In an initiative towards the inclusive policies aimed at addressing the specific challenges faced by key affected populations (KPOs) in the fight against HIV, Lhak-sam, a network representing people living with HIV/AIDS (BNP+), organized a policy dialogue on 20 November, marking a significant step forward in recognizing and addressing the unique needs of marginalized communities.
Before delving into the policy dialogue, it’s crucial to understand the backdrop of the HIV situation in Bhutan. From January to June 2023, 26 new HIV cases were reported, with 11 males and 15 females. Of these cases, 65 percent were between the ages of 25-49, highlighting the vulnerability of this demographic. Notably, all cases were contracted through sexual contact, underscoring the need for targeted prevention efforts.
The mode of detection revealed that 35 percent were diagnosed through medical screening, 42 percent through Voluntary Counseling and Testing (VCT), 15 percent through contact tracing, and 8 percent through screening of pregnant mothers attending Antenatal Care (ANC) services. These varied detection methods showcase Bhutan’s commitment to comprehensive screening approaches.
As of June 2023, the total number of HIV cases in Bhutan stands at 900, with a fairly balanced gender distribution of 52 percent males and 48 percent females. The age categorization shows that 70 percent of cases fall within the ages of 25-49, emphasizing the need for targeted interventions in this age group.
A recent projection by the National HIV, AIDS and STIs Control Program, in collaboration with UNAIDS, estimates 1,140 HIV cases in 2023. The decrease from the previous estimate of 1,300 is attributed to the high and sustained coverage of antiretroviral therapy (ART) and enhanced prevention measures.
The case detection gap, representing the difference between estimated and diagnosed cases, stands at 21.1 percent as of June 2023. This marks a commendable 11.9 percent reduction from December 2022, reflecting Bhutan’s successful efforts in improving case detection rates. The commitment to closing this gap signifies progress in the fight against HIV.
The policy dialogue aims to create an enabling environment for KPOs in Bhutan, including the LGBTI+ community, sex workers represented through Red Purse Network (RPN), and drug and alcohol users represented by Chituen Phendhey Association, along with people living with HIV represented by Lhak-sam, are considered among the most vulnerable segments of society.
The dialogue is structured in two phases. The first phase focused on training representatives of key populations in policy advocacy, equipping them to identify underlying policy issues and challenges affecting their rights and access to health, economic, and legal services. The second phase involves lobbying relevant policymakers and stakeholders to bring about policy changes based on the concerns raised by the KPOs.
During the dialogue, each KPO presented their unique challenges and issues. Pride Bhutan highlighted the absence of national policies protecting the rights of the LGBTI+ groups. RPN shed light on the threats faced by sex workers, including sexually transmitted infections. RPN advocated for the amendment of Section 373 of the Penal Code of Bhutan, 2004, which currently criminalizes sex work. Member of Parliament of the Upper House, Pema Tashi, expressed support for RPN’s proposed solution.
Wangda Dorji, Executive Director of Lhak-sam, voiced concerns about the ripple effect of HIV due to keeping sex workers underground, aligning with RPN’s call for decriminalization. Tshering Tshomo, Chairperson of the Social and Cultural Committee, NC, commended Lhak-sam and other NGOs for their dedication to bringing marginalized groups to the forefront of national concern.
The policy dialogue represents a pivotal step towards fostering an enabling environment for key affected populations in Bhutan. It reflects the commitment of stakeholders to address the unique challenges faced by marginalized communities, signaling progress in the pursuit of more inclusive and compassionate policies.
As Bhutan navigates these conversations, it demonstrates a commitment to leaving no one behind in the journey towards sustainable development. The dialogue sets the stage for collaborative efforts to create policies that safeguard the rights and well-being of all citizens, ensuring a more inclusive and equitable society for Bhutan’s future.