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Advancing Gender Equality in Global Fund

Despite increased commitments, there are still challenges in realizing gender equity in Global Fund processes. Only one funding request in the 2020-2022 allocation cycle used a gender assessment in its prioritization process.

ICW and W4GF utilized a multifaceted approach to collect information from women living with HIV interested in participating in GC7 processes.

The process encompassed technical assistance projects, interviews, and an online survey specifically tailored for women living with HIV.

To give a bit of context, we wants to highlight the pivotal role of gender equality and human rights in the Global Fund Strategy 2023-2028, as in their third objective, 'Maximizing Health Equity, Gender Equality, and Human Rights,' we know is crucial in the AIDS, tuberculosis, and malaria response. this led to a required gender assessments for country proposals and using a Gender Equality Marker to monitor progress. The goal is to integrate gender equity across all programs, from targeted health interventions to policy advocacy.

However, a recent UNAIDS-commissioned report showed us some challenges. Out of 46 funding requests in the 2020-2022 cycle, only one utilized a gender assessment. Lessons from the Technical Review Panel stress the urgent need for community engagement, especially from women living with HIV.

The idea of this report its to shed a light on the experiences of women engaging in Global Fund initiatives. The 2023 GC7 allocation period introduces new gender-focused initiatives like 'Breaking Down Barriers' to combat gender-based violence. While progress is seen in equity, consistent gender and human rights scoring indicates ongoing work is required.

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ICW and W4GF utilized a multifaceted approach to collect information from women living with HIV interested in participating in GC7 processes.

The process encompassed technical assistance projects, interviews, and an online survey specifically tailored for women living with HIV.

By July 13, 2023, a total of 81 responses were gathered from women residing in 23 countries across nine distinct regions.

ICW and W4GF employed a comprehensive approach to collect this information, encompassing technical assistance projects, in-depth interviews, and an online survey specifically tailored for women living with HIV networks. This multifaceted strategy ensured that a broad range of voices and perspectives were captured.

By July 13, 2023, we had successfully gathered a remarkable 81 responses from women in 23 countries across nine distinct regions. This impressive response rate underscores the importance of engaging women living with HIV in these processes and their strong desire to contribute their expertise and experiences.

The information gathered through this multifaceted approach will prove instrumental in shaping future GC7 processes and ensuring that the needs of women living with HIV are taken into account.

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Virtual consultations:

Data was collected from 53 respondents in 10 sub Saharan African countries including Cameroon, Eswatini, Ghana, Kenya, Nigeria, Malawi. Tanzania, Uganda, Zambia, and Zimbabwe.
The survey explored four areas: gender assessments, engagement in country processes, achieving women’s priorities, and implementation of gender transformative programmes

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Gender Assessments

Gender assessments are a critical tool for promoting gender equity in the Global Fund process.
However, they are underutilized and often lack meaningful engagement of women living with HIV.
Only 37.74% of respondents in our survey confirmed that gender analysis had been utilized during their Global Fund proposal prioritization.
Where gender assessments have been implemented, they have not consistently translated into program design improvements.

Engagement in the GC7 and Country Processes

Challenges persist for women living with HIV in their involvement within the GF country processes.
45.28% of respondents felt they were not as involved as they wanted to be in the GC7 process.
Only 24.53% of respondents expressed being very involved in country-level dialogues, and only 9.43% stated they were part of the proposal writing team.
Some of the challenges reported included lack of clarity and transparency of the CCMs, accessibility issues, financial limitations, and difficulty in advocating for increased participation of women and girls.

Gender assessments are an important tool for promoting gender equity, but they are not being used effectively. Only 37.7% of respondents in a survey said that gender analysis had been used in their Global Fund proposal prioritization process. Even when gender assessments are done, they often do not result in program design improvements.

There are also challenges to women living with HIV participating in the Global Fund country processes. Only 25% of respondents said they were very involved in country-level dialogues, and but 9% said they were part of the proposal writing team. Some women reported that their priorities were not included in the final proposals.

There are a number of reasons for these challenges, including a lack of clarity and transparency about the Global Fund processes, accessibility issues, and a lack of political commitment from stakeholders. Cultural factors can also make it difficult for women's priorities to be addressed.

Despite these challenges, there are positive examples of women being involved in the Global Fund processes. In Tanzania, the government supported the incorporation of women's issues into the Gender Inequality agenda.

More needs to be done to ensure that gender assessments are used effectively and that women living with HIV are meaningfully involved in the Global Fund processes. This will help to ensure that Global Fund programs are effective and equitable.

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Achieving Women's Priorities

Women's priorities were often not included in the final proposals, but nevertheless women made progress despite the challenges.
An early consultation led by ICW revealed common challenges among local networks, including limited engagement with required gender assessments and lack of coordination among women's efforts.
Women’s engagement in Nigeria led to the inclusion of PMTCT/EMPOWERMENT and AGYW components in the proposal, albeit with limited involvement in the writing process.
In Eswatini, women have actively participated in proposal writing and engaged in country-level dialogues, benefiting from technical assistance provided by the CRG.

Advancing Women-Led Responses in Global Fund Program Implementation

Networks of women living with HIV also reported challenges being considered as recipients of funds and in competing to implement GF funded programming.
ICW Malawi highlighted the need for improved data, gender analysis, and organizational strengthening.
ICW Mozambique requests support for women's consultation and collaboration to address these issues, along with technical assistance for Gender Analysis review and priority formulation.

what we saw is that women's priorities are often not included in the final Global Fund proposals, but there have been some successes in getting them included. For example, in Nigeria, one woman's efforts led to the inclusion of PMTCT/EMPOWERMENT and AGYW components in the proposal. In Eswatini, women have been actively involved in proposal writing and country-level dialogues.

However, there are still challenges to achieving women's priorities. Networks of women living with HIV often face challenges in being considered as recipients of Global Fund money and in competing to implement Global Fund-funded programming. ICW Malawi has highlighted the need for improved data, gender analysis, and organizational strengthening. ICW Mozambique requests support for women's consultation and collaboration, along with technical assistance for Gender Analysis review and priority formulation.

More needs to be done to ensure that women's priorities are included in the Global Fund processes and that women living with HIV are involved in implementing Global Fund-funded programs.

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Conclusions :

The Global Fund has made powerful commitments to gender equity,

However, It is more urgent than ever to prioritize women's needs within the Global Fund framework, given the rising tide of misogyny and concerns about transparency, accessibility, and representation.
Clear and transparent decision-making procedures, enhanced accessibility for all, and broader representation across all stages of engagement are essential to ensure effective participation and to elevate women's perspectives.
We must address the cycle where the lack of influence or accountability in prioritization processes has led to underfunding or deprioritization of women's programs, low rates of program implementation led by women-led responses and projects, and limited funding to prevention of vertical transmission services only.

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Recommendations :

Ensure meaningful participation of women living with HIV in all stages of the Global Fund process. This includes gender assessments, priority setting, proposal development, and implementation.
Empower networks of women living with HIV to utilize gender assessment findings to inform priority interventions and support gender-transformative initiatives.
Strengthen women's representation and voice within the Global Fund's country processes. This includes addressing barriers such as language constraints, limited internet access, and financial constraints.
More research is needed in the active participation of women living with hiv in the GF processes.

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