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Equal Access to Health Services for All People in the Americas
November 25, 2013

A Victory for LGBT Health in the Americas
By Nils Daularie

This blog post by Nils Daulaire, assistant secretary for global affairs at the U.S. Department of Health and Human Services, was published on the AIDS.gov and Huffington Post websites on November 21. There are no republication restrictions for use by U.S. embassies.

Assistant Secretary for Global Affairs Nils Daulaire, U.S. Department of Health and Human Services.
Assistant Secretary for Global Affairs Nils Daulaire, U.S. Department of Health and Human Services.

22 November 2013

Early in October, global health leaders in the Americas Region made a major step forward to improve access to and quality of health care for lesbian, gay, bisexual, and transgender (LGBT) persons.

At the annual meeting of the Pan American Health Organization, delegates from governments throughout the region unanimously passed a resolution entitled Addressing the Causes of Disparities in Health Service Access and Utilization for Lesbian, Gay, Bisexual and Trans (LGBT) Persons. By passing this resolution, health authorities in the Americas have pledged to promote equal access to health services for those in the LGBT community, taking into account the widespread stigma, discrimination, and persecution experienced by many in the population. This is a huge victory, as approval of the resolution marks the first time any United Nations body taken steps to address discrimination in the health sector against LGBT persons.

Unequal treatment against LGBT people exists both in and outside of the health sector in the Americas region. In some countries it is government sanctioned, where laws or policies exist criminalizing same-sex conduct. However, even where there are no explicit laws, stigma and outright discrimination often prevent LGBT persons from accessing needed services. However, the discussions my colleagues and I had at PAHO before the vote took place were not about areas of disagreement, but instead focused on what it would take to reach the public health goal of achieving universal access to care. When I introduced the nondiscrimination agenda item on behalf of the United States I cautioned, “If we exclude the LGBT population from our work, a portion of universal health care will become an illusion.”

This resolution will improve norms and standards in the Americas to promote equal access to health services for all people. Director-General of the World Health Organization Dr. Margaret Chan has called universal coverage, “the single most powerful concept that public health has to offer. It is the best way to cement the health gains made during the previous decade. It is a powerful social equalizer and the ultimate expression of fairness.” This resolution also creates an important precedent for other World Health Organization (WHO) regional bodies as well as for WHO itself. The U.S. government stands firm in our resolve to capitalize on this significant step forward for LGBT health. We will continue our work at WHO to raise these issues and we look forward to the report PAHO will produce on “the health situation and access to care of LGBT persons, the barriers they can face in accessing health care services, and the impact of reduced access for this population.”

While discussions about LGBT health are sensitive in every country, what I said at PAHO remains true: “Ensuring access to nondiscriminatory care is a goal that all countries can and should support. Despite religious or cultural differences, we all recognize the fundamental principles of making sure that every person can see a health provider when they are injured, get medicine when they are sick, and have access to the basic preventive care necessary to live a healthy and active life.”

I am proud of the leadership role the United States continues to play to advance LGBT nondiscrimination, and we will continue to push ahead to provide equal and quality health outcomes for all citizens of the world.

(Nils Daulaire is the assistant secretary for global affairs, U.S. Department of Health and Human Services.)