Michael G. Bare, MPH
Program Coordinator
National LGBT Cancer Network 

In the past few weeks there have been several negative developments in terms of LGBT human rights, particularly from Uganda and Brunei. Uganda, to adding legislation to the existing anti-LGBT laws enacted by the country in December of 2013 (life in prison if found guilty of homosexuality), passed a law that forces healthcare workers to out LGBT Ugandans and one that bans foreign NGO’s from “helping LGBTI peoples”. This came only shortly after Ugandan police raided a US military medical center that was one of the few places in the country that LGBT people could go to get tested and treated for HIV without stigma, the government officials claiming it was a training camp for homosexuality. The Sultan of Brunei publicly stated that the country’s sharia law system would allow for stoning to death for breaking laws against homosexuality and adultery.


Yet strategies to help LGBT peoples around the world through health aid and diplomacy are continuing from US international programs. The Kaiser Family Foundation last week published a brief titled “The U.S. Government and Global LGBT Health: Opportunities and Challenges in the Current Era” which sited challenges, opportunities and made suggestions for areas for future development to benefit the health of LGBT peoples around the world.


Uganda Pride Gathering
Uganda Pride Gathering

While it is heartening that the State Department, NGOs and think tanks recognize that the heath and human rights of LGBTI peoples around the world is worth fighting for, strategy is also key. In his book “The Honor Code; How Moral Revolutions Happen” noted philosopher Kwame Appiah presents case studies of programs to enhance social change. Looking at issues such as foot-binding in China, dueling, slavery in the West, and honor killings, his thesis is that the best campaigns have been won by engaging communities, through grassroots change, while those dictated top-down tended to fail considerably. With this in mind we should listen to LGBT activists in Uganda who say that sanctions from the Western world would further endanger LGBT lives in Uganda. For even if it didn’t bring about the collapse of social order as the activists suggest that sanctions could do, couldn’t it also shift the blame of the sanctions onto the LGBT community in Uganda themselves? In order to ensure community health, we have to remember that a key aspect is to work with the community, especially in an international development context. Working with activists and thought leaders on the ground, and not fall into the trap of we-know-best, top-down decision making, to truly work in unity with peoples with whom we are hoping to assist. Guaranteeing that their voices, concerns and needs be respected and met accurately, and engaging with their opponents with the cultural competence that working with local activist would bring, will yield the most effective results.



  1. The ploy of telling the international community not to intervene in a situation where LGBT people are being assaulted, criminalized, and murdered is a poor excuse for laziness, and cowardice. What is going on in Uganda, Nigeria, Brunei, and other countries are crimes against humanity, and horrific violations of universally held human rights. Killing LGBT people just for who we are anywhere on the planet should ignite international outrage, sanctions, and any other measures we can employ, designed to put an end to these crimes.

    This nonsense about “top down” interventions not working is nothing more than letting the world off the hook, to stand by silently, do nothing, and give tacit approval for such horrors.

    It is our job to make sure the interventions work and to keep fighting until human rights are respected around the world. You can always find a few people in any situation who say “Don’t rock the boat, because of the backlash it will provoke.” which only allows the horrors to continue unchecked, and gives the perpetrators the satisfaction of success; they have gotten away with their grisly actions without repercussions. When LGBT people are being assaulted, imprisoned, and murdered by vigilante groups with the approval of government and law enforcement it doesn’t get any worse than that, so what exactly are we “protecting” Ugandan activists from if we sit back and wait interminably for some sort of “community engagement” in a country where 90 plus percent of the population agree with the persecution of LGBT people? Ask other Ugandan activists and they are begging us for help, not to sit back and forget them while they are facing torture and death.

    If you want to help in Uganda stop trying to discourage the few people who actually CARE about anything beyond their own noses and are willing to speak out against gross injustices in Uganda, and send money to the fund to help them survive and escape the persecution. Real help is what helps, not academic theorizing.


    1. Jay, I appreciate your response, and engaging in this discussion. I don’t disagree that these are crimes against humanity, but it was never my intention to say we not interact at all. In fact nowhere did I say the international community not intervene; I believe we should, but to intervene in ways that are in coordination with the objectives and goals of local LGBT communities, and not just acting without understanding how our actions may effect those on the ground. Sanctions have never been proven to work in any situation, they never hurt the governments we seek to sanction, only the people.

      Thank you for sharing the link to the Rescue Fund, this is an importan and real way we can help. Another way we can help is to prevent further American interference, making it illegal for religious extremists to spread their specific brand of hate around the world. In fact SMUG (Sexual Minorities of Uganda) has filed for, and been approved to hold Scott Lively accountable in court for crimes against humanity for his anti-LGBT organizing in Uganda (http://ccrjustice.org/ourcases/current-cases/sexual-minorities-uganda-v.-lively); steps like these could prevent future atrocities from being supported by similar individuals within our own borders.

  2. I would think the best way to intervene is look a little closer to home (eg: bible thumpers who continue to inform Ugandan policy through shady mission charity work). When LGBTQ Ugandans tell us we are part of the problem not the solution we should probably listen.

  3. Dear Michael,

    I am the editor-in-chief of Public Diplomacy magazine and we are so pleased to read your above piece. Our upcoming issue focuses on LGBT diplomacy, and we’re hoping to include a piece on global LGBT health. We would like to start a conversation with you about authoring a piece in our upcoming issue and are wondering how to get in touch with you. Please feel free to contact me using the information listed on our website: http://publicdiplomacymagazine.com/

    I look forward to hopefully hearing from you soon.

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