Community, Rights and Gender Annual Report
Amida KariburyoArticle Type:
Article Number: 9
This article provides an update on the Secretariat's report related to Community, Rights, and Gender. In the context of its 2023-2028 Strategy, the Global Fund takes a significant step by emphasizing human rights, gender equality, and health equity. These priorities are crucial not only for addressing the challenges posed by diseases but also for countering the growing threats from anti-rights and anti-gender movements targeting vulnerable populations globally. This article explores the critical aspects of the Global Fund's Strategy, emphasizing its initiatives to empower communities, remove barriers, and advance inclusive health programs.
Between 9 and 11 October the Strategy Committee (SC) met to discuss, among other things, the Community, Rights and Gender (CRG) Annual Report. This article provides a brief summary of the key issues of the report.
The Global Fund has long been at the forefront of global health initiatives, providing crucial support to communities affected by communicable diseases. In its 2023-2028 Strategy, the Global Fund takes a significant step forward by centering its focus on human rights, gender equality, and health equity. These priorities are not only essential for addressing the challenges posed by these diseases but also for tackling the rising threats of anti-rights and anti-gender movements targeting vulnerable populations worldwide.
The Global Fund operates in a challenging landscape where civic space is threatened due to growing restrictions imposed by governments on civil society and community-led organizations. In 65 of the 129 countries supported by the Global Fund, civil society organizations (CSOs) operations are constrained and they risk harassment, surveillance, and violence. Notably, these countries accounted for a substantial proportion of AIDS, TB, and malaria deaths in 2021.
Anti-rights movements that undermine human rights, particularly those of marginalized populations and gender equality, are on the rise. These movements have led to restricted access to healthcare and information, the enactment of anti-LGBTQI laws, and the rollback of policies against gender-based violence (GBV). Organizations advocating for human rights and gender equality, especially those led by key and vulnerable populations (KVPs), face significant risks.
In this context, the Global Fund’s commitment to prioritize community involvement, reduce inequities, and address barriers related to human rights and gender is of paramount importance. It underscores the importance of maintaining community and civil society engagement in global health responses, especially during ongoing discussions about the global health architecture.
Strengthening community leadership and engagement
The Global Fund model hinges on strong, organized, and resilient communities actively advocating for their needs and participating in the design, delivery, and monitoring of HIV, TB, and malaria programs. However, significant obstacles hinder the full engagement of communities, particularly KVPs, in health decision-making and service implementation.
The Global Fund’s CRG department, through Strategic Initiatives, Matching Funds, and partnerships, is working to create an ecosystem where communities take the lead in developing policies, programs, and service delivery. This includes supporting underrepresented and marginalized communities in decision-making processes, addressing safety and security risks, and promoting tools like community-led monitoring (CLM) to tailor services to their needs.
Efforts are underway across the Global Fund, including within the Country Coordinating Mechanism (CCM) Hub, to integrate and prioritize community engagement at all stages, from funding requests to grant-making and implementation. Special emphasis is placed on providing greater access to funding and technical assistance for community-led and community-based organizations (CBOs).
Strengthening the safety and security of key population (KP) programs
The Global Fund recognizes the challenges faced by KP programs in hostile environments, which hinder their effectiveness. To address these issues, the Global Fund is taking a multi-pronged approach, including strengthening the capacity of local organizations, particularly KP-led organizations, to assess and address security risks.
In collaboration with the Civil Society Institute for Health (CSI), it has developed a Security Toolkit to help organizations systematically assess their security capacities and vulnerabilities and plan to reduce vulnerability. This toolkit encourages the mainstreaming of security considerations in program design.
The Global Fund is working with regional learning hubs and various departments to share lessons learned, assess security risks, and improve crisis response strategies. In cases of escalating crises, the Global Fund seeks advice from key affected communities and uses tools like rapid reprogramming and budget flexibility to adapt programs.
Engaging KVPs in TB and COVID-19 responses
The Global Fund is working to ensure that communities deeply affected by COVID-19, such as slum dwellers, people with disabilities, refugees, migrants, and those in prison, are actively engaged in country-level taskforces and the design of funding requests. The Community Engagement and Leadership in Pandemic Governance project aims to identify strategies to engage the most excluded communities in national TB networks and provide technical support.
The project, conducted in partnership with regional organizations in several countries, is piloting community engagement assessment tools and strategies in specific communities. This one-year pilot project will offer insights into existing coordination mechanisms among excluded communities, the barriers they face, and effective strategies for involving them in health decision-making.
Deepening partnerships with organizations led by and working with women, girls, and gender-diverse communities
The Global Fund has collaborated with partners on initiatives to enhance women’s leadership and engagement in HIV responses. These initiatives have provided grants and capacity development for CBOs led by women and adolescent girls, strengthening their participation and leadership in health decision-making. Building on these successes, the Global Fund has launched a new Gender Equality Fund in collaboration with partners.
The Gender Equality Fund aims to collaborate with women, girls, and gender-diverse communities to design, deliver, advocate for, and influence gender-transformative and gender-affirming approaches to health. It will provide multi-year funding to organizations, focusing on those most affected by HIV, TB, and malaria (HTM), and support advocacy for greater representation at decision-making tables.
Increasing transparency and accountability through CLM
CLM empowers communities to hold service providers, governments, and donors accountable and improve service quality and accessibility. The CRG Strategic Initiative focuses on strengthening community capacity, integrating CLM into disease responses and national strategies, and building evidence on its impact.
Key lessons include the importance of building trust between communities, governments, and service providers and ensuring community ownership of data. The Global Fund is increasing its investments in CLM and exploring how it can strengthen civic space in hostile environments.
Maximizing human rights, gender equality, and health equity
In a determined effort to maximize human rights, promote gender equality, and ensure health equity in Global Fund-supported programs, the organization unveiled its roadmap for 2023-2028, the Global Fund Strategy. This visionary strategy acknowledges the crucial role of investing in these areas to strengthen responses to HTM.
The strategy operates on a two-pronged approach, underpinning its commitment to human rights, gender equality, and health equity:
Strategic Initiatives and Catalytic Funding
The Global Fund is significantly increasing investments in programs designed to address human rights and gender-related barriers. These initiatives aim to directly target these challenges and bring about substantial improvements.
Embedding equity-oriented approaches
Simultaneously, the Global Fund is working to integrate equity-oriented, human rights-based, and gender-transformative approaches throughout all its operations. This involves infusing these principles into the organization’s processes and practices.
In Grant Cycle 7 (GC7), the Global Fund has collaborated with various departments within the Secretariat to put the 2023-2028 Strategy into action. This includes reinforcing the language used in funding request (FR) templates to encourage countries to consider and maximize human rights, gender equality, and health equity in their proposals.
Addressing human rights and gender-related barriers
For TB and HIV programs, addressing human rights and gender-related barriers, reducing stigma and discrimination, increasing legal literacy, and supporting community-led mobilization and advocacy are now regarded as Program Essentials. In malaria programs, FRs are encouraged to incorporate equity, human rights, and gender considerations to ensure that services are tailored to subnational contexts and people-centered.
To enhance the integration of these principles, the Global Fund has introduced stronger risk management tools that prompt those involved in grant-making and reviews to assess and mitigate how political and social environments, as well as the technical capacities of recipients, might contribute to human rights and gender-related risks.
The Gender Equality Marker (GEM)
The Global Fund designed the GEM to track how programs it supports address gender equality. The GEM is based on a three-point scoring system evaluating the extent to which gender equality is a focus of a FR, ranging from a principal focus to not targeted.
The GEM is applied during the FR development stage to measure program intent, not implementation or results. It helps assess how countries consider and address gender inequalities in their FRs, identify gaps, and determine the Global Fund’s overall investment in gender-responsive and -transformative programs.
Breaking Down Barriers Initiative
The Breaking Down Barriers Initiative, which addresses human rights-related barriers to HTM services, has expanded to 24 countries in GC7. However, there has been a decrease in the overall allocation to Human Rights Matching Funds in GC7, which could undermine the scale up of such programs.
Addressing health inequities
The Global Fund is taking a more systematic approach to integrating health equity considerations throughout its work. Key actions include capacity building, guideline changes, and monitoring and accountability to reduce disparities in health outcomes among different subpopulations.
Conclusion and future considerations
The Global Fund’s 2023-2028 Strategy is a comprehensive and forward-thinking roadmap to address human rights, gender equality, and health equity in programs related to HTM. The organization aims to improve social accountability, strengthen community leadership and engagement, overcome human rights and gender-related barriers, address health inequities, and use its diplomatic voice to advocate for these essential principles.
In the coming years, the Global Fund plans to scale up safety and security investments, increase investments in addressing human rights-related barriers, and invest in social accountability through community-led monitoring. Furthermore, it aims to strengthen equity-oriented approaches, including intersectional approaches, to better address the diverse needs of KPs.
With its bold and ambitious strategy, the Global Fund is poised to make a lasting impact on human rights, gender equality, and health equity in the fight against HTM, leaving no one behind in the quest for healthier communities worldwide.
Several stakeholders expressed their appreciation for the Secretariat’s efforts in CRG. They recognized the importance of focusing on the safety and security of KPs, particularly in countries with eroding human rights situations. They have also commended the progress made in initiatives such as the Community Engagement and Leadership project and the new Gender Equality Fund.
Additionally, stakeholders appreciated the Technical Review Panel’s (TRP) observations and recommendations from GC6 and GC7, as well as the GEM’s pilot. They requested updates on the implementation of TRP recommendations, particularly concerning gender assessments, sex- and age-disaggregated data, and the integration of human rights and gender considerations into program design and budgets.
People emphasized the value of Strategic Initiatives and Matching Funds in driving progress in CRG and CLM. They expressed concerns about discontinuing such investments and strongly urged the Secretariat to systematically incorporate CRG considerations into country grants and portfolio optimization to mitigate the impact of reduced CRG funding/programming.
Stakeholders praised the Global Fund for its increased focus on human rights, safety, and security. They called for more transparency regarding funding and program priorities, given the deteriorating human rights situations in many countries. They highlighted the importance of gender-disaggregated data and addressing GBV, as well as incorporating a gender perspective into evaluations.
The establishment of the Gender Equality Fund has been appreciated, but there is a need for clarity on its origin and decision-making processes. Concerns have been raised about data and digital technology issues, including the handling of sensitive data and the potential misuse of community data. People also supported CLM in harm reduction programs and advocated for three minimum requirements for community engagement metrics.