A contentious election over representation by key populations on Uganda's country coordinating mechanism ended on 12 February with an amicable resolution that activists in Kampala say will help to ensure Global Fund-supported activities are more effectively targeted towards the people who need them most.
Representation for key populations -- which in Uganda include men who have sex with men, sex workers, long-distance truck drivers, the fishing community and uniformed personnel -- in the CCM is critical for Uganda's HIV response. HIV prevalence among the MSM community is estimated at over 12% and among sex workers at some 33%. General prevalence in Uganda is 7.3%.
A first ballot in December 2014 saw the election of two members of staff from the Most at Risk Population Network (MARPS Network), which added a second, alternate, seat to the one already held by the network prior to the election. It was later discovered that the two winning candidates were brother and sister as well as colleagues.
The decision not to throw the election open to all interested candidates was roundly decried by the activist community in Uganda, which, despite the criminal penalties imposed on homosexuality and sex work, is thriving and includes a number of civil society Global Fund sub-recipients.
Activists from the lesbian, gay, bisexual, intersex and transgender community have sought representation in the CCM since 2010, according to Sexual Minorities Uganda (SMUG) executive director Frank Mugisha, to make sure that Global Fund-supported activities responded to the needs of those most vulnerable to HIV infection.
To resolve the issue and prevent the internal politics from upending Uganda's efforts to develop its activities portfolio in anticipation of a joint HIV/TB concept note proceeding to grantmaking, the election was annulled a month later by the CCM chair. A second election was set for early February, ahead of which the eight sub-constituencies of key affected populations were asked to each nominate five potential candidates. This electoral slate of 40 candidates would then yield the two representatives for key populations.
Even then, however, there were disagreements over what was described to Aidspan as a heavy-handed role by the MARPS Network in both choosing and approving the potential candidates. The election, set for 5 February, was ultimately boycotted by dozens of activists and civil society groups, primarily those representing Uganda's sexual minorities.
A tense meeting on 11 February culminated with the decision by the MARPS Network representative, Dr Geoffrey Mujisha, to step down from the post he has held since 2013. His sister will remain the alternate member representing key populations. A new representative for key populations was subsequently selected.
While the controversy over the election sowed a great deal of discord within the civil society actors in Uganda's HIV community, it does demonstrate that countries are working to implement the new minimum requirements established for CCMs as they follow the process from country dialogue through to the submission of their concept notes. Nor should Uganda's challenges be seen as the exception; in neighboring Kenya, a similar election for civil society representation in the CCM was annulled after it was determined that an activist network had trucked in supporters and given them a directive on whom to vote for.
Requirement 1A, "to clearly document efforts to engage key population groups in the development of a concept note" has been found by the Fund to be challenging for countries to achieve. In an analysis referenced as part of the 2014 NFM year in review progress update (see article here), it was found that 59% of concept notes submitted were compliant with the requirement; another 35% were found to be 'compliant with challenges'.
For requirement 1B, "to coordinate the development of concept notes through transparent and documented processes that engage a broad range of stakeholders -- including CCM members and non-members -- in the solicitation and the review of activities to be included in the application", 43% of submitted concept notes were compliant. Another 52% were 'compliant with challenges'.
In overseeing the resolution of the dispute, CCM chairman Vinand Nantulya told Aidspan that it was good that all parties had agreed to work together for the good of the country.
"Uganda is a poor country; the Global Fund money is important for us," he said. "Surely we can sort out this and avoid a protracted war that does not serve anybody any good and actually does harm to our country.“
Uganda was allocated $275.6 million for TB and HIV under the new funding model for the period 2014-2017.