Sex workers call to put the last mile first in Universal Health Coverage


Sex workers and other key populations call on their allies and partners in the UN system and broader civil society to speak up, loudly and clearly, to support the call to put the last mile first in the Universal Health Coverage negotiations and implementation.

The UN General Assembly will agree a political declaration on UHC at a High Level Meeting in September 2019, which will serve as the basis for global efforts to provide access to affordable and quality health care services. Many criminalised populations of gay men and other men who have sex with men, people who use drugs, sex workers, and transgender people, demand that governments put the last mile first - "placing the needs of the poorest and most marginalised members of society at the start and centre, and transforming ‘leave no one behind’ from rhetoric to reality". 

This should involve demanding that UHC has, as ‘top-line’ demands:

  • A public and unambiguous re-commitment to the recommendations for decriminalisation of sex work and other key populations, as well as the decriminalisation of HIV transmission, exposure and non-disclosure.
  • A clear re-affirmation that the legal and structural barriers to health, including punitive laws, policies and practices, violence, stigma & discrimination must be addressed in a rights-based approach, or UHC will fail
  • A commitment to investment in sex worker and other key population-led health services, including technical and financial support and capacity-building
  • The inclusion of key HIV services in the UHC benefit package, including prevention services and community-led services, with effective targeting of HIV services by and for key populations and people living with HIV
  • A commitment that sex workers and other key populations, and people living with HIV, will be meaningfully involved in the planning of national health responses, in the discussions where UHC ‘care packages’ will be decided upon, and in the monitoring of the UHC response to ensure governments are held to account.

What can sex workers do?

  • Stay informed. Find out what UHC planning is taking place in your country
  • Hold your governments to account. Demand a seat at the table where discussions about UHC are taking place
  • Promote knowledge about UHC in your community
  • Build partnerships with other key population-led organisations, people living with HIV organisations and other allies to demand inclusion within the UHC agenda.

Read more about UHC in our Briefing Note, and on the GNP+ website