Achieving Health Equity for Young Key Populations (YKPs) in Africa

1. Achieving Health Equity for Young Key Populations (YKPs) in Africa through generating evidence, mobilising communities, creating enabling legal and policy environments AMSHeR – African Men for Sexual Health and Rights COMMUNITY MECHANISMS TO PROMOTE THE ROLE OF YKPS IN FORMULATION AND IMPLEMENTATION OF PROTECTIVE POLICIES AND LAWS FOR BETTER ACCESS TO HIV AND SRH SERVICES INSOUTHERNAFRICA

2. NATURE & MANIFESTATION OF VULNERABILITIES • KP associated vulnerabilities • Social constructs, norms and beliefs rejecting non-conforming identities and choices; • Patriarchy and hegemonic masculinity being oppressive to gender and sexuality that do not fall in the box; • Legislative framework and goat-scaping of sexuality-related issues by politicians and fundamentalist ideologies; • Inability to fit in the box and the visibility that came with the history of KP organizing: Globalization and CSOs advocacy efforts • YKP associated vulnerabilities • The age factor in a patronizing/paternalistic society/world; • The syndrome of youth inexperience, likelihood of exploitation and denial of agency, autonomy & choice; • The challenge of guardianship/parental consent, conflicting ages of maturity and legal framework not aligned to societal realities;

3. WHERE DO VIOLENCE AND DISCRIMINATION OCCUR? STORIES FROM COMMUNITY DIALOGUES • The following issues and places of violence/discrimination came out from the community dialogue we had with young key populations in 5 SADC countries: • Stories from Zimbabwe: • Sexual and Gender based violence against young key populations in places of detention; • Lack of adequate services for trans*, sex workers and people with disabilities; • Adherence to treatment/care services due to safety-related mobility; • Trust and confidentiality issues with health care providers; • Health care setting rejecting YKP clients as a result of stigma and discrimination • Zambian YKP issues: • Inadequate reforms to current government programmes and policies for young key populations (case of IEC messages being very conservative); • High levels of stigma and discrimination (taboo and shame around KP issues + youth factor); • Hostility from families and service providers towards young key populations (denial and suppression of YKP realities).

4. WHERE DO VIOLENCE AND DISCRIMINATION OCCUR? STORIES FROM COMMUNITY DIALOGUES… • Stories from Mozambique: • Prevention materials not accessible to YKPs (not allowed in prisons, not distributed to IDUs); • Protective laws not enforced/implemented or complied with; • Ignorance of prisoners and other YKPs of their basic rights; • Hostile legal framework for IDUs; • Healthcare providers, police officers and religious leaders not friendly to Trans* and other YKPs due to bias, stigma and discrimination; • Positive: improvement of legal and policy framework for some KPs (LGBT) • - Stories from Angola: • Sexual violence among YKP, self-esteem and fear of exposure due to discriminatory attitudes from health professionals, prison officials and other entities • Lack of integration of KP issues into the reproductive sexual health program, taking into account the social and economic status of this population; • lack of training amongst health professionals, prison officials and other authorities regarding YKP’s human rights, especially regarding the equality and non- discrimination principles. • Positive: Recognition by the constitution and political momentum of the new regime as an opportunity

5. WHERE DO VIOLENCE AND DISCRIMINATION OCCUR? STORIES FROM COMMUNITY DIALOGUES… • Stories from Madagascar: • Stigma and discrimination against young key populations at school and in accessing to justice by educators and police officers; • Physical and mental violence against sex-workers by their clients and police officers; • Inappropriate laws governing detainees and drug injecting users (providing prevention materials to these groups is illegal); • Analysis: • State and Non-state actors are behind violence and discrimination against YKPs; • External vs. Individual factors: legal/policy framework vs. ignorance and lack of knowledge – culture of respect to authority; • Private vs. public sphere: role of families and parents; • Policymakers go beyond classic definition. • More tacceptance in Portuguese-speaking countries: Mozambique & Angola (decrim. Iris registration) • RESPONSE TO THESE CHALLENGES: • Multi-stakeholders advocacy Working Group (YKPs, Policymakers, Service providers, Law enforcement agents); • 18-months Advocacy Operational plans (operational work-plan); • Engagement and joint implementation processes for policy change; • Regional engagement for standards settings.

6. YOUNGKEYPOPULATIONSTRADITIONAL FORMS OF COMMUNITY ORGANIZING – LIMITATIONS FROM THE AGE FACTOR! • - Criminalization & (Y) KP limitation of association rights: illicit goal of association and therefore no registration; no legal age, therefore no capacity to freely enter into a contract • Criminalizationofsamesexbehavior, of sex work and drug use: purpose confused with identity; • Legal age not in line with social needs and realities: more restrictive than protective; • - The new love/addiction to social media and the reality of a young virtual world: online community and form of organizing: Twitteratis and Facebookers : • How do we deliver information and educational message to YKP without breaking the law of parental consent and age of maturity? • Internet freedom/restriction and the impact on access to SRHR education for YKPs; • How do we promote agency and autonomy of YKPs in a world that is paternalistic and patronizing? Youth-led and youth-friendly initiatives! • What strategies do we adopt to ensure that YKPs’ choice are informed or educated choices? (promises of online and offline channels – youth-friendly platforms);

7. COMPREHENSIVE SEXUALITY EDUCATION & ACCESS TO TAILORED INFORMATION FOR YKPS • Comprehensive Sexuality Education and the challenges of acceptability and breaking the taboos: denial and the violent silence; • What approaches have been used so far & what are the results: top-down/shut down attitudes, information gap, lies and myths around sexuality • Key messages and lessons from the Abidjan Sexual Health Institute and KP Pre-conference for young KPs: • enough is enough: stop to exploitation and economic exclusion of YKPs; Stop to neo-liberal, neo-colonial and paternalistic approaches that are north-based and donors-driven; Stop to health systems that serve to deny YKP’s ability to exercise agency and multiple forms of autonomy; • Demand for 3Is: • (more) Investment, Involvement (meaningful) and Intergenerational & cross-sectoral partnerships in equitable and dignifying models that promote agency and community ownership for YKPs; • The Gaborone Learning Institute took place ahead of the PAI conference 1-2 June 2018, and a pool of young KP Advocates attended it. Two take-aways stood out of the institute: • a. A lot is assumed about what the key actors know about KP groups; • b. The importance of engaging YKPs from hard to reach areas such as rural and peri urban communities who may not have access internet and other resources

8. FORWARD LOOKING • Given all positive national laws, policies, strategies and frameworks (although not implemented in most cases) on one hand; • Given the promising regional/international norms and standards • African Youth Charter Africa Health Strategy 2030 • AUC catalytic framework on HIV/TB/Malaria • SADC Regional strategy for Key Populations • Against a serious backlash at national (Zambia cases, Tanzania, etc.) and regional levels setback (AU challenging progressive KP-related decisions/recommendations and resolutions by the African commission); • What does the future look like? • - Is there any hope for addressing youth challenges and harnessing the dividends of a young continent? • - Why do youth lives matters & how alarming are the current situation and data (non-investment in KP studies vis-a-vis lack of data) ? • - What should we do differently to ensure a sustainable youth-centred development ? Are SDGs & Agenda 2063 viable alternative frameworks in a world that challenges human rights as a framework?

9. THANKYOU ASSANTE OBRIGADO MERCI Contact: info@amsher.org; www.amsher.org ; http://twitter.com/AMSHeRorg