The World Bank’s spring meetings in April 2014 saw the first official meeting between the Bank’s president, Jim Yong Kim and 15 lesbian, gay, bisexual and transgender (LGBT) leaders. The meeting took place just two months after the Bank postponed a $90 million loan to Uganda’s health care sector following the government’s introduction of an anti-homosexuality act which imposes lifetime imprisonment for homosexuality. The Bank said it wanted to ensure that the development outcomes of this loan “would not be adversely affected by the enactment of this new law.”

The Banks involvement with LGBT rights has attracted controversy. UK magazine the Economist suggested in April that the Bank has “to pick its battles” and that “setting up gay rights as a test of its lending decisions is likely to make the Bank less effective at what Mr Kim himself has emphasised is its core job: tackling extreme poverty.” A response by a number of LGBT activists who attended the meetings in Washington argued that the loan demonstrated the need for the Bank to “adopt a safeguard policy on sexual orientation and gender identity that would prevent exclusion and recognise these individuals as important stakeholders in its work”, as part of its safeguards review (see Observer Autumn 2014).

An April report submitted to the Bank by consultants reviewing the case is alleged to suggest that, despite the anti-homosexuality act, the Bank should proceed with the loan but ensure strict conditions that health care workers should not be prosecuted for serving LGBT patients. In an early May letter six US-based NGOs, including Health Global Access Project, wrote to to Kim arguing “that there have not yet been sufficient safeguards put in place to prevent discrimination in health service provision for LGBT patients” for the loan to be approved.