The theme of Zero Discrimination Day 2023, “Save lives: Decriminalize”, reminds us of the importance of removing discriminatory and punitive laws and policies to end AIDS as a public health threat. Decades of evidence from all over the world point squarely to the fact that laws, policies and practices which criminalize people living with HIV and other key populations increase stigma, block access to services, impede effective HIV responses and cost lives.  An equally compelling evidence base tells us what works – laws, policies and practices based on public health evidence and human rights, preventing and responding to gender-based violence and the meaningful inclusion of people living with HIV and other key populations. 

Countries are following the evidence: in August 2022, the St. Kitts and Nevis High Court decriminalized same-sex sexual relations thanks to efforts by the St. Kitts and Nevis Alliance for Equality and the Eastern Caribbean Alliance for Diversity and Equality. Due to the collective advocacy of young key populations, the Government of Zimbabwe adopted new policies in 2022 to protect intersex minors and strengthen efforts to address gender- and sexual orientation-based violence. The Government of Zimbabwe also decriminalized HIV transmission in 2022. In December of 2022, after decades of civil society advocacy and activism by sex workers organizations, the South African government  announced plans to decriminalize adult consensual sex work.  

People living with HIV and other key populations are also taking action to address other structural barriers. People living with HIV, people who use drugs and other affected communities in Kyrgyzstan have launched an electronic system to register human rights violations. Transgender-led organizations in Paraguay and Panama are preparing advocacy strategies to support the development of supportive gender identity laws. People living with HIV are training as community paralegals in the Democratic Republic of Congo.

Efforts led by and for people living with HIV and other key populations must be scaled up. UNDP and the United States President’s Emergency Plan for AIDS Relief (PEPFAR) have partnered on the SCALE initiative to support countries to drive progress on the historic 10-10-10 targets, in particular the commitment to remove punitive and discriminatory laws, policies and practices undermining HIV responses. At the heart of this partnership is supporting the leadership of people living with HIV and other key populations.

Zero Discrimination Day is a call to action. The time for debating the science and evidence is over. Countries can and must follow the evidence to recognize, respect and elevate the voices of those left furthest behind in HIV responses. Affirming the realities, rights and efforts of people living with HIV and other key populations in law and policy can accelerate progress on decriminalization and inclusion, and ultimately save lives. To create a world free of discrimination for people living with HIV and other key populations, it is time to scale up what works.