The Global Fund is poised at a critical and exciting juncture in the evolution of its work on gender quality and key populations. But if a range of fundamental challenges go unaddressed, further progress will be severely limited. This was the conclusion of a report released last week by the Community, Rights, and Gender (CRG) Department at the Global Fund.

The 58-page report, Gender Equality and Key Populations: Results, Gaps and Lessons from the Implementation of Strategies and Action Plans, is technically a progress assessment of the Gender Equality Action Plan 2014-2016 and the Key Populations Action Plan 2014-2017, but is functionally an overview of the steps the Global Fund itself has taken since 2014 in the areas of gender equality and key populations. The report, which was developed by long-time advocate Sarah Middleton-Lee, focuses on, “the role of the Global Fund Secretariat in developing, implementing, monitoring, and promoting the Action Plans.” Thus, its focus is narrowly upon the actions of the Secretariat, and not on the wider experience of Global Fund-supported programs.

The report goes through the gender equality and key populations action plans objective-by-objective and provides examples of progress, wherever they were found, between 2014 and 2016.  The findings are then synthesized into a series of “strategic messages,” which form the heart of the document. The strategic messages seem to be the author’s attempt to present findings in a useful and actionable way, particularly for the Global Fund Secretariat, which is the primary audience of the report. Below we summarize each of the strategic messages.

Strategic message 1 describes how the action plans have been useful in providing “clear and strategic frameworks” for the Global Fund Secretariat, and observes that, “they serve as a strong statement that these issues matter to the institution.” However, the fact that action plans have had varied visibility and accountability within the Secretariat is an important consideration in weighing their impact. The author states that both plans could be further strengthened through greater conceptual clarity, more fluid coordination within the Secretariat, and continual “adaptation to [a] dynamic environment.”

Strategic message 2 posits that implementation of the action plans, in conjunction with the roll out of the new funding model, has led to the Global Fund making “significant progress in the areas of gender equality and key populations.” The report assessed progress with respect to the Global Fund’s “policies, processes, tools, and good practice, data and evidence, capacity and expertise, and leadership.” Some examples include: changes to the Eligibility Requirements and Minimum Standards for CCMs (policies); establishment of the CRG Special Initiative (leadership); the implementation of Country Dialogue (processes); and trainings and sensitization sessions for Global Fund Board members and Secretariat staff (capacity and expertise).

Strategic message 3 details the limitations of the action plans in advancing investments in gender equality and key populations. Ten specific challenges are discussed, including:

• data limitations, particularly the dearth of quality data on key populations;
• inadequate meaningful engagement, specifically the disparity between institutionalized processes for engagement of gender and key population stakeholders and the actual impact of said engagement; and
• concerns that as countries transition out of Global Fund eligibility, there is a “major threat to key populations … in middle-income countries,” in terms of their access to funding and programs in the absence of the Fund and its commitment to key populations.

Strategic message 4 considers how the Global Fund’s strategies and actions on gender equality and key populations have been largely driven by, and modeled on, experience in the HIV field, despite the Fund’s three-disease mandate. The author attributes this to greater “conceptual clarity [in HIV],” a more active HIV civil society sector, and “agreed good practice” within the HIV field, particularly where gender and key populations are concerned. While “momentum is building within the field of TB,” the author said, there are “less clear directions for malaria.” However, the report does not discuss whether (or how) gender equality and key populations frameworks are appropriate for TB or malaria.

Strategic message 5 highlights that while the Global Fund Secretariat’s capacity in gender equality and key populations has grown overall, “it continues to heavily depend on the drive and expertise of the CRG Department.” The report identifies the Grant Management Division as the priority unit within the Secretariat for further capacity development in these areas.

Strategic message 6 acknowledges the essential role of strategic partnerships between the Global Fund, technical agencies, and civil society. “As a financing mechanism without country presence, [the Fund] cannot, and should not, work in isolation.”

In strategic message 7, the report singles out the Global Fund’s new Strategy for 2017-2022, as “an unprecedented opportunity to demonstrate institutional commitment to gender equality and key populations.” But it also cautions that “success will depend on: integrating action on these areas throughout the operational plans; addressing identified gaps and weaknesses; securing positive outcomes…; and mobilizing collaborative action across the Global Fund.”

The report builds on the strategic messages with a series of recommendations directed at the Secretariat. The recommendation are as follows:

1. Champion the rights and publicize the needs of women and girls, and key populations, through advancing the relevant commitments in the Strategy, and by continuing to play “a leading and catalyzing role within the global health architecture.”
2. Develop and integrate updated action plans for gender equality and key populations, with accompanying accountability frameworks.
3. Address the challenges (as articulated in strategic message 3).
4. Build capacity and expertise on gender equality and key populations across the Secretariat, with emphasis on the Grant Management Division.
5. Strengthen the focus and accountability of its strategic partnerships, particularly those with technical partners and community networks.

Some of these same themes are expected to be addressed in a thematic evaluation of the implementation of the Gender Equality Strategy at country level, which the Technical Evaluation Reference Group expects to release later this year.