This quarterly update covers the period July – September 2019 and will look at the Global Fund replenishment, Universal Health Coverage, key populations, changes to the modular framework and HIV2020.
Global Fund replenishment is looking very positive. For the next three-year period, Germany has pledged €1 billion, a 17.5% increase; Italy has pledged €161 million; India US$ 22 million and Norway around US$ 220 million, making them the most generous per capita. On a recent Global Fund Advocates Network (GFAN) call, Peter Sands (Global Fund Executive Director) said that they were in sight of reaching US$1 billion from the private sector. Although the final amount will not be clear until the Replenishment Conference (9th-10th October in Lyon), it is looking very positive for the Global Fund to reach or surpass its $14 billion target. A successful replenishment should mean that funding for key population programmes continues to be available within grants and through the Community, Rights and Gender Strategic Initiative (CRG SI). With a number of countries planning to submit proposals in window one, sex workers need to be engaging with their CCMs now to ensure rights-based programmes for sex workers are included in the proposals.
The Political Declaration from the UN High Level Meeting on Universal Health Coverage (UHC) last week was weak, failing to recognise key populations or name them specifically. Some opposition was expected from conservative governments, but there was also a lack of support from many international NGOs. The Global Fund is positioning itself as a key partner in the roll-out of UHC and need to be strong advocates for the inclusion of sex workers and other key populations. It was disappointing to see the Global Fund press release applauding world leaders on their commitment to UHC. For sex workers, and other key populations, that commitment is not there.
The Global Fund continues to work to keep focus on key populations within grants, as a part of catalytic investments and within the Global Fund Secretariat. The CRG team continues to work hard at encouraging Global Fund Health Advisers and country teams in grant management to focus more effort on inclusion of key populations. This has to be the right way forward as it is not productive for all key population issues to be the sole prerogative of the CRG Team. For sex workers, this means continuing to build relationships with Fund Portfolio Managers. It was made clear during the recent GFAN call that key populations are central to the Global Fund pitch to potential donors, and it was emphasised that they will encourage countries to increase their investment in key population programmes in grants as well as catalytic investments. Whilst this is good to hear, it is not without risk. One of the strengths of the CRG SI is their understanding of key population issues, but if increased grant investment brings with it the need to involve a broader range of actors, who may not share the same understanding, this might lead to misunderstandings and poor decision-making. It is important that sex workers build country-level partnerships with the CCM, Principal Recipient and the FPM and country teams. Constructive relationships can mitigate against any misunderstandings.
The Global Fund Modular Framework Handbook, used by countries to develop their proposals to the Global Fund, has been reviewed and modified for the next allocation period (2020-2022). The Handbook is used by the Global Fund to organise programmatic and financial information for each grant throughout its life cycle, from the initial funding request to grant-making and implementation. It can be accessed here.
Under the Prevention Module, PrEP is a key intervention for sex workers, MSM and people who use drugs. This does raise concerns because not all of our community is convinced about the efficacy of PrEP or the credibility of existing research, and the risk that countries will invest in PrEP at the expense of other prevention approaches. This is not to making the case for or against PrEP, but to encourage you to be aware and to ensure that other prevention methods for sex workers are included in proposals to the Global Fund.
There has been great support for HIV2020, to be held in Mexico as an alternative gathering to AIDS2020 (which will take place in San Francisco and Oakland in the USA). Peter Sands referenced HIV2020 during the GFAN call and it is expected that the Global Fund will be present in Mexico.