Introduction: Centering Key Populations in Africa’s HIV and Human Rights Response
The AMSHeR Key Populations Network Manifesto is a powerful political and advocacy tool developed to position key populations at the center of HIV, health, and human rights responses across Africa. It brings together the voices and priorities of communities most affected by HIV and by structural discrimination, demanding a shift from tokenistic inclusion to genuine leadership by key populations in decision-making spaces.
Grounded in principles of equality, dignity, and self-determination, the manifesto calls on governments, donors, civil society, and regional bodies to adopt a transformative agenda that addresses criminalization, stigma, violence, and social exclusion. It insists that sustainable progress in ending AIDS and advancing public health in Africa is impossible without fully recognizing and respecting the rights of those most marginalized.
Who Are Key Populations and Why They Matter
Key populations are groups that face higher HIV risk and burden, combined with systemic barriers to accessing services and justice. In the African context, this includes, among others, gay and bisexual men and other men who have sex with men, sex workers, transgender and gender-diverse people, people who use drugs, and people in prisons and other closed settings. Many also experience overlapping vulnerabilities related to gender, age, migration status, disability, and poverty.
The manifesto underscores that key populations are not passive beneficiaries of aid or policy; they are experts in their own lives, rights-holders under international and regional human rights law, and essential partners in designing effective responses to HIV, sexual and reproductive health, and broader social justice issues. Recognizing their leadership is critical to achieving the targets set in the Sustainable Development Goals and continental frameworks such as Agenda 2063.
A Vision Rooted in Human Rights and Social Justice
At the heart of the AMSHeR Key Populations Network Manifesto is a clear vision: an Africa in which every person, regardless of sexual orientation, gender identity and expression, sex characteristics, occupation, or health status, can live free from violence, discrimination, and criminalization. This vision is grounded in existing regional instruments, including the African Charter on Human and Peoples’ Rights and relevant resolutions of the African Commission on Human and Peoples’ Rights, which affirm the universality and indivisibility of human rights.
The manifesto reframes key populations’ demands not as special rights, but as the practical realization of obligations that African states have already accepted. It emphasizes that public health and human rights are mutually reinforcing: protecting rights and dismantling structural barriers is a prerequisite for effective HIV prevention, treatment, care, and support.
Core Principles of the Manifesto
The manifesto is anchored in a set of guiding principles that define both the political stance of the network and the standards against which governments and institutions should be held accountable. These principles include:
- Self-determination and community leadership – Key populations must lead on issues that directly affect them, from policy design to implementation, monitoring, and evaluation.
- Non-discrimination and equality – All people must enjoy equal rights and access to services, without stigma or bias based on identity, behavior, or perceived moral status.
- Intersectionality – Responses must recognize and address multiple, overlapping forms of oppression, including those based on gender, race, class, disability, migration, and age.
- Meaningful participation – Engagement processes must be safe, accessible, and adequately resourced, ensuring that participation goes beyond symbolic representation.
- Accountability and transparency – Governments, donors, and implementing partners must be open to scrutiny and responsive to community-defined priorities and evidence.
- Evidence-informed policy – Laws, policies, and programs should be grounded in robust public health and human rights evidence rather than ideology, prejudice, or moral panic.
Key Demands to Governments and Regional Institutions
The AMSHeR manifesto articulates a set of concrete demands addressed primarily to African governments, regional bodies, and other power-holding institutions. These demands highlight what must change to create an enabling environment for key populations and to advance the broader struggle for equality and public health.
1. Decriminalization and Legal Reform
One of the manifesto’s central demands is for the repeal of laws that criminalize consensual same-sex sexual conduct, sex work, drug use, HIV transmission, exposure, or non-disclosure, and other provisions used to target key populations. It calls for the removal of vague offences such as “loitering,” “vagrancy,” “public indecency,” and “against the order of nature” that facilitate harassment, arbitrary arrests, and extortion.
The manifesto further advocates for the enactment and enforcement of anti-discrimination protections based on sexual orientation, gender identity and expression, sex characteristics, health status, and occupation. It urges states to align national laws with regional and international human rights obligations and to ensure that law enforcement agencies receive training on rights-based policing.
2. Ensuring Access to Comprehensive, Quality Health Services
The manifesto emphasizes the right of key populations to non-judgmental, confidential, and accessible health services, including HIV prevention, testing, treatment, care, and support. This includes harm reduction services, gender-affirming care, sexual and reproductive health services, and mental health and psychosocial support.
It calls for the integration of key population programming into national health systems and strategic plans, with dedicated funding lines and indicators. It also insists that service delivery models must be community-led, designed and implemented in partnership with key populations, and adapted to local realities rather than imposed externally.
3. Protection from Violence, Abuse, and Extortion
Structural violence is a daily reality for many key populations across the continent. The manifesto calls for active measures to prevent and respond to violence, including:
- Training and oversight of police, prison officials, and other law enforcement actors to prevent abuse and harassment.
- Accessible reporting mechanisms that are safe and responsive for survivors of violence, including community-based monitoring systems.
- Legal aid, psychosocial support, and redress mechanisms for people whose rights have been violated.
- Accountability for state and non-state actors who perpetrate violence against key populations.
4. Resourcing Community-Led Organizations and Networks
The manifesto insists that key population organizations must be properly funded and supported if they are to play a meaningful role in shaping policies and delivering services. It calls on states, donors, and international partners to prioritize direct funding for community-based groups, to reduce restrictive eligibility barriers, and to support capacity strengthening, security, and sustainability.
This includes recognizing the expertise of key population networks in data generation, research, advocacy, and service delivery, and ensuring they are not sidelined by larger organizations that lack community roots.
5. Ending Stigma in Health, Education, and Social Services
Beyond legal reform, the manifesto addresses the pervasive stigma that key populations face in health facilities, schools, workplaces, and religious and cultural spaces. It urges the adoption of comprehensive anti-stigma policies and training across sectors, with specific measures to protect young key populations, migrants, and those living in rural or underserved areas.
The document calls for the integration of human rights, sexuality education, and diversity curricula within training institutions for health workers, teachers, social workers, and public servants, to shift the broader social attitudes that underpin exclusion and discrimination.
Strategic Priorities for the Key Populations Network
The manifesto not only addresses external actors, but also outlines strategic directions for the AMSHeR Key Populations Network itself. These priorities are designed to strengthen collective power, enhance coordination, and deepen regional solidarity.
Building and Strengthening Regional Solidarity
The network aims to foster stronger links among national and sub-regional key population groups, encouraging shared learning, joint advocacy, and coordinated responses to emerging threats and opportunities. By consolidating a regional voice, the network seeks to influence continental platforms, including African Union mechanisms and regional economic communities.
Producing and Using Community-Generated Evidence
Evidence is a critical tool in challenging harmful narratives and shaping policy. The manifesto encourages investments in community-led research, documentation of human rights violations, and the production of data that reflect the lived realities of key populations. This includes monitoring the impact of criminalization, tracking access to services, and documenting successful community-led interventions.
Engaging in Policy and Legal Reform Processes
The network commits to actively participating in national and regional policy dialogues, legislative reforms, and judicial processes. This includes submitting shadow reports, engaging with human rights mechanisms, and building alliances with other social justice movements, such as feminist, labor, youth, disability, and environmental justice movements.
Strengthening Internal Governance and Security
Recognizing the risks that key population defenders face, the manifesto highlights the importance of robust internal governance, safety, and security protocols. It encourages transparent leadership structures, community accountability, and mechanisms to prevent internal discrimination or abuse, including on the basis of gender, age, or disability.
The Role of Allies and Partners
While the manifesto is grounded in key population leadership, it acknowledges the important role of allies and partners, including broader civil society, faith-based actors committed to human rights, academia, and progressive policymakers. Allies are encouraged to amplify community voices, share resources, challenge stigma and discrimination, and push for legal and policy reforms aligned with the manifesto’s demands.
However, the document is clear that allyship must respect community autonomy and avoid reproducing power imbalances. Support should be guided by key populations’ own priorities and strategies, rather than external agendas or short-term project cycles.
Why the Manifesto Matters Now
The AMSHeR Key Populations Network Manifesto emerges in a context of both progress and backlash across Africa. On one hand, there have been important advances in HIV treatment, expanded civil society engagement, and growing recognition of LGBTIQ+ and sex worker rights in some countries. On the other hand, many states are adopting or reinforcing punitive laws, restricting civil society space, and fueling moral panics that target people on the margins.
In this environment, the manifesto serves as a roadmap for resistance and transformation. It offers a shared language and set of demands that communities and allies can use to engage policymakers, challenge harmful narratives, and insist on accountability. It also reaffirms that the fight against HIV, and the struggle for broader social justice, are inseparable.
Looking Ahead: From Words to Action
The manifesto is not an endpoint, but a living document that should guide ongoing organizing and advocacy. Moving from words to action requires sustained political will, long-term investment in community structures, and an unwavering commitment to human rights even in the face of opposition.
The future envisaged by the AMSHeR Key Populations Network is one in which key populations are recognized as full and equal citizens, with control over their bodies, lives, and destinies. Achieving this future is both a moral imperative and a public health necessity for the African continent and beyond.