Funding for vital HIV-prevention programmes could be adversely affected under a Donald Trump presidency.

This was the concern raised by lesbian, gay, bisexual, transgender and intersex (LGBTI) activists following Trump ’s victory in the presidential election in the United States.

South African public health activist Victor Lakay said: “Given Trump’s track record – and the disregard he shows for minorities by making derogatory and bigoted statements against anyone who isn’t a cisgendered, white man – we should all be deeply concerned. Trump has, for example, courted Vladimir Putin – and we know what his stance is on LGBTI rights.”

In a statement made a day after the presidential election, the US Human Rights Campaign president, Chad Griffin, said: “Over the past 18 months, Donald Trump and Mike Pence have intentionally sowed fear and division for cynical political purposes. They now face a decision about whether they will also govern that way. We hope, for the sake of our nation and our diverse community – which includes women, people of colour, those with disabilities, immigrants, and people of all faiths and traditions – they will choose a different path.”

Lakay said that Trump’s track record on LGBTI rights and that of other minorities’ could result in dire consequences for LGBTI-focused healthcare programmes locally, which are funded by the US government.

“My guess is that if they were going to plug aid to Africa, they will cut funding to health programmes,” Lakay said.

“It’s important to remember that South Africa has moved from a HIV treatment-focused movement – in which we have made incredible advances – to a prevention-focused movement. Pre-exposure (Prep) and post-exposure (Pep) medication, as well as microbicides, form an integral part of this prevention armoury. And some are only funded through Pepfar.”

The United States President’s Emergency Plan for AIDS Relief – Pepfar – is a government initiative which was started in 2003 with the aim of helping “save the lives of those infected with and affected by HIV/AIDS around the world”.

An initial outlay of $15-billion was set aside to urgently respond to HIV and tuberculosis by providing financial and technical support across several affected countries, including South Africa.

According to the US embassy’s website: “Pepfar has been active in 80 countries, saving over one million babies from being inadvertently infected by their HIV-positive mothers. In 2015 alone, due to Pepfar support, 267 000 babies that would otherwise have been infected were born HIV-free. As of September 2015, Pepfar is supporting life-saving antiretroviral treatment to more than 9.5-million men, women and children.”

Participants in Swakopmund Gay Pride march down the main street of the Namibian city on June 4 2016. (Oleksandr Rupeta, NurPhoto)
Participants in Swakopmund Gay Pride march down the main street of the Namibian city on June 4 2016. (Oleksandr Rupeta, NurPhoto)

“Losing this kind of initiative would see a rollback in the advances we have made because it will not help to stem the number of new HIV infections,” said Lakay.

Where LGBTI rights are concerned, Trump’s regime is expected to differ starkly in policy and advocacy efforts to that of President Barack Obama’s.

Graeme Reid, the director of Human Rights Watch’s LGBT programme, said: “The Obama administration has provided political cover, material support and high level advocacy for LGBTI people around the world. Most recently the appointment of the special envoy, Randy Berry, has played an important role, particularly in behind the scenes advocacy. The US has also supported the advancement if LGBTI rights at the UN.”

Reid said that Trump’s election campaign – in which he relied on a rhetoric of racism, misogyny and xenophobia – did not auger well for a rights-based foreign policy on any issue, including the rights of minorities.

While “it remains to be seen what policy decisions are taken”, Reid added that the implications for Africa’s health care programmes aimed at LGBTI people could prove dire.

“In the event that there are funding cuts to health programmes, clearly this will have a detrimental effect not only on LGBTI people, but to the population as a whole.”

Matt Beard, executive director of All Out, said: “If the US had any moral authority left to influence African governments to make positive change for LGBTI people, this has now gone. The election of Trump and the homophobia and transphobia that he has enabled will encourage and embolden those across the African continent who are trying to use LGBTI people as scapegoats.”

Beard added: “We are very concerned about funding for health programmes in Africa. The Trump campaign was woefully short on policy detail and we cannot know for sure what he is planning with regards to US development aid. But based on the ‘America First’ mantra of the campaign, I would not be surprised if we saw a cut to such programmes.”

It’s not a new problem.

“Look, LGBTI Africans have organised and advocated for their rights long before the US administration supported them. And they will continue to do so. However, an about-turn on US policy will leave LGBTI groups exposed and under-resourced,” said Reid. What now remains to be seen, he says, is to what extent the progress Obama’s administration made in advancing LGBTI rights will be halted or reversed.