IRGT and MSMGF Report: “Most Impacted, Least Served”: Ensuring Engagement of Transgender People in Global Fund Processes

W4GF supports the meaningful involvement of all transgender people in all Global Fund processes. W4GF advocates please read the full report here


The IRGT and MSMGF are proud to announce the release of a new report entitled “Most Impacted, Least Served: Ensuring the Meaningful Engagement of Transgender People in Global Fund Processes.” The document is produced by the IRGT: A Global Network of Transgender Women and HIV, which has broad cultural, global and geographic representation.

Worldwide, transgender women are disproportionately affected by HIV/AIDS and yet are often excluded from policy, program, and funding decisions at national, regional, and global levels. This exclusion contributes to transgender women being severely underserved by the global HIV epidemic response.

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For over a decade, the Global Fund to Fight AIDS, Tuberculosis, and Malaria has been one of the world’s largest donors in the HIV epidemic. Through engagement with processes such as country dialogue, including the work of Country Coordinating Mechanisms (CCMs), transgender activists and organizations have helped to increase funding and programmatic focus on transgender needs related to HIV prevention and treatment.

However, extensive barriers remain to sufficiently addressing transgender needs in the HIV epidemic, and little work has been done to document good practices for engaging key donors such as the Global Fund. The report offers 5 specific recommendations for improving policies and fostering a more enabling environment for transgender people to participate in and engage with Global Fund processes. These are:

  1. Support trans-specific data collection and engagement
  2. Recognize and reinforce the engagement of trans activists and organizations as technical and community experts contributing to Global Fund processes
  3. Ensure that Global Fund withdrawal from middle income countries does not undermine trans programming and engagement
  4. Reinforce capacity and development of trans activists and organizations
  5. Finance and work with global and regional trans networks to increase the meaningful engagement of trans people, improve gender sensitivity, and advance policy change.

In the words of IRGT co-chair JoAnne Keatley, “we are pleased to issue this report on the meaningful engagement of transgender people in Global Fund processes. We believe that this report identifies concerning trends in the lack of meaningful engagement of trans people in many countries and world regions, as well as specific opportunities for improving programming and policies.”

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Likewise, according to IRGT co-chair Amitava Sarkar, “The Global Fund has numerous policies and strategies, including a Sexual Orientation and Gender Identities Strategy and a Key Populations Action Plan, that encourage the meaningful engagement of trans people. However, this report documents that meaningful engagement rarely occurs, even as several examples of good practices point to improvements that can and must be made in the future.”

For the report, 12 interviews were conducted between October and December 2015 with key informants purposely recruited for their experience and work on behalf of transgender people and HIV, in Asia and the Pacific, Latin America, Eastern Europe and Central Asia, and sub-Saharan Africa. They included a U.S. government official, a Global Fund Portfolio Manager, and Community, Gender, and Rights Special Initiative Staff.

We invite you to read the full report here for further details and information.

Further questions regarding the IRGT can be addressed to Co-Chair Amitava Sarkar at or Co-Chair JoAnne Keatley at


The IRGT works with trans organizations, communities, and advocates around the world. Its members are transgender advocates with extensive experience in different world regions, including Africa, India, South America, North America, Asia, and Europe. Members have a wide range of skills, knowledge, and experience, including HIV, human rights, high-level advocacy, strategic planning, and programming and service delivery for transgender communities. MSMGF currently serves as the administrative hub for the IRGT.


MSMGF has worked since 2006 to encourage targeted, tailored, better resourced, and rights-based sexual health services for gay men and other men who have sex with men (MSM) worldwide through its advocacy and technical support work. As a global network, MSMGF has successfully influenced HIV responses at the local level through shifts in global-level policies and has effectively utilized public health as an entry point for advancing the human rights of LGBT people. MSMGF currently supports programs in 15 countries.

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