Liberia AIDS Commission, Partners Want An End To Stigma Against Key Populations, Vulnerable Groups

By: Mark B. Newa

Fellow, AAMIN Health and Human Rights Journalism Fellowship

As part of Liberia`s determination to end AIDS by 2030, the National AIDS Commission of Liberia (NAC) has been working with  human rights organizations and relevant state actors to address potential obstacles that societal stigma and discrimination against key populations and vulnerable groups pose to HIV prevention and control in the country.

Liberia has a generalized HIV epidemic with reproductive aged population showing HIV prevalence of 2.1%, according to the 2013 LDHS. However, UNAIDS’ 2021 Spectrum Estimates show 1.1%, with an estimated HIV population of 35,000 (20,000 women, 12,000 for men and 3,000 for children). 

The LDHS further indicates that significant variations in HIV prevalence exist among and within regions and counties. HIV prevalence is higher in urban (2.6%) than in rural (0.8%) areas. The South-Central Region has the highest prevalence of 2.8% among the five regions, while Montserrado, Margibi, and Grand Bassa counties have the highest HIV prevalence among the 15 counties, and together account for about 70% of the burden of disease in the country.

At the same time, the 2018 Integrated Bio-Behavioral Surveillance Survey (IBBSS) which was launched in 2021 in Liberia shows a high HIV infection rate among key population groups, which include Men who have sex with Men (MSM), People Who Inject Drugs (PWIDs) and female sex workers among others.

The report reveals that men who have sex men account for 37.9% of HIV infection rate, 9.6% for People Who Inject Drugs (PWIDs) and female sex worker at 16.7% respectively.

Liberia is a member of the world, determined to end AIDS as a public health threat by 2030 through a robust effort to test 95% of persons living with HIV, place 95% of persons tested for HIV on treatment and ensure 95% of viral load suppression for persons on treatment. The strategy is known as 95-95-95 target.

The ambitious 95-95-95 strategy was announced by UNAIDS in 2020 as an intermediate goal of the earlier 90-90-90 strategy launched in 2014, to end the AIDS epidemic by 2030, however the National AIDS Commission (NAC) and partners viewed HIV-related stigma and discrimination as a threat to achieving the global target, which must be dealt with first.

In an interview with a team of Anti-AIDS Media Network specialized health and human rights reporters in Monrovia, the Chairperson of the National AIDS Commission, Theodosia S. Kolee said Liberia needs a strong political commitment (will power) through the enactment of laws that protect the rights of people against stigma, discrimination and hate messages.

Madam Kolee said Liberia as a member of the Global Partnership for Action to eliminate all forms of HIV-related stigma and discrimination, must do everything possible to implement its portion of the commitment to frontload investments in reaching the 95-95-95 by 2030.

“For this to happen we need a strong political will from policymakers, especially our legislators to consider domestic budgetary allocation for HIV intervention programs to increase awareness around stigma and discrimination particularly against key and venerable populations. We also need political will to accelerate progress toward the attainment of the global targets meeting the target to ending AIDS,” Mrs. Kolee said.

She observed that: “Liberia cannot afford to miss out or leave behind other countries in ending AIDS by 2030. We feel strongly that the time for policymakers to consider domestic financial support is now. predicated upon this, we are collaborating with relevant partners to scale up HIV treatment to reach the global required target level for persons living with HIV, eliminate mother-to-child transmission of HIV to less than 2%, scale-up HIV combination prevention to reach 90% of the general population, and scale-up HIV interventions to reach 60% of the estimated key populations.

The AIDS Commission boss wants members of the Liberian parliament to repeal all existing HIV–related discriminatory laws, regulations and policies to provide space for 90% of persons living with HIV, members of key populations and other marginalized groups to access justice and can challenge rights violations, because these people account for about 70% of HIV burden in the country.

Madam Kolee: “This is the time that we act as a Country to implement our portion of the global partnership commitment. We need a bold call to action to fast-track HIV response and reach people being left behind such as key populations and vulnerable groups”.

Madam Kolee told our reporters that “reducing stigma and discrimination will mean allowing people to feel confident and secured in accessing and adhering to life saving treatment at health facilities in line with the universal human rights standards”.

She is urging duty bearers, healthcare providers and social workers to expose discrimination taking place in health-care settings, misinformation, privacy violation and stereotyped hate messages.

Dr. Julia Toomey Garbo, Program Manager of the National AIDS and STIs Control Program (NACP) said her institution is working closely with the AIDS Commission and other partners to ensure an enabling environment for key populations and other marginalized groups in the national HIV response.

Dr. Toomey-Garbo revealed that there are so many actors involved in responding to human rights issues including the Ministry of Justice human rights platform intended to allow stakeholders to discuss different rights issues.

“NAC leads the process of sensitization, creating social space for inclusion, and ensuring that key populations and other marginalized groups are protected from sexual violence, while NACP is responsible to provide bio-medical services,” Dr. Toomey-Garbo said.

According to her, members of key populations and marginalized groups are not only the drivers of the HIV epidemic, but they have high prevalence of the virus due to risky practices.

Dr. Toomey-Garbo said, “Key population networks are currently working with the Independent National Commission on Human Rights, the Ministry of Justice and the Liberia National Police to ensure the protection of key populations and other marginalized groups in the country”.

“Knowing that key populations are not accepted in our society we are also working with them to distribute condoms and lubricants for prevention purpose, she said.”

Dr. Toomey-Garbo: “Since people living with HIV (PLHIV) are facing worse forms of stigma and discrimination from family members, communities they reside, as well as health facilities that they seek treatment, care and support, NACP and NAC are closely working with them to embark on a campaign to say to discourage stigma and discrimination.”

She named poor infrastructure and supply chain, minimum financial support, human resource, staff retention and attrition, stigma and discrimination against PLHIV as looming challenges to the national HIV response efforts in the country, which need to be addressed urgently.

“To end AIDS by 2030 to an epidemic control with a global action to end inequality, government must meet up with its commitment. We should do away with rhetoric,” Dr. Garbo emphasized.

Although Dr. Garbo disclosed that more women are living with HIV out of the numbers that infected in the country as compared to their male counterparts, she wants the general public to develop the interest getting tested.

“It is better for people to know their status, and if diagnosed positive, they can be placed on early treatment, she said.

Atty. Edrick Naoh, Assistant Justice Minister for Administration and Public Safety, thinks that members of the LGBTI (Lesbian, Gay, Bisexual, Transgene and Intersex) community who are classified as key populations exit in Liberia; and people need to accept the reality because they are exposed to various health issues.

Assistant Minister Noah said the Constitution of Liberia provides for the protection of the rights of all of citizens void of discrimination.

“When we talk about key population we need to be frank and face the reality. There are people among us that are members of the key populations that need to be captured. Sometimes they are overlooked because they are far from us, but when you get to realize that they exit then you know that people need to be protected, Atty. Noah noted.”

“Those people that are infected in the key populations are Liberians and they need to be accommodated. We need to train law enforcement officers to understand that persons living with HIV and key populations have rights, and those rights need to be protected, Atty. Noah urged.”

The Independent National Commission on Human Rights (INCHR) is a national institution leading dialogue efforts to push human rights protection and end stigma and discrimination, mostly directed at key and vulnerable populations.

Atty. Mohammed E. Fahnbulleh, Oversight Commissioner for Legislative Assistance, Treaty Matters and Laws at the INCHR said the commission is committed to working with relevant human rights institutions to push for an enabling environment for all to live, including key populations and other marginalized groups in the country.

Commissioner Fahnbulleh is urging the media to take the lead in protecting the human rights of people, by reporting rights violations to the public.

“The manner in which you communicate is also important. So, your partnership in this endeavor is highly laudable, and we hope that we can begin to work together to ensure that all persons whether living with HIV or members of LGBTI to ensure access to health, Commissioner Fahnbulleh said”.

This story was made possible through the professional intervention of Anti-AIDS Media Network (AAMIN), with funding from the American Jewish World Service (AJWS).