Summary
The World Health Assembly is the decision-making body of World Health Organization (WHO). Held annually in Geneva, Switzerland, it is attended by delegations from all WHO member States. During its last day, the 75th World Health Assembly addressed the global health sector strategies (GHSS) on, respectively, HIV, viral hepatitis, and sexually transmitted infections[1]. The strategy was put to a vote, after some States opposed the mention to sexual orientationrefers to a person’s capacity for profound emotional, affectional and sexual attraction to - and intimate and sexual relations with - individuals of a different gender or the same gender or more than one gender. More and to the International technical guidance on sexuality education in the document.
JUST NOW: World Health Assembly adopts the Global Strategy on HIV, hepatitis and STIs 2022-2030, affirming the right to health without discriminationunequal or unfair treatment which can be based on a range of grounds - such as age, ethnic background, disability, and diverse sexual orientations, gender identities and expressions or sex characteristics, amongst others. More on the basis of sexual orientation, for the first time, by 61 votes in favour and only 2 votes against #WHA75 @ILGAWORLD pic.twitter.com/DROdrq2NhR
— Gabriel Galil (@GalilGabriel) May 28, 2022
The global health strategies are evidenced-based guidelines drafted by the WHO department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, providing technical support to address public health gaps and challenges. The GHSS 2022-2030 called for a more precise focus to reach the people who are most affected and most at risk for each disease, and to address inequities.
The approved document states that the right to the highest attainable standard of physical and mental health “applies to everyone and to all communities”, but also includes a specific reference to sexual orientation, stating that this right “(…) should not be compromised by discrimination based on age, genderrefers to a social construct which places cultural and social expectations on individuals based on their assigned sex. More, sexual orientation, and other population characteristics”.
While the document was built on a strong base of evidence, and it is in line with international human rights standards developed by different UN human rights bodies, the reference to sexual orientation as a prohibited ground of discrimination was contested by propositions introduced by the Eastern Mediterranean Region group.
The propositions would have included two footnotes by member States in the expert-written strategy, one of them introducing the inaccurate idea that sexual orientation is not an agreed term among member States.
“The proposed footnote was misleading, because it ignored more than twenty years of history of UN resolutions, both at the General Assemblythe main deliberative and policy-making organ of the United Nations which makes decisions on international issues such as development and peace and security. All 193 member States are represented, and each has one vote. More and Human Rights Councilan inter-governmental body within the United Nations which has the responsibility to promote and protect human rights. It is comprised of 47 member States, each elected to 3-year terms by the 193 member States of the United Nations. More on issues of sexual orientation and gender identityrefers to a person’s deeply felt internal and individual experience of gender, which may or may not correspond with the sex assigned at birth. More. Moreover, language on sexual orientation was adopted by consensus at the 76th General Assembly resolution on strengthening the role of the UN in the promotion of democratisation and enhancing periodic and genuine elections” , said Gabriel Galil, Senior Programme Officer at ILGA World.
A second footnote would have stated that the International technical guidance on sexuality education drafted by UNESCO, UNAIDS, UFPA, UNICED, UN Women and the WHO was not the result of an intergovernmental negotiation among member States.
The proposition to include the two footnotes was rejected by 49 votes against, 27 votes in favour and 11 abstentions. Following the defeat of the amendment and the lack of consensus on the strategy, for the first time the GHSS had to be put for a vote – contrary to the 75 year-long customary practice of the World Health Assembly in adopting global health strategies.
“It is regrettable that the GHSS on HIV, hepatitis and STIs was put for a vote”, continued Galil. “The commitment to end these epidemics by 2030 without discrimination of any kind, including when it comes to one’s right to access health services, should not be controversial for any member State – it would only reflect their commitment under Agenda 2030 to leaving no one behind. (Having had to go to a vote) is even more regrettable given the tireless efforts of the Mexican delegation and like-minded States to engage in constructive dialogue and propose compromises that would accommodate everyone’s positions.”
The decision of the Assembly to take note of the Strategy without any footnote was adopted by 61 votes in favour, 30 abstentions and only 2 votes against.
“The disproportionate impact of HIV/AIDS in our communities is historically documented. It was high time for the WHO to acknowledge that the right to health cannot be compromised by discrimination on the basis of sexual orientation,” said Julia Ehrt, Executive Director at ILGA World. “It is also an important step for the strategy to approach the issue of comprehensive education and information about sexual and reproductive health: this is crucial not only to HIV prevention but also to the fight against stereotypes that are harmful to sexual and gender minorities. However, it is worth noticing that the strategy still falls short in ensuring the right to health without discrimination based on gender identity and expression or sexrefers to the classification of a person as male, female, or other - usually made at birth, written on a birth certificate, and usually based on the appearance of their external anatomy. A person’s sex, however, is actually a combination of bodily characteristics, including chromosomes, hormones, internal and external reproductive organs, and secondary sex characteristics. More characteristics”.
[1] The final draft of the strategy can be found in https://cdn.who.int/media/docs/default-source/hq-hiv-hepatitis-and-stis-library/full-draft-who-ghss-hiv-vh-sti_1-may_final.pdf?sfvrsn=35aa9640_3