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Source: aidspan.org

Among the several background papers for information provided to the 47th Board meeting held on 10-12 May 2022 was the annual update on Community, Rights and Gender. While members appreciated the progress that had been made, they also felt that the Community, Rights and Gender portfolio does not seem to be prioritized in a manner that reflects its critical role in implementing the Global Fund’s current Strategy, programs and funding mechanisms. In particular, key performance indicator targets have not been met.

As the current Global Fund Strategy (2017 – 2022) is coming to an end and plans are underway for the implementation of another (2023 – 2028), 2022 provides an opportunity to reflect upon achievements, challenges and lessons learned for advancing community, rights and gender throughout the Global Fund partnership’s work. It also provides an opportunity to look ahead and consider how best to apply those lessons to leverage the full ambition of the 2023 – 2028 Strategy and lay the groundwork for greater impact in the years to come. The Community, Rights and Gender (CRG) annual report to the Board is structured around five key areas of work: community leadership and engagement; community systems and responses; human rights; gender equality; and key and vulnerable populations. The report also includes a set of ten conclusions or ‘concluding considerations’.

Context

Since the last CRG Annual Report, the global response to the COVID-19 pandemic has necessitated shifts in how the Global Fund works and how it functions as a partnership. Human rights and gender-related barriers, as well as deepening inequities within and between countries, have been exacerbated by the pandemic and efforts to control it; and has also highlighted the need for strong and well-resourced community systems and responses.

The CRG Annual Report also noted that, at the same time, humanitarian crises ranging from Afghanistan, Ethiopia and Myanmar to most recently Ukraine further threaten communities and put human rights, disease responses and lives at risk. The Global Fund is evolving its work to protect and advance human rights, gender equality and health equity, to be a champion for community leadership, and to further evolve its work and partnership in these areas.

It noted that in the face of the continuing COVID-19 pandemic, 2021 was a year of both admirable achievements and challenging setbacks for the Global Fund’s CRG investments. And yet, it further noted, communities affected by HIV, TB and malaria (HTM) have shown remarkable innovation, resilience and resolve to minimize service disruptions and protect human rights; highlighting the importance of investing in a range of activities to support community systems and responses; community engagement; human rights; gender equality; and key and vulnerable population (KVP) programs and leadership.

The Report reflected upon progress made and described some of the key challenges that remain. With an eye on preparations to support implementation of the new Strategy, the Report concluded with several considerations which, to varying degrees, have been initiated to ensure that CRG areas are strengthened throughout the Global Fund partnership in the years to come. The report was structured around five mutually reinforcing areas which form the backbone of the Secretariat’s CRG portfolio: (1) Community leadership and engagement; (2) Community systems and responses; (3) Human rights; (4) Gender equality; and (5) KVPs. The Report provides a summary of the most significant highlights as well as critical challenges. Additional process and outcome details across these five areas, including country specific case studies, are included in an Annex 1 to the Report.

We do not repeat the findings in these areas since they can be read in the report; instead, we describe the concluding considerations and the stakeholders’ response to the Update.

This article is based on the CRG Annual Report to the Board and its Annex, constituency feedback and Board discussion.

Concluding considerations of the Annual Report

The Report concluded by noting that, as the Global Fund carries out the final year of its current Strategy period and prepares to implement the new one, key community, human rights, equity and gender-related opportunities should be leveraged and lessons applied to increase the quality, focus and impact of its investments. In addressing CRG-related challenges through community resilience and resolve and the application of an intensified focus across the organization, the responsiveness, agility and flexibility of the Global Fund was demonstrated over the last twelve months. These qualities are now actively being factored into how the Global Fund responds to the following ten considerations:

1. Implement a bold vision and necessary changes to support a Secretariat and Partnership wide focus on scaling up investments in Community Led and Based responses.
2. Advance a practical and programmatic approach to equity.
3. Improve safety and security for HIV KP communities and implementers.
4. Leverage the effectiveness of catalytic investments to make further progress on challenging CRG priorities in the new Strategy.
5. Increase leadership and competency on gender equality across the Secretariat.
6. Update key indicators for better measuring outcomes and impact of KVP programs.
7. Reaching adolescent girls and young women (AGYW) in all their diversity with appropriate HIV prevention should remain a critical priority in Eastern and Southern Africa.
8. Harmonize the approach towards the provision of technical assistance to and delivered by communities and civil society across the organization.
9. Increasingly strengthen and invest in social accountability mechanisms like community-led monitoring to actively inform routine monitoring and evaluation on program performance, effectiveness, and quality of services.
10. Adopt a portfolio-wide approach to incentivize increased commitments to comprehensive human rights programming.

Stakeholder feedback, discussion and commentary

Members found the report informative report and commended the Secretariat for the thoughtful analysis, noting that it was gratifying to read the progress made in the five areas of work focused on in the report, while at the same time observing the ongoing challenges.

People commended the efforts made to support populations where CRG issues have been exacerbated by the COVID-19 context and to engage communities in the COVID-19 Response Mechanism (C19RM) planning and implementation.

Stakeholders welcomed the leadership of communities living with and affected by the three diseases, including their valuable contribution to ensure that the new Strategy has a strengthened focus on advancing community, rights and gender. The planned recruitment of a gender specialist within the Secretariat will be important to build expertise and people requested an update for when s/he would be brought on board.

Catalytic investments in adolescent girls and young women

Participants also supported the use of catalytic investments (Cis) to further progress CRG aims, based on their impact to-date. In particular, it was agreed that HIV prevention for AGYW in Eastern and Southern Africa should be a very high priority, adding that a better understanding of, and commitment to, CRG across the Secretariat and Country Coordinating Mechanisms (CCMs) is critical and acknowledging the efforts made to achieve this.

Stakeholders complimented the implementation of the AGYW Strategic Initiative of $8 million and the additional matching funds that have been made available for 13 AGYW priority countries. They wanted to know how the Global Fund would build on those current investments in the 13 priority countries in the new Strategy 2023-2028 and how an enhanced focus on global sexual and reproductive health and rights be ensured.

Breaking Down Barriers

It is worth noting that progress has been significant in the countries where special initiatives have been implemented such as Breaking Down Barriers (BDB). It is of concern, however, that progress in investment in HIV prevention for KVPs was primarily attributable to four countries. Inevitably this raises the question of how similar progress can be achieved in many more countries.

The level of investments in countries not part of the BDB initiative remains far below the target at 1.69% of HIV grants. While there has been an increase in the proportion of investments in programs for HIV prevention for KPs in NFM 3, at 7.7% this is significantly below the 10% target for Key Performance Indicator (KPI) 5A and that progress is primarily attributable to a small number of high impact portfolios.

Hence, stakeholders welcomed building on the lessons from BDB and think the Secretariat must act with increased urgency (not waiting for the new grant cycle) in finding ways to incentivize increased and ultimately sustainable investments as well as the commitment of country ownership to comprehensive programs and initiatives to reduce human rights related barriers.

Key performance indicators paint a gloomy picture

Many stakeholders, while commending recent progress, also noted the results from the preliminary Multilateral Organisation Performance Assessment Network (MOPAN) report and the key and critical challenges that remain. The MOPAN report has identified major issues around CRG-related KPIs in gender equality and women’s empowerment, human rights, and KVPs, which continue to fall short behind targets.

Likewise, the risk report again outlines how KVPs are particularly affected by the disruptions caused by COVID-19. This underlines the need to increase efforts towards resilient and sustainable systems for health (RSSH) and Universal Health Coverage (UHC), scaling up community-led interventions and investing in programs that reduce human rights barriers to services to mitigate the pandemic’s impact on KVPs and reduce the gap towards programmatic targets. The challenges in these areas faced by Global Fund programs are persistent. Also, a comprehensive and holistic approach to how the Global Fund intends to achieve more investments in this area, increase programmatic impact and leverage its diplomatic role, is still missing.

To this end, stakeholders suggested that it would be very important to have appropriate KPIs on community, rights and gender, looking at how CRG is being put at the heart of implementation of all Global Fund funding mechanisms. To complement the KPIs and modular indicators covering these areas stakeholders encouraged the inclusion of reviews/evaluations that cover these topics in the evaluation plan.

Concluding considerations

The ten concluding considerations of the report, people felt, should be given serious consideration and lead to committed action. While they provide a good basis for accelerated action across the Global Fund and its portfolio of investments, the partnership needs to quickly step up its ambitions in how this is operationalized, to reflect the centrality of human rights and gender equality in everything the Global Fund does. It was noted that COVID has shown us that better, more granular and up-to-date data are not only needed but are possible, and this needs to be applied to KVPs as well as human rights and gender interventions. The Global AIDS Strategy provides a good platform to step up how the Global Fund tracks and measures progress on removing punitive laws, ending criminalization, and ultimately transforming the legal environment.

Conclusion

Stakeholders recognized that work in this area is and must continue to be across the partnership and looked forward to furthering collaboration in this area.

However, many Delegations were concerned that the CRG portfolio does not seem to be prioritized in a manner that reflects its critical role in implementing the Global Fund’s current Strategy, programs and funding mechanisms. They reiterated calls to include the CRG team leader in the Management Executive Committee on the basis that it is important to ensure that cross-cutting KPIs on community, human rights, KVPs and gender have elevated visibility and Secretariat-wide accountability.

The Board paper GF/B47/12, Community Rights and Gender Annual Report, should be available shortly at https://www.theglobalfund.org/en/board/meetings/47/.