A/79/177 5. Same-sex relations 40. Despite increased recognition of the human rights of LGBTIQA+ persons, around 77 countries still have discriminatory laws that criminalize private, consensual same-sex relationships. 90 Many of these laws were first implemented under British, French and Spanish colonial rule, and continue to serve as post -colonial legacies through “anti-sodomy” laws. 91 41. This criminalization exposes the LGBTIQA+ community to risks of arrest and deprivation of liberty, and contributes to hate-motivated violence, torture and ill treatment, across various settings, including those that are vital to health and the social determinants of health, such as hospitals and clinics, schools and places of employment. 92 The fear of existing in unsafe spaces, in and of itself, can cause severe mental distress and can lead LGBTIQA+ persons to forgo health care or other services. Furthermore, rates of HIV testing are far higher in countries that maintain the least severe anti-LGBTIQA+ policies. 93 6. Harm derived from corporate activities and the co-opting of harm reduction narratives 42. Power asymmetries manifest largely because of inadequate or ineffective regulation on the part of Governments. Such is the case of corporate activities to manufacture and commercialize inherently harmful products, including tobacco, alcohol, and, in the food and nutrition realm, those with an excess o f sugar, salt or fats, often found in ultra-processed products. 94 This is also the case of products that may be harmful when improperly used, including prescription drugs. 95 In some instances, in their effort to commercialize these products, corporations have been documented as having targeted specific groups that are protected under international law. 96 43. Furthermore, corporations exert their power by co-opting the harm reduction narrative or by seeking to position themselves as part of the solution to problems they have largely created, 97 including through alleged harm reduction efforts. 98 7. Tobacco 44. Tobacco use is one of the leading risk factors for several non-communicable diseases, including cardiovascular and respiratory diseases and over 20 types of cancer, among other diseases. 99 While the world has made much progress in taking effective measures to address the tobacco crisis since the adoption of the WHO Framework Convention on Tobacco Control in 2003, tobacco use continues to be __________________ 90 91 92 93 94 95 96 97 98 99 24-13226 See www.un.org/en/fight-racism/vulnerable-groups/lgbtqi-plus. International Lesbian, Gay, Bisexual, Trans and Intersex Association, “The impact of colonial legacies in the lives of LGBTI+ and other ancestral sexual and gender diverse persons”, 26 May 2023. See www.un.org/en/fight-racism/vulnerable-groups/lgbtqi-plus. HIV Policy Lab and others, Progress and the Peril: HIV and the Global De/criminalization of Same-Sex Sex (2023). WHO, “Noncommunicable diseases”, 16 September 2023; and A/77/197, para. 30. WHO, “Opioid overdose”, 29 August 2023. A/77/197, paras. 45–46. A/78/185, para. 58. WHO, Reducing the Harm from Alcohol by Regulating Cross-Border Alcohol Marketing, Advertising and Promotion: A Technical Report (Geneva, 2022), p. 24. See www.who.int/health-topics/tobacco#tab=tab_1. 11/28