” This is a particular important question for 76 countries that currently criminalize homosexual relations. Seven countries have the death penalty for same-gender relations. There are other countries where homosexuality may not be illegal but there is still a climate of hostility and misinformation that still makes it extremely difficult for LGBT to emerge from poverty and hopelessness.
For example, from 2008-12, more than 1,100 transgender people were murdered globally, according to Transgender Europe. There are higher levels of substance abuse, suicide and HIV infection in the LGBT populations than in the general population. This is not because LGBT people are morally inferior to heterosexuals, as many institutions would have us believe, but because people are denied access to a series of support and educational systems that have serious outcomes.
HIV and LGBT poverty
For example, one of the programs that St. Paul’s Foundation for International Reconciliation supports is a HIV testing program for Ugandan gay men where services would have been denied because they were seen as criminals.
HIV infection rates are 13.7%, which is consistent with other data on MSM in other countries. The general Ugandan population is around 7.2% testing positive (and rising). These men also are deeply fearful of being fully known and closeted, some are married and half of them are having sex with both men and women. Their sero-prevalence is higher, not because these men are necessarily more promiscuous, but because there is a hostile climate even in the health sector, often shaped by faith leader’s condemnation of homosexuality, who then in turn force their political leaders to make even more punitive laws as we are seeing with the virulent debate around the Ugandan Anti-Homosexuality Law. This cycle is particularly of concern when we know that 40% of health delivery in Africa is through faith based clinics, hospitals and home care.
The positive and negative role of faith community programs
St. Paul’s Foundation organized a panel that addressed some of these issues on the opening day of the conference. I spoke about the positive and negative role of the faith community and the need to include LGBT people when programs are being planned, evaluated and funded.
LGBT people brought important gifts to organizations and communities all around the world and many of the structures and procedures recommended by the World Bank and other important development organizations like USAID were still not including us.
“Every institution from the family, the church, the World Bank and governments are failing the LGBT community right now. The presence of this panel was seen as a positive step to begin to address the appalling neglect of this community in heath, education and employment opportunities,” I said.
I also reminded the audience that in some countries who are members of the Bank’s governance structures, our workshop would be deemed illegal and would be shut down for merely discussing anything to do with LGBT. I commended the Bank for “leaning into the wind” rather than running away from the issues.
Maxensia Nakibuuka is the executive director of Lungjugga Community Health Caring Organization in Uganda’s largest city and capital, Kampala. As a leader in both the HIV community and the Roman Catholic Archdiocese, she has spoken at the United Nations and various international conferences on the need to provide comprehensive services for the poor and marginalized.
Nakibuuka’s home healthcare network of 3,000 people (mainly care giving women) has organized a women’s economic development program and HIV testing and home healthcare for some of Uganda’s most invisible populations. Maxensia talked about how home based care is the most cost effective way to do prevention and care and her program included LGBT people who are often rejected by the families and do not have traditional family systems of support
Another panelist was the Rev. Macdonald Sembereka, an Anglican priest from the Church of Malawi. As one of 7,000 active clergy living with HIV (INERELA), he has worked tirelessly for the reduction of stigma and discrimination in Malawi, even when his house was firebombed with his children at home.
Sembereka is now the personal adviser for non-government organizations to President Joyce Banda. He has spoken at many conferences and is a member of the COMPASS Coalition (Coalition of Minority Protection Against Sexual Stigma). MacDonald gave examples of how faith and civil society organizations can include LGBT people and issues and we would never be able to reduce HIV infection, deaths and stigma without including everyone in country planning and funding.
The most passionate accounts of homophobia, rejection and often violence from his own experience came from Victor Mukasa, who founded Sexual Minorities Uganda (SMUG) and is internationally recognized as one of the leading experts in LGBT issues in the Global South.
Mukasa told of being stripped and exorcised by a pastor in front of the congregation, being harassed by the Ugandan government that he took the case to court on charges of human rights violations and he won. It became impossible for Victor to live in Ugandan and he is now seeking asylum in the USA. He wants to organize the expertise of the exiled African LGBT and ally community now living in the USA and see how it can inform government and civil society response in places where it is still illegal to be LGBT.
Dr. Philip Moeller, who serves on the boards of Reconcilingworks and St. Paul’s Foundation, summarized the conclusions of the panelists (a full report will be given to the Bank next week and be made available on line). He welcomed the Bank’s commitment to this issue by commissioning a study on the economic impact of homophobia globally. This report will be available by the end of the year.
A safe and welcoming audience
The panel also spent time attending other workshops on issues like sustainable development, genocide prevention and improving education. The receptivity to this new and voiceless global community from civil society organizations was very supportive and people are genuinely interested in including LGBT people at all levels of engagement.
We represented only four organizations out of 500 this year. Our hope is we will have at least 10% of CSO’s attending the conference next year ... perhaps 50 organizations who can continue to tell our stories and seek specific ways to engage the resources and expertise of the Bank. Our thanks to the sponsors and donors who made our presence possible and to John Garrison (Senior Civil Society Specialist) and his staff for inviting us.
The Bank is also willing to support an LGBT representative to attend its October annual meeting in Washington, D.C. for the first time ever.
Perhaps the most important recognition of our presence and contribution came from Rachel Kyte, senior vice president for sustainable development, who noted the importance of LGBT issues that will be part of a major Social Inclusion Report to be released later this year. She also noted the sad reality that LGBT staff at the World Bank, with a wealth of expertise in poverty reduction strategies, are the only identified group that cannot serve in all countries that are part of the Bank’s mission. Not only is the Bank’s management and staff concerned about value for money, but clearly they are concerned about the economic cost when a minority community of talented human beings is simply not valued.
RGOD2, written by the Rev. Canon Albert Ogle of St. Paul’s Cathedral in San Diego, looks at faith and religion from an LGBT point of view. Ogle is known around the world for his work in support of LGBT rights and HIV-prevention efforts. He is president of St. Paul’s Foundation for International Reconciliation. Donations to the foundation can be made by clicking HERE.