The Developing Country NGO constituency participated actively at the 44th Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria held virtually on 11 and 12 November 2020. We urged the Board and Secretariat to focus intensely on reversing the effects of Covid-19 on the HIV, TB and malaria response and to robustly assess the ever-evolving risks of further disruption of services for people living with HIV and affected by TB or malaria. We also called for Global Fund’s next Strategy to have Community Systems Strengthening at the core of all areas of the Strategy for 2023 and beyond, as outlined below.
Covid-19 and Business Continuity:
We commend all the Global Fund partners, especially implementers and the Secretariat for the very difficult work done in 2020. We are well aware that staff and the Executive Director are under severe stress and are approaching burnout and agree that robust reprioritisation is necessary.
However, the Developing Country NGO constituency remains concerned that the bigger picture analysis of the ever-evolving risks is not sufficient to inform and course-correct the work of the Global Fund or to allow the Board to provide oversight. While modelling that illustrates the current disruptions in HIV, TB and malaria services are available, we called for real-time evidence from countries on what the true impact and risks are. We cannot simply accept that we have lost the gains made in the HIV, TB and malaria responses.
“We are concerned that the continued focus on our response to Covid-19 as a stand-alone may be overshadowing other priorities. In the initial stages of the emergency it was necessary to respond quickly. The Board now needs to critically assess and prioritise the extent of our response to Covid-19, to ensure that we remain on track with our core mission related to HIV, TB and malaria. As we have stated before, we strongly believe that the many other social and structural barriers to us reaching our mission still exist, such as criminalisation of key populations and other human rights barriers, and our focus on Covid-19 should be primarily on mitigating the impact on the three diseases.” stated Andriy Klepikov, Board Member for the Developing Country NGO constituency.
It is critical to ensure uninterrupted service provision and programming on the ground, especially for key populations. The Global State of Harm Reduction 2020 reports that harm reduction service delivery has been disrupted by the pandemic and we must address this,
We are also concerned about the exclusion of communities and civil society in the Covid-19 Response Mechanism (C-19 RM). A survey on civil society and community engagement regarding C-19 RM worryingly shows that one third of respondents were not at all involved in the concept note drafting at all and half respondents and one third of County Coordinating Mechanism (CCM) members did not see the final draft of the application. While we note that some of the processes were conducted in haste, communities and civil society have played a critical role in the Covid-19 response, and are best placed to understand where HIV, TB and malaria resources have been disrupted. We strongly called for the Secretariat, especially the CCM hub, look into the barriers for meaningful inclusion, and to address them urgently.
Sustainability, Transitioning and Co-financing:
The Report by the Executive Director highlighted that Covid-19 has created challenges for Sustainability, Transition and Co-Financing (STC). We called for a halt to any planned transitions for countries, until the approach to sustainability has developed a new strategy and realistic plan that takes into account the new context, especially with regard to:
- Transitioning, and the impact of the economic crises most countries are facing and how this will impact their income classification and most importantly their ability to sustain the gains of the fight against the three diseases
- Ability and willingness to sustain key population services.
- Human rights and involvement of communities and civil society in decision-making
- Access to medicines and other health products and the impact of the disruptions in supply chains globally, and how this increases countries’ dependence on solidarity supply mechanisms
The Next Strategy:
The Global Fund is developing the next Strategy for 2023 and beyond, through Board consultation, an online consultation process and Partnership Forums. The Developing Country NGO constituency again reiterated that the Global Fund must maintain sharp focus on HIV, TB and Malaria and that we were not created to address the most infectious diseases, but to specifically address HIV, TB and malaria and to not extend the mandate beyond these 3 diseases.
We strongly advocated for prioritisation and investment in Community Systems Strengthening to be at the core of the next Strategy.
“At the center of the development of the next Global Fund Strategy must be Community Systems Strengthening (CSS). Before there were institutions, there were communities who organised and supported each other as we say with Covid-19. There is consensus of the need and value of community systems strengthening as a way of achieving our strategic goals. We strongly believe that we now, as a Board, need to move to addressing how we can do this,” said Carolyn Gomes, Alternate Board Member of the Developing Country NGO constituency and member of the Global Fund’s Strategy Committee.
The many ways that the Global Fund can translate its high-level support for CSS into action at country level include:
- Incentivise and support countries to request adequate resources for all aspects of community systems and response (in line with 2016 UN political declaration on ending AIDS target that at least 30% of service delivery is community-led).
- Creating indicators and targets to track coverage and outcomes for the main sub-elements of Community Systems Strengthening such as community-led monitoring.
- Making dual track financing a requirement to guarantee resources to civil society and communities, and strengthen community leadership. Where possible, resources should go to local community organisations and NGOs instead of repeatedly supporting the same international NGOs or UN partners.
- Restore regional/multi-country grants which make effective use of regional expertise and are critical for civil society to do difficult human rights-related work that will not be done by the Government partners involved and cannot be done safely by local organisations, including in non-eligible countries.
We look forward to working closely with civil society and communities as we prepare for the Partnership Forums in early 2021.
The Developing Country NGO delegation to the Board of the Global Fund is a voting constituency that represents NGOs from the developing world, serving those living with and affected by HIV/AIDS, TB, & Malaria. The delegation seeks to influence decisions and policies to ensure strategic, continuous and appropriate responsiveness to the needs of those affected by the three diseases and the NGOs providing services to them. For more information or to arrange a call or submit a letter, please contact Lesley Odendal, Constituency Focal Point, Developing Country NGO delegation, L.Odendal@developingngo.org