fight against TB Momentum grows among advocates to end tuberculosisWashington, D.C. (Mar. 24) – World Tuberculosis (TB) Day, observed March 24th each year, comes with growing momentum among advocates to eradicate an ancient disease that continues to impact millions of people throughout the world. Alarmed by a steady rise in cases of drug-resistant TB (DR-TB; including multidrug-resistant TB (MDR-TB), advocates have become more targeted in their calls for greater investment in research that will lead to less toxic drugs, modern diagnostic tools, and shorter treatment regimens for people who contract the disease. These efforts are beginning to draw responses.

At the Ministerial Meeting Towards Ending TB in the South-East Asia Region, New Delhi, on March 16, 2017, anurgent call to action was signedby 11 health ministers, committing to scale-up efforts targeted at ending TB. The strongly worded document noted that TB remains the leading cause of death among all infectious diseases in the World Health Organization’s (WHO) South-East Asia Region, having claimed nearly 800,000 lives in 2015 alone.

The Community Rights and Gender (CRG) Advisory Group*, a body that provides advice to the Global Fund’s CRG Department, oversaw this independent review, which was carried out by the Community Action and Leadership Collaborative (CLAC)**, and led by MSMGF. Preliminary findings and recommendations were validated by more than 100 people through community consultations and interviews in seven countries:

Cameroon, the Dominican Republic, Kenya, Moldova, the Philippines, Suriname, and Tunisia – and nineteen community key informants from Morocco, Sierra Leone, Indonesia, Armenia, Ethiopia Argentina, Tanzania Nepal, South Africa, Thailand, Costa Rica and Tunisia.

$55 million in catalytic funding is available to support HIV programmes among adolescent girls and young women in 13 countries
For the first time, gender equality is included as a top-line strategic objective in the Global Fund’s Strategy (2017-2022). HIV prevention among adolescent girls and young women (AGYW) in sub-Saharan Africa will be a strong focus for the Global Fund in the coming funding cycle (2017-2019).

This is something that the African constituencies strongly pushed for. The number of new HIV infections among AGYW remains exceptionally high, especially in sub-Saharan African countries. UNAIDS estimates that there were 450,000 new HIV infections among AGYW (15-24) in 2015 – that’s 8,600 new infections each week. In East and Southern Africa – the hardest hit region – HIV prevalence is 3.3% among young women (15-24), compared to 1.6% among their male peers. This disparity is strongly linked with social and structural factors, including gender inequality and gender-based violence.

New and ambitious global targets require greater HIV prevention efforts among AGYW. The 2016 United Nations Political Declaration on Ending AIDS sets a specific target to reduce new HIV infections among AGYW to fewer than 100,000 by 2020 – a 75% reduction from 2010.
“We are at a pivotal moment for women and girls everywhere,” said Heather Doyle, Senior Technical Advisor on Gender at the Global Fund. “In this environment, it is imperative that we in the global health community demonstrate measurable progress in our work to target women and adolescent girls.”

The initiative will expand access to technical assistance during the 2017-2019 grant cycle

The Global Fund will invest $15 million over the next three years (2017-2019) to bolster community responses, human rights and gender equality in its grants. The Board has approved this funding for a Community, Rights and Gender (CRG) Strategic Initiative, building on progress made in strengthening engagement of civil society and community groups in Global Fund processes through the first CRG Special Initiative for 2014-2016 (see GFO articles here and here). The Global Fund’s Special Initiatives have been rebranded as “Strategic Initiatives” for the coming grant cycle.

The anticipated impact for the CRG Strategic Initiative from 2017-2019 will be to:  

  • Strengthen the meaningful engagement of community and civil society in Global Fund processes across all stages in the grant cycle.
  • Better reflect civil society and community priorities in concept notes, transition planning and related national strategies.
  • Provide greater emphasis on evidence-informed and rights-based programming demonstrated in Global Fund grants.
  • Identify the critical technical assistance needs of community and civil society key stakeholders.
  • Strengthen community and civil society’s capacity to design and deliver quality technical support.

The CRG Strategic Initiative for 2017-2019 will have the same three components as the 2014-2016 CRG Special Initiative: technical assistance (TA) programs, capacity-building of key population networks on Global Fund processes, and regional civil society and community communication and coordination platforms. It is not yet known if the same technical assistance providers, regional platform hosts and key populations networks will continue on as partners for the new CRG Strategic Initiative.

There will be a lot more funding for strategic initiatives and multi-country programs

The Global Fund Board has approved $800 million to be set aside for catalytic investments over the 2017-2019 grant cycle. These investments are intended to catalyze country allocations to ensure they deliver results against the aims of 2017-2022 Global Fund Strategy.

The 2017-2019 allocation methodology provided for “up to” $800 million to be spent on catalytic investments, meaning it could be less, depending on available funds. Following the success of the Fifth Replenishment in Montreal in September, where nearly $13 billion was pledged, the Global Fund’s Strategy Committee recommended to the Board that the full $800 million be made available for catalytic investments.

Catalytic investments will have three distinct modalities: (1) matching funds, (2) multi-country approaches and (3) strategic initiatives.

  • Matching funds are intended to incentivize the programming of allocations towards key strategic priorities, including for key and vulnerable populations, human rights, data strengthening, among others. Matching funds will be awarded at the time of funding request review.

  • Multi-country approaches will target a limited number of key, strategic multi-country priorities deemed critical to meet the aims of the Global Fund’s 2017-2022 Strategy. These approaches will include those which are unable to be addressed through country allocations alone.  

  • Strategic initiatives will provide limited funding for centrally managed approaches that cannot be addressed through country allocations due to their cross-cutting nature, or because they do not align neatly with grant cycles. These initiatives are deemed critical to ensure country allocations deliver against the Global Fund’s 2017-2022 Strategy.

Workshop held at Amber Hotel in Nairobi Kenya, from the 24th-25th October 2016On 24th and 25th October 2016, civil society and community groups from Anglophone African countries gathered in Nairobi Kenya at Amber Hotel for a training workshop for the Shadow Report and Scorecard Initiative and to improve the Transparency and Accountability of Country Coordinating Mechanisms (CCM) in Africa. This is a joint initiative between EANNASO (As the Anglophone Africa CRG Platform) and AIDS Accountability international AAI. Participants were also encouraged to share experiences on role of civil society in holding CCMs and decision makers accountable.

The civil society CCM shadow assessment will not duplicate the Global Fund supported Eligibility and Performance Assessments (EPAs). This is because whilst EPAs are consultant-facilitated self-assessments of CCMs that are largely driven by the Global Fund to facilitate accountability using a top down approach, the shadow CCM assessment will be undertaken by the civil society in country. Hence, they will help to improve CCM accountability using a bottom-up approach.

Nine countries were selected from Anglophone Africa to attend the training to pilot the CCM Scorecard shadow reporting initiative. These countries are: Ghana, Kenya, Nigeria, Swaziland, Tanzania, Uganda and Zambia, Rwanda and Malawi.