The One Love armband, which includes a heart containing colours representative of all backgrounds, was proposed by the Union of European Football Associations (UEFA) Working Group in 2020 in support of inclusion of people from diverse sexual orientations, gender identities, and expressions, including but not limited to lesbian, gay, bisexual, transgender and queer (LGBTQ+). At the World Cup 2022, the Fédération Internationale de Football Association (FIFA), the organization that controls international football and organizes the World Cup, threatened to issue yellow cards against team captains who wear the armband. This is because the world cup 2022 organizing country, Qatar, does have laws in place that criminalize same-sex relationships.
All the participating teams, including the European teams, did not wear the armband. The national football federations of the Netherlands, England, Wales, Belgium, Switzerland, Germany, and Denmark, who previously advocated for wearing the armband, jointly backed off stating that they could not put their players in a position of facing sporting sanctions. It is necessary to discuss what implications such policies and activities in the biggest international sporting event could have in global health, and particularly, in the health and wellbeing of LGBTQ+ people in African and Middle Eastern countries where same-sex relationship is criminalized.
For example, nearly 34 African countries criminalize consensual same-sex sexual acts, with punishments ranging from life imprisonment (Cameroon, Egypt, Kenya, Tunisia, Uganda, and Zambia) to death penalty (Mauritania, Nigeria, Sudan). Further, these countries do not recognize or address the needs of LGBTQ+ people in the context of their existing national health systems and as a result, most LGBTQ+ persons have no safe access to relevant health information and public health services. Homophobic attitudes have continued to grow, which at the local level means institutionalized exclusion of LGBTQ+ in families, communities, education, healthcare, religion and employment systems. LGBTQ+ people fear seeking healthcare and participating in sports; they do not have safe spaces to socialize, and they face verbal and sexual harassment as well as violence. Although, in more recent years, success in decriminalizing same-sex relationship has been observed in a few countries such as South Africa, Guinea Bissau, Mali, Mozambique, and Angola, but still sexual stigma is largely prevailing in the communities.
In this view, FIFA threatening to penalize wearing the One love armband and the national sports officials abiding with this justify existing injustices towards LGBTQ+ communities, lower levels of religious, cultural and political tolerance towards them and an unwillingness to address the social and structural barriers that limit LGBTQ+ people’s participation in public events, such as sports, or their access to healthcare.
In African and Middle Eastern countries where same-sex relationship is criminalized, the under-representation of LGBTQ+ people in sports and particularly, their access to healthcare are often less talked about and international events, such as the FIFA World Cup, not advocating for the right of all the gender and sexual minorities could further fuel the rising anti-homosexuality sentiments. Global health aims to understand and address these existing health inequalities, with the much-needed support and leadership, not only from the health sector actors, but also from international sporting associations, such as FIFA and national sports federations. Global health actors, as well as other international actors should stand together and advocate for the right of LGBTQ+ persons and address the social and structural barriers for their inclusion in healthcare and sports.
Anti-homosexuality laws are not acceptable based on the grounds of human rights, and state sovereignty in the matter of practicing anti-homosexuality laws should be questioned. Moreover, the responsibility of every individual nation is to ensure that human rights of diverse sexual and gender identities including the LGBTQ+ communities are addressed. Particularly for global health professionals, to achieve the goals of universal access to health, it is time to start the discussion on how to advocate for decriminalization campaigns and support for acceptance of LGBTQ+ communities and same-sex behaviors with a focus on African and middle eastern regions.
While there were voices raised against FIFA’s anti-One Love armband policy in the FIFA world cup 2022, the World Health Organization (WHO), which is the leading agency in international issues for improving global health, chose to remain silent about this. In fact, the WHO and global health professionals have a crucial role to play, which is to work with policy makers to decriminalize, and work with international bodies, such as FIFA, and national governments to develop policies that increase social tolerance and acceptance of LGBTQ+ communities. This simultaneously would lead to establishment of the national public (health) systems that prioritize health needs of LGBTQ+ people and only then, safe access to healthcare and safe participation in sports become possible.
About the author: Subash Thapa is an assistant professor at the Research Unit of General Practice, University of Southern Denmark, Odense, Denmark. His area of work includes teaching and research in Global Health policy and implementation, inequality and prevention, and vulnerable populations. Twitter handle: @SubashThapa09
Competing interests: None
Handling Editor: Neha Faruqui