Global Fund Strategy: Summary of civil society asks (updated Sep 2015)

8/21/2019 Global Fund Strategy: Summary of civil society asks (updated Sep 2015)

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M i d d l e I n c

o m e C o u n t i e s ( M I C s ) , G r a d u a t i o n s a n d T r a n s i t i o n

s

This document produced by ICCS and ICASO provides a list of the key recommendations made during civil society consultations held toprovide input into the development of the GF strategic plan 2017-21. The intention in preparing this summary is to ensure that the richand diverse comments are documented and available to the Communities and NGO delegations in their deliberations on the strategy and toprovide background for future consultations. Links to the full meeting reports are available in Annex A.

Draft Summary of civil society priority ‘asks’ concerning the 2017-2021 Global Fund Strategy

• “leave no one

behind”: focus onpeople, not countries

• controlling theepidemics is one ofthe key componentsof sustainability –stress the importantrole of CS andCSS in monitoringsustainability andtransitions plans

• GF shouldbe prioritizing

populations in need

• GF shouldarticulate fully whatit means to supportand accomplish “responsible”transitions

• develop aneffective plan andthe necessaryresources to managesituations wherebygovernments do not

effectively deliver theright to health forkey populations

• GF should leave no

one behind

• support countriesto expand domesticinvestments andsupport them tomaintain fundinglevels, post-transition

• negotiate medium-to-long termtransition plansbetween the GF andMICs

• develop anapproach toincentivize domesticinvestments priorto cutting GFinvestments at thepoint of exit

• plan well inadvance using aresponsible timehorizon

• it is unacceptable

to abandon supportfor health programsabruptly when theaction is likely toresult in resurgentepidemics, no matterwhat the income levelof the country

• rights basedtransitions should bebased on clear andtransparent criteriaand meaningfulconsultation with key

populations

• negotiationsmust addresscriminalization andother barriers usedas excuses to notprovide services toKPs and others

• GF must ensure

responsible, long-term, and sustainableexit strategies forMICs, with a focus onCSS

• ensure fundingfor key populationsand vulnerablecommunities isincluded in transitionplans

• fund civil societyadvocacy for resource

mobilization andengagement inmonitoring efciencyand quality ofinvestments

• “no one is left

behind”: every effortshould be madethrough countrydialogues, transitionsupport, regionalapproaches, non-CCM proposals, andother mechanismsto make ethicaltransitions

• provide targetedand urgentorganizationaldevelopment to

equip NGOs tocourt alternatefunding sourceswhen graduationsand transitions arelooming

• articulate, inadvance, a country-specic protocol todeal with situationswhere governmentsdon’t follow throughon their transitioncommitments

• provide technicalsupport and fundingto CS so theycan participate incountry dialogues fortransition planning

www.icaso.orgComments: [email protected]

http://icssupport.orghttp://www.globalfundadvocatesnetwork.org

September 2015

• “leave no one

behind”: focus onpeople, not countries

• ensure responsible,long-term, andsustainable exitstrategies for MICs,with a focus on CSSand communityresponses

• fund civil societyengagement andadvocacy for resourcemobilization in

countries in transition

• continue investingin key populationsand youth incountries that lackthe political will todo so

• maintainengagement withpost transitioncountries foradvocacy andtechnical support

• re-consider

eligibilitycriteria beyondepidemiological andeconomic averages;consider readinessand political willto invest in bestpractices for diseasecontrol

• implementa strategy forresponsible transitionto domestic funding

• source otherfunding for NGOsto continue workingwith KPs if countriesare unable orunwilling to continueprogramming; ensurefocus includes workto address legalbarriers and CSS

• safeguard continuityof services provisionsof the GF; ensure KPsare not left out in

national responses• consider transitionssuccessful if theyhave a sustainednational system inplace

ICAS0/ICSS Addis Pre Meeting Delegations OFS Communities/GFAN BKK Pre Meeting Communities/EHRN Buenos Aires PF April 29 to PF May 5-6 Apr-May April 13-14 May 26-27 to PF Jun 22-23 Moldova Jul 13-14 Sept 1-4

• the World Bank

income classicationcriteria are notrelevant

• responsibletransition strategiesmust involvecommunities and allkey populations

• graduation criteriaand timelinesshould be tailored tocountry’s readiness,and a safetynet mechanism

is needed forcountries that fail tograduate/transitionsuccessfully

• adopt a ‘graduationin’ and ‘graduationout’ approach sothat when diseaseor human rightsviolations are upfunding eligibility canbe reestablished

• support policy

dialogue andadvocacy priorto, during’ andafter transition;both technical andnancial support areneeded


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• increaseunderstanding ofhuman rights andgender equity thatreect speciccountry andcommunity level

challenges andpromote strategiesto improve well-beingand better healthoutcomes

W o m e n a n d G i r l s , G

e n d e r E q u i t y

• move beyondbio-medical tounderstanding theimpact of the threediseases on gender

• ensure governments

integrate effectivelygender, health, andHIV policies

• ensure accessto quality andcomprehensiveservices for women,young people, andkey populations

• collect the mostappropriate indicatorson gender andhuman rights (for

example, more robustdisaggregated data)

• human rights,gender, and keypopulations should, inprinciple, stand alonefor added visibilityand attention ratherthan be mergedin the strategyframework

• develop corporateKPIs on gender and

key populations

• increase theevidence base toscale-up genderand human rightsprogramming

• elevate the genderdimension of humanrights in the newstrategy and expressmore clearly thelink between theGF human rights

strategy and issuessuch as genderbased violence andwomen’s propertyinheritance

• develop a genderkey performanceindicator

• encourage a widerunderstanding ofgender interventionsto include diversity ofgender identity andsexual orientation

• increaseinvestments incommunities ofwomen and girls,particularly in keyaffected women

• make strongerlinks to sexual andreproductive healthand rights (SRHR)

• ensure thatgender- and age-disaggregated data

is collected throughthe right indicatorsto monitor theeffectiveness ofprogram outcomesfor women and girls

• GF should gathergender andkey populationdisaggregated datato understand who isaccessing services

Comments: [email protected]

• increaseinvestments incommunities ofwomen and girls,particularly focusingon key affectedwomen

• strengthen linksto sexual andreproductive healthand rights (SRHR),and efforts to ensurethat gender- andage-disaggregateddata can be collectedthrough the rightindicators to monitorthe effectiveness ofprogramme outcomesfor women and girls

• clarify existingguidance, work withpartners to raiseawareness, andfacilitate technicalassistance on gendertransformativeprogramming • create incentivesfor funding ofcomprehensivegender programs forHIV, TB, and malaria

• ensure dedicatedexpertise on gendertransformativeprogramming onCCMs

• strengthen nationalprograms to preventmother-to-childtransmission of HIV

• focus on supportinggender-orientedprograms thatdocument andaddress genderinequalities in accessto services

Draft Summary of civil society priority ‘asks’ concerning the 2017-2021 Global Fund Strategy ICAS0/ICSS Addis Pre Meeting Delegations OFS Communities/GFAN BKK Pre Meeting Communities/EHRN Buenos Aires PF April 29 to PF May 5-6 Apr-May April 13-14 May 26-27 to PF Jun 22-23 Moldova Jul 13-14 Sept 1-4

• scale up andsustainability willonly be achievedif we address therights and needs ofkey populations andvulnerable groups,

and the fundamentalissues of genderinequality andhuman rights

• GF should statea stronger positionon the removal ofpunitive laws in theCaribbean and astronger recognitionof the impact ofthese laws

• promote research

and evidence tosupport removal oflegal barriers

• increaseinvestment andscale up thesupport providedto key populationsand vulnerablepopulations tomeaningfullyand effectivelyparticipate inall levels of GF

processes, planning,implementation, andM&E


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• conrm a strongcommitmentto encouragecommunity-basedresponses, buildcapacity, andsupport the roleof CS in advocacy,

accountably, andimplementation

• expand targetedcapacity buildingprograms for CS toaccess GFprogrammingthrough technicalassistance channelssuch as the GF’sspecial initiativesfunds and RobertCarr NetworkingFund (RCNF);strengthen humanrights and genderequity capacitybuilding throughthese mechanisms

• work with CS,KP networks, andcountry partnersto achieve amore coherentand consistentunderstanding ofwhat is meant by arobust CS responseand CSS

• build the evidenceto justify fundingcommunity responsesand CSS

• enhancecommunity capacityto access thenon-CCM fundingmechanism,particularly inprogramming toaddress gaps incountry proposals

C o m m u n i t y R e s p o n s e a n d C S S

• a standalonestrategic objectiveto invest in andtrack funding forcommunity systemsstrengthening isneeded

• merging HSS withCSS will weakenattention given toCSS, which does nothave the same strongbacking HSS has

• develop a clearerdenition andstructure of CSSand dene optimalbudget allocations

• develop astandalone strategicobjective and KPI totrack investment and

impact of CSS

• ask the GF toreport on spending atthe community level

• consider asking fora spending targetfor communityresponses and CSS;(Note: UNAIDS FastTrack initiative thatcommunity-basedservice delivery willneed to be rampedup to 30% of total

spending on HIV;funding for advocacyand monitoring ofaccess and qualitywill also be needed)

• develop indicatorsand measurement forcross-cutting issuessuch as meaningfulengagementand investing incommunities

• proactively workingto achieve scale-up of communityservice deliveryapproaches (includingcommunity systemsstrengthening) will beessential in reachingthe unreached,improving outcomes,and ultimatelyachieving the GF’sstrategic goals

• a new strategicaction related to CSSshould be includedin the strategicframework, giventhe importanceof CS capacity toimplementing humanrights programs aspart of maximizingthe impact of GFinvestments

• explicitly supportinvestments forCSS, with clearindicators forensuring communityengagement

• support andengage in dialogueswith governments toimprove the legal andpolicy environmentsfor key affectedcommunities

• meaningfulparticipation ofcommunities andcivil society needs tobe strengthened andclearly articulatedin the new strategic

framework


• sustain andexpand investmentsin CSS throughexplicitly supportinginvestments forCSS/communityresponses, withclear indicatorsfor measuring andensuring communityengagement thatcan lead to theempowerment andinclusion of keypopulations • strengthenthe meaningfulparticipation ofTB and malariacommunities andcivil society as

supported by the KeyPopulations ActionPlan

• focus ondevelopment ofCSS components aspart of national andregional projectsfacilitate introductionof specic, qualitativeCSS indicators at thenational level

• expand ‘dual track’and ‘NGO rule’funding to encourageinvolvement of CBOsand CS in advancingresponse among keyaffected populations,especially in countrieswhere governmentsare reluctant tosupport suchactivities

• avoid completingthe transition from GFto domestic fundingunless the meaningfulinvolvement of NGOsis reected in nationalresponses

• expand regionalprograms to increasecapacity building forCBOs in the EECAcountries

• encourage moreeffective involvementof donors andtechnical partnersin the provision ofstructured TS toCBOs to increasetheir capacityand foster furtherdevelopment


• gender, humanrights, and keypopulations aremost effectivelyaddressed at thecommunity levelthrough increasedinvestmentsin communityresponses andcommunity systemsstrengthening

• increaseinvestments that godirectly to CSS

• align CS spendingto ‘fast track targets’

• dedicate aspecic % funding

window to CS withlower bureaucraticoverhead

• CSS and HSS arecomplimentary;CSS must not besubsumed by the HSS

• the GF shouldinvest in andstrengthencommunity systemsby empowering thecommunities via

direct delivery andcontrol over servicesand supporting theircapacity to engage inpolicy dialogue


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• promote the roleof communitiesas watchdogsof CCMs and GFprocesses, includingbuilding expertisein community-ledmonitoring and

evaluation

• develop a strongerfeedback loopfor communitiesexperiencingchallenges at thecountry level withCCMs to identifyconcerns and seekresolutions

• develop betterresources and toolsto deepen countrylevel expertise incommunity responseand CSS

• GF funding targetsshould assessambition at thecountry level to endthe epidemics andreect this ambitionin the replenishmenttargets

• funding targetshould take intoaccount the coststo support residual

demand in countriestransitioning fromlow income (LIC) tomiddle income (MIC) –particularly the costsrelated to advocatingfor increased levels ofdomestic investmentand putting in placecontingency plans sono one is left behind

• improvecommunication,information sharing,consistency ofmessaging, re:the new fundingmodel, and provideadequate time toengage communitiesin country dialogues

• improve technicalassistance to helpCS be stronger on

concept note draftingteams, etc.

• clarify that theindicative countrydisease split is only arecommendation andcountries can makedecisions based onneed and thus avoiddisempowerment ofcommunities

• GF shouldmaximize itsimpact by reachingvulnerable peopleand communitiesmost in need

• GF should tailor itsinvestments basedon local prioritiesand opportunities forepidemiologic impact

• sustainabilitydenitions shouldnot be based on anarrow frameworkof nancialsustainability, buton a thoroughunderstanding ofepidemic controland how increasedquality of livesand health can besustained beyond GFgrant cycles

• the idea of loan orcredit instrumentsbeing facilitatedby the GF tosupport countriestransitioning fromGF funding needs tobe examined withcaution to ensurethat programmingfocusing on keypopulations is notleft behind

• consider eligibilitycriteria that areappropriate tothe realities ofpeople’s needs,including programsled by affectedcommunities

C o m m u n i t y R e s p o n s e

a n d C S S

F i n a n c i n g t h e R e s p

o n s e – F u n d i n g M o d e l


• consider revisingeligibility criteriabeyond diseaseburden and income,especially whereservices for keypopulations may notbe sustained

• support regionalproposals wherecountries are nolonger eligible (e.g.

China) to addresscross-border issues(e.g. malaria) andsensitive humanrights issues


• it is not enough tosustain inadequateprograms; if we wanttrue sustainabilitywe need to scale upprograms now to endthe epidemics

• any changes inthe GF allocationmethodology shouldbe made in atransparent manner

with the input ofgovernment, CS,and multilateralstakeholders andnot before there isrobust data on theimpact of the currentmethodology


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F i n a n c i n g t h e R e s p o n s e

– F u n d i n g M o d e l

• GF should deviseand implementa resourcemobilizationplan that bettercoordinates andcollaborates with

other healthnancing initiativessuch as GAVI,UNITAID, and theWorld Bank

• GF shouldproactivelyengage withinnovative nancingmechanisms, suchas the nancialtransaction tax(FTT) to helpshape the future of

innovative nancingfor health

• GF shouldexplore the costof achieving otheradditional healthbenets to addressco-morbidities or co-infections for peopleliving with any ofthe three diseases,and considerincluding thesein the resource

mobilization targets

• support andexpand ‘regionalapproaches’to addressingvulnerablepopulations

• ensure that thefull expression ofdemand is expressedin the concept notes

• maintain andstrengthen the

incentive stream andother non allocationbased approaches

• consider specicfunding modalitiesfor key populations

• analyze theGF allocationmethodology toidentify strengthsand weaknesses

• facilitate the

development ofhealth investmentcases to demonstrateto governmentsthe rationale forinvesting in health

• developmechanisms that canbe used to facilitateincreased South-South collaborationand investment

• resource

mobilization mustbe based on afull expression ofdemand by countries

• GF should expandresearch intoinnovative nancingmechanisms andshow leadership inthis area

• nancialsustainabilityshould not be astrategic goal inand of itself, but ameans to eliminateand eradicate thediseases

• sustainabilityrequires assessmentof critical humanrights barriersaffecting vulnerablepopulations

• implementation ofthe funding modelshould encouragerobust investmentcases that includefull expression ofprioritized demand bycountries, rather than

applicants respondingonly to the envelopeavailable

• the allocationformula should beadjusted in order tolearn lessons fromthe rst three years;for example, placemore emphasis oncurrent indicatorsand need and less onprior programmaticperformance

• catalytic fundingfor high impact civilsociety advocacyin order to winincreased domesticinvestments in healthor to change legalenvironments willbe more importantin some countrycontexts than fundingservice delivery

• governmentco-nancingmust be carefullyassessed beforeGF withdrawal todetermine whetherpledges are backed

by willingness topay and sociallyexcluded groups arebeneciaries

• expand regionalfunding windowswith a mandate toincrease humanrights programming



• clearly dene theterm ‘sustainability’,including the role ofthe GF as a globalmechanism tomobilize resourcesfrom non-traditional

ways such as debtswaps and tax onnancial transactions

• reachingsustainability of HIVand TB responsesand responsibletransition to domesticfunding of HIVand TB programsmust be a strategicpriority within the GFstrategy

• invest inpartnerships betweenthe GF, governments,and civil society


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H u m a n R i g h t s

• human rightsand gender equitylanguage shouldbe embeddedthroughout theobjectives, mission,and vision

• increaseunderstanding ofhuman rights andgender equity thatreect speciccountry andcommunity levelchallenges andpromote strategiesto improve well-being and betterhealth outcomes

• increase humanrights investmentsfor key populations,women-led CSOs,and human rightsorganizations

• explore non-

traditionalmechanisms wherebyhuman rights andkey populationsprogramming canseek support insituations where theygo unfunded throughexisting channels

• ensure governmentcompliance withhuman rightsstandards

• develop clearindicators to measure

human rightsperformance

• interpretationof human rightswording in thecurrent GF strategyhas led to a narrowfocus on KPs;the new strategyshould broadenthe understandingto include otherpopulations facingrights abuses thatincrease theirvulnerability,especially women

• measure the overallimpact of humanrights work beyondremoving legalbarriers

• increase technicalexperience on issuesrelated to humanrights and keypopulations among

• GF must ensurethat countries notonly promote,defend, and protecthuman rights, butalso ensure thathealth programs

are designed ona human rightsbased approachand create rights-based environmentsthat sustain theinvestments andhelp to achieve thedesired impacts

• GF should increaseinvestments ininterventions thatare driven by keypopulations and

aimed at protectingthe rights of theircommunities

• GF should investin responsibleassessment ofage, gender, andkey populationsdisaggregated datain order to be ableto understand thepotential needs forservices

• ensure thatinternational humanrights standardsare upheld by theorganization, andamongst its grantees

• supportinterventions targetedat young people,especially thosebelonging to keycommunities

• retain the currenthuman rightsobjectives but addthat human rightsanalysis needs tobe integrated in thegrant cycle as wellas in all GF policiesand policy makingprocesses

• develop policyguidance andsupport to promotenon-CCM grantswhen needed towork reach excludedcommunities andpopulations

• commissionanalysis to assessthe HR initiatives

needed in keycountries and theircost; advocate withGF donors to ensurededicated fundingis available throughchannels such asthe Robert Carr CSNetworking Fundand others

• develop monitoringprocedures withrespect to theve human rightsprovisions in

grant agreementsand proactivelymonitor themrather than relyon the complaintsmechanism

• enhance humanrights capacity ofand dene roles andexpectations forsecretariat, TRP, LFA


• ensure thatinternational humanrights standards areupheld internally bythe organization,and amongst itsgrantees throughout

the concept notedevelopment,grant-making, andimplementationprocesses

• scale up rights-based, community-led, gender-responsiveprevention,treatment, care, andsupport interventionson the three diseasesthat is inclusive of key

affected populationand vulnerablecommunities,including womenand girls, and youngpeople from keypopulations

• create incentivesfor greaterinvestment in humanrights and genderprogramming, as wellas funding for keypopulation programs;

consider identifyingmechanisms such asreserving a portionof total allocationfor a countryspecically fortargeted programmingor expanding theregional proposaloption

• continue toimprove GF policyon preventinghuman rightsviolations, includingdiscrimination basedon sexual orientation

and gender identity• develop clearcriteria and indicatorsfor assessing theimplementationof human rightscomponent in GF-supported projects

• focus on programsthat reform orcreate enablinglegal environmentsfor working withvulnerable groups,and programsthat address thecriminalization of keypopulations

• scale up supportfor community-basedmonitoring andprotection of humanrights and quality ofservices

• prioritize programsworking with lawenforcement agenciesto prevent policeviolence, stigma anddiscrimination againstpeople living with HIVand representativesof key affectedpopulations

• make it mandatoryfor CCMs to monitorhuman rights


• the strategicobjective on humanrights must remainin the GF strategybut implementationmust be signicantlystrengthened

• critical attentionmust be paid toremoving legalbarriers and theimpact of harmfulsocio-cultural norms

• increaseinvestment in humanrights programmingin order to scaleup and sustain theresponse

• decriminalizationshould be explicitin the strategicobjective on humanrights

• develop acomprehensivedenition ofhuman rights thatincludes protecting,promoting, andensuring humanrights, includingthe removal of legal

barriers

• develop HRsindicators andevidence for why HRsmatter in addressingthe three diseases


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H u m a n R i g h t s

members of CCMsand national AIDScouncils and conceptnote writing teams

• link how humanrights is reectedin the new strategyto the SustainableDevelopment Goals

• ensure newstrategy reects thepriorities of other UNagencies working onhuman rights

• promote the rightsfor people living withdisabilities

• promote thealignment of law,policy, and strategyin relation to keypopulations

ChallengingOperatingEnvironments• what constitutes achallenging operatingenvironmentshould be clearlyarticulated: arecountries thatcriminalize keypopulations, such asmen who have sexwith men, meantto fall under thiscategory?

• dene the skillsneeded in thesecretariat to workin challengingoperationalenvironments

CCMs• reinforce eligibilityrequirements forCCMs and hold themaccountable if theydo not comply

O t h e r

• strengthencapacity to gatherdisaggregated dataon vulnerable andkey populations

• include moreexplicit languageabout poverty,inequality, andinequities; those inneed due to poverty,rights violations, orother obstacles arethe GF’s mandate

• signicantincrease in fundingis required if co-infection and co-morbidity (COIM)interventions areto be included inthe GF mandate; ifadditional resourcesare available, themandate of the GFcould be expandedto support HCV

• focus rst andforemost onaccelerating progressin order to end thethree diseases by2030; all strategicobjectives shouldemanate from thisprimary goal

• GF investmentsshould contribute toaccelerated accessto game changingdevelopments forpeople most in need

• GF should prioritizedramaticallyshortening thetime between theemergence of newevidence-basedinterventionsand access bycommunities most

• consider developingMOUs with humanrights technicalpartners (UNAIDS,WHO, UNAIDS, etc.)and support theseagencies to carry outtheir in-country roleto ensure greaterfocus on humanrights programmingin proposals andprogramming • state clearly thatthe GF understandsaccess to medicines isa fundamental right

• support mechanismsto ensure availability,affordability, andaccessibility oftreatment anddiagnostics forthe three diseasesand co-infectionsby addressingintellectual property(IP)-related barriersand promotingimplementation of fullTRIPS exibilities

• ensure access to2nd and 3rd lineART, medicines fordrug-resistant TB andmalaria, and OpioidSubstitution Therapy(OST)

• make sure that PRePand PEP are availableand accessible


• ensure availability,affordability, andaccessibility oftreatment anddiagnostics for thethree diseases andco-infections, includingby addressing IP-related barriers,implementation of fullTRIPS exibilities, andreview and revisionof national patentlaws and legislationframeworks

• address barriersto equitable accessto medicines andtechnologies such asparental or spousalconsent requirements;mobility-relatedbarriers; and lack ofaffordable, accessible,quality SRHR services

violations anddiscrimination of KPsin the context of GFprograms

• explicitlyindicate a desireto improve access

to HIV servicesfor transgenderpeople who arenot acknowledgedas a priority keypopulation in EECAcountries

• support buildinga strong evidencebase around HIVepidemiologyamong KPs who areignored by nationalgovernments

• increase efforts withcountries to advocatefor reduced pricesand ensure thatcountries are able toprocure affordablequality drugs(especially the newand more effectivemedicines) aftertransitioning from GFsupport

• support

communities inprice reductionnegotiations

• support countries todevelop and introducetreatment protocolsconsistent withinternational WHOrecommendations

• analyzeprocurement policieswith a humanrights lens – theProcurement forImpact (P4i) ande-marketplaceinitiatives maynot lead to thelowest prices; theywill concentrateprocurement inthe hands of theGF rather thanbuild country level

procurement capacity

• GF shouldrecommit to usingall the tools at itsdisposal to ensurethe lowest-pricedquality medicine forall and re-commit toaffordable medicineas a matter of humanrights


• scaling upsustainabilityin middle- andupper middle-income countriesrequires aggressiveefforts to keep theprices of quality,essential medicinesdown by usingTRIPS exibilitiesand addressingcorruption

• ensure there isuninterrupted accessto treatment andservices in countriesfacing transition

• for countriesthat have alreadygraduated dueto ineligibility,or are currentlyimplementing their


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O t h e r

• GF should increasesupport for countriesto take advantageof the exibilitiesprovided in theTRIPS agreementto support them to

access lower drugprices

• GF should increaseits engagementin the access totreatment arena

in need, in order tomaximize impact anddeliver health justice

• GF should supportefforts to makequality medicines

and other healthcommodities availableat the lowest possibleprice, including theuse of provisionsin national lawsand internationalintellectual propertyagreements for theproduction and supplyof generic medicines

• GF should increaseinvestments ininterventions that

are driven by keypopulations

• eliminate co-infection and co-morbidity betweendiseases

• address barriersto equitable access

to medicines andtechnologies likeparental or spousalconsent requirements

• oppose Free TradeAgreements (FTAs),including the Trans-Pacic PartnershipAgreement (TPPA)


• ensure access to2nd and 3rd line ART,medicines for drugresistant TB andmalaria, and OpioidSubstitution Therapy

• ensure that PReP andPEP are available andaccessible

• eliminate co-infectionand co-morbiditybetween diseases,including HIV, HepatitisC, TB, and/or malaria

• engage with effortsto promote accessto medicines as partof Universal HealthCoverage

ChallengingOperatingEnvironments• Dene the term ‘challenging operatingenvironments’ – doesthis include countriesthat criminalize keypopulations, contextswhere the environmenttowards civil societyis unfavorable, suchas organizations notbeing able to legallyregister or which are

harassed/repressed bygovernments?

• allocate specialfunding to countries incomplex humanitarianemergencies where thehealthcare of patientsis immediately anddirectly affected

• facilitateprocurement bidsthrough internationalmechanisms (suchas the Green LightCommittee) to reducecosts and increase

transparency

• support countriesto develop simplieddrug registrationprocedures

• support HCVprevention andtreatment for PLHIV

• supportprogramming forpersons withoutcitizenship and

migrants through GFspecial initiatives fund

• develop a systemof TB care, includingnon-medical care,to encourage andmaintain adherenceto treatment in orderto reduce the rates ofMDR-TB in EECA

• supportengagement of KPsand CS in monitoring

procurement planningand implementation,particularly duringtransition to domesticfunding for diseasecontrol

• increasetransparency byre-establishingan independentadvisory groupon procurementmechanisms and

policies

• leave qualityassurance ofmedicines to theWHO

• support countriesto access the leastexpensive qualitymedicines andavoid the eroding ofgeneric competition


last grants, anemergency solutionmust be developedto assure their gainsare not threateneddue to lack oftransition support

and systems (scal,governance, orpolicy)


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Women and Girls, Gender Equity

• develop staff-level performance indicators on gender equality• increase the visibility of gender equality and women and girls in GF communications and advocacy materials• increase investments in programs that address barriers women and girls face in accessing information, education, support services• invest in programs that transform harmful gender norms and address unequal power in relationships• support the meaningful participation of women’s groups in country-level mechanisms and processes through sustained funding and TA

Community response and CSS

• ensure appropriate and equitable gender-responsive programming in funded CSS and HSS approaches• require gender-responsive capacity-building in M&E, accountability, and research in CSS strategies and programs• require programs to train health care providers and inuence infrastructure to be community and gender responsive in HSS strategies

Human Rights

• increase investments, competencies, and delivery of activities to address and remove human rights and gender related barriers to access• meaningfully integrate human rights and gender equality throughout the grant cycle• do not provide money to programs that infringe on human rights (with monitoring and evaluation throughout the life cycle of the grant that goes beyond

the current complaint mechanism)• integrate the human rights of women and girls in all their diversity as key considerations throughout the grant cycle

Women and Girls, Gender Equity

• ensure meaningful engagement and representation at all levels• support communities in need• increase investment in communities of women and girls• support the right programmes• address structural issues• foster stronger links to Sexual and Reproductive Health and Rights• collect the right data through the right indicators

Community Response and CSS

• address the gap in the understanding of what CSS is, and what it means for organizations of women and girls

Human Rights

• spell out the issues on human rights from key populations, so that the messaging does not get lost; human rights cuts across all three diseases and allpopulations, communities, and vulnerable groups



IWHCMarch 14

W4GF advocacy brief on the GF strategy includes the following recommendations


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Free Space Process: Observation, concerns, and recommendations for the Global Fund board to consider in the new Global Fund Strategy

development process

1. Scale-up is essential – It’s unequivocally clear that the mission to end the diseases cannot be achieved without scaled investments in quality services thatreach communities. The ambition to scale up must be reected in all Strategic Objectives of the Strategic Framework.

2. The Global Fund urgently needs a sustainability and transition policy – The Global Fund should develop a sustainability and transitions policy that clariesthe GF’s responsibilities regarding sustainability of programming. This policy should guide the GF’s deliberations on the Equitable Access Initiative and futurefunding allocation model (and not vice versa). The GF must assess the willingness of governments to address the needs of key and vulnerable populations.

3. Strategic objectives must lead to increased funding – We need KPIs that specically measure progress in achieving the strategic objectives with respect tohuman rights and key and vulnerable populations as well as the corresponding actual investments. It would also be helpful to link the strategic objectives thatare related to human rights and key and vulnerable populations with the grant management KPIs.

4. Capacity needs to be strengthened – Increase investments in capacity building for key population engagement. Invest in the CRG team and otherSecretariat divisions to better support the community response.

5. Better and safe data collection – strengthen the use and gathering of better, disaggregated data (across the diseases and by key population, age, gender andgender identity, acknowledging transgender people as separate from MSM)

6. Access to medicine and diagnostics – GF should strengthen its support to countries to exercise full use of TRIPS exibilities.

7. A call on technical partners – GF’s technical partners should support the GF in setting ambitious targets in relation to key and vulnerable populations, anddrive enhanced investments in Community Systems Strengthening.

Statement of the Latin American Civil society on the Global Fund’s new strategy to Fight AIDS, TB and Malaria (GF) Call to Action Second Latin American andCaribbean Forum on the Continuum of HIV Care: ‘Enhancing Combination HIV Prevention to Strengthen the Continuum of Prevention and Care’ Rio de Janeiro,Brazil, 18-20 August 2015.

• Fund the ght against the three diseases – Per capita income is not a parameter to measure the scourge of inequality, poverty and their consequences inmost at risk populations, as it hides serious situations of the economic inequality and human rights violations. GF must clearly dene how it plans to contributeto ght the diseases, instead of funding countries.

• Don’t punish commitment – Disinvestment by donors in middle-income countries penalizes those that have taken up the response and increased their funding

levels. Legal and political conditions are not in place for governments to assume direct investment in civil society organizations and key vulnerable populations.The GF’s new strategy must encourage and reward national investments.

• Protect the gains – The GF’s abrupt and unpredictable exit as an investor in middle income countries’ responses puts at risk the achievements made to date.The GF should promote non-traditional sources of non-traditional sustainable resources, such as nancial transaction taxes.

• No one left behind – The GF must increase its investment in approaches and interventions related to structural barriers. The GF must adhere to the highesthuman rights standards and continue to strengthen community systems and to promote the participation of the most affected populations in the design,execution, and monitoring of its programs.

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ICASO/ICSSCS input into GF strategy development: Summary report of recommendations from April 29 kick off meeting, Amsterdam, ICAS0/ICSS – April 29 2015http://www.icaso.org/les/cs-input-into-global-fund-strategy-development-summary-report-of-recommendations-from-april-29-meeting-amsterdam

The Global Fund Summary Report: Pre-Meeting of the Community and Civil Society Constituency, Addis Ababa Partnership Forum, May 5-9 2015http://www.globalfundadvocatesnetwork.org/wp-content/uploads/2015/04/Summary-Report-Pre-Meeting-Addis-04-6-Final-Version.pdf

Communities Delegation, the Developing and the Developed Countries NGO delegationsPriorities in discussing the new Global Fund 2017-2021 Strategyhttp://www.globalfundadvocatesnetwork.org/wp-content/uploads/2015/04/Position-Paper-Strategy-Development-6-May-2015.pdf

Women 4 The GF Advocacy Brief Prioritizing Gender in the Global Fund strategy 2017-2012http://women4gf.org/2015/05/advocacy-brief-on-women-and-girls-for-the-new-global-fund-strategy-2017-2021/

Open Society Foundations (OSF)Solidarity Sidelined: Is there a future for human rights-driven development assistance for health at the Global Fund? Brieng Paper #1

http://www.opensocietyfoundations.org/brieng-papers/solidarity-sidelined Access to Medicines and the Global Fund Brieng Paper #2http://www.opensocietyfoundations.org/brieng-papers/access-medicines-and-global-fund

The Global Fund at a Crossroads: Informing advocacy on Global Fund efforts in human rights, support to middle-income countries, and access to medicines –Meeting Reporthttp://www.opensocietyfoundations.org/brieng-papers/global-fund-crossroads

Communities Delegation and Eurasian Harm Reduction NetworkReport on Key themes and positions on the Global Fund Strategy 2017–2021 as stated by civil society representatives from Eastern Europe and Central AsiaMoldova July 13-14, 2015http://www.harm-reduction.org/library/key-themes-and-positions-global-fund-strategy-2017%E2%80%932021-stated-civil-society-representatives

Communities Delegation of the BoardThe Global Fund That We Wantwww.globalfundadvocatesnetwork.org/wp-content/uploads/2015/04/Final-Communities-Delegation-and-GFAN-AP-Statement-on-Global-Fund-Strategy-15.06.2015.pdf

Eurasian Coalition on Male HealthECOM’s Position Statement in relation to the Strategic Priorities of the Global Fund to Fight AIDS, Tuberculosis and Malaria for 2017-2021http://ecom.ngo/ecom-position-global-fund-new-strategy/

Meeting reports and other relevant links


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International Women’s Health CoalitionCommunity Consultation on Gender Equality and the Global Fund to Fight AIDS, Tuberculosis and Malaria June 2015

Free space processObservation, concerns and recommendations for the Global Fund Board considerations in the new Global Fund Strategy development process, September 2015

Other:Statement of the Latin American Civil society on the Global Fund´s new strategy to Fight AIDS, TB and Malaria (GF)

Call to Action Second Latin American and Caribbean Forum on the Continuum of HIV Care: “Enhancing Combination HIV Prevention to Strengthen theContinuum of Prevention and Care” Rio de Janeiro, Brazil, 18-20 August 2015.https://onusidave.wordpress.com/2015/09/08/call-to-action-second-latin-american-and-caribbean-forum-on-the-continuum-of-hiv-care-enhancing-combination-hiv-prevention-to-strengthen-the-continuum-of-prevention-and-care/

Make The Global Fund money work for young key populations in Asia and the Pacic

A Joint Statement of youth-led and youth-serving organizations working with and for young key populations in Asia and the Pacic

Documents

Global Fund Strategy: Summary of civil society asks (updated Sep 2015)