The Global Fund: A Champion for Gender Equality

The Global Fund: A Champion for Gender Equality

For over 14 years, the Global Fund has been a gender equality champion. In this article, we interviewed Rukia Mannikko (Technical Advisor, Gender, in the Community Rights and Gender Department of the Global Fund) to talk about the way in which the Global Fund’s approach evolved over time and the importance for ending HIV, TB and malaria.

What is the place of gender equality in the Global Fund’s work?

“Efforts to advance gender equality, gender equity and addressing human rights barriers in the context of HIV, TB and malaria, have been embedded throughout the work of the Global Fund, including in the design and operationalisation of grants.

The Global Fund approach has evolved over time, starting with a stand-alone gender equality strategy that was adopted in 2008 to affirm the Global Fund’s commitment to encourage a positive bias in funding programs and activities that address gender inequalities and strengthen the responses to the three diseases for women and girls.

Following implementation challenges, the Global Fund in 2011, renewed its commitment to the continued support of gender-responsive, evidence-based programming that achieves impact, including the promotion of reporting using age- and sex-disaggregated data, and also affirmed a renewed focus on women and girls.

A gender equality action plan to support implementation during the 2014-2016 new funding model period was further developed and focused on:

  1. Ensuring that the Global Fund’s policies, procedures and structures effectively supported programs that addressed gender inequalities;
  2. Establishing and strengthening partnerships that effectively supported the development and implementation of programs that addressed gender inequalities and reduced women’s and girls’ vulnerabilities, provided quality technical assistance, and built the capacity of groups who were not participating in Global Fund processes but should be;
  3. Development of a robust communications and advocacy strategy that promoted the Gender Equality Strategy and encouraged programming for women and girls and men and boys; and
  4. Provision of leadership, internally and externally, by supporting, advancing and giving voice to the Gender Equality Strategy.

Complementary to the Gender Equality Strategy is the Sexual Orientation and Gender Identity Strategy which guided the Global Fund’s work when it comes to addressing the unmet health and human rights needs of SOGI priority populations.

Within the current 2017-2022 Strategy, gender equality is positioned within a stand-alone strategic objective focused on “promoting and protecting human rights and gender equality”.

In the new 2023- 2028 Strategy, the Global Fund’s approach to gender is bolder and more ambitious. Our strategy vision emphasises the need to ensure equitable health for all, and our mission contains an explicit ambition to reduce health inequities – for which gender equality is critical. Specifically, our new strategy commits to:

  1. Scaling up comprehensive programs and approaches to remove human rights and gender-related barriers across the portfolio;
  2. Supporting comprehensive SRHR programs and their strengthened integration with HIV services for women in all their diversity and their partners;
  3. Advancing youth-responsive programming, including for AGYW and young KVPs and their partners;
  4. Deploying quantitative and qualitative data to identify drivers of HTM inequity and inform targeted responses, including by gender, age, geography, income and for KVPs; and
  5. Leveraging the Global Fund’s diplomatic voice to challenge laws, policies and practices that limit impact on HTM.

We are particularly excited to take forward our work on supporting comprehensive SRHR and better integrating it with our work on HIV. This is because supporting women to realise their sexual and reproductive health and exercise their rights is fundamental to gender equality and can be truly transformative, giving women control over their bodies, lives and futures.

In addition, recognising that more work needs to be done to better address gender-related barriers and advance gender equality in our grants, we are in the early stages of developing a Gender Equality Marker to help us more systematically assess the extent to which our grants or are not working to advance gender equality.”

Interested to know what programmes the Global Fund has to advance gender equality? Go here.

Can you highlight your greatest achievements/results?

“With the 2017-2019 grant cycle, the Global Fund launched an innovative matching funds program in HIV grants in 27 countries. Eligible countries could access additional funding to address human rights barriers, and increase/strengthen HIV prevention for key populations and adolescent girls and young women (AGYW) if they matched the amount with funds dedicated in their allocation. This unique funding mechanism used US$55 million dollars to catalyse an additional US$120 million dollars in programs to reduce the HIV incidence rate, unintended pregnancies, and violence for AGYW in the 13 priority countries.

Catalytic investments enabled the launch of a bold initiative called “Breaking Down Barriers”, where countries fund programs to remove human rights-related barriers to health services for women and girls and other key and vulnerable populations. Twenty focus countries research and quantify the barriers to services, who are affected by them, and what it will take to overcome them and develop a national plan. In many countries, the human rights investments went to interventions to address the barriers to services faced by key populations, girls and women.

The Global Fund is continually working to improve countries' capacity to know their epidemics with investments in Health Management Information Systems (HMIS) and encouraging the use of sex and age disaggregated data. The organisation has set a target that by the end of 2022, at least 32 of a cohort of 51 countries will have 80% of health facilities reporting for a combined set of sub-indicators and functional HMIS. The organisation also set a target to ensure that countries were reporting on the required sex and age disaggregation across the three diseases. Increasingly,  countries have been able to report all required and relevant sex and age breakdowns. This has improved the ability of countries, and the Global Fund, to know which populations are at increased risk to HIV, TB and malaria and invest accordingly.

UNAIDS finalised and disseminated the HIV Gender Assessment Tool (GAT) in 2014 and is supporting the process in more than 50 countries. An updated version of the GAT was relaunched in February 2019. The GAT supports a comprehensive process to identify the needs of women and girls in all their diversity and in the context of HIV at the country level. Countries use the compiled and analysed information to elaborate and review strategic planning processes, increase the capacity of women’s organisations, and leverage political commitment to address these needs. In many cases, the GAT informs both the National Strategic Plan and the Global Fund country dialogue and funding applications.

Our strategy vision emphasises the need to ensure equitable health for all, and our mission contains an explicit ambition to reduce health inequities – for which gender equality is critical.

To support countries to identify gender and rights-related risks and barriers to services, the Global Fund supported the Stop TB Partnership to undertake community, human rights and gender (CRG) assessments in priority countries as part of a broader “Finding the Missing Cases” initiative.

With the RBM Partnership to End Malaria, the Global Fund developed and piloted the Malaria Matchbox – an equity assessment tool to determine who is being left out of malaria services, and how to better reach them. The Malaria Matchbox Toolkit, launched in 2019, was a ground-breaking advancement toward understanding human rights and gender-related barriers to malaria services. In 2021 it served as the foundation for relevant activities under the Human Rights Strategic Initiative (HR SI), which, for the first time, includes a malaria component, implemented in close partnership with RBM Partnership to End Malaria (RBM). It focuses on building capacity to identify vulnerable and underserved populations and on designing programmatic approaches and interventions to address inequities in access to malaria services. As part of this work, RBM’s pool of technical assistance (TA) providers was expanded to include new CRG-focused consultants, providing short-term TA to support the design and implementation of evidence-informed interventions that address human rights and gender-related barriers to malaria services.

Since 2014, the Global Fund Risk Assessment has included Human Rights and Gender Risk indicators as part of the broader programmatic risks to the Global Fund grants. However, the broad definition of human rights and gender risks, and limited guidance to Country Teams on how to use the indicators to measure those risks in their portfolios, often led to the tokenistic and ineffective use of the risk indicators. This resulted in a failure to accurately identify and develop clear and programmatic mitigation measures against human rights and gender risks. Together with the Risk Department, the definition of human rights and gender risks was revised in 2021 and new human rights and gender risk indicators were developed. These indicators will help country teams objectively measure the underlying factors that contribute to human rights and gender risks. The human rights indicators were piloted in the 25 top Risk Portfolios in 2021. This work is particularly important in a context where gender and human rights risks have increased due to COVID-19.”

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