A roadmap for strengthening community engagement with the Global Fund
Author:
Mr. K. Victor Ghislain Some (REVS+ and RISE study group), Sibongile Tshabalala (Treatment Action Campaign and RISE study group), Mr. Kuraish Mubiru (Uganda Young Positives and RISE study group),
Dr. Richard Muko (AVAC and COMPASS consortium),
Ms. Alana Sharp (Data Etc and RISE study group),
Dr. Jennifer Sherwood (amfAR and RISE study group),
Kennedy Mutale (Key Populations Trans-National Collaboration, KP-TNC),
Maureen Luba (COMPASS consortium),
Solomon Wambua (KP-TNC)
Article Number: 5
This article presents a roadmap for strengthening community engagement with the Global Fund, based on findings from the RISE study and launched by civil society and community members at the 52nd Board Meeting in Malawi. The roadmap highlights key challenges faced by community representatives in Country Coordinating Mechanisms (CCMs), including limited onboarding, high turnover, lack of transparency, and power imbalances. It offers actionable recommendations for Grant Cycle 8 (GC8), such as improved funding mechanisms for community organizations, enhanced transparency of CCM operations, and strengthened accountability measures.
What is the Roadmap for CCM engagement?
Community engagement is at the heart of the Global Fund’s response to fight AIDS, tuberculosis, and malaria. This focus is evident throughout its operations. At the global level, communities most affected by the three diseases hold key governance roles on the Global Fund’s Board. The Secretariat’s 2023-2025 Strategy emphasizes, “maximizing the engagement and leadership of most affected communities to leave no one behind.” At the national level, key and vulnerable populations (KVP) and populations living with or affected by the three diseases are required to hold positions on Country Coordinating Mechanisms (CCMs), which operate as the country-level decision-making bodies for Global Fund Grants.
The RISE (Representation, Inclusion, Sustainability, and Equity) study was a civil society-led global project to assess community engagement of communities with CCMs. The final report was published in April 2024 at the 51st Board Meeting in Geneva and has been reported on here. While study participants described CCMs as a critical space for communities to advocate for programmatic priorities and to engage with governments and other stakeholders, several barriers to meaningful participation emerged.
Addressing these challenges and barriers is a critical priority, particularly as the Secretariat prepares its operational policies and procedures for Grant Cycle 8 (GC8). At the 52nd Board Meeting in Malawi, a coalition of nearly 120 civil society and community members launched a Roadmap for Strengthening Community Engagement with the Global Fund (also available in French). These recommendations are based on the findings from the RISE study and are designed to be feasible and implementable with minimal or no cost to the Secretariat and its partners. This article describes several of the recommendations from that Roadmap.
What can the Secretariat do to prepare for GC8?
Strengthen investments and support to ensure that community CCM representatives are well-equipped and empowered
The RISE study found that community representatives on CCMs are often challenged by limited onboarding, high turnover, highly technical work, and term limits. Making sure that incoming representatives can meaningfully engage from the very beginning is crucial.
In Grant Cycle 7 (GC7), the community strengthening support from the Community Engagement Strategic Initiative (CE SI) and other partners was important. But if we are to fill information and capacity gaps and retain institutional memory, the Secretariat must make sure that GC8 community engagement support is strengthened. This support must include peer mentorship of current community CCM representatives by former representatives. The RISE study found that when current CCM representatives are supported by former representatives, they are more empowered to be strong CCM members. In addition, in the Roadmap we propose that the Community, Rights and Gender (CRG) department should continue its localization of technical assistance, including for international consultants to be partnered with locally-based consultants. The CRG must implement a process for the communities that receive Global Fund capacity building to be able to evaluate and rate their consultants.
To improve the onboarding process, we ask the Secretariat or other partners to support a “Community Guide for CCM Engagement.” This guide would be different from existing resources, since it would be a one-stop resource about what the CCM is, the rights and responsibilities of CCM members and communities, written in clear and plain-language, co-developed with CCM members, and with guidance for resolving bottlenecks and governance challenges. After the guide is developed, the Learning Hubs and other civil society partners should provide trainings on this guide (online and/or in-person), and technical assistance providers should reference it in their work.
We also have found that when communities face barriers participating in CCMs, they usually also have difficulties advocating for community priorities to be funded and for community-led organizations to implement them. In the Roadmap we ask the Grant Management Department (GMD) to create a new strategy for directly funding community organizations, as well as their coalitions both in country and at a regional level, through new approaches for GC8. These new funding approaches must bring us closer to ensuring that trusted local partners are eligible and able to receive payment for their work. New funding mechanisms must be streamlined to reduce the administrative burden on small organizations and must provide support for organizational administrative costs.
Empower CCM members, partners, and advocates to strengthen CCMs by improving transparency and access to information
The findings from RISE show us that there is a lot of confusion around Global Fund’s policies around CCM membership, funding, and participation. When this kind of information is hard to access, it can lead to the exclusion of communities from CCMs and make it more difficult to participate. In the Roadmap we recommend several transparency initiatives designed to empower community members.
The Secretariat provides funding to the CCMs for their administrative costs. These funds can be used for the salaries of the CCM Secretariats, consultancy fees, office expenses, meeting expenses, and communications costs. Importantly, these funds are also used to pay for civil society constituency consultations, including travel costs for community participants. But the RISE study found that the people who participate in these consultations are often underfunded. Often, participants don’t know what support is available and reimbursements of costs are often delayed. We ask that the funding levels for community engagement in the CCM budgets must be high enough to cover the actual work, time, and travel of participants.
Since “the Global Fund reserves the right to publish the CCM Funding Agreements, including the CCM Funding Performance Frameworks and the Costed Work Plans, on its website,” (OPN pg. 69) the CCM Hub must publish these documents to strengthen accountability and transparency. The CCM Hub should develop and share a guide for how to budget for community consultations, including the costs of participating in preparatory meetings, feedback sessions, and other engagement activities through the cycle. The Secretariat should also review its Country Coordinating Mechanism Funding Policy to promote the idea of using CCM budgets for one full-time CCM Secretariat salary focused on community issues. This position would be filled by a community member, with accountability and a mandate to the community. It would be separate from the existing executive secretary staff and would focus on supporting and coordinating the CCM’s community delegations.
An important initiative from the CCM Hub is the tracking of several metrics of CCM functioning, using what is called the Integrated Performance Framework (IPF) for CCMs. These data are focused on CCM performance targets and eligibility requirements. However, communities have no access to these data, leaving them unable to assess how their CCMs are performing or identify areas where strengthening is needed. The CCM Hub must publish country-level data from the IPF on the Global Fund’s website once per year. This level of transparency will help communities advocate for better performance in GC8 and beyond.
We also ask that in GC8 the IPF should track key measures of community engagement, like the number of full-time community staff supported, whether the CCM Secretariats are operated independently from governments and Principal Recipients, and should also include community-led reporting of CCM functioning and their participation throughout the cycle.
Lastly, since community representatives have a critical role in overseeing Grant performance, the Secretariat must improve transparency around implementation arrangements. Too often CCM representatives and community advocates do not have visibility on who is charged with implementing which programs, which blocks meaningful grant oversight. In the Roadmap we ask that the Allocation Letters and the Implementation Arrangement Map(s) from the Funding Requests must be published on the Global Fund’s website, to clearly describe early thinking about who will implement what parts of the Grant(s). Currently, only a subset of the Funding Request documents are online.
Step up its accountability function to support country-led advocacy
We find in the RISE study that community representatives face power imbalances on the CCMs and that many face challenges advocating to government representatives. However, there are clear ways that the Secretariat has helped communities advocate for stronger programs. In GC8, the Secretariat must continue to support communities with policies, tools, and information sharing to level the playing field and make sure that every CCM representative can meaningfully participate in decision-making.
Mandatory documents and checkpoints are a key strategy for requiring community engagement. One of these is the requirement that all CCM representatives must sign off on the Funding Request before it is submitted to Geneva. This checkpoint is extremely important because it prevents some CCM members from quietly submitting the document without giving everyone the time to review it, and it gives community representatives the ability to withhold their signatures in case serious problems need to be resolved.
In the Roadmap, we request that a second checkpoint be added at the Grant-making stage, where the Principal Recipient(s) must produce the signatures of all CCM members in cases when Grant budget lines are more than 30% different from the approved Funding Request. Similarly, to help CCMs engage in reprogramming and reinvestment, we ask the Global Fund Secretariat to notify the full CCM anytime there is either (1) a round of Portfolio Optimization and (2) if in-country savings and efficiencies have been found that are at least 30% of the signed intervention budget. Currently, significant changes to programs can occur without the CCM having the opportunity to provide input.
The Community Annex (“Funding Priorities of Civil Society and Communities Most Affected by HIV, Tuberculosis and Malaria”) was introduced as a mandatory Funding Request document in GC7. We consider this document to be an important step towards ensuring that communities are consulted during Funding Request development and that their priority activities have been heard by the writing teams. Since it has an important role in community engagement, the Annex must be continued into GC8. We also ask that the Secretariat publish the Community Annexes on the Global Fund’s website, since greater visibility of this document will help communities to continue tracking funding priorities and advocate for reprogramming throughout the three-year cycle. Similarly, another key requirement is the Gender Equality Marker (GEM), which must be conserved in GC8.
Even with checkpoints and transparency, challenges can arise that cannot be resolved in-country. The Global Fund runs the “I Speak Out Now” reporting mechanism, which lets communities report fraud and abuse. However, the RISE study finds that communities are often either unaware of the mechanism or refrain from using it due to fear of retaliation. The Global Fund must take steps in GC8 to promote the platform, ensure protections against retaliation are in place, and that the platform is accessible and safe for all community representatives.
Lastly, in the roadmap, we advocate for the creation of a standing CCM Advisory Body to provide support to the CCM Hub and recommend strategies that will enable the strengthening of CCMs to reach higher maturity levels. Long-term, regular engagement of the Board with CCM issues will be key throughout GC8. The CCM Advisory Body should report to the Strategy Committee (SC) and the Ethics and Governance Committee (EGC), and include SC and EGC members and independent technical experts such as CCM Chairs, Vice Chairs, and members, as well as technical assistance funders and providers.
What’s the way forward?
The year 2025 will be a crucial time for preparing for GC8. Strengthening the engagement of communities with Global Fund, both as CCM representatives and as community partners, will be imperative for ensuring that the new grants are impactful, focused on the populations at greatest need, and that move the Global Fund toward achieving its strategic targets. The Roadmap is intended to serve as a guide for the Secretariat to achieve these priorities.
Authors:
Mr. K. Victor Ghislain Some (REVS+ and RISE study group),
Sibongile Tshabalala (Treatment Action Campaign and RISE study group),
Mr. Kuraish Mubiru (Uganda Young Positives and RISE study group),
Dr. Richard Muko (AVAC and COMPASS consortium),
Ms. Alana Sharp (Data Etc and RISE study group),
Dr. Jennifer Sherwood (amfAR and RISE study group),
Kennedy Mutale (Key Populations Trans-National Collaboration, KP-TNC),
Maureen Luba (COMPASS consortium), Solomon Wambua (KP-TNC)
