World Bank May Grant Uganda $90 Million Health Care Loan

Uganda should still be able to receive a $90 million health care loan from the World Bank, as long as the government guarantees the safety of LGBT people and health care workers, a new report from a group of consultants hired by the bank argues.

The World Bank officially delayed the health care loan just one day before it was set to be approved in February, after Ugandan president Yoweri Museveni signed into law the Anti-Homosexuality Act, which imposes lifetime jail sentences for certain instances of gay and lesbian sex, and criminalizes the "aiding and abetting of homosexuality." In February the World Bank announced that it was delaying the loan indefinitely, until it could "ensure that the development objectives would not be adversely affected by enactment of this new law."

Now a report commissioned by the bank suggests that the loan can continue, as long as several "stringent conditions" are met to ensure equal access to medical services, according to BuzzFeed. Those guidelines reportedly include assurances that health care workers cannot be penalized for treating LGBT patients, and the report suggests a monitoring system to ensure that patients are not required to disclose their LGBT status to health care workers. The bank's executives have until June to review the report and release the funds, or the loan will be canceled, reports BuzzFeed.

But the likelihood that health care organizations, specifically those working to combat HIV and AIDS, would actually be free from prosecution is seriously in doubt, as a U.S.-funded HIV organization in Uganda was raided last month after local police did weeks of undercover work to determine that the group was "carrying out recruitment and training of young males in unnatural sexual acts."

Adding to the concern is a document obtained by BuzzFeed's Lester Feder, reportedly from the office of Ugandan health minister Ruhakana Rugunda. Titled "Draft Guidelines for Health Workers Regarding Services for Homosexuals," the 15-page document details the scenarios in which health care providers are required to disclose a patient's LGBT identity.

After claiming that LGBT Ugandans have a fundamental right to medical care and privacy surrounding that care, the guidelines note that there is no guarantee of privacy when the person seeking care is a minor, "where a woman has been sodomized," or "in cases where clients['] ... mental status is compromised." Medical professionals are also allowed to disclose a patient's LGBT status when transferring that patient's care, when required by a court order, for publication in research, or "when disclosure of such information is vital for the protections of the health status of others or the public and the need for disclosure overrides the interest in the information's non-disclosure."

When listing the rights and obligations of LGBT patients seeking medical care, the proposed guidelines set an ominous standard: "Clients with a homosexual orientation" are required to disclose their sexual orientation, and to provide "clear, accurate and timely information for diagnosis, treatment, counseling and rehabilitation purposes."

Given that the document's foreword points to the pseudoscientific report commissioned by President Museveni which claimed homosexuality is not an innate trait but rather a socially acquired ill that can be "cured," it seems highly unlikely that the "treatment, counseling and rehabilitation" described in these guidelines would result in anything safe or affirming for LGBT Ugandans.