The Global Fund Strategy, Investment and Impact Committee (SIIC) meets on the 8 – 10 March 2016 where key recommendations will be made for decision-making at the 35th Board Meeting in April on the Strategy Narrative 2017 – 2022 and Corporate KPIs 2017 – 2022.
For the pdf copy of the statement, please download here.
Women4GlobalFund (W4GF) Position Statement
Global Fund Strategy Framework 2017 – 2022
Global Fund Corporate KPIs 2017 – 2022
In November 2015, the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) approved a new Framework for its 2017-2022 Strategy to maximize impact, strengthen systems for health, promote and protect human rights and gender equality, and mobilise additional resources.
W4GF welcomes the move of the Global Fund to, for the first time in history, elevate gender equality to one of the four key objectives in the new Strategic Framework. We are pleased to note that Objective 3 explicitly aims to “Promote & Protect Human Rights & Gender Equality”. Objective 2,another key objective to “Build Resilient & Sustainable Systems for Health” includes a sub-objective that aims to “Support reproductive, women’s, children’s and adolescent health, and platforms for integrated service delivery”.
This position paper aims to inform the draft Strategy Narrative 2017 – 2022 and its Corporate Key Performance Indicators (KPIs) Framework 2017 – 2022 to be discussed for recommendation to the Global Fund 34th Board Meeting by the 17th Strategy, Investment and Impact Committee (SIIC). The position paper was developed with the inputs of participants at the W4GF organised workshop “Strengthening and Integrating TB and Malaria in the HIV Gender Response” held from 6th – 8th December 2015, as well as feedback on a webinar organised by W4GF 25th February 2016 on the Corporate KPI Framework 2017 – 2022.
We put forward to the SIIC and Global Fund Secretariat the following suggestions and inputs from gender advocates from communities and civil society to ensure impact and a real difference in the lives of women and girls, and to achieve the objectives outlined in the new Global Fund Strategic Framework 2017 – 2022.
1. Strategy Narrative 2017 – 2022
We support the overall ambition within the Strategy Narrative to improve the national strategic plans and health systems, strengthening data systems for gender-disaggregated data, scale up programmes to support women and girls reproductive health and rights, and investing to reduce health inequities including gender- and-related disparities. We note the reference to how the work of the Global Fund and its investments seek to achieve the Sustainable Development Goals (SDGs) and
We remain concerned on the following issues within the Strategy Narrative:
- The Strategy Narrative fails to highlight more specifically the gender inequality issues in the context of malaria and TB. Gender assessment tools have so far noted availability of programmes and analysis addressing gender disparities amongst the HIV and TB communities, and emphasised the lack of the same for women and girls affected by malaria;
- We understand that the Sustainability, Transition and Co-financing (STC) policy will be discussed by the SIIC and recommended at the 35th Board Meeting for adoption, and that this will further inform the Strategy Narrative. We note that gender inequality and disparities continue to be faced by communities of women in countries despite of their Country Economic Capacity (CEC), and that the narrative should seek to address and highlight how Global Fund investments are able to address gender inequities in this regard;
- We note the move of the Global Fund in directing and tracking investments towards service delivery along the reproductive, maternal, newborn, child and adolescent health (RMNCAH) continuum of care through clinical and community based models and the areas of integrated services suggested. We are concerned that rights-based services are not highlighted as an area of service delivery as this is critical in achieving sub-objectives 2a and 2b. Rights-based services is a critical gap on the ground, especially for key affected women who face gender-based violence and have difficulties accessing harm reduction and/or STI clinic services;
- Understanding that 3b could be achieved through the implementation/operational plans, we hope for further clarification/expansion/unpacking of language with the Strategy Narrative on how “the Global Fund will ensure that all policies, processes, procedures and structures reflect its commitment to gender equality, and addressing gender-related barriers to services”;
- Furthermore, we understand that the Gender Equality Strategy and its Action Plan and the Key Populations Action Plan are currently undergoing a review and it is uncertain if they will remain as individual documentation to support the policies and implementation of the work of the Secretariat on women and girls, and key populations. We seek clarity on the language on the narrative to reflect the changes that can be anticipated;
- We note the weakness of the narrative around programmatic interventions and addressing the role of men and boys in achieving gender equality and the socio-economic and cultural barriers that need to be overcome for this to be realised; and
- The Global Fund was set up as a partnership, and we note the importance of the technical and bi-lateral partners in enabling and promoting mutually accountable HIV, TB and malaria gender-transformative programming. While we acknowledge the importance of the role of technical partners, we underscore the equal importance and legitimacy of the role of communities and civil society in ensuring robust and accountable national, regional and global data collection, treatment, strategic planning, policy formulation, and programme implementation on the three diseases. The successes of gender-transformative programming and its implementation needs the political will and commitments of governments, and it is important that technical partners are able and willing to support countries in the collection of relevant age- and sex-disaggregated data to provide the accurate evidence in directing resources towards gender inequalities and reducing and addressing vulnerabilities.
2. Corporate KPIs Framework 2017 – 2022
We note that the Corporate KPIs are aimed to be at a strategic level and to provide high-level information to the Global Fund Board in its oversight role. We note that results from the suggested corporate KPIs need to be seen in their entirety, to complement the strategy narrative and focus on gender equality, and women and girls.
We acknowledge that indicators measured across many of the suggested KPIs will provide a more holistic understanding of the investments of the Global Fund towards ensuring that women and girls, including key affected women. We strongly encourage that this be considered as one of the thematic reports.
The current suggested measure for KPI 8, which is the only KPI recommended on gender equality, solely measures HIV incidence in women aged 15 – 24 in a subset of African countries. We recognise that the aim of high level strategic indicators are to provide the Global Fund Board with adequate information on the achievements of the Global Fund in achieving impact and understanding how investments can be better directed, but note that the KPI 8 in its current form does not serve to provide a holistic indicator across the three diseases on how the Global Fund is seeking to address its strategic objective.
Whilst we understand the importance of capturing HIV incidence in the most high burden countries to achieve the greatest impacts, we are concerned that:
- The suggested measure very inadequately covers the strategic vision to “reduce gender and age disparities in health”;
- Such a sole measure sends a strong, though implicit message that gender related barriers and disparities are not a concern of investments of the Global Fund should they fall outside the subset of countries suggested for the measure;
- The incidence only focuses on HIV and neglects to capture the full picture of gender inequalities faced by women and girls in TB and malaria epidemics; and
- There is no KPI to capture/measure investments on gender equality programming.
In addition, we raise the following general concerns and recommendations:
- To understand the impacts/outcomes of the Global Fund investments, gender- and age-disaggregated data needs to be available for KPIs 2 and 5;
- KPI 9 has room to ensure gender dimensions in its measurements, and this could relate to how countries manage their health information systems. We stress that there needs to be a robust system that can ethically and sensitively collect data to sustain the programmes;
- That the Global Fund works more closely with partners, including the Partnership for Maternal Newborn & Child Health (PMNCH) in ensuring accountability for life-saving health care delivery for marginalised women, newborns, children and youth, and support the Global Strategy for Women’s and Children’s Health and Every Woman Every Child, and in achieving SDG 5 on gender equality; and
- The strategic level KPI needs to provide a clear picture on Global Fund investments on gender equality, where HIV is but just one dimension, and demand for the measure to holistically address gender disparities/inequities across the three diseases.
A strategic/corporate level KPI that seeks to accomplish its objectives and realises its vision for Gender Equality needs to be able to be used by communities and civil society in holding their governments accountable towards its prioritisation of investments through Global Fund allocations to overcome gender disparities towards truly gender-transformative programming and interventions.