ESA Networks: defending GBMSM rights in East & Southern Africa
Criminalisation does not only prosecute people. It reorganises health systems around the assumption that some communities will not come forward.
By Andrew Spieldenner
In much of East and Southern Africa, the legal environment for gay and bisexual men has tightened rather than eased over the past three years. New provisions have widened what counts as an offence, and in several countries they have extended liability to the organisations that provide services.
The health consequence is structural
The obvious harm of criminalisation is prosecution. The larger harm, measured across a population, is what it does to a health system: outreach workers stop carrying commodities that could be used as evidence, clinics stop recording the data that would show who is being missed, and people stop presenting until presenting is unavoidable.
A health system then produces statistics that appear to show a community with little need for services, which is used to justify not funding services. The loop closes.
What the network partners do
- Legal support and documentation, so arrests and clinic refusals are recorded rather than absorbed.
- Security and digital safety training for organisations working under surveillance.
- Regional advocacy at the African Commission and in Global Fund country dialogues.
- Quiet, practical continuity of services — the part that does not make a press release.
Why regional matters
No single organisation can safely carry this work alone, and several cannot be publicly named at all. A regional network distributes the risk: documentation can be held outside the jurisdiction it concerns, advocacy can be voiced by partners who are not the ones exposed, and a group under pressure has somewhere to hand work to.
Solidarity here is not a sentiment. It is an operational arrangement that keeps services running when one node has to go quiet.
Our role is to strengthen that infrastructure rather than to speak over it — technical support, funding pass-through, and presence in the rooms where regional decisions get made. Get involved if your organisation works in the region.
