The ruling made by High Court calls for jubilation among the LGBTQ+ community in Botswana and Africa. However, this ruling will have negative implications for health in the short run which will abate in the long run. And it poses good fortune to come for its economic standing.
On March 12, 2012, the High Court of Botswana ruled that the constitution “does not recognize homosexuals.” This meant that the LGBT rights group, LGB of Botswana (LEGABIBO) could not formally register as an organization under the Botswana Societies Act. At the time, many in the LGBTQ+ community (hereafter, the article will separate the “T” as it was not necessarily advocated for by LEGABIBO) in Botswana, and certainly around the world, saw this as another example of backsliding on civil liberties. Since then, however, Botswana has taken two steps in the right direction. On November 24, 2014, the High Court reversed its decision. And earlier this month, on June 11, 2019, the High Court voted to decriminalize gay sex.
Botswana is very unique on the African continent. It champions itself as the continent’s longest continuous multi-party democracy. It is fairly free of corruption and has a reputable human rights record. LGBTQ+ rights on the African continent have seen both progress and reversion. South Africa took the first step in the continent to decriminalize homosexuality.
A strong example of regression on this issue in Kenya. A few weeks prior to this landmark decision in Botswana, Kenya made a very different ruling on LGB(T) rights and freedoms. Judges in Kenya upheld a colonial-era law criminalizing gay sex, condemning it as antithetical to the values of the country. Furthermore, they found no scientific evidence of LGB(T) people being “born that way,” as Justice Arburili stated that the “courts should be loath to fly in the face of public opinion.” While this made some worry about the regression of LGB(T) rights on the continent, the Botswanan ruling certainly subsided some of these concerns.
With this ruling in Botswana, it is important to understand the implications, especially for healthcare and the economy in the nation.
Implications for Health
This policy has significant consequences for health and health-care provision in Botswana, particularly in relation to the HIV/AIDS epidemic. This can go one of two ways. Either the apparent acceptability of the LGBTQ+ community in Botswana will allow for greater liberty and more homosexual sexual relations, thereby increasing the already-high rates of HIV in the country. Conversely, greater societal openness can make it easier for gay people to access the medical provisions they need, decreasing the amount of HIV-positive cases. And of course, both of these can simultaneously occur.
In 2017, reportedly 380 000 people in Botswana lived with HIV. This excludes those who are hiding it or are unknown of their status. Scholars have noted that male homosexuality is a significant factor contributing to the spreading of HIV in Botswana. According to Avert, a UK-based charity providing information on HIV and sexual health worldwide,
“Botswana [in 2017 was] still one of the countries most affected by HIV in the world, despite its provision of universal free antiretroviral treatment (ART) to all people living with HIV.”
While Botswana does have this ART coverage, and it is one of the first countries in sub-Saharan Africa to provide it, low testing rates and a lack of HIV knowledge have failed to comprehensively mitigate the high rates of HIV. In 2017, Botswana had the third-highest HIV rate in the world at 21.9 percent, down 3.5 percent from 2005. However, the inclusion of homosexual men in HIV epidemic surveys was not in place until 2012, so the real rates invite questions.
Impact on HIV epidemic
The question of this article is how this ruling will impact the HIV epidemic in Botswana. Some scholars have written that
“Gay men and other men who have sex with men are disproportionately burdened by HIV infection. Laws that penalize same-sex intercourse contribute to a cycle of stigma, homonegativity and discrimination. In many African nations, laws criminalizing homosexuality may be fueling the epidemic, as they dissuade key populations from seeking treatment and health care providers from offering it.”
A 2009 study revealed that of the Botswana men that have sex with other men, 34 percent are married to females, exposing women who are unaware of their partner’s sexual history to HIV. And of the 117 men studied, 76.3 percent were not aware of their HIV status. The men kept this information secret due to a fear of being ‘discovered’ and ousted, and having to face the predominant religious, occupational, and familial prejudice that goes along with being bisexual or homosexual in Botswana.
The lack of knowledge about HIV status and the stigma saturated in Botswana against the LGBTQ+ community makes it likely that both aforementioned scenarios will persist. In the short run, repealing of the law is likely to make sexual relations among men more prevalent, as the legal disincentive has been alleviated. This, compounded with the lack of knowledge on HIV status, should mean the number of HIV-positive cases increases. It will take time for the social stigma to die off. Consequently, some men will continue to be involved sexually with both men and women, thereby increasing the number of cases of women with HIV as well.
However, in the long run, as social stigma is reduced, things should look up. Men will become more comfortable with coming out, as well as seeking medical testing and treatment. And this, combined with the advance of modern medicine, antibiotics, and vaccinations will mean over time that the number of cases will substantially decline. Moreover, since 2012 the U.S. government alone has spent over $41 million to promote gay rights globally, of which $6.6 million has been spent on sub-Saharan Africa alone. In the long run, the confluence of these events make the health implications of this court decision sanguine.
The Economic Implications
A major implication for this High Court decision is that Botswana is becoming ever-more democratic. According to Freedom House, an independent watchdog aiming to advance global democracy, Botswana is rated 72/100 (the higher the number, the freer the country). It can be expected to receive a bump in civil liberties from its current 2 out of 7 rankings after this ruling. And as acknowledged by scholars such as Stanford economist Thomas Sowell, democratic nations receive more foreign investment because investors feel their money is more secure in a country with robust civilian control. Freedom House can provide a good – albeit imperfect – quantitative measure of democratization.
An article written by M.V. Lee Badgett, an economist from the University of Massachusetts, wrote, “What’s the secret to convincing the world to back a movement? Figure out how it could impact the global bottom line.” This Botswanan law certainly has significant economic implications. Her article states that absenteeism, low productivity, inadequate training, and high turnover cause higher labour costs and lower profits: in other words, marginalizing workers is bad for business. She writes that India’s stigmatizing of the LGBTQ+ community may be costing it approximately $26 billion a year.
Badgett wrote in an academic paper that lower productivity and output, inefficient investment in human capital, lost output because of health disparities, and social and health services squandered on addressing the effects of exclusion are costly to economies. In another paper, after studying 39 countries, Badgett noted that “The positive link between rights and development is clear: Countries that come closer to full equality for LGBT people have higher levels of GDP per capita over the 22 years we studied.” They conclude that each additional right is associated with an increase in per capita GDP of approximately 3 percent of the average output produced by an economy.
Discrimination is an impediment to economic progress. When an entity diminishes its source of the competent, hardworking, and qualified labour force by race, gender, sexuality, or other social identifiers, it confines itself. There is a significant economic gain to be had in utilizing a more competent and productive workforce with greater medical care. Moreover, democratization provides a strong sense of security to investors, and the advancement of civil liberties on the nation of Botswana certainly serve to increase the nation’s democratic profile. This all means that the economic implications of this policy mean a positive benefit to Botswana in the long run.
