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End Gender Inequalities and End Aids by 2030

We have to agree that the epidemic will not be over until the cycle of new HIV infections is stopped and all people who need it are on lifelong treatment. Treatment alone is unlikely to end AIDS, prevention is also essential. Too many adolescents and young women are still falling between the cracks of the global response.
It is important to note that gender inequality such as gender-based violence leaves young women and girls more vulnerable to HIV. It also restricts the rights of women and adolescent girls, including their ability to refuse unwanted sex or negotiate safer sex, and access HIV and sexual and reproductive health services.

By Mary Nyaketcho

For over 40 years, the 1st of December has offered an opportunity to rally support for people living with and affected by HIV and also to honour those who have died from Aids-related illnesses across the world. Uganda and the world at large are still lagging behind in reaching the commitment to end Aids by 2030 not because of a lack of knowledge or materials to beat Aids, but because of various barriers that obstruct HIV prevention and treatment. Discrimination, gender inequality, poverty, and criminalisation are barriers that prevent people living with HIV/Aids from accessing healthcare. Therefore, World Aids Day raises awareness of the impact of HIV on people’s lives to advocate against stigma and discrimination against those living with HIV and also to highlight how far we have come.

The theme “ending inequalities among adolescent girls, young women and boys” is a call to action. It is a call to action for all of us to confront the inequities that drive AIDS and hinder access to essential HIV services, especially for adolescent girls and young women and boys. The high HIV prevalence among adolescent girls and young women and boys suggests that factors beyond behaviour may be contributing to the heightened vulnerability of this group. Without bold action against inequalities, the world is likely not to reach the target of ending AIDS by 2030. 

Regardless of the enormous advances made to eradicate AIDS globally, adolescent girls, young women and boys are disproportionately at risk of acquiring HIV, a fact that must change. Urgent action to reduce the risk of adolescent girls and young women to HIV is vital to end the epidemic. This won’t be achieved without addressing the entrenched gender inequalities that exist where these girls and young women live.

Globally, young people are among the populations most at risk of and affected by HIV and AIDS and Uganda’s population constitutes a significant percentage of young people. Young girls and boys rarely receive sexuality education and only rely on the wrong perceptions given by their fellow youth. This situation might continue unabated unless causes of vulnerability to infection among them are clearly identified and addressed within respective contexts.

Many adolescent girls and young women aged 15 to 24 years in Uganda are more susceptible to HIV infection than their male counterparts. Adolescent girls and young women are biologically more vulnerable to AIDS and twice as likely as men to become infected, according to the UNAIDS Global AIDS Update 2022. They are at a greater risk because they are physically and physiologically more vulnerable to the sexual transmission of HIV than men their own age. 

It is important to note that gender inequality such as gender-based violence leaves young women and girls more vulnerable to HIV. It also restricts the rights of women and adolescent girls, including their ability to refuse unwanted sex or negotiate safer sex, and access HIV and sexual and reproductive health services. Take for example the situation of early marriage. Gender inequality is at the heart of what drives these marriages. In poverty-stricken communities, most girls are married before the age of 18. Early marriage has profound consequences for the health and well-being of adolescent girls and young women. They are at a greater risk of sexual and gender-based violence and sexual violence is closely linked with an increased chance of acquiring HIV. The men they are married to are also often older and have already been sexually active, which also increases the risk. In addition, it is quite difficult for adolescent girls and young women to negotiate safe sex and condom use. 

Many cultural practices also impede efforts to tackle Aids-related issues. A girl is taught from an early age to be submissive and obey men. The girls have not been taught how to say no, how to say what they want and what they do not want. As a result, adolescent girls and women cannot say no to sex, and not request safe sex if a man does not want to use protection.

For that reason, tackling inequalities is a long-standing global need, whose urgency has only increased. However, ending inequalities requires a lot of transformative change. Economic, political, social, cultural and legal inequalities obstructing progress must be addressed. 

We should endeavour to look into laws and policies that address these inequalities and observe the need to protect the rights of everyone especially adolescent boys and girls and young women. By removing punitive laws, policies, practices, stigma and discrimination that block effective prevention and treatment of AIDS, inequalities will be struck out and with more advocacy on this, HIV/Aids shall subsequently end.

At the societal level, we should address the social and cultural norms and practices that perpetuate inequality. It is clear that addressing inequalities and inequity will require the motivation and engagement of the people who are most affected. Therefore, efforts should be made to empower and strengthen people. 

Staying in school reduces the likelihood that adolescents will be infected with HIV/Aids. Education helps individuals protect themselves against HIV infection. But education itself alone does not help, also, there is a need to integrate sexuality education into the curriculum to equip young people with knowledge about HIV/Aids and their rights.

It is time for the government to act with bold and accountable leadership and move from commitment to action. It must promote inclusive social and economic growth. The government ought to also realise that ending HIV/Aids requires ending all inequalities and driving multisectoral action across a range of sustainable development goals (SDGs) and targets and that promoting equal opportunity are fundamental issues for development and sustainable growth. 

We have to agree that the epidemic will not be over until the cycle of new HIV infections is stopped and all people who need it are on lifelong treatment. Treatment alone is unlikely to end AIDS, prevention is also essential. Too many adolescents and young women are still falling between the cracks of the global response.

Therefore, this year, let us be mindful of the inequalities that exacerbate the dangers for everyone, no matter our status, we are all affected by HIV/Aids in one way or another. So, let’s do all we can in order to help tackle the inequalities and end AIDS.

The writer is an intern in the Community Empowerment Programme at CEHURD

Call for Expression of Interest to Conduct a Midterm Evaluation for the Joint Advocacy for Sexual and Reproductive Health and Rights (JAS) Programme in Uganda

The Center for Health, Human Rights and Development (CEHURD) with nineteen (19) partners are implementing a four-year programme (1st January 2020 – 31st December 2023), titled: The Joint Advocacy for Sexual and Reproductive Health and Rights in Uganda (JAS) Programme in Uganda. The JAS programme is due for midterm evaluation to assess the progress so far made in the implementation. CEHURD therefore, seeks to engage a consultant / firm to support in the external evaluation of the programme that will inform decision making for the remaining period of implementation.

My Work Summer Experience

The learning was deep and significant. The work was beautiful and challenging. Living was both fun and hard. It was exhausting, amazing, sad, intense, and so very many more adjectives. I am grateful, however, for the complexity. I don’t think that one can successfully seek simplicity in human rights.

By Rebecca Clayton

I wrote my first blog as five lessons from my early days in Uganda, so I figured I would conclude with five more lessons from the end of my internship (and in the space since returning home). I would be lying if I said that my reflections since returning to Canada have been easy – translating what I have been feeling into words has been a steep uphill battle. I’ve wrestled (probably for longer than I should have) with what to say on the tail end of an experience like this one. I think my reflections can best be summed up in the following five lessons:

Language is a key player in human rights work; An obvious (but perhaps underestimated) truth in human rights work. Even though English is common, in many of the circumstances where I assisted with client intake or mediation, Luganda was the language spoken. I appreciated being a part of this work but felt at times disappointed that I couldn’t offer more. It was an important reminder about the role of language, and how central it is to everything we do. The best of intentions and the most in-depth knowledge of the legal system don’t mean anything if you can’t communicate with someone – if you can’t learn about them and their experiences. I think this lesson is important to keep in mind as we navigate the world of human rights and public interest law.

There is magic in an organisation that creates space for its employees to connect with one another; In my second last week at the Center for Health, Human Rights and Development (CEHURD), the entire staff went on their bi-annual staff retreat. Twice a year, the staff spend a week somewhere in Uganda (in this case, it was the Ssese Islands) to report to one another, teach one another about new topics in their work, and receive feedback from management on their work over the past six months. Most significantly, though, I noticed that a key outcome of this retreat week is how it provides a space for CEHURD staff to connect with one another. Outside of work hours through meals, exploratory trips, and evenings filled with dancing (and maybe some alcohol), CEHURD staff get to unwind and enjoy each other’s company. All summer, though there was often not much overlap between teams as everyone was busy and focused on their own work, I noticed that staff members were well-connected with each other. After participating in a staff retreat, I think I figured out why. The work at CEHURD is serious, and expectations are high for their employees. It is challenging in more ways than one to work in the human rights field, but carving out space for their teams to feel connected to one another changes the entire workplace culture. I was impressed with much of what CEHURD does, but this was one of my favourite of those things. Having worked in the non-profit sector, I know that organisations need to choose their priorities, as time and funding are always limited. Prioritising this chance to invest in their work culture makes a huge difference in the work that they do, and I felt so fortunate to get to experience it firsthand.

Predictably, a lion lounging in a tree is pretty cool; When Somaya and I went on a safari trip on a long weekend in June, we were on a mission to see lions. Having come all the way to Western Uganda to Queen Elizabeth National Park (famous for tree-climbing lions), we were adamant that seeing lions was non-negotiable. After a disappointing morning game drive, we lucked out in the late afternoon and proceeded to spend the rest of the day passing binoculars between us to watch the sleeping lioness in a tree. And it was exactly as cool as we thought it would be.

Being a cultural outsider can hinder at times, rather than help; In June, CEHURD went to court to argue a seemingly “sensitive” case. A week before the court date, we had a legal expert meeting with the entire Strategic Litigation team, as well as other lawyers and community organizations to talk about our case and what it entails. We discussed strategy, anticipated counterarguments, asked questions and, importantly, discussed public messaging. The way that we wanted to appear in court was carefully weighed – do we pack the courtroom with lots of bodies, trying to control the energy and drawing the public’s attention? Or do we fly under the radar to minimize coverage, and as such, minimize the amount of pressure that the judiciary might feel? Ultimately, the decision was made to do the latter. Weighing out how the public would inevitably respond to a case about such a “sensitive” issue was a careful undertaking – not even our entire team went to watch the case be argued. When I asked my manager if I might go with those who were going to attend, she gently explained that my presence might hinder rather than help. My face in the courtroom might have sent a message, my manager feared, about “external cultural influence” guiding this case. Perhaps unlikely, but we weren’t taking any chances on such an important issue.

This decision, however, reminded me of a whole line of challenges against human rights work. Sometimes, the human rights structures that have originated in the West can cause more harm than benefit through their origin and rigidity. By imposing specific ideas about how rights manifest in all circumstances – these specific ideas being tied up in Western values and perceptions – there are groups that have dug in their heels to resist this imposition and some people have become more marginalised because of it. As with all human rights work, it is important to be aware of our impact in different circumstances, and this court case was a good reminder for me about this. Sometimes, it is best for everyone to sit back and hear about how things went the next day.

I am a super sensitive person – and I need to remember this in my work; Quite honestly, I was not expecting to find working in Uganda as challenging as I did. Having lived abroad, travelled extensively, and worked in the non-profit sector, I had enough related experiences that I thought I would transition rather seamlessly into my life there. I’m not sure whether it was a post-COVID mental health slump, the work itself, or (most likely) a mix of the two, but this summer was incredibly emotionally taxing for me, and I am still trying to figure out how I feel about the experience that I had. I have always known that I am a deeply sensitive person, but I was more exhausted than I ever anticipated at the end of every workday. Progressively throughout the summer, I retreated deeper into books and other sources of comfort in my downtime to avoid thinking too much about the human rights violations I was reading about all day. I missed my security networks – my partner, my family and my friends – in ways I had not expected. And, by the time I returned home, I felt entirely drained. This feeling was made all the more challenging by the fact that it was entirely unexpected for me, and I was wholly underprepared to respond to it. The lesson here for me is one that I am still unpacking but requires me to look seriously at what I need to do to better prepare myself for human rights work in the future, as well as what that work looks like for me to be able to partake in it without having it take over my entire capacity. This personal learning is hugely valuable as I navigate law school and try to figure out a prospective career path. The objective of this programme, I believe, is not just to learn about human rights practice, but to explore how you fit into it. I am grateful for this opportunity to have looked a bit deeper into my own strengths and weaknesses when it comes to human rights, to give me more reference points as I plan for my future.

All in all, there is no one way to sum up my experience in Uganda this summer. The learning was deep and significant. The work was beautiful and challenging. Living was both fun and hard. It was exhausting, amazing, sad, intense, and so very many more adjectives. I am grateful, however, for the complexity. I don’t think that one can successfully seek simplicity in human rights.

The writer was a fellow in the Strategic Litigation Programme at the Center for Health, Human Rights and Development.

A copy of this article was first published in the McGill Human Rights Interns blog

Now is the Time to Secure the Girl Child’s Future

Ten years later, the condition of the girl child across the world is still a matter of shame and concern. Uganda is a country where social disadvantage outweighs the natural biological advantage of being a girl. Girls are disadvantaged and are not enjoying their fundamental human rights. These rights include non-discrimination, the right to survival, protection from harmful influences, exploitation and full participation in family and social life, amongst others.

By Mary Constance Nyaketcho

This year’s global theme for the International Day of the Girl Child is “Our time is now-our rights, our future”, offering us an inspirational entry point to advocate for, promote and celebrate the girl child’s rights, translating into actions that will build a better world for them. The first celebration of International Day of the Girl Child was on 11th October 2012, making this year the 10th commemoration.

Ten years later, the condition of the girl child across the world is still a matter of shame and concern. Uganda is a country where social disadvantage outweighs the natural biological advantage of being a girl. Girls are disadvantaged and are not enjoying their fundamental human rights. These rights include non-discrimination, the right to survival, protection from harmful influences, exploitation and full participation in family and social life, amongst others.

In some communities, it is still challenging for the girl child to pride in her gender because she has continuously been undervalued and violated. This has greatly influenced the health and well-being of the girl child, her personal development, participation in society and ability to achieve her fullest potential. At the early age of 13 even before they hit menstruation, girls are forced into marriage. Imagine how miserable that girl child will be for most of her ‘married’ life. Several of them have also been sexually abused by relatives, guardians and community members but nothing has been done to stop this. The abusers are never castigated while the girls are dealing with the consequences like unwanted pregnancy and sexually transmitted diseases while continuing to be victimised.

Violation of the rights of the girl child begins with denying her the right to education. Education is an essential tool for achieving the goals of equality, development and peace. It is evident that girls are more likely to be kept out of school than boys. They have missed out on education simply because the girl child is obliged to stay home and do house chores with their mothers as the boys went to school. It is not okay that a boy’s education is valued over a girl’s. While these cases are majorly seen happening in the rural areas, even in the urban areas, the prospects of the girl child are not too bright as well. Although women are acquiring status and positions in places of influence, they still do not get the respect their male counterparts get in the offices. Besides no matter what status a woman achieves outside the home, inside the home setting, by and large, she remains an object of care for work and domestic responsibilities. It thus appears that even education and financial independence have not helped them in enhancing their status and rights.

“Our time is now-our rights, our future” is a theme that aims at empowering, advocating and protecting the virtue of the girl child is a social development policy that works and a long-term investment that yields exceptionally high. A glance at the current slow and patchy progress towards equality, reveals that we were overly ambitious to expect the eradication of a regime of gender inequality and outright oppression that has lasted for over a thousand years in only a few years. We have also been held back by the emergence of the COVID-19 pandemic which has resulted in a number of other human rights violations. The effects of the pandemic on the girl child are dire and need immediate action and if not addressed, may last a lifetime.  

It is time, therefore, that we begin to do the right thing. It is crucial for generations to come together to reimagine the type of world we want to create for the girl child. We ought to take note that is every individual’s constitutional right to acquire education, and the future of the nation rests on the education of all its youth. This does not exclude pregnant and young mothers, whom we should mentor and encourage to report back to school and finish their education. But education doesn’t stop with the girl child alone. School leaders, teachers, parents and community leaders also need to be sensitised and made aware of tirelessly emphasising the need for educating the girl child. By doing so the girl child acquires enough knowledge and viable skills to advocate for themselves, accomplish their goals and live a healthy and comfortable life.

We need to empower and support the girl child to engage in decision-making more than ever, and in that regard, every girl can decide what to do with her body, her life and her future. Girls must be encouraged to speak up, and to have a meaningful voice, ensuring they can engage in the planning and implementation of their rights. And this can only be achieved if the girl child is taught about their rights, for they need to have a clear idea of the issues affecting them, address what they would like to voice, that their voices are meaningfully recognised and that they can do so in a safe and child-friendly format. The boy child should also be taught how to exist with empowered girls as equals rather than competitors.

We need to make necessary investments and hold ourselves accountable for results. But investment in the girl child goes beyond monetary endowments. It is about making long-term efforts at demystifying harmful misconceptions that affect the girl child. It is therefore an appeal to the Government and other responsible organs to ensure the passing and implementation of policies such as the National Strategy to End Child Marriage and Teenage Pregnancy in the country by 2026, and the National School Health Policy among others. It is also important to mainstream the gender perspective into all policy programmes in order to generate awareness and elevate the girl child.

Uganda has well-developed policies on young people, gender equality and girls’ education, which are often backed up by laws. However, there are certain gaps in advocacy, focus and coordination, while significant problems remain in implementation and enforcement capacity. It is important to enhance the effectiveness of legal redress mechanisms and child protection systems and to enact district-level ordinances to back up and pave way for the implementation of national laws.

It is nevertheless noteworthy that a number of girls have “made it in life”. They have graduated from school, taken on professions and risen to positions of political leadership, successfully balancing their role with family commitments. So, as we celebrate the International Day of the Girl Child, let us celebrate the success stories of the girl child and also join hands and analyse why gender equality gaps still persist and how we can deal with it immediately. Let us all act now and provide a friendly environment for the girl child.

The writer is an intern in the Community Empowerment Programme at CEHURD.

Reflecting on CEHURD’s Achievements and Stories of Success in Uganda’s Health Care System

CEHURD launched a national campaign to raise awareness of and advocate for safety in health-care facilities, recognizing that safety is a prerequisite for a strong health-care system.

Israel iya jeep

Post-World Patient Safety Day 2022 by Israel Iya Jeep                                    

The world patient safety day is observed annually on 17th September with the objective of increasing public awareness and engagement, enhance global understanding, and work towards global solidarity and action by member states to promote patient safety.[1] Across the world, unsafe medication practices and medication errors are a leading cause of avoidable harm in health care [l1]  and this year’s theme for the World Patient Safety Day embraces this fact. The theme builds on the ongoing efforts by the World Health Organization to ensure medication without harm. The theme provides the necessary motivation to take urgent action towards reducing medication-related harm through strengthening systems and practices of medication use.[2]  The world patient safety day is thus a global campaign calling on stakeholders to prioritize and take early action in key areas associated with significant patient harm that may occur due to unsafe medication practices. Furthermore, the world patient day offers great potential to raise awareness and understanding of health issues and mobilize support for action, from local communities to the international stage to further the fundamental principle of medicine “do no harm”.[3]

CEHURD with support from the Joint Advocacy for Sexual and Reproductive Health and Rights (JAS) Programme in commemoration of world patient safety day, kick-started a national campaign to amplify and advocate for safety in health facilities, recognizing that safety is a prerequisite for a strong health system. CEHURD is contributing – towards ensuring safety issues in health facilities are addressed and to this end, CEHURD has challenged the actions and inactions of hospitals that put patients safety at stake for instance, it challenged Mulago hospital on new born care and management, challenged the actions and omissions of the government of Uganda for failure to provide minimum maternal health services in petition 16 – What the constitutional court decision on access to basic maternal healthcare means, CEHURD with the Uganda Medical Association advocated for Prioritization of safety of health workers to protect patients during covid-19-and-beyond, an increase of salaries for health workers, documented facts on the state of health facilities and amplified the voice to renovate, build and ensure adequate health infrastructure. All these efforts are aimed at ensuring that patients’ safety is guaranteed and no patient suffers injury or dies because of unsafe and poor health care.

CEHURD’s efforts have recorded stories of success and progress in the health sector; he first success was achieved in constitutional appeal 01 of 2013, In this case, CEHURD contended that the non-provision of basic indispensable health maternal commodities in government health facilities and the imprudent and unethical behaviours of health workers towards expectant mothers contravened the constitution.  The supreme court, in rejecting the political-question-doctrine defence raised by the Attorney General, held that the executive cannot escape scrutiny where its actions or inactions violate constitutional provisions and that Article 20 of the constitution does not exclude any institution from respecting, upholding and promoting human rights. 

In addition to the above, the supreme court opened gates for public interest litigation especially in the area of health rights and patient safety when Justice lady Esther Kisaakye held that it’s not a requirement under the constitution for a petitioner who seeks redress to show that they suffered a personal legal grievance. CEHURD has leveraged on this order to bring legal action to advance health rights and cause structural reforms in the health sector as demonstrated in civil case No. 212 of 2013 in the High Court of Uganda between Center for health, human rights and development and others v Executive Director Mulago Hospital and others. In this case, court issued orders in form of structural interdicts in the health sector for instance orders requiring that Mulago hospital as a mandatory obligation takes steps to ensure and or enhance the respect, movement and safety of babies, dead or alive in hospitals and orders relating to the Executive Director of Mulago hospital to submit as a mandatory duty a written report every after 4 months regarding the steps taken to enhance the respect, movement and safety of babies to CEHURD.

Still in the jurisprudential circles, the dismissal and the decision in Uganda v Kato Frederick criminal case 56 of 2020 builds confidence among medical practitioners to continue providing safe-post-abortion care to different people that enter the doors for help which in turn may   reduce the severe effects of unsafe abortion that contribute to high maternal mortality rates[l2] . The case demonstrates that medical practitioners can provide safe post abortion care without fear of getting prosecuted.

CEHURD has conducted policy and legal framework mapping aimed at identifying laws, bills, policies, strategies and guidelines affecting self-care to identify opportunities and gaps that  inform advocacy for institutionalization of self-care in Uganda. [l3] 

CEHURD has also conducted research and facilitated investigations on the state of health facilities in Uganda for example the “No safety guarantees in moribund health system | PANORAMA” documentary which identified issues relating to poor quality health care, health expert shortage, unskilled man power, inadequate documentation of statistics relating to patient safety, inadequate man power, lack of infrastructure, ageing infrastructure among others. All these efforts have culminated into structural reforms in the health sector such as provision of safety gears to health workers, mitigating health expert shortage, building homes for cancer patients at the Mulago cancer institute, renovation of Busolwe Hospital, and influencing budgetary innovations in the health sector.

CEHURD has condemned detention of persons with mental illnesses and patients in health facilities, emphasising that Hospitals are not gazetted detention facilities according to the law of Uganda, and that there are special places where we have to detain people “No health facility is allowed to detain patients for any reason despite the business background. If people owe you, hand them to institutions who have that mandate.” ~ Dr Katumba | Uganda Medical & Dental practitioners’ Council.

We talk about these successes, achievements, progress to inform, influence, and inspire movements, the government, and all stakeholders to join the campaign aimed at causing positive structural changes in our heath sector and ensuring patient safety because a flourishing health sector is key in achieving our national goals. We call everyone to engage in advocacy efforts with key stakeholders including developing national campaigns, organizing policy forums, advocacy and technical events, capacity-building initiatives, lighting up iconic monuments with the goal of pursuing the objectives of the world patient safety day and the year’s theme of raising global awareness on the high burden of medication-related harm due to medication error and unsafe practices. We must not tire to advocate for urgent action to improve medication safety through engaging with health workers and other partners in the health sector in the efforts to prevent medication errors and reduce medical-related harm. We must empower patients and families to be actively involved in the safe use of medication, and scaling up implementation of the global patients’ safety challenge which is medication without harm.

In conclusion therefore, we all have a role to play in ensuring patient safety and the call for all persons to fully embrace and actively take part in activities aimed at promoting awareness and mobilize support for safety in health facilities at large.

The writer is an intern at the Center for Health, Human rights and Development.


[1] World patient safety day 2022 accessible at https://www.who.int/news-room/events/details/2022/09/17/default-calendar/world-patient-safety-day-2022

[2] Supra

[3] World patient safety day accessible ta https://nationaltoday.com/world-patient-safety-day


 [l1]This is repeated in the same sentence so lets keep the one at the beginning of the sentence

 [l2]I don’t know if this is a fact because we don’t have evidence that the numbers have reduced

 [l3]This is not very accurate so just leave it out.