Don’t say “gay”? How about don’t say “sexual health” or “sexual rights”? Such were the topics of a prolonged debate before the World Health Assembly adopted a new global strategy on HIV, hepatitis and sexually transmitted infections (STIs), which sets goals and guidelines for tackling these health issues for 2022 to 2030.

The new strategy was eventually approved by a vote of 61–2, reported Health Policy Watch, which added that an unprecedented 120 delegates either abstained from or were absent for the final vote, a sign of the discord among member states over language in the health strategy.

The WHA is the decision-making body of the World Health Organization (WHO), whose 194 member states work to set global health policy. To that end, the assembly proposes and oversees WHO budgets, determines policies and appoints the director general. The 75th meeting of the assembly, during which member states voted on numerous policies, took place in Geneva the last week of May. Tedros Adhanom Ghebreyesus was reelected as the WHO’s director-general.

Disagreement arose over language in the global HIV, hepatitis and STI strategy about “sexual rights,” “sexual orientation,” “sexual health” and phrases such as “men who have sex with men.”

Led by Saudi Arabia, conservative countries, including 22 members of the Eastern Mediterranean Region, objected to the terminology regarding sex, even though, as Health Policy Watch points out, the language is regarded as part of standard care and treatment for health issues such as HIV and STIs.

In a compromise, the strategy’s glossary of terms was removed from the document altogether. But even that didn’t go far enough for the conservative nations, which wanted all sexual rights terminology redacted from the entire document. Hence, the unprecedented number of members who did not take part in the final vote.

“We should not need to hold a vote on the existence of entire communities of people,” said Loyce Pace, assistant secretary of state for global public affairs in the U.S. Department of Health and Human Services, according to Health Policy Watch. “We have a strategy on critically important global health issues, yes. But at what cost to those we risk leaving behind? So to gay, lesbian, bisexual, queer, intersex, transgender and gender-nonconforming people around the world, the United States government sees you and will continue to support you. Stay strong.”

Although the WHA adopted the health plan, many delegates regretted that a consensus couldn’t be reached. Whether member states will follow its guidelines remains to be seen.

Still, organizations such as the International Lesbian Gay Bisexual Trans and Intersex Association (ILGA) praised the adoption of the new strategy and the fact that, despite efforts of some WHA members, inaccurate information about sexual orientation was not added to the strategy.

A statement by ILGA noted: “The approved document states that the right to the highest attainable standard of physical and mental health ‘applies to everyone and to all communities,’ but also includes a specific reference to sexual orientation, stating that this right ‘(…) should not be compromised by discrimination based on age, gender, sexual orientation, and other population characteristics.’”

Read an early draft of the complete global strategy for 2022 to 2030 here. It is similar to other global plans to eliminate HIV, viral hepatitis and STIs.

For example, the section of the strategy about HIV notes that as of 2020, about 1.5 million people contract HIV each year globally. Meeting the new strategy’s targets would see that number reduced to 370,000 people a year by 2025 and 335,000 by 2030

By 2030, the strategy aims to have 95% of people living with HIV aware of their status, 95% of those with HIV on treatment and 95% of those on treatment maintaining an undetectable viral load, meaning they do not transmit HIV, a fact referred to as U=U.