Global Fund Quarterly Update 4, 2019


The 42nd Global Fund Board Meeting took place 14th-15th November, and included some important items for sex workers to consider.

The Communities Constituency Statement highlighted the ‘immense disappointment’ regarding the lack of mention of key and criminalised populations in the UHC Declaration, made during the High Level Meeting in September this year. It stressed the importance of ‘putting the last mile first’ and, as the Global Fund gave public support to the Declaration, called for the Fund to be a champion for the implementation of an accountability framework.

The statement made the following key points on Global Fund Strategy development:

  • The Board should lead and direct the process, not the Secretariat
  • The Communities Delegation must be members of the Strategy Committee who will lead the process. From the Secretariat guidance, it is unclear who is leading the process
  • The Partnership Forum a must be held at an appropriate time to influence and inform the strategy discussions.

The Statement supported an increase in the Secretariat operating expenses (OPEX) but called for flexibility within this for the CRG Department to support the Partnership Fora and strategy development. These issues are important for sex workers and other communities as they are about ensuring we have a voice in the most important discussions, and that the CRG Department is properly resourced.

The statement commented on (the Global Fund’s online procurement platform) and supported the move to allow transitioned countries and NGOs access, but raised concerns around its value since countries can procure cheaper drugs directly from the manufacturers.

CCM Evolution: the Communities Delegation expressed disappointment that the findings missed the opportunity to learn from CCMs that function effectively, including for communities.

OIG Progress Report: the Communities Statement called for mechanisms to improve grant implementation without compromising the need for multi-country grants, which play a big role in reaching communities (especially those marginalised by things like criminalisation and stigma).

The delegation also challenged the Fund on its statement on Sustainability and Transition: “The Global Fund’s ability to influence these challenges will remain inherently limited” referring to political will and policy decisions. It is clear that influence can happen through supporting CSS and investing in community advocacy, and this point was clearly made.

Board decisions of interest to sex workers were the US$12.11 billion, allocated for grants with an extra 0.60 billion to be added prior to determining country allocations. It is really important that sex workers start mobilising now, engaging in country dialogues, preparing submissions to the proposal writing teams, building partnerships and engaging with CCM representatives for countries eligible in windows 1 and 2.

The other relevant Board decision relates to the selection process of Strategy Committee membership for the development of the Strategic Plan. The Communities message was heard and the modified selection process means it is very likely Communities will have a seat on the Committee at a time of development.

Peter Piot’s speech laid out 10 points on “setting the scene” to start the new strategy discussions:

  • The need to take a long-term funding view and not just think in terms of 3-year replenishment cycles
  • The Global Fund should focus on its core mission and not be side-tracked, because this is what has made it successful.
  • Partnerships are essential. The Global Action Plan must work for people on the ground.
  • Invent a ‘stress test’ to see if programmes promote UHC
  • Be more explicit about what sustainability means
  • Transition should consider more than GNI and GDP, perhaps using a sustainability framework
  • Special attention must be given to those left behind – UHC aims are the same and have to be made to work
  • Evidence-based interventions and quality of services should be non-negotiable
  • The Global Fund should embrace innovation faster
  • Increase investment in effective data collection

In the context of CCM Evolution, the failure to implement existing eligibility requirements and CCM policies was raised many times. The Secretariat response was ‘how do we do that?’, which is quite extraordinary. NSWP will be following up with the Global Fund about this.

There was a lot of discussion on UHC, including in the Executive Director’s report, and this is clearly something sex workers need to be informed about. It is important to understand what it is, what it means, how your country will implement it and how you can be involved.

Finally, CSS and community-led monitoring was also discussed a lot and perhaps now is the time to really push for these to be included in country proposals.