US$12.71 billion has been earmarked by the Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund) for country allocations and US$890 million for catalytic investments as of 1 January 2020. Women4GlobalFund (W4GF) is delighted by this substantial – 23% increase – over the previous three-year period. However, there is an urgent need to step up action to make sure that the new proposals deliver for women and girls. Gender equality advocates need to be central to this planning to make sure that Global Fund supported programmes and services deliver for women.

W4GF Collaborators from 8 countries (Albania, Ghana, Kenya, India, Malawi, Namibia, Tanzania and Zimbabwe) submitting new proposals to the Global Fund for these new allocations (including Window 1, which is due in March 2020) gathered to share experiences, including how they are engaging in the country dialogues that are already underway. There have been many successes in advancing gender equity in recent years and several obstacles and challenges. W4GF has drafted guidance to assist W4GF advocates and other gender activists to strengthen new proposals and now calls on countries and the Global Fund systems to step up and take more action so that future programmes and services have the greatest impact. This means making sure that programmes reach more adolescent girls and young women, especially key affected women including sex workers, women who use drugs and transgender women.

Many countries have undertaken country dialogues, and are advanced with new proposals. In those countries we urge:

Country Coordinating Mechanisms (CCMs) to:

  • Recognize that in several countries there has been limited engagement of key affected women in new Global Fund proposals and to take proactive action to ensure that in the time remaining there is meaningful engagement of women and girls, especially key affected women. This includes:
  • Taking steps to share the First Draft Proposal for comment by a wide range of community stakeholders, including gender equity advocates and key affected women;
  • Sharing the feedback received from the Technical Review Panel (TRP);
  • Sharing the Final Proposal for comment before it is submitted, and noting any changes (including cuts – especially during grant making) to gender sensitive and transformative programmes previously included.

The Technical Review Panel (TRP) to:

  • Seek out detail around how countries are investing in gender sensitive and gender transformative programming;
  • Call out funding requests that have not invested in community systems – especially where countries have returned unspent resources (allocated to Government) rather than reprogramming them to women’s rights groups conducting unfunded work;
  • Return funding requests with specific and concrete guidance and instructions to revise and strengthen gender-sensitive and transformative interventions, programmes and services if they do not include interventions to address the needs and rights of women and girls. This should include action in countries where key affected women are criminalized (e.g. women who use drugs, sex workers and transgender women) and are missing from proposals.

To support countries making proposals for Windows 2 and 3, we urge:

The Global Fund Secretariat to:

  • Be explicit about the financial support (for community engagement and time on the CCM) that is allocated to civil society through the CCM budget, including (in some countries) for communities’ engagement during the country dialogue. Many women living with HIV and key affected women are keen to participate but have no access to the support necessary to be part of the processes. Since many women directly affected by HIV, TB and malaria participate from below the poverty line, their costs should be covered;
  • As part of the country dialogue, Global Fund country teams should conduct checks and balances to ensure that the funding request process meaningfully engages communities.

In all countries W4GF urges:

Country Coordinating Mechanisms (CCMs) to:

  • Ensure that new Global Fund proposals include funding for gender-transformative interventions that fully support the rights of women and girls, especially key affected women. This means taking proactive action through the numerous steps of the country dialogue process. In particular:
  • Take into account National Strategic Plans (NSPs) that are gender-transformative and lay out effective strategies to respond to inequalities;
  • Support civil society and improve communication channels to ensure participation and representation of all CCM members, recognizing that resources available to civil society CCM members differ greatly and some face large and consistent challenges to effective communication within the groups they represent and will require additional support;
  • Ensure that gender budgeting and reporting becomes standard practice so that gender sensitive and transformative programmes are costed and tracked from NSPs, and in Global Fund budgets, funding agreements and reports;
  • Be transparent and address any confusion around timelines, schedules and processes including to select the writing team to develop the funding application;
  • Ensure that writing teams are meaningfully guided by our lived experiences and informed by the challenges that communities face to access services;
  • Be clear with the process and guidance to the Principle Recipient/s (PRs) to declare any/perceived Conflict of Interest (CoI) as they select Sub Recipients (SRs) and Sub Sub Recipients (SSRs) – especially those who are represented on the CCM;
  • Develop a quota system for community-based organizations to become SRs and SSRs, and ensure that they are supported with capacity building opportunities;
  • Build in community-based monitoring to proposals so that communities remain engaged in implementation.

W4GF Advocates are reminded to:

  • Use the W4GF guidance on Navigating the Global Fund Allocation Cycle 2020-2022 and:
  • Become familiar with the Global Fund’s Modular Framework Handbook and then frame proposed activities using this, being clear about precise activities and priorities;
  • Call out any gaps in the NSP, and make the case for changes drawing on other evidence and national strategies in other countries;
  • Negotiate for balance and representation of women in all module working groups so that community perspectives and community led responses are integrated throughout;
  • Field a team of data diggers, those with programmatic experience and those with costing expertise and good writing skills – and watch closely for proposals that are so medicalized that they miss opportunities to advance Global Fund Strategic Objective 3;
  • Make use of evidence in your country and leverage all strategies, gender assessments, and especially any age and sex disaggregated recent studies;
  • Make plans to hold national authorities accountable for delivering Global Fund supported programmes effectively, including in the funding request. Include a budget for community-based monitoring and agree on a common framework to track what is most important;
  • Leverage the power of civil society not to endorse the funding request until it is ready. Write letters to the CCM and copy the Fund Portfolio Manager (FPM) and the Global Fund secretariat’s Community, Rights and Gender (CRG) department – and explain why you won’t sign, and what needs to change. This carries more weight than you think. This is especially important for criminalized communities such as women who use drugs, sex workers and transgender women who are often left behind and are most at risk;
  • Make our lived experience and knowledge central – it counts! We have power in this process and must not forget that our lived experience, power, capacity and knowledge counts. In the past if things have not gone well some women have refused to sign the grant! SO, refuse to sign it:
    • If women in all their diversity have not been engaged in the country dialogue and in developing the funding request;
    • if gender equity is not central, and programmes and services are not gender sensitive and transformative.
  • Stick with the process to the end! The bulk of the work will happen after the proposal request has been sent – Make sure to remain engaged through the grant making phase and insist on equal representation during this phase.

WHY does this matter?

HIV continues to be the leading cause of death and disease for women of reproductive age and the Global Fund, through its Strategy – Investing to End Epidemics – is working to promote and protect human rights and gender equality. Whilst we acknowledge that our countries have taken strides to address gender inequality – especially in the Global Fund’s 13 priority countries – the inequalities women and girls face continue to compound our vulnerability to HIV, TB and malaria and we look forward to more leadership from all countries in this allocation cycle (2020 – 2022).

[box type=”info”] Why is gender equity so important in Global Fund proposals? In sub-Saharan Africa, home to the world’s greatest HIV burden, more than 60% of all people living with HIV are women, and 4 out 5 new cases of HIV annually among those aged 15–19 are among girls. In that region, despite representing just 10% of the population, adolescent girls and young women account for 25% of all new infections globally.[1] And young women (10-24 years old) are twice as likely to acquire HIV as young men the same age. This disproportionate picture is often due to the unequal power dynamics including the lesser cultural, social and economic status that women and girls have in society – in many cases further exacerbated by gender based violence. The heightened risk for HIV translates into heightened risk for TB because people living with HIV are more than 15 – 22 times more likely to develop active TB, including among those taking antiretroviral treatment, and it is the major cause of HIV-related deaths (WHO).[/box]

This document draws on insights from W4GF Collaborators: Abhina Aher, HIV/AIDS Alliance India, India; Daxa Vitthal Patel (Viradia), National Coalition of People Living with HIV in India (NCPI+), India; Cecilia Lodonu-Senoo, Society for Women and AIDS in Africa (SWAA), Ghana; Eunice Makena Henguva, Namibia; Happy Assan, Tanzanian Network of People who Use Drugs (TaNPUD), Tanzania; Lucy Wanjiku Njenga, Positive Young Women Voices, Kenya; Mara Kumbweza Banda, Paradiso TB Patients Trust, Malawi; Olimbi Hoxhaj, People Living with HIV Albanian Association, Albania; Phelister Abdalla, Kenya Sex Workers Alliance, Kenya; Talent Madziva, Katwse Sisterhood, Zimbabwe; and supported by Sophie Dilmitis, Global Coordinator & Nyasha Sithole, Support Officer, W4GF Secretariat.

To download this statement click here

For more information, please contact Sophie Dilmitis, Global Coordinator, Women4GlobalFund (W4GF) – or on Facebook W4GF is a dynamic and global platform of women and gender equality advocates who share a deep commitment to ensuring that Global Fund programmes are gender-transformative to meet the rights and specific priorities of women and girls in all our diversity.

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