Sex Work and the ‘National Strategic Plan on HIV, STIs and TB 2017-2022’ – time to be brave!
No HIV plan or response will be wholly successful if it does not candidly address the context in which sex work takes place, and do so from within a human rights framework. South Africa’s HIV programmes have taken the lead in acknowledging the need to partner with sex workers and sex work advocacy groups. Some AIDS plans have even be so wise as to recommend the decriminalisation of sex work – this means that all criminal laws that apply to sex work are removed, and sex work is dealt with as ‘work’. Modelling research has shown that decriminalisation will reduce HIV transmission by 33%-46% among female sex workers and clients within a decade. In fact, South Africa is one of the first countries to have a sex work-specific plan in the form of the South African National Sex Worker HIV Plan 2016-2019, and it specifically endorses decriminalisation.
There is much to be proud of – but it is not yet enough.
The drafting and consultation process for the NSP 2017-2022 has been a tricky one, with drafts radically changing from one month to the next. One draft would have a robust human rights chapter, only to be followed by a version where there is none, which will catalyse strong push-back from civil society.
The last version of the NSP we studied was dated 24 February 2017. It had remedied many of the issues raised by consultations and submissions including a clear commitment towards human rights, and should be applauded.
We would however like to see much more robust sections on the structural factors that impact on sex work, and submit the following key recommendations:
- Strong call for the decriminalisation of sex work with clear indicators. The last NSP draft calls for “steps to be taken towards the decriminalisation of sex work”, which we applaud and support as this form of law reform is absolutely key to protect sex workers and their clients from HIV and other illnesses. However SANAC and the Department of Health should take the lead in pushing for law reform, and these efforts should be measured and monitored in the careful log frames that are included in the drafts.
- Eliminate the police practice of ‘Condoms as Evidence’: The sub-objective on sensitising law makers and law enforcement agents should include an explicit statement on the elimination of the police practice of using possession of condoms, lubricant, ARVs or any other legal commodity as evidence of sex work and grounds for confiscation or arrest . In shorthand, called the ‘Condoms as Evidence’ practice, some police undermine public health principles by harassing sex workers carrying condoms, or destroying them. This has to stop.
- Remove ideology-based funding restrictions: The Department of Health and SANAC should petition US agencies for the removal of the so-called PEPFAR ‘Anti-Prostitution Pledge’ from funding agreements between US donors and SA NGOs and agencies that prohibit funding recipients for advocating for law reform on sex work. This is currently the case, and is causing organisations working with sex workers to remain silent on the human rights abuses experienced by sex workers. Law reform is urgently needed on sex work to reduce the violence and abuse of sex workers, and the voices of organisations providing services to sex workers need to be heard.
- Include the Social Impact Bond: Social Impact Bonds should be included under the discussion of innovative funding mechanisms, and be supported. The SIB is an exciting intervention that we need to watch carefully as it could support the empowerment of sex workers and the reduction of their vulnerability to HIV and other illnesses. SANAC has been collaborating with Social Finance (UK) to explore if some components of the funding for the Sex Worker HIV Programme 2016-2019 could be raised through an outcomes-based financing model that could be an SIB.
- Include a migration focus: There are strong links between migration and sex work in South Africa and the region, and it is regrettable that this NSP makes almost no provision for migration-aware health services or responses in its text.
We look forward to seeing the final NSP 2017-2022, and we trust that it will be the best one South Africa has ever had.
 Sonke Gender Justice
 SANAC Sex Work Sector leader
 SANAC Sex Work Sector leader