17 community advocates from 10 countries in addition to resource people and technical partners, gathered in Bangkok for a workshop in late June 2016 to discuss gaps, challenges and opportunities around Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) programming from a human rights and gender perspective. Participants, mostly women, included a wide range of people living with or affected by HIV, TB or malaria and came from diverse country contexts, backgrounds and experiences, with several based in Challenging Operating Environments (COEs) such as South Sudan.

All participants represent or work directly with women and girls, who are uniquely and highly vulnerable to HIV, TB and malaria. All also work with—and many are members of—key affected populations for one or more of the three diseases, including sex workers, men who have sex with men (MSM), transgender individuals, people who use drugs, indigenous people, prisoners, miners, migrants and young children. More than half serve on a Country Coordinating Mechanism (CCMs) or are directly involved in other Global Fund processes and structures, such as participating in country dialogues or serving as a Sub-Sub-Recipient (SSR).

Here are progress updates based on workshop commitments.

In Bolivia one participant translated workshop documents into Spanish and shared these with indigenous organisations in the region: Ecuarunari (Ecuador), Conacami (Peru) and Conamaq (Bolivia). In addition to this in mid October they hope to organise a workshop in Ecuador hosted by Ecuarunari and have begun dialogues with UNFPA to seek support for this workshop.

In South Sudan following the workshop one W4GF advocate briefed the staff from National Empowerment of Positive Women United (NEPWU) on the training especially on gender transformative programming and discussed how to involve more men in implementation. In terms of advocacy around female representation on the CCM – “A strong request was made to the CCM to ensure more female CCM members given that we now know this is part of the CCM eligibility criteria and this was agreed to be addressed. I also discussed the representation of the different diseases, which is lacking in our CCM and it was agreed that both the TB and malaria constituency must elect male and female representatives. I have not met with the NEPWU Board members because most of them have taken refuge outside the country”.  The NEPWU Secretariat in partnership with UNAIDS agreed to mobilise funds for an advocacy and gender transformative training but given the volatile situation and the fact that the NEPWU offices were burnt down the situation is being reassessed. The greatest challenge is the ongoing national insecurity across South Sudan.

In Tanzania W4GF advocates working on Malaria have reached out to other W4GF advocates as well as civil society CCM members. Another W4GF advocate from the Tanzania Network of People who Use Drugs (TANPUD) conducted training with Board members around advocacy and developing greater understanding on demanding accountability on how Global Fund money is being spent nationally. One of the key challenges raised was around data collection. “What we most need support with is data collection tools to keep accurate records on key populations. Data collection is challenging but essential to effective advocacy, without which we remain unheard. We can’t advocate for better health services for people who use drugs if we don’t have documented evidence of those ill treated in hospitals”.

One participant in Uganda made connections to CCM members representing people living with HIV as well as those affected by TB. “They appreciated the discussion, and the issues raised by the statement and both called me (more than once) to seek additional information. They informed me that they would share the concerns at the CCM meeting”. The workshop outcomes statement was shared with civil society, non-governmental and faith based organisations, government and HIV/TB activists. This created discussion around gaps in service delivery and enabled issues to be raised in different forums. The statement was also shared with 98 District Health Officers (DHOs) who oversee the health management response at district level who presented concerns outlined in the statement to other political and administrative district duty bearers. The lack of coordination and inclusion of civil society in planning processes, poor data, marginalisation of women and lesbian, gay, bisexual, transgender and intersex (LGBTI) communities was noted throughout discussions.

Another participant from Uganda (representing the sex worker community) committed to sharing new knowledge about the Global Fund country processes empowering key affected women with legal literacy to advocate and become champions of the Global Fund. A WhatsApp group supported discussion on Global Fund country processes and sex workers are now aware of national steps to request and receive Global Fund resources. “We discussed country dialogues, concept note writing, grant making and sub recipients. Key population engagement in the Global Fund country processes is essential to bridge gaps in service delivery as we know the programmatic priorities able to reduce HIV and TB in our country”. A Global Fund key population activists group has strengthened partnerships between key populations and CSOs to remove barriers to full participation by addressing collective needs and engaging in discussions with CCM members to ensure observer status during CCM meetings.

In Zimbabwe – one W4GF advocate (CCM Member) initiate dialogue with key populations, young people and women to build consensus and organised three feedback meetings with women’s organisations to discuss the status of Zimbabwean women’s organisations and the Global Fund. This is in addition to regular updates through WhatsApp. “I have been able to generate interest within the Women’s Coalition of Zimbabwe who are now aware of processes and we are preparing to participate in the country dialogues in October. We have a list of priorities and an un-resourced advocacy plan. We are also ensuring priorities are included in the National Strategic Plan currently under review. “At the workshop I committed to developing an issue paper to present to the CCM. I was informed that presentations are made at the committee level (even though civil society remains financially unsupported to engage in time-consuming processes) so I joined the HIV Committee, the Management Committee, and I intend to join the TB Committee. I also was part of the Task Force that carried out the Eligibility Assessment for Zimbabwe and I am learning about processes and utilising the platforms effectively”. Regarding ensuring a key population representative on the CCM – this will not happen unless key populations themselves nominate a representative and there are real concerns that key population representatives will face discrimination if they sit at the table.

Another Zimbabwean W4GF advocate shared the workshop content with key affected populations who were mostly unaware of international laws and policies (that Zimbabwe ratified) that are there to protect them from abuse and gender inequalities. “Engagement and participation remain major challenges and people in power continue to ignore the roles of key populations in communities and the structure – much more needs to happen to ensure that the CCM supports men who have sex with men, young people living with HIV and women and girls – holding our CCM accountable remains our challenge. People in communities are supposed to be beneficiaries to the Global Fund but we need more champions affected by HIV, TB and malaria to push for accountability.”

Eastern Africa National Networks of AIDS Service Organisations (EANNASO) participated in the workshop as a resource partner and following the workshop, the outcomes statement and materials were shared with EANNASO staff and the information and data received on TB and gender and human right strengthened capacity in resource mobilisation. EANNASO also held a dialogue forum workshop at the end of August for Principle and Sub Recipients promoting a platform for learning and sharing experience, best practice and building capacity of civil society to work with key stakeholders including the Global Fund Secretariat, CCMs, Local Fund Agents (LFAs), other civil society.

As a result of the workshop EANNASO is gathering civil society from Global Fund principle recipients (PRs) from across Anglophone Africa to share, learn and network. “We came up with an idea of establishing an ‘African Civil Society PR community of practice’ A forum which will give space and opportunities for civil society PRs to continue networking and engaging with each other”. The community of practice is to be housed within EANNASO in its capacity as host of the Regional Platform for Communication and Coordination for Anglophone Africa (part of the Global Fund Community, Rights, and Gender Special Initiative). The community of practice will meet bi-monthly for virtual conference calls and webinars to identity and define the key issues and challenges that members need to address. EANNASO is also supporting and facilitating consultation meetings with civil society to ensure effective participation and engagement in mid-term reviews and to develop national strategic plans and policy processes for HIV, TB and malaria. From October EANNASO will be visiting Rwanda, Zambia, Zimbabwe and Ghana to continue this work.