Immediately before the 11th International Congress on AIDS in Asia and the Pacific (ICAAP) – from 14-16 November 2013 – the Women4GF Asia-Pacific advocates workshop was held to mobilize stronger action on gender equality through the Global Fund’s NFM. More than 30 individuals attended from 11 countries in the region. All represent or work directly with and for populations vulnerable to HIV, TB and malaria – or living with the three diseases – and most are working at the grassroots level. The majority were women (including transgender women) and three men also participated; a quarter of workshop participants were sex workers or represented sex worker communities. These advocates were invited because they expressed a strong desire to learn about the Global Fund as they seek to help their communities get access to more and better services in the future.

Gender diversity has a long and rich history in the Asia-Pacific region. That does not mean, however, that the lives of women in all their diversity have been easy or that tolerance reigns. Most societies are patriarchal, leaving women in general as second-class citizens who face significant economic, social and health challenges compared with men.

The situation is even worse for women who are transgender or sex workers. Stigma and discrimination force most to live on the margins of society. Members of these communities are poorer than average and highly vulnerable to violence and abuse, and in many cases have been stripped of their basic human rights. Due to fear, discrimination and isolation, they are often unwilling and unable to seek out and obtain adequate health, care and social services. Partly for those reasons, they have long experienced HIV and TB prevalence far above national averages.

The Global Fund to Fight AIDS, TB and Malaria (Global Fund) was created to address such challenges. Gaps persist, however. Despite some progress, the specific needs of women, girls and transgenders in the Asia-Pacific region in regards to HIV, TB and malaria remain largely unacknowledged and unmet. There is cause for optimism nevertheless. The launch in 2014 of the Global Fund’s new funding model (NFM) offers an opportunity for real change to better the lives of women in all their diversity.

The two-day workshop was organised and facilitated by AIDS Strategy, Advocacy and Policy (ASAP) and supported by the Global Fund. Representatives from the Global Fund Secretariat and the Joint United Nations Programme on HIV/AIDS (UNAIDS) joined the community-based participants to provide background information and better understand experiences and needs in implementing countries.

It was the third such gathering under the banner of an emerging project, Women4GF, launched in July 2013. Women4GF aims to coordinate and strengthen the ability of women’s rights advocates — in particular women living with HIV and affected by TB and malaria, and key affected women—to engage at country, regional and global (including Board) levels with the Global Fund and its NFM from a gender-equality perspective. The first and second workshops focused on HIV and TB, respectively, with participants from around the world. The Asia-Pacific workshop, in contrast, was for advocates in the region only. It was also unique in that it included a large share of participants with little or no previous experience with the Global Fund. Those advocates were invited because they expressed a strong desire to learn about the Global Fund as they seek to help their communities get access to more and better services in the future.

Priority demands from participants:

Based on discussions at the workshop, and looking to the Gender Equality Strategy that the Global Fund adopted five (5) years ago, the Women4GF Asia-Pacific advocates identified a series of demands and actions that they would take – and that they expected partners and key stakeholders – to ensure that Global Fund resources reach country programmes that have the greatest impact and advance gender equality:

The Global Fund should invest more extensively and thoroughly in communities at the grassroots level.

This is essential to achieve real impact because community groups are best placed to reach and support key populations, including transgender women, sex workers and women living with HIV. The Global Fund already provides an entry point for such funding through its community systems strengthening (CSS) focus area. Few CSS interventions are proposed and funded, however. The Global Fund should make a concerted effort to increase uptake of this funding stream in all countries in the Asia-Pacific region, an effort that may require specifically requesting such interventions during the country dialogue, concept note development and NFM’s iterative grantmaking process. This could also include re-shaping existing grants to ensure that they are gender-transformative.

All Global Fund stakeholders should recognize and support the need for women—especially key affected women, transgender women and women living with HIV—to be central to, initiate and be involved in all Global Fund processes.

In practical terms this means that representatives from these populations must be included in reviews and updates of national strategic plans (NSPs), country dialogues, concept note writing and negotiation teams. This also means putting in place effective mechanisms for women to play a “watchdog” role and hold key players, including the Global Fund, accountable for following through on their promises. Similarly, all country coordinating mechanisms (CCMs) should include representatives with strong gender expertise, and have a diverse representation of women. The Global Fund Secretariat and CCMs should ensure that such meaningful engagement occurs—with monitoring mechanisms used to identify when it is lacking.

More Global Fund money should reach communities, especially those working with and for women, transgenders and sex workers at the grassroots level.

The majority of Global Fund funding for non-governmental stakeholders currently goes through international non-governmental organisations (INGOs). It is essential that steps are taken to “watchdog” that this support reaches communities working at the grassroots level. The NFM focuses on “investing for impact”, a principle that underscores the imperative of ensuring that a larger share of funding reaches community-based groups with better links and trust among individuals most in need of support. Such assets make these groups most able to conduct appropriate and effective outreach.

Technical partners, in particular UNAIDS, should provide more targeted support to communities, in particular to secure quality data and information on vulnerable populations and key affected women.

The NFM requires prioritized, evidence-based grantmaking. Communities are well-placed to design data collection tools, and to help collect, organise and present essential data on the real impacts of HIV, TB and malaria—and thereby show the true impact on women and key populations. Technical partners should support efforts to mobilize community-generated data and to validate and affirm such data collection. Such support is critical to push countries and the Global Fund to identify who is truly most in need and thus where interventions should be directed.

Targeted financial and capacity support is required for community mobilization at country level, and to sustain the development and effectiveness of regional and national action by networks of key affected women and women living with HIV.

Collective advocacy and increased community capacity are needed in the Asia-Pacific region to ensure that the NFM opportunities are seized everywhere. Community mobilization at the regional and national level will help to increase awareness and build capacity, and support joint advocacy around the NFM, and enable the sharing of good practices. Ongoing mobilization is essential to ensure that community groups are more united in their demands and approaches, and to keep gender equality as a high priority. Workshop participants expressed a willingness to host such a regional networking function and to support ongoing capacity building, training, etc. in order to drive a community-led effort to bring women’s advocates together. The ultimate goal would be two-fold: i) to ensure that the Global Fund maximizes its impact by targeting resources where they are most needed, and ii) to reach key affected women and women living with HIV with the services they need through gender-transformative programmes.

Outcomes Statment (PDF File) from the Asia-Pacific Advocates Workshop for download

Outcomes Statement from the October 2013 Women4GF TB Advocates Meeting

Outcomes Statement from the July 2013 Women4GF global retreat