‘Everyone Can be Part of the Change’
This #WorldAIDSDay, GFAN Speaker Eudora Ogechukwu spoke with Peter Wiessner from Action Against AIDS Germany about the urgent need for healthcare reform in Nigeria, where millions of people—especially those within the LGBTQIA+ and intersex communities—face systemic barriers to care. As an intersex activist, Eudora shared their work with the Silent Voices Initiative, advocating for better healthcare access and visibility for marginalized groups. Despite the challenges, Eudora remains committed to the fight for gender and health equity, believing that true healthcare equality can only be achieved when everyone, regardless of identity, has access to the care they need without fear of discrimination.
Nigeria is making progress in the fight against HIV, tuberculosis and malaria. However, a significant portion of the population, particularly queer community, remains marginalized and excluded from essential healthcare services. Eudora Ogechukwu is deeply committed to supporting this community, as well as intersex individuals, on multiple fronts.
As Africa’s largest nation, with a population exceeding 200 million, Nigeria accounts for a quarter of the world’s malaria cases. To combat this significant issue, the Global Fund has invested more than 4.8 billion USD since 2002, including 1.2 billion in the most recent cycle, establishing Nigeria as its primary beneficiary.
This substantial commitment has had notable results – Nigeria has made solid progress in the fight against HIV, tuberculosis, and malaria thanks to the local activists and the support of donors and partners. 90% of people living with HIV now know their status, 98% of them are on treatment, and 95% of those treated have a viral load below the detection limit, and new HIV infections have declined by 28% since 2012. Tuberculosis treatment rates have increased from 24% to 40% between 2019 and 2021. Malaria prevalence has been reduced by nearly 50% between 2010 and 2018, partly thanks to the distribution of 90 million insecticide-treated mosquito nets. While these achievements are commendable, more comprehensive reforms are necessary to ensure universal access to healthcare for all Nigerians.
Health equity requires gender equity
The Global Fund recognizes that gender inequality exacerbates health disparities, particularly for women and girls. They often face higher risks of infection, limited access to health information and services, and reduced decision-making power. Moreover, rigid gender norms have detrimental health consequences for everyone – not only for women and girls but also for boys and men, and marginalized groups like the LGBTQIA+ community. Eudora Ogechukwu, an intersex activist from Abuja, Nigeria, champions the rights of the LGBTQIA+ community, and specifically the intersex community. As a minority within a minority, intersex and trans* people face unique challenges and discrimination, as Eudora Ogechukwu highlights in the interview.
“Intersex people like me don’t officially exist in Nigeria”
Intersex individuals face significant discrimination and marginalization in Nigeria due to a lack of official recognition. “Intersex people like me don’t actually exist officially in Nigeria,” says Eudora. This is because there are no official surveys or data for this group of people, nor are intersex people mentioned in the curricula of the medical professions. Doctors, nurses, and other people who work in healthcare services are therefore never informed in their training that they may encounter an intersex person in the course of their work, explains Eudora. As a result, anyone seeking help in a hospital is categorized as either male or female as soon as they register. “Our existence as intersex people is thus completely erased.”
The United Nations assumes that up to 1.7% of the population is born with intersex characteristics. This means that there are probably around 3.9 million intersex people living in Nigeria alone.
As a young LGBTQIA+ activist with the Silent Voices Initiative in Nigeria, Eudora aims to increase visibility for intersex individuals, both nationally and continentally.
“We are also using the development of the community to identify other intersex people and ultimately to be able to present concrete figures on the intersex community in Nigeria.” says Eudora. “Empowerment is only possible once we have established a connection to organizations that offer appropriate services,”
The Silent Voices Initiative seeks to provide essential information, support networks, and access to mental and physical healthcare to LGBTQIA+ individuals, particularly those in remote regions.
“It is the criminalization of same-sex relationships that makes us vulnerable.”
Ogechukwu is outraged. They argue that it’s not their sexuality or sexual identity that makes them vulnerable but rather discriminatory laws, guidelines, and societal attitudes, particularly the criminalization of same-sex relationships. “It is the criminalization of same-sex relationships that makes us vulnerable. We must take up the fight against the stigmatization and discrimination that arise, for example, from religion and a heteronormative upbringing” they say.
Nigerian society is deeply conservative, with widespread negative attitudes toward LGBTQIA+ individuals. Traditional African societies prioritize family units and gender roles. Meanwhile, queer community questions it.
Since former President Goodluck Jonathan signed the 2014 Same-Sex Marriage Prohibition Act, the situation of the queer community has worsened.
Homosexual acts are punishable by up to 14 years in prison, and in some northern states, Sharia law imposes the death penalty. The law also criminalizes advocacy for LGBTQIA+ rights, putting activists as risk. Raids on queer gatherings, or queer parties, and persecution of LGBTQIA+ individuals are common. This climate of fear and discrimination extends to healthcare. LGBTQIA+ people face open rejection from doctors in public and private clinics and practices. Many avoid the healthcare system because of such experiences, says Eudora Ogechukwu.
Fear of discrimination drives many queer Nigerians to avoid healthcare
“90% of trans* people in Nigeria that I know self-medicate because they no longer dare to seek care at a hospital.”
They buy the medication they need at the pharmacy, but they don’t get any advice, no examinations, and therefore no real treatment. “This puts their health at risk, but they have no other way out,” emphasizes Eudora, “everyone should have the right to unrestricted access to healthcare services, regardless of their sexuality, sexual identity or gender. True healthcare equality will be achieved when I have access to basic healthcare without having to fear that I will be discriminated against, stigmatized, or even arrested and killed. When intersex people like me are no longer forced to undergo gender reassignment surgery, and people—regardless of gender, sexuality, or identity and whether they live in the city or in a remote region—can access healthcare”
“We must not leave anyone behind.”
Eudora and their colleagues at the various organizations recognize the long journey ahead. They believe in the power of collective action, small steps and individual empowerment.
“When I joined the Global Fund Youth Council in 2020, I was relatively new to this world,” they said. “I had a little knowledge of the Global Fund’s work and structure. But this work has allowed me to develop personally and professionally.” They have embraced a core principle: “We must leave no one behind. I feel committed to this credo, and I follow it in my activist work.” This commitment drives their activism across a whole range of organizations, including the African Network of Adolescence and Young People Development (ANAYPD), the Women Health and Equal Rights Initiative (WHER), and the International Centre for Advocacy on Right to Health (ICARH).
Through their work on Global Fund committees, they’ve discovered the power of their voice and are determined to use it effectively. “The Global Fund has given me the tools to bring about change for my community and stand up for our rights”. In concrete terms, this means, for example, working to ensure that intersexuality is noted during hospital registration.
Eudora is passionate about empowering others and encourages her community to resist “Every individual can be part of the change, and we must join forces and work together with the Global Fund to fight any inequalities.”
Text: Axel Schock
Interview: Priyanka Ayer, Global Fund Advocates Network, and Peter Wiessner, Action against AIDS Germany
Editor: Ghita Zaoui, Global Fund Advocates Network
Contact: info@aids-kampagne.de