LGBT rights in a Republic of Therapy. HIV/AIDS policies and the redefinition of citizenship in Cameroon

Abstract

The links between the fight against HIV/AIDS, and lesbian, gay, bisexual and transgender (LGBT) mobilizations around the world have been extensively demonstrated. However, there are few empirical studies on the effects of new strategies based on access to treatments for homosexuals in Africa, especially in countries where same-sex relationships are punishable by law. In discussing the relationship between HIV/AIDS policies and the formal recognition and inclusion of homosexuals, we ask if it is possible to speak of a therapeutic citizenship. From a sociological and legal perspective, what is important is how the recent global strategies and human rights discourses on HIV/AIDs are impacting the emergence of engaged social actors whose claims go well beyond access to treatments but challenge the Cameroonian legal and health systems. However, LGBT rights advocates’ claim for full citizenship through participatory inclusion in public life may not turn out to be successful as it encloses their rights within a pathologized identity, the HIV epidemic. This paper also raises a crucial issue (citizenship) associated with the politics of homosexuality in Africa and offers an empirical dimension on how global health and human rights discourses affect the relationship between State and society in Cameroon.

Les liens entre la lutte contre le VIH/SIDA et les mobilisations LGBT dans le monde entier ont été largement démontrés. Cependant, il existe quelques études empiriques relatives aux effets de nouvelles stratégies fondées sur l’accès aux traitements pour les homosexuels en Afrique, en particulier dans des pays où les relations entre partenaires de même sexe sont sanctionnées par la loi. Discuter de la relation entre les politiques en matière d’VIH/SIDA et la reconnaissance et l’inclusion formelle des homosexuels, est l’occasion de nous demander s’il est possible de parler d’une citoyenneté thérapeutique. D’un point de vue sociologique et juridique, ce qui importante est la façon dont les stratégies mondiales récentes et les discours sur les Droits de l’homme sur les VIH/SIDA ont un impact sur l’émergence d’acteurs sociaux engagés dont les revendications dépassent largement l’accès aux traitements et questionnent les systèmes juridiques et de santé du Cameroun. Cependant, la prétention des défenseurs des droits des LGBT revendiquant une citoyenneté complète à travers une inclusion participative dans la vie publique pourrait ne pas réussir puisque cela enferme leurs droits dans une identité pathologisée, l’épidémie de VIH. Cet article soulève aussi une question essentielle (citoyenneté) associée aux politiques relatives à l’homosexualité en Afrique et présente une dimension empirique sur la façon dont les discours mondiaux sur la santé et les droits de l’homme affectent la relation entre l’Etat et la société au Cameroun.

Keywords:

• HIV/AIDS
• therapeutic citizenship
• state building
• homosexuality
• human rights
• Cameroon

Mots-clés:

• VIH/SIDA
• Citoyenneté thérapeutique
• Construction de l’Etat
• Homosexualité
• Droits de l’homme
• Cameroun

Acknowledgements

I would like to thank my friends and colleagues, Mame Yaa Bosumtwi and Stephanie Alexander for their careful re-reading and their constructive comments.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

1. The GF is a partnership organization designed to accelerate the end of AIDS, tuberculosis and malaria. More than 70% of national needs is covered by the GF (GTC-CNLS 2012). Country Coordinating Mechanisms (CCM) are central to the GF’s commitment to local ownership and participatory decision-making. These country-level multi-stakeholder partnerships develop and submit grant proposals to the GF based on priority needs at the national level. After grant approval, they oversee progress during implementation. CCM include representatives from both the public and private sectors, including governments, multilateral or bilateral agencies, non-governmental organizations, academic institutions, private businesses and people living with the diseases. For each grant, the CCM nominates one or more public or private organizations to serve as Principal Recipients.

2. Key populations at risk for HIV have the highest risk of contracting and transmitting HIV. They also have the least access to prevention, care and treatment services because their behaviours are often stigmatized and even criminalized, as is the case of MSM, sex workers and injecting drug users.

3. Biopolitic is ‘a power that has taken control of both the body and life or that has, if you like, taken control of life in general – with the body as one pole and the population as the other’. Foucault (1976, 252–253) cited by Laura Garrison, https://anthrobiopolitics.wordpress.com/2013/01/21/biopolitics-an-overview/.

4. Rather than the local level. This is because of a formal political inclusion in State-action policies.

5. The term Practice (s) is understood here as a set of actions, attitudes, procedures, behaviours or conducts in relation to others or to a specific situation.

6. Each of these are specific claims regarding the environment or non-human natural world (ecological citizenship), the biological condition (for example for people who are sick or at risk), the sexuality (where same-sex couples are denied rights recognized to heterosexuals couples), or the use of technology to change the society (digital citizenship).

7. The concept citizenship has its roots in Antiquity. The word ‘Citizen’ comes from the Latin ‘Civis’, but the citizen status is an invention of Greek philosophy. It means those who have the right to participate in the conduct of public affairs.

8. PLWA emphasize more and more their lay expertise. Their actions within the health system have contributed to ‘health democracy’ (Kpoundia 2015).

9. Interview conducted via Skype, February 17, 2015.

10. Interview conducted via Skype, January 12, 2015.

11. The law currently does not provide them any protection. However most of them became aware of what to say, how to react, what to ask and who to call to in case of issues with the law. Sometimes, some are arrested without any warrant of arrest. Simply asking if there is any warrant arrest can stop abuse, or if not, it can be used later to object a procedural defect.

12. Following the work of Bayart on extraversion strategies (Bayart 1989), by extroverted State we want to highlight the significant imbalance between rich countries and poor countries in the process of globalization. These asymmetrical relations are due to unequal dependence on international assistance.

13. Interviews conducted via Skype between January 5 and March 15, 2015 with gay-rights activists in Cameroon.