Global Fund Quarterly Update 2, 2019

The Global Fund continues to prepare for the 6^th Replenishment meeting that will be hosted by the French Government in Lyon on the 10^th October 2019.

As reported in the last update, the German Government had increased their pledge to €40 million. There is further good news as the United Kingdom has announced they will also increase their Global Fund contribution to £1.4 billion over the next three years. This amounts to £467 million annually and is a 16% increase in previous contributions. This is an encouraging sign and it is now thought the Global Fund will reach their replenishment target of $14 billion. This is welcome news for sex workers as it means that funding for the Community Rights and Gender (CRG) Strategic Initiative and Catalytic Funding, the main sources of financial support for sex workers in addition to the country grants, are unlikely to see a reduction. However, sex workers should continue to focus on impact; funding support from the Global Fund will not continue unless it can continue to be shown that sex workers are having an impact on the diseases.

To assist support at country level, the Global Fund and UNAIDS have signed a new strategic framework. This new agreement highlights critical areas for enhanced collaboration between the two agencies including HIV prevention and treatment access, community-led service delivery, gender, rights and community engagement and a special focus on West and Central Africa. For sex workers, it is too early to say if this new arrangement will have a significant impact in the support available at country level. UNAIDS is going through change at the moment, with a new Executive Director soon to be appointed and medium-term financing issues to be resolved. Support for sex workers from UNAIDS varies from country to country, but this new framework should add weight to your requests for support, especially around facilitating sex worker engagement in key policy and decision making fora. Conversations with your Fund Portfolio Manager (FPM) and UNAIDS Country Offices should help maximise benefits this new framework offers for sex worker engagement in processes and decisions affecting sex workers’ lives and health.  

The Global Fund are also preparing to introduce revised funding request forms, including changes to the form template and application material. Countries will now be expected to submit an Essential Data Table; this is pre-filled by the Global Fund Secretariat and countries will be expected to update and fill in any gaps in data. For sex worker-led organisations, the table includes population size estimates, but nothing to indicate how much criminalisation impedes access to services. The forms, particularly the Transition form, require narrative sections on the situation in-country, and this must include challenges to implementation of key population programmes and human rights and age-related barriers and disparities. These are areas to be aware of to ensure who ever represents sex workers in the proposal writing team has all the necessary information relating to sex workers. In the guidance documents, the Global Fund states wording in proposals “must focus or must include as appropriate interventions that respond to key populations, human rights and gender vulnerabilities”. This raises the question of when these types of programmes are not ‘appropriate’. This could be used to exclude programmes for sex workers as ‘not appropriate’ in particular settings.  

Finally, the 41^st Global Fund Board Meeting was held in Geneva between 15-16^th May. Key decisions that have relevance for sex workers were:

• Approval of the updated allocation methodology, used to determine the allocations for countries for the 2020-2022 period. $800 million will be used to scale up effective programmes. The Strategy Committee was instructed to approve a method by which the Global Fund Secretariat will apply and report on qualitative adjustment, including the use of disease incidence.
• The Board approved the revised set of priorities for Catalytic Investment. Within that decision, and dependent upon the result of the replenishment, were 5 different scenarios ranging from $200 - $900 million available for Catalytic Investments. The funding for CRG Strategic Initiative is in all the scenarios, adjusted depending on the replenishment.
• There was a decision to agree the changes to the Restricted Financial Contributions Policy. This is the policy that allows a donor to “choose” where a part of their contribution can be targeted, within a strict framework. This is part of a process of registering programmes under ‘Unfunded Quality Demand’. This policy potentially allows donors to direct some of their contributions based not on need but on other reasons, and could be used to exclude sex worker programmes (although this has not happened so far).
• Approval of the 2018 Annual Report;
• Appointment of KPMG SA as external auditors;
• Appreciation of the outgoing Chair and Vice Chair, Aida Kurtovic and John Simon.

The Global Fund Board instructed the Secretariat to prioritise funding for key populations, adolescent girls and young women (AGYW), and harm reduction when considering Catalytic Investments. Although this is a good thing for sex workers, there is no information as to how the Secretariat will monitor and implement this guidance.

Under Qualitative Adjustment, the Global Fund Board supported HIV incidence as an "important metric both generally and particularly in key and vulnerable populations and context where human rights are declining”. The Board also stated there should be an increased focus on prevention needs for key populations and AGYW, and the size estimates and incidence rates of these populations.