In a study published in early March, Aidspan found that participation by representatives of key affected populations in country coordinating mechanisms (CCMs) in southern Africa has somewhat improved, although barriers to participation remain related to professional and technical capacity and a lack of experience in policymaking.
The research was driven by a lack of clarity as to how representatives from KAP groups are able to effectively participate in the decision-making at the CCM level. There is good evidence that CCMs have and continue to recruit members of key populations, both before and in line with Global Fund new requirements that came into effect in January 2015.
Traditionally, key population representatives work from within networks of persons living with or affected by the diseases: either individuals who themselves are members of these groups or their representatives. However, they have rarely held leadership positions in the CCM and have often been seen as somewhat token members. Their participation and influence in the CCM processes remains unclear.
Aidspan did a rapid survey in 2014, and used short semi-structured interviews to ask questions about recent experiences of key population representatives about their engagement with the work of the CCMs. The CCMs in this study include those in Botswana, Lesotho, South Africa, Swaziland, Zambia and Zimbabwe.
The results aim to advise CCMs themselves, their supporters and any group with a stake in how the CCMs function and what they produce. There is a continued need for improved communications between the KAP constituencies and their CCM representatives. Other findings show a need for improved professionalization among KAPs represented in CCMs to ensure they are fully present, and fully briefed, to participate in CCM meetings.
Stigma faced by many of those representing key populations remains a major challenge. Indeed some KAPs reported feeling safer in the context of CCMs, and able to speak about their community’s issues, than outside. CCMs may not necessarily be the place to solve this problem, but it was suggested that thought-leaders and community influencers be engaged to on the CCMs to further address the stigma felt in societies.
All of these findings demonstrate that evolving the CCM model is a process that will take time. Noticeable progress in the last year, coinciding with the roll-out of the NFM, should be seized as momentum for bigger, bolder changes in the ways CCMs conduct business and integrate the needs and agendas of all of its members -- including representatives of the very groups that the Global Fund investments are designed to support.