Key Population’s experience on the Global Fund’s New Funding Model

The African Men for Sexual Health and Rights (AMSHeR) has today released the results of a survey tracking the inclusion of constituencies representing gay men and other men-having-sex-with-men (MSM), sex workers and people living with HIV (PLHIV) in key aspects of the Global Fund’s New Funding Model.

Results of an AMSHeR Survey Show That More Effort is Needed to Achieve Full Inclusion of Key Populations in the Global Fund’s New Funding Model

“While the survey results show that there has been important progress to include MSM, sex workers and PLHIV in the New Funding Model, we are still a long way from seeing the critical health needs and human rights priorities for these groups included in Global Fund budgets and work plans at country level,” said Kene Esom, Executive Director of AMSHeR.  “These results are very important as they also guide us in terms of what still needs to be done to achieve full inclusion of health and human rights priorities for key populations in Global Fund investments across the African region,” he continued.

The survey findings were based on questionnaires submitted by 30 respondents representing key population constituencies in 13 Anglophone and francophone countries which are part of the AMSHeR network.

The survey sought to capture the experiences of key population constituencies in the region-wide roll-out of the Global Fund’s New Funding Model.  As part of the model, the Global Fund made express commitments to more fully include the health needs and human rights priorities of key populations within the context of national HIV programmes supported through Global Fund grants.  The survey measured the extent to which these commitments were fulfilled for the perspective of key population constituencies in selected countries where AMSHeR member and affiliated organisations were located across the African region.

“The survey tells us that although groups representing the needs of PLHIV, MSM and sex workers were at the table during the country dialogue process in most countries, their critical health needs as well as human rights challenges were not fully reflected in specific activities and budgets in the finished concept notes that  were submitted,” said Mr. Esom.  “While it is important to recognize this important progress towards inclusion, in some countries we have not yet moved beyond tokenism,” he continued.  “Until we see specific activities and budgets linked to critical health needs and human rights priorities in Global Fund submissions, we cannot say that the main goals of the New Funding Model in relation to the health and human rights of key populations have been met.”

Survey respondents identified barriers to full inclusion. The existence of punitive laws and policies meant that groups representing MSM or sex workers, for instance, were not considered to be legitimate and, therefore, not invited to participate in country processes around the New Funding Model.  Government stakeholders, in particular, were extremely reluctant to acknowledge or support inclusion of specific items addressing health needs and human rights priorities for key populations, often citing population-wide religious or cultural beliefs as the reason for their exclusion, or the lack of comprehensive evidence to justify these specific requests.  In such situations, key population representatives felt that they were included simply to meet a Global Fund requirement and not to have their issues acknowledged and addressed in country-level HIV programmes.  Finally, some organisations themselves lacked sufficient capacity to advocate for full inclusion of their constituencies’ needs and priorities, largely because they had limited knowledge of, and had no previous experience in Global Fund processes.

On the positive side, the results made clear that where there was targeted support from technical partners, such as UNAIDS, specifically to enhance key population inclusion; where there were enabling laws and policies; and where there was previous Global Fund experience, there were stronger results, including specific activities and budgets in concept notes related key population needs.

“I think it is important to mention that the results of the AMSHeR survey align with the findings of the Global Fund’s Technical Review Panel regarding the first year of the New Funding Model roll-out,” commented Dr. Steave Nemande, AMSHeR’s HIV and Health Systems Specialist.  “They too noted that although there was more evidence of participation of key population constituencies in country dialogue processes, for instance, there was very little specific continent in the concept notes that were submitted that directly addressed what key populations need to reduce their vulnerability to HIV infection and to improve their health and well-being.”

The findings of the survey point to a number of recommendations and next steps.  “Clearly at country, regional and global levels, we need to see stronger commitment towards including key populations in Global Fund processes and that commitment needs to be measured in terms of increases in the number of countries offering programmes and services specific to key population needs,” said Mr. Esom.  “Only when this occurs will we be able to say that full inclusion in the New Funding Model has been achieved.”

AMSHeR intends to use the results as the basis for scaling-up its regional and global level advocacy with the Global Fund and other partners.  The aim of this is to increased financial and technical support for greater inclusions and for addressing key population needs and priorities through country-specific Global Fund investments.

Click here to read the The full survey report

Contact:  Kene Esom, Executive Director

+27 11 242 6800/+27 72 889 7810