Key Population Hero: Addressing stigma and discrimination among LGBT people in Kenya

Written by Levis Nderitu, co-founder, Sullivan Reed

Sullivan Reed is an organization in Nairobi, Kenya that specializes in the economic and social empowerment of LGBT people in Kenya, where homosexuality is criminalized and HIV prevalence is almost three times higher among men who have sex with men than the general population.

Many lesbian, gay, bisexual, and transgender (LGBT) people in Kenya are facing stigma and discrimination silently. They may not know how to access HIV services and, even if they do know, they wonder how will they be treated when they get there.

LGBT-friendly services do exist and we encourage people to use them. But not every provider is affirming. People are worried that they will be outed by medical staff, and with good reason. I’ve heard LGBT people talk of nurses calling other nurses over and “making an example” of them. I’ve heard of young LGBT people having their parents called. You can imagine how traumatizing this is.

People’s fears about accessing health care are compounded when they face other stigmatizing, even violent, situations. I saw this clearly recently when my friend’s boyfriend celebrated his birthday. He invited a few friends to his home, all of whom are LGBT. Then men, armed with sticks, broke in and started beating people. They said they did not want “people like [my friends]” in the neighborhood. Despite living there for two years without any complaints against them, my friends were evicted. It’s a tight-knit community and rumors soon spread. All those who had been there were scared; they had been exposed as LGBT and their lives were at risk.

Lots of LGBT people look at a situation like this and think “if I can’t even be happy in my own neighborhood, around people who know me, how do I then go to the hospital?” The impact of this type of intimidation is huge.

To help, we applied for funding through the International HIV/AIDS Alliance’s Rapid Response Fund, which issues emergency grants of up to $20,000 in 29 countries when stigma, discrimination, and violence threaten HIV services for LGBT people and MSM. Since its inception in October, the fund and has already received more than 235 applications.

The money came through quickly. We relocated all those in fear to a safe house and linked many of them to LGBT-friendly health services. Through the fund you can also apply for support for initiatives that will have a longer-term impact. I’m developing a mobile app to enable people to find LGBT-friendly services near them, and again I have turned to the Rapid Response Fund for help.

Many Kenyans are hostile to LGBT people, mainly because of the legal framework. But among younger people and in more cosmopolitan communities, attitudes have been improving. We have a new crop of people who believe in diversity and inclusion. I believe more and more straight people will begin to champion LGBT rights here and bring this community out of the margins.

We need to look at the issue of economic empowerment as many LGBT people struggle to find work. Some turn to sex work, which increases their vulnerability to HIV. We must enable people to support themselves; it’s a critical component of change.

As long as the existing penal code is in place, the fight will be tough. But when I look around me I see a lot of hope. Things are changing. Everyone should be able to live a full life, regardless of who they are and whom they love. We are working to make that happen.


To learn more about the Alliance’s Rapid Response Fund visit rapidresponsefund.org

 

 

Reducing Gender-Based Violence Against Women Who use Drugs: The Right to be Free

Written by Judy Chang, Board Member, International Network of People who use Drugs

Globally, it is estimated that one out of three women experiences gender-based violence (GBV) in her lifetime. Data on women who use drugs and their experiences of violence are scarce; this is not surprising given our status as an invisible population. As a result of criminalization, discrimination, and stigmatization, women who use drugs are disproportionately affected by violence. Women who use drugs commonly experience violence at the hands of state actors, notably the police, and when violence comes from intimate partners and the wider community, it is often perpetrated with impunity.

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Tanzanian Network of People who use Drugs. Photo by Ruth Birgin.

GBV against women who use drugs manifests as a result of a range of interrelated structural, systemic, and sociocultural drivers. Our experiences of GBV are both driven and compounded by stigma and discrimination and inequality. In 2015, the International Network of Women Who Use Drugs (INWUD), along with Women and Harm Reduction International Network, released a statement for the International Day for the Elimination of Violence against Women. The statement included a number of testimonials from women who use drugs and have been affected by violence. One woman shared her story.

“The insidious creep of abuse of domestic violence makes it hard to speak out. But when police fail to act on a charge, it becomes a double act of injustice. The neighbours called the police to my house, after I had just gone through a window. Under questioning he [my partner] told the police officer I was a drug user. Tearful and shaken, I found the tables turned on me. Rather than pursue a clear case of domestic violence, he chose to search me for drugs. It only took those two little words of ‘drug user’ for the police officer to see me not as a victim of domestic violence, but as a woman not deserving of equal protection under the law. At a time when I felt the most broken, I had to bear the force of a broken system which treats women who use drugs as undeserving of the same rights as other women.” (INWUD Virtual Consultation, 2015)

Our current value system that embraces prohibition places an inordinate amount of focus and effort on regulating and controlling what a woman puts into her body, rather than what is being inflicted on her body, more often than not by those with more power. Driven by political ideology and moral attitudes, the damage that the war on drugs wages on women’s bodies needs a political solution. INPUD argues that community organizing, community mobilization, and solidarity building remain the most effective and protective barriers against abuses and violations. Historically, we have seen these used as political tools to make critical gains in labor rights, civil rights, liberties, and in the HIV movement.

Ruth Birgin, INPUD’s Women’s Policy Officer has been catalyzing women who use drugs in countries in Asia and across Africa. She has been working with women from national drug user networks and supporting them to come together, develop plans and strategies to meet their community-defined needs, and create mechanisms for collective support. In Indonesia, for instance, INPUD supports the activities of PKNI, the national drug user network, that contributes to broader goals of increasing understanding and awareness of violence against women who use drugs and developing elements of protection. In Tanzania, INPUD’s Women’s Policy Officer is coordinating with women from the Tanzanian Network of People who use Drugs (TANPUD), who will be running their own activities, including a public event on December 10. A women’s advocacy team comprised of TANPUD members has been formed.  They are currently developing a statement on violence against women who use drugs, which is to be presented to the Ministry of Community Development Gender and Children on the 2016 International Day for the Elimination of Violence against Women.

The upcoming years are crucial. As we prepare for increasing onslaughts on the rights of women worldwide—including sexual and reproductive health rights, the right to bodily integrity and self-determination, and the right to be free from violence and sexual assault—women who use drugs need to come together to organize and strengthen our networks and communities. This is the first, crucial step to challenging damaging political realities. Now more than ever, the status quo will no longer suffice.


Judy Chang (MIntDev) is a board member of INPUD; a consultant with Coact, which is a technical support agency specializing in HIV and drug use; and an MPhil Candidate at the National Drug Research Institute (NDRI) in Australia.

INPUD is a global peer-based organization that seeks to promote the health and defend the rights of people who use drugs. INPUD challenges stigma, discrimination, and criminalization of people who use drugs and the impact they have on the drug-using community’s health and rights. The International Network of Women Who Use Drugs is a subnetwork comprised of those who self-identify as women and who use drugs.

Comprehensive violence-response services in the Dominican Republic: A spotlight on CEPROSH

LINKAGES would like to thank the clinical staff members of CEPROSH, the police chief, and the key population members in Puerto Plata who contributed to this interview.

LINKAGES has the privilege of working with many incredible community-based organizations throughout the world that offer violence-response services to key populations. Below is an interview with The Centro de Promoción y Solidaridad Humana (CEPROSH), an HIV/AIDS awareness and prevention organization based in the northern region of the Dominican Republic. CEPROSH works to improve regional capacity to deliver quality services related to HIV and gender-based violence to key populations

1. How are key populations affected by gender-based violence in Puerto Plata? What types of violence do they most experience?

Intimate partner violence, hate crimes, and stigma and discrimination are significant issues faced by transgender people and sex workers in the Dominican Republic (DR). Transgender people also face difficulty in securing employment and are often rejected because of their gender identity or sexual orientation. Transgender people who engage in sex work also experience violence at the hands of the police. Police will often handcuff them, spit on them, and pull their hair.

Stigma and discrimination against key populations are prevalent in the DR. A patient at CEPROSH relayed her experience with transphobia, which she said humiliated her and left her in a great deal of pain:

“I got in a taxi and when the driver realized that I was trans, he stopped the car, got out, opened my door, and said, ‘Get out my car you *expletive*! I don’t allow *expletive* in my car!’ In that moment, I wanted nothing more than the ground to open up and swallow me. Everyone was looking at me, and only one onlooker showed any kind of indignation at the taxi driver. I will never forget that kind of humiliation for as long as I live.”

2. What are some of the links between violence and HIV for key populations in the Dominican Republic?

The links between violence and HIV that we see through our work at CEPROSH stem mainly from:

  • Social and family exclusion
  • Lack of knowledge among key populations about their health and human rights
  • Lack of will to seek health services
  • Poor mental health
  • Stigma and discrimination

3. What kind of services does CEPROSH offer to support key populations who have experienced violence?

We work with peer outreach workers and counselors at the clinic, and counsel key populations on their rights in an effort to empower them. We also have agreements with their supervisors at their jobs (for those who are able to work), which permit key populations to leave work in order to make their appointments at the clinic. For those who are not able to visit the clinic, we offer community-based HIV testing. Additionally, we take a comprehensive approach toward offering health services to key populations by offering the following:

ceprosh-photo

CEPROSH Peer Educators

  • Crises response services
  • Clinical services
  • Psychosocial support
  • Rapid HIV testing
  • Post-exposure prophylaxis
  • STI testing and treatment
  • Emergency contraceptive
  • Mental health services
  • Legal services
  • Support groups

 

 

 

 

 

 

4. What is something you learned during your time working with key populations who have experienced violence?

We learned that it is very difficult for someone to leave the circle of violence that entraps them. We have seen how violence can rob you of your identity, your profession, your family and friends, and your willpower. We also learned that through counselling and violence-response services, you can return a sense of confidence, strength, and self-worth to victims so that they can move forward.

5. What is a lesson that you’d like to share with other organizations that offer services to key populations who have experienced violence?

In order to help key populations who have experienced violence, you need to train organizational staff and health workers on key population service delivery. This includes helping staff to confront and address any negative biases they may have toward key populations, to dismantle any myths or negative stereotypes about key populations, and to deliver correct health information in a stigma-free environment.

6. How does CEPROSH work with other members of the community (police, doctors, religious leaders) to address gender-based violence toward key populations?

We sensitize community stakeholders through informal meetings and workshops with key populations to help them to understand the ways in which systemic violence is a violation of human rights for all people. We explain that often this violence comes from a fear of the unknown, or from people operating with misinformation about key populations. We work to reverse those preconceived notions and prejudices about key populations. We also form alliances among various community services that could work to protect the health and human rights of those most vulnerable.

7. How have the attitudes of CEPROSH staff and the community members mentioned above changed as a result of the LINKAGES project?

There have been many positive changes, but there is still work to do. Many of us recognize that before receiving gender sensitivity training from the LINKAGES project, we treated key populations with disrespect. Some of us growing up were even taught to hate them because they were different. Since the trainings, we have recognized the need to not treat key populations differently, but rather, treat them with the kindness, respect, and dignity they deserve.

The urgent need for violence response systems within HIV programming

Written by Tisha Wheeler, Senior Technical Advisor for Key Populations, U.S. Agency for International Development (USAID)

Never before have HIV prevention, care, and treatment programs for key populations been available in so many countries. Key population access to HIV services globally is expanding at a rate we can see changing monthly. However, structural barriers that key populations face persist, and violence, stigma, and discrimination continue to pose significant roadblocks to achieving meaningful progress toward an AIDS-free generation.

The wide-ranging manifestations of violence that key populations (transgender people, men who have sex with men, sex workers, and people who inject drugs) routinely face are often socially sanctioned and institutionally perpetuated. As criminalized and discriminated groups, key populations experience violence that is exacerbated by the lack of recourse available for addressing these abuses, compared to those offered to the general population. This lack of support and violence manifests in the family, among police, partners, landlords, in schools serving the children of key populations, and in many other facets of life. The violence and resultant trauma faced by key populations lead to a lack of stable housing and schooling for their children, a lack of agency in sexual negotiation, riskier sexual behavior, lower service uptake, and eventual increase in HIV incidence among key populations. It is obvious to conclude that HIV programming for key populations will continue to be incomplete and ineffective without basic violence response mechanisms at the community level.

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Bithia, a sex worker and a peer navigator of CHAMP Cameroon

For many of the key population individuals in HIV programs, addressing violence is of greater importance than HIV. If prompted, a member of the key population community will speak with deep emotion and fluency about the far-ranging violence that they and their friends face. If you ask that same person to speak about HIV testing services, it is unlikely that you will hear the same level of urgency in their voice despite their knowledge about HIV diagnosis and treatment. I recently had the opportunity to sit down with Bithia,* a sex worker, and a peer navigator of CHAMP Cameroon, about her lived realities dealing with violence and the steps she has taken to advocate for change in her community:

“There are three main types of violence, number one is police. Two, the clients and people around in the bar, and yes three, health facilities that don’t receive us well. They all see who we are and they don’t like us. They see we are dressed half naked, they know what we do. I have started to work with my friends, the other sex workers who are around where I work. We started a group called Glamour Girls. We talk about issues of violence and we find ways to help each other. We have been able to meet in the drop-in clinic, but we don’t have money for anything. Still, change is possible. We just need to plan and work together.”

In order for HIV programs to be effective, they need to be designed to address these realities. In the past five years, the international donor community has made significant strides to work toward this. Recognizing the importance of key population programs both to control the HIV epidemic, and to address the human rights of key populations who face violence and discrimination, PEPFAR has funded the largest scale-up of key population programming by any single donor through the LINKAGES project. The Global Fund, Robert Carr Civil Society Networks Fund, Elton John Foundation, and USAID have been recognized for their dedication to funding comprehensive HIV programming. Moving forward, the vision is that governments will build upon this momentum to further scale up key population programming beyond the levels we might have imagined just five years ago and that they will do this hand in hand with local key population civil society groups, who should drive the programming on the ground to best meet their needs.

We know that inadequate funding for global HIV programming will always be a persistent challenge. However, even in the face of resource constraints, we must reframe the conversation to focus on how to prioritize funding to address stigma, discrimination, and violence in key population programs and institutionalize those approaches in national program planning. For example, the Kenya national program under the leadership of Dr. Martin Sirengo has included violence as an indicator in its national key population HIV dashboard, and PEPFAR has included a budget line item for violence programming in their HIV expenditures. More countries need to follow this example.

To support national programs, PEPFAR also needs to go further to invest in policy change, to bring new funding opportunities, and to work on creating country budgets for key population programs that include violence. By taking these important steps, we can gain a better understanding of how to scale up violence response work through key-population-led approaches and create the changes needed to fast-track the end of the epidemic.


*The author and the LINKAGES project would like to thank Bithia and the staff at CHAMP Cameroon for their contributions to this post.

Let’s acknowledge that gender-based violence also affects transgender people and other key populations

Written by Hally Mahler, Project Director, FHI 360 LINKAGES and Rose Wilcher, Director, Research Utilization, FHI 360

Last year, a friend and colleague, Beyonce Karungi, wrote about what it is like to be a transgender woman in Uganda. She talked about being rejected by family members and about being beaten up and burned with cigarettes for being transgender. She described being harassed by police who wanted to make her a “proper man.” She recounted being raped at gunpoint by a client when she was a sex worker, because she insisted that he use a condom. Beyonce wrote that “… from the standpoint of a transgender woman like myself — our human rights and unique challenges are not addressed and not given the attention they deserve.”

Beyonce’s story is not uncommon. Experiences of violence are widespread among key populations: sex workers, men who have sex with men, transgender people and people who inject drugs. Here are just a few examples:

 This violence can often be traced back to homophobia, transphobia and other rigid beliefs about acceptable behavior for men and women. For example, perpetrators of violence against men who have sex with men often claim that they are attempting to “cure” men who are perceived to have rejected their masculinity. Likewise, transgender people experience violence from those who believe they have not fulfilled expectations associated with the sex they were assigned at birth.

Trans women are particularly vulnerable to violence from those who believe that experiencing violence is part of what it means to be a woman. Much of the violence that is directed at female sex workers and women who inject drugs is a manifestation of gender inequality and discrimination against women more broadly. But levels of violence against both are exacerbated by the belief that women who sell sexual services or inject drugs are immoral and have strayed from socially acceptable behaviors for women.

 A broader understanding of gender-based violence

From November 25 through December 10, individuals and organizations around the world are participating in the 16 Days of Activism against Gender-based Violence campaign. Every year, this campaign brings attention to the urgent need to eliminate violence against women and girls. But, the campaign is also an opportunity to examine the root causes of gender-based violence and shed light on those who experience such violence but who are not traditionally recognized during the 16 days.

FHI 360’s LINKAGES project promotes an inclusive view of gender-based violence — one that acknowledges that it affects not only women and girls in the “general population,” but also men who have sex with men; transgender individuals; and highly marginalized groups of women, such as sex workers and women who inject drugs. These groups are often omitted from calls to end gender-based violence.

HIV and gender-based violence

Experiences of violence increase the risk of key populations acquiring HIV and deeply affect their desire and ability to obtain health care, get tested for HIV and adhere to HIV treatments. For example, epidemiologic modeling has shown that reducing violence against female sex workers would reduce new HIV infections among sex workers and adults in the general population by 25 percent and 6 percent, respectively.

We will not make sustainable gains against the HIV epidemic if we do not also address the violence that key populations experience at the hands of family, community members, health care providers and police. Here are five ways that everyone who works with key populations can address gender-based and other forms of violence:

  1. Uncover the root causes and gender dimensions of violence against key populations. By conducting gender analyses, as LINKAGES has done in Kenya and Cameroon, we can reveal how gender norms and beliefs underlie much of the violence faced by key populations and identify ways to challenge harmful beliefs and better address such violence.
  2. Support community-led solutions. Community-based organizations headed by members of key populations are taking the lead in delivering the HIV services that their community members want and need, including addressing violence. In addition, outreach workers and peer educators from key population communities can be trained to screen for violence and provide first-line response in line with global best practices.
  3. Work with police and other community power holders so that they become allies in responding to violence and building stronger crisis response systems. Programs must garner commitments from local attorneys, hospital staff, psychologists, peer educators, and police that they will offer client-centered, nonjudgmental services to all survivors of violence, and that they will facilitate key populations’ ability to report violence when it occurs.
  4. Advocate for legal and policy reforms that explicitly protect the human rights of key populations. Even in hostile legal environments, steps can be taken to prevent and respond to violence. For example, we can advocate for the explicit inclusion of sex workers, men who have sex with men and transgender people in any legislation that is created to protect women and girls from gender-based violence.
  5. Draw attention to the science and the stories on the causes, consequences and experiences of gender-based violence among key populations, as well as the evidence-based strategies for addressing such violence. Through the LINKAGES blog series, Key Population Heroes, and our project newsletter, The LINK, we amplify the voices of key population members who have bravely shared their experiences of stigma, discrimination and violence and called on us to join them in fighting for change.

 Toward a more inclusive campaign against gender-based violence

Many people think of gender-based violence only in relation to women and girls. But, by developing a more inclusive view, we can help ensure that policies, preventive efforts and response systems benefit all those who experience such violence. Understanding and addressing the broader gender-based aspect of this problem will also allow us to strengthen the networks and combine the resources of the groups that are working to dismantle gender-based discrimination and advance the human rights of all women, girls, and sexual and gender minorities.

During the remainder of the 16 Days campaign, we will hear from colleagues representing key population communities about how they are affected by gender-based violence and what they are doing about it. We invite you to subscribe to the LINKAGES blog, contribute to the conversation on social media, and join us in advocating for the right of all people to live free from gender-based violence.

 

 

Key Population Hero: I support TRANS rights, do you?

Written by Amitava Sarkar (preferred name – Amrita), Co-chair, IRGT

“Please help, somebody please help!” Despite my shouting, my two friends and I drew no attention from passersby. We were surrounded by at least 10 men who were beginning to get violent. This happened in Kolkata, a metropolitan city of India, also known as “City of Joy,” though sometimes it becomes “City of Horror” for trans people like us.

fullsizerenderGoddess Durga is the Goddess of Power, and she is worshiped in India and other places of the world, but in Kolkata she is celebrated with special zeal. Temporary temple-like structures (called Pandals) are created in and around the city, where she is worshipped by visitors from different parts of the state and country, and sometimes from outside the country as well. This incident took place in front of a huge crowd visiting one of these Pandals in South Kolkata. It was very difficult to rescue myself from that situation, but ultimately I was able to run away while the men were busy clearing space to torture the three of us. I remember that as I was trying get free, no one from the large crowd that had gathered came to our aid despite our pleas for help.

This is just one example of violence that took place in a public space, in a metropolitan city, and in front of huge crowd. One can easily imagine how frequent these experiences are for trans people, and how difficult it often is for transgender woman to escape from these acts of violence. Other kinds of violence (mainly gender-based) against transgender women take place everywhere—within families and by intimate partners, at educational institutes and work places, and when trying to access health services. Data[1] show that in 2016, 21 transgender people died from violence-related causes; however, I believe the number is much higher, because I can recall what is happening just in my own country. There was an “honor killing” of a trans women a couple of months ago, and one can imagine that many similar incidents are taking place around the world but are not documented.

The way out is to work at two different levels—building the capacity of the community to advocate for themselves and continuing effective advocacy initiatives for stakeholders and policymakers. My journey toward this goal started when I met JoAnne Keatley (co-chair, IRGT) for the first time in Mexico during the 2008 AIDS conference. After observing the handful of trans women represented and the limited coverage of trans issues in such an important and international conference, we discussed the need to build a global-level platform for trans advocacy. Finally, we are here today with IRGT, a global network of trans women and HIV, comprising 18 very active members from different parts of the globe who are leading trans activists and doing commendable jobs for our community.

IRGT seeks to safeguard the health and human rights of transgender people and is able to conduct this work through a variety of important partnerships. With LINKAGES we are working to:

  • Mobilize and sustain advocacy by trans communities for service improvements in the response to HIV and AIDS
  • Foster trans leadership skills to create a new generation of articulate, tech-savvy advocates who can present their constituencies’ needs to government, health care workers, and police
  • Provide technical support and tools to inform national policy, program design, and management for trans populations

Apart from this, IRGT is one of the 10 member organizations supported by Robert Carr Civil Society Networks Fund, to form the Consortium of Men who have Sex with Men (MSM) & Transgender Networks. This consortium is a coordinated effort to address the factors that affect MSM and transgender health and human rights, leverage our respective complementary strengths as advocacy and technical support providers, strengthen community responses via consolidated mechanisms for information exchange, and raise awareness through media outreach.

IRGT has received another important award from ViiV Healthcare for implementing training workshops for trans women and organizations spread across various parts of the globe. The project will conduct training of trainers with eminent trans leaders to help build the capacity of trans-led organizations.

Several other recent developments have raised the visibility of trans rights, many with the support of LINKAGES. This past summer, IRGT organized the first-ever trans pre-conference event in Durban, South Africa during AIDS 2016. IRGT also helped lead the development of the TRANSIT, global guideline on implementing HIV and STI programs for trans people, and has published studies about issues faced by trans women, the most recent of which is entitled, “Most Impacted Least Served: Ensuring the Meaningful Engagement of Transgender People in Global Fund Processes.”

My message to my community is this: identify your strong, positive qualities and begin using them for the development of yourself and our community. Believing in an alternative gender or sexual identity is not a crime. Don’t hide your talents and your identities; instead try to come out in true spirit to better serve yourself and your community. From my own experience I have realized that we have to make our own space and we have to support each other. Let’s stand together to take our movement forward for a better and more trans-friendly world, free from violence.

To learn more about IRGT please visit – http://transglobalactivism.org/


 

[1] http://www.hrc.org/resources/violence-against-the-transgender-community-in-2016

Key Population Hero: Human rights for drug users in Nepal

Written by Anjay Kumar, drug user activist in Nepal 

There were an estimated 52,174 people who inject drugs (PWID) in Nepal in 2013 with an annual growth rate of 11.36% (Government of Nepal Ministry of Home Affairs).1 Drug use in Nepal is paired with domestic social, economic, and political issues. Nepal is one of the poorest countries in the world and, as a result, it is ill-prepared to deal with many of the health issues that drug users face, including multi-drug-resistant tuberculosis, HIV and AIDS, and the new threat of hepatitis C.

Drug users in Nepal are often from lower-income and marginalized communities. They are too often stopped, searched, arrested, prosecuted, convicted, and incarcerated with inequitable treatment by the criminal justice system. Some drug users have been detained in prison-like conditions and forced to do unpaid labor. Others have been subjected to physical and psychological abuse in the name of “drug treatment.” Most of the drug users I’ve known have never been out to hurt anybody, but they have their rights taken away, face violence, and are ostracized.  Negative social perceptions, stigma, and discrimination all help to fuel this inhumane treatment toward drug users. Drug use is not recognized as a health issue but instead is seen as a moral depravity, marginalizing a substantial proportion of drug users and depriving them of access to treatment and care.

anjay-speech-rbbIn my opinion, the focus should be on whether a drug user is stable and capable of carrying out their social duties and responsibilities. As a drug user living with HIV, a family man, and a working man, I have been forced to discipline myself after stumbling many times in the past. For me this has been the key to holding my own life together.

The Coalition of Drug Users in Nepal (CDUN) advocates for the attainment of the highest standard of quality health care in a nondiscriminatory and dignified manner for all drug users. We advocate for a human-rights-based approach, substantiated by evidence, to inform policies related to drug use.

We want to change society’s perception of drug users by empowering them to lead noble and productive lives and to contribute to society.

We are also in the process of consolidating lessons learned from former drug users who later became care providers for their peers. These individuals provide care to drug users when others will not, due to discrimination. CDUN endeavors to promote these best practices and other emerging evidence to create a larger social impact for drug users. We envision a world where every person with a history of drug use is equipped to make informed, personal choices without fear of being denied their health, human rights, or prospect for a fulfilling social existence.


Anjay Kumar KC, aka ‘The Impactivist’ (for impact + activist), is a drug user activist and advocate for health, human rights, and harm reduction for drug users and HIV related policy in Nepal and globally. Anjay is also a person living with HIV and Hep C co-infection and a proud family man supporting a wife and child who are also living with HIV. He has been fighting against social injustice and working with most at risk, vulnerable and key affected populations such as PWID, LGBT, FSWs, migrants and AIDS orphans since 2002.