For the first time, "key affected populations" figure prominently in the Global Fund's requirements and recommendations regarding Round 8. Yet despite this fact, they have been largely ignored in the Round 8 process.
The Global Fund defines "key affected populations" as women and girls, youth, men who have sex with men (MSM), injecting and other drug users (IDUs), sex workers, people living in poverty, prisoners, migrants and migrant labourers, people in conflict and post-conflict situations, refugees and displaced persons.
The Fund recommends that each CCM have one or more members who represent key affected populations. And it would like all proposals to address, in part, the needs of at least some key affected populations. (Proposals from lower-middle and upper-middle income countries are required to have a predominant focus on one or more key affected populations.)
Civil Society Action Team (CSAT), hosted and supported by ICASO, for which I work, is closely involved in coordinating technical support to community groups representing these populations. Below are some findings from CSAT's regional coordinators for Eastern Europe and Central Asia. (Where I refer to "community groups", I mean those that represent key affected populations.)
- CCM members representing the most powerful sectors – government, UN agencies, international NGOs and, in some countries, GONGOs (Government-Organized NGOs) – frequently agree among themselves what the Global Fund proposal will say and who will become Principal Recipients (PRs). The international NGOs and GONGOs sign papers on behalf of civil society, but they don't generally represent the interests of key affected populations. Governments ignore community groups, which are small and scattered. And the UN agencies tend to work with larger, better organized and more technically advanced groups within the civil society sector.
- Community groups need help in building their capacity, but they rarely get it from their governments or from UN/WHO in-country offices. Even with the new Global Fund guidelines for Round 8 applications, community groups are not benefitting from Global Fund grants because many lack the capacity to get involved in the process, and because groups within the most powerful sectors appear not to be interested in building their capacity and sharing decision-making power with them.
- Sometimes, representatives of NGOs/CBOs on the CCMs are hand-picked by the government. When this happens, they don't represent anyone because there was no consultation or selection process. As a result, the real key affected populations have no opportunity to participate in programme development, contribute to proposal writing, or access funding from the Global Fund (other than bits and pieces from PRs after the proposal is approved).
- When CSAT has raised these issues, representatives of the most powerful sectors have sometimes said that they have tried to involve community groups but that there was no one obvious to talk to, no clear organizational structure to deal with, etc. They have used the lack of organizational capacity of key affected populations as an excuse not to include them in the process, rather than as a reason to help them build capacity and get included.
- Community groups are advised by representatives of the most powerful sectors to keep quiet; they are told that if the proposal is approved, they may still get something. So community groups don't report these problems to the Global Fund. (Of course, CSAT could report such things itself, without necessarily identifying the groups that have been excluded. But it's not clear what the Global Fund would do with such information. Nor is it clear what would be in the best interests of the community groups.)
These problems are typical within Eastern Europe and Central Asia. Fortunately, the situation is better in Sub-Saharan Africa, where the governments, international NGOs and UN agencies are more open to working with community groups, and the CCM processes are followed much better. But even there, the inclusion of certain key affected populations (particularly MSM, sex workers, and IDUs) is often hindered by their illegal status. This means they still cannot benefit from new opportunities offered by the Global Fund. More thinking is needed on how to overcome this obstacle.
Here are some recommendations on how to improve the process to make it truly inclusive of key affected populations:
For UN agencies and the Global Fund:
- UN agencies should develop better strategies to work specifically with key affected populations, within their broader strategies for working with civil society.
- UN agencies should help community groups access support to build their organizational capacity, and should promote their real participation in CCMs at all stages of the Global Fund grant cycle.
- Technical support providers should be called in to build the technical capacity of community groups, and specific funds should be allocated for this.
- The Global Fund should expand the information provided on CCMs at its website, and should publish proposed Terms of Reference and Key Performance Indicators for CCM members, including those representing community groups.
- When CCMs implement the Global Fund's requirement that they must put in place and maintain a transparent, documented process to solicit and review submissions for possible integration into the proposal, they should specifically invite input from community groups.
- When CCMs specify Sub-Recipients within their proposals, they should ensure that a certain percentage of the Sub-Recipients are community groups.
For international and national NGOs:
- When international and national NGOs receive Global Fund funding as PRs or Sub-Recipients, part of this funding should be used for strengthening community groups.
The involvement of community groups representing key affected populations cannot be left entirely to the discretion of other players. It should be a Global Fund requirement that CCMs build into their proposals a detailed explanation of how key affected populations will benefit from the proposal as implementers and as service recipients.
[Note: Natalia Ciausova (firstname.lastname@example.org) is Acting International Coordinator of Civil Society Action Team (CSAT). CSAT, established in March 2008, is a civil society-led global initiative whose goal is to inform community groups – primarily those representing key affected populations – about their rights, and to strengthen their role, within Global Fund processes. The views expressed here are her own, based on feedback received from CSAT regional coordinators.]