On 1 July 2016 – Geneva, Switzerland – The Stop TB Partnership in collaboration with UNAIDS and partners launched the first ever gender assessment tool for national HIV and TB responses to support countries in Global Fund applications which builds on the UNAIDS HIV Gender Assessment Tool launched in 2013– and adapted to include TB.
This tool is a document intended to assist countries in assessing their HIV and TB epidemics and responses from a gender perspective, to ensure the responses are gender sensitive, transformative and effective in responding to HIV and TB. The gender assessment identifies gender transformative priorities and actions to support countries in preparing gender sensitive concept notes and grant applications to the Global Fund to Fight AIDS, TB & Malaria.
The gender assessment process, led by national stakeholders and partners, helps to identify gender-related barriers to services as well as the specific needs of women, men, transgender people and key and vulnerable populations, in the context of HIV, TB or HIV/TB co-infection. The process also increases and reinforces political commitment and increases civil society engagement and capacity to better respond to these needs.
“Reaching UNAIDS Fast-Track targets will require an even greater focus on achieving gender equality and reducing tuberculosis-related deaths. Innovative tools such as the HIV/TB Gender Assessment Tool, will be essential to integrate efforts and accelerate progress towards ending the AIDS epidemic by 2030” said Michel Sidibé, Executive Director of UNAIDS.
“I am happy that we have this tool, and I hope we will use it and adjust it as we learn more. In the past, gender has been equated with women. This must change if we are to truly address all gender inequities in TB. We must find those barriers to services that men and boys, transgender people, women and girls, face in accessing quality services for health and we must develop interventions that address this,” said Dr Lucica Ditiu, Executive Director of the Stop TB Partnership.
In 2014, over 60% of TB incidences occurred in men. Despite higher HIV prevalence among women in sub-Saharan Africa, incidence of TB is higher in men except in women who are 15-24 years old in areas of high HIV prevalence. Male-specific risks of becoming ill with TB, for example, occurs when they have more social contacts, work in high-risk settings, smoke, possible high alcohol consumption, and limited health seeking behaviour. Female-specific risks include higher stigma, delayed diagnosis, less access to treatment services and previous policies of passive TB case-finding. High rates of extra-pulmonary TB among women also mean they are harder to screen and diagnose. Gender-responsive TB services are needed to capture these different needs.
“To end TB as an epidemic, we have to have a good understanding of the gender-related challenges that continue to drive this disease so as to improve and expand our investments to respond to those barriers,” said Mark Dybul, Executive Director of the Global Fund. “That is why the launch of UNAIDS and Stop TB Partnership’s gender assessment tool is pivotal to the TB response.”
In Bangkok this week, the Stop TB Partnership, co-hosted by APCASO and Women4GlobalFund, conducted a workshop for community advocates, technical partners and civil society focused on Supporting Gender Equality and Human Rights Champion in Global Fund Country Processes. Forty people from nine countries, including countries with challenging operating environments (COEs) – South Sudan, Sierra Leone, Zimbabwe, Uganda, Tanzania, Indonesia, Pakistan, Bolivia and Ethiopia were present at the workshop. Participants came from diverse country contexts, backgrounds and experiences including people living and/or affected by HIV, TB and malaria, and from key populations, in particular sex workers, transgender women, women who use drugs and young women.
Their varied country contexts was less important than their shared challenges and the passion for gender equality and human rights. The sessions addressed how cultural traditions and religious beliefs directly and indirectly discriminate against and stigmatise, and how communities can use gender transformative programming and addressing human rights barriers to help change this. Participants stressed an overarching priority for the Global Fund to focus on financing and to level influence to better identify these and other gender-related obstacles to effect programmes and processes especially for key populations.