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GFO Issue 316



Gemma Oberth

Article Type:

Article Number: 7

A further $50 million was proposed in prioritized above allocation requests

ABSTRACT In funding requests submitted to the Global Fund in window 1 and window 2, more than $100 million was proposed for adolescent girls and young women. In an eight-country analysis, the Global Fund has indicated that gender and gender-based violence was prioritized in seven out of eight countries, while no country has so far prioritized post-exposure prophylaxis or social protection. The Technical Review Panel has urged countries to use evidence-based ap

In funding requests submitted to the Global Fund in Window 1 (20 March 2017) and Window 2 (23 May 2017), more than $100 million was proposed for adolescent girls and young women (AGYW). This calculation includes both allocation amounts and matching funds. In addition, more than $50 million was proposed for AGYW in prioritized above allocation requests.

These figures were reported by the Global Fund Secretariat in a recent (4 July 2017) webinar, hosted by Women4GlobalFund. During the webinar, the Fund also shared information from an eight-country analysis on the level of funding and priority areas for AGYW. The analysis disaggregates between AGYW funding in the allocation and in the matching funds (Figure 1).

Figure 1: Proposed investments in AGYW from select window 1 and 2 funding requests

Source: Global Fund Secretariat Presentation Delivered at Women4GlobalFund Webinar, 4 July 2017

Thirteen countries were notified in December 2016 that they are eligible for additional funding for HIV programs for AGYW, above their allocation amount. A full list of countries and the matching funds they were allocated is online here. Along with AGYW, matching funds are available for five other strategic priorities.

One of the requirements for accessing the AGYW matching funds is that an equal or greater amount must be ring-fenced for AGYW in the allocation request. An additional requirement is that the funding dedicated to AGYW in the allocation must be greater than funding for AGYW in the current grant.

In Zambia and Tanzania, nearly $14 million was requested for AGYW-related interventions in the allocation amount. For Zambia, this represents a significant increase, as the country’s matching fund request indicates that $3.4 million is dedicated to AGYW in the current grant.

It is important to note that the Global Fund includes investments in voluntary medical male circumcision (VMMC) as an investment in AGYW. This is based on the interventions included in the Global Fund’s technical brief on AGYW in high-HIV burden settings. The Fund’s decision to count VMMC as funding for AGYW has raised eyebrows among some women advocates. “Whilst it is true that VMMC indirectly protects women from contracting HIV given the reduced HIV prevalence in men, we must ensure that investment in AGYW go beyond biomedical interventions and remain girl-centered,” says Sophie Dilmitis, Global Coordinator of Women4GlobalFund. “This way, these matching funds support AGYW in all their diversity to break the cycle of gender inequality – especially in the 13 priority countries,”

As a ratio of allocation versus matching funds, Namibia prioritized AGYW well above the minimum 1:1 match required. The country dedicated more than $8 million of their allocation to AGYW and $1 million in matching funds. Kenya, Mozambique and Uganda all had roughly the same amount of funding in their allocation as in their matching funds request.

At the other end of the spectrum, Zimbabwe placed far more funding for AGYW in its matching funds request than it did in its allocation. Though the figure from the Global Fund indicates that all AGYW funding was in the matching funds, Aidspan has been informed from country partners that $3.1 million was included in the allocation. Regardless, the 1:1 match was not met. According to the country’s matching fund request, “the highly commoditized nature of Zimbabwe’s funding request prohibits a 1:1 matching ratio for AGYW.” This is a provision that is explicitly stated in the matching funds instructions, which indicate that flexibilities may apply in the case of heavily commoditized grants, and where there is limited fiscal to increase funding for the designated strategic priority.

As much as the amounts vary, the activities prioritized for AGYW across different countries are equally diverse (Table 1). Gender-based violence was a popular investment focus, with seven out of eight countries prioritizing this activity (all but Uganda). On the other hand, so far not one country has prioritized post-exposure prophylaxis (PEP) or social protection (access to social grants/poverty reduction). In May 2017, UNAIDS published a new tool on integrating HIV and social protection which may help more countries include this element in their Global Fund requests.

Table 1: AGYW interventions prioritized in select window 1 and window 2 funding requests

Source: Global Fund Secretariat Presentation Delivered at Women4GlobalFund Webinar, 4 July 2017

Three of the eight countries prioritize cash transfers for AGYW as part of their grants. Aidspan has previously reported on cash transfer programs in Kenya, South Africa and Swaziland, which the Global Fund currently supports.

All of the activities in Table 1 will help the Global Fund achieve its key performance indicator (KPI) to reduce HIV incidence among AGYW (age 15-24) by 58% (47-64%) over the 2015-2022 period. Towards this KPI, the Global Fund has also urged countries to consider specific sub-population targeting when designing interventions. As an example, Zimbabwe’s matching funds application specifically addresses young women who sell sex as a sub-population of AGYW that requires tailored support. $52,512 in matching funds was requested and approved by TRP to provide peer-education services to this group.

Based on lessons from window 1, the TRP recommended that counties use evidence-based approaches for AGYW interventions. Alternatively, the TRP suggested that pilot projects for new AGYW innovations are encouraged, with a plan to scale-up based on findings. In addition, the TRP also urged countries to plan for simple evaluations within the matching funds application.

A recent lessons learned brief published by Women4GlobalFund, highlights some of the successes and challenges around prioritizing AGYW funding. For instance, women in Kenya pushed for more time to review the matching funds request, given their lack of comfort with what was being submitted around AGYW. The matching funds request was held back and reworked by the writing team as a result. Women in Malawi also struggled to ensure that the matching funds focused specifically on AGYW themselves, with lots of other related interests around the table.

Among window 3 applications anticipated for 28 August 2017, Swaziland will be applying TB/HIV funding. The country is eligible for $1.5 million in AGYW matching funds.  In a country where AGYW account for about 46% of new HIV infections, the strategic prioritization of these funds is critical. Aidspan plans to continue to track investments in AGYW, including window 3 and 4 applicants.

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