Opinion: The Anti-Homosexuality Act (AHA), 2023 May Have Exonerated Uganda The Dust Has Not Settled, What Remains Is a Paradox of Bare Virtues

 Bare virtue can't make nations live. Mindfulness makes nations thrive.

The AHA is a detrimental capital to the overall public health principles rooted in calling for aspirations whose fabric and backdrop is mindfulness. Fast forward and subsequent to the AHA in Uganda, there are assumptions that have come about: a culture of stigma, intrusiveness and discrimination has churned out a guilt by association context. Men hugging in greeting will be suspect and so will women hugging; men sharing the same room and hotel bed will be suspect and so will women; innocent acts such as play-weddings among children of same-sex will be punished. Youths with sagging pants will be the pariah of society. Tomboys or boys who throw like girls stand warned. Rainbow symbolism of any kind be it in dress, dance, drama, flag or Rasta-culture, will trigger investigations into aiding, abetting, recruiting and sponsoring homosexual acts in Uganda. All this is circumstantial fodder that will feed into the post-AHA Uganda’s criminal justice mill. Families, hotels, health facilities, education facilities and entire communities must report such suspect events.

The AHA comes with the death penalty, life imprisonment and fines that are hoped to be the deterrents exonerating Uganda. Uganda’s HIV Prevention sovereignty was made possible by the Global Fund and PEPFAR. So, cutting off ARVs will affect that sovereignty. This has other ripple effects.

The fear of ARV drug stockouts will lead to some people hoarding ARVs thereby leading to an ARV inequity; all those vulnerable to HIV will suffer which means everyone in Uganda because there is no household, family or clan without a person living with HIV. The AHA is a disruption of the HIV care continuum in Uganda. The AHA is a risk-factor to the HIV mindfulness. Health care workers will now turn into intrusive informers because it turns out that HIV has been seen as a pathway for notifying the government about those they are treating.

The smooth flow of the care algorithm has its steps such as: immediate testing for those eligible; those who test positive have to be linked to ART; clinics are set up to allow attendance within schedule; on time pill pick-up and refills;  retention on ART for 12 months; address drug stock outs; increase and maintain an awareness of viral load status; ensure viral load suppression for 12 months; make it possible for those eligible to switch to 2nd line prescriptions; ensure that there are mechanisms for finding those susceptible to getting lost to follow up; and taking note of those lost to follow up at 12 months.

Those celebrating the AHA have also revealed the power dimensions in Uganda. Mindfulness is a baby that has been thrown out with the bath water. There are those who miss the social-cultural-behavioural acts around sexual intercourse. There are those who still think that anal-sex is risk free and prevention messaging highlighting this is not encouraged. With the AHA in place the messaging that informs better life promoting practices has been censored too to fit the valorised heterosexual hegemony.  Those in the HIV care continuum world know better. It is not only homosexuals (saying as it is said in Uganda) who engage in anal sex. Anal sex disinhibition is prevalent among heterosexuals too.

Those trained legally say that new or old laws have veils and do not extend punitive hands back in time. This AHA has eyes and therefore; it is assumed may go backwards in time enabling health workers to report all those targeted by the AHA; it may go forward as well; and it is assumed it will only target a few who after all are assumed will eventually die out. Those who remain lurking in society have the following options: escape from Uganda; if they remain they will face the wrath of the law; volunteer for rehabilitation; or they should not expose themselves to HIV or any form of disease lest they will have to present to a health facility where they will be reported to the government authorities.  

But, all the above prescribe a paradox too. The AHA is a single autonomous virtue that has blinded Ugandans to a far more life affecting aggregate negligence which will decrease the gross citizen enjoyment of life. The AHA has made it clear that it is prioritised as the single most useful antidote to all evils in Uganda. The lesser evils now include: dismissing complaints from hospitals that lack water supply as trivial; disrepair of major trunks leading to poor traffic flow; providing allowances for medical check-ups abroad for the elite; not providing smooth access to microcredit to unleash the economic potential of those eligible and many other aspects. This will eventually mean individual attempts to engage in self-determination will be affected, harm micro-economies and eventually the wider economy. The parts must always be true of the whole. The AHA is thought to be a political capital but may affect the social, gender, civic, cultural, economic and physical collectives that are key enabling and responsive contexts for a fuller life for all.

With the AHA in place it shows that Ugandans are trying hard to be happy, have made feeling happy a goal but are not aware that in the end this well-being may suffer. The government has prescribed virtue and happiness and, in the process, has interfered with so many other catalysts for happiness or virtue. Uganda will bid farewell to the hallmark moniker: “Africa’s HIV care continuum benchmark.”