INTEGRATING GENDER INTO THE NEW FUNDING MODEL OF THE GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS, AND MALARIA

JUNE 2014 United Nations Development Programme

Together we can…

Index

        Gender perspective in the response to HIV, TB and malaria

Understanding the NFM

Integrating Gender into the New Funding Model/checklist Q&A Supporting tools for integrating gender into the NFM and NSPs (UNDP’s “On course”; Whatworksforwomenandgirls.org; UNAIDS’ gender assessment tool; and UN Women, et.al. gender and HIV indicators) Q&A Experiences of integrating gender into GF processes, including W4GF Final Q&A

Gender equality and HIV

Gender & HIV: key facts

 The number of new HIV infections among adults in low and middle-income countries in 2012 was 30% lower than in 2001.

 Still, HIV is the leading cause of death for women of reproductive age: every minute, 1 young woman acquires HIV.

 52% of all PLHIV in low and middle income countries are women rising to 58% in sub Saharan Africa  New infections among women are rising in Europe and Central Asia and the Middle East and North Africa.

UNAIDS Global Report. 2013

Gender and HIV (2)

 Though data remains scarce, evidence suggests that women from key populations are particularly vulnerable to acquiring HIV  Women living with HIV also face a heightened risk of cervical cancer  Unequal gender norms undermine effective HIV responses for men as well as for women  UNAIDS; Francheschi, S. and Guglielmo, R. (2010). The prevention of cervical cancer in HIV-infected women. AIDS, 16: 2579–2580.

Gender and malaria

Gender, TB and malaria

    In 2012, about 2.9 million women contracted TB,  410,000 women died of TB  more than half of TB cases among women went undetected, compared to less than 40% among men. were 50% of PLHIV who died of TB were women In 2012, pregnant women were four times more likely to acquire malaria than other adults In many contexts, men decide who can seek treatment and care for malaria. Lack of female health care workers often limits women’s access to treatment and care  PLHIV are at high biological risk of contracting malaria. This rises to a severe risk for women with dual HIV and malaria WHO, Fact Sheet on gender and TB

Women and TB

Some relevant gender policies

   

Gender Equality Strategy of GF

(2008) and

Action Plan

(2014)

Information note on gender for GF

UNAIDS

Agenda for Accelerated Country Action for

Women, Girls, Gender Equality and HIV UNDP

Gender Equality Strategy 2014-2017

Global Fund New Funding Model

Principles of the new funding model

Principles of the new funding model

• Bigger impact: focus on countries with the highest disease burden and lowest ability to pay, while keeping the portfolio global • Predictable funding: process and financing levels become more predictable, with higher success rate of applications • Ambitious vision: ability to elicit full expressions of demand and reward ambition • Flexible timing: in line with country schedules, context, and priorities • More streamlined: for both implementers and the Global Fund

living with and affected by HIV, TB and malaria

http://www.theglobalfund.org/en/events/2014-04-02_Regional_Meeting_Ecuador/

What does country dialogue entail?

Country Dialogue The term used by the Global Fund to refer to the ongoing discussion that occurs at country level to prioritize how to fight the three diseases and strengthen health and community systems

Country owned process

Ongoing Country Dialogue

Govt-led CCM led PR-led CCM/PR-led

National Strategic Plan

determined by country

Concept Note Grant-Making Grant Implementation

3 years *Country dialogue is a country-owned, on-going process that should include the

meaningful participation of women, girls and key populations

http://www.theglobalfund.org/en/events/2014-04-06_Regional_Meeting_Namibia/

Who plays a role in country dialogue?

Academia Country government Other donors Global Fund Private sector Country Dialogue Technical partners Civil society/ key populations

These actors meet in the CCM, but the dialogue should expand beyond the CCM http://www.theglobalfund.org/en/events/2014-04-06_Regional_Meeting_Namibia/

Integrating Gender into the New Funding Model

Entry-points for integrating gender

Overview of the UNDP Checklist

1.

2.

3.

4/5. Strengthening of National Strategic Plans Country dialogue process Development of concept note Independent review by TRP/Determination of upper budget ceiling 6/7/8. Grant agreement *Monitoring and Evaluation

How to use the Checklist

     The Checklist provides concrete and practical guidance to integrate gender transformative components into the implementation of programmes supported by the Global Fund Strengthen attention paid to gender in the implementation of programmes supported by the Global Fund through the roll out of the Global Fund’s New Funding Model Follows the procedures set out in the NFM of the Global Fund. A gender-responsive/transformative approach requires additional actions that can transform unequal power relations and promote respect for human rights.

Available at: http://on.undp.org/xOcqd

(EN, FR, SP)

Gender Checklist for the NFM

Entry points into the NFM → → Gender-responsive M&E framework --- Gender evidence collected and documented __

M&E

→ → → → Ensure gender priorities implemented --- Ensure gender trans’ve approaches at activity level -- Include gender responsive budget Outline gender responsibilities of SSR and SRs -- ---

6/7/8. Grant making/Approval by GAC/Approval by GF 1. Strengthening the NSP

Funding for Gender Transformative HIV Programming ← ← ← ← Gender Assessment using appropriate Tools Gender data, targets and indicators Identify key priorities Develop timeline

2. Country Dialogue Process

← ← ← Involve gender stakeholders Capture recommendations of consultations Include findings from the gender analysis of NSP

4/5. Independent review by TRP/Determination of upper budget ceiling 3. Concept Note

← ← ← Capture gender analysis of NSP Define gendered impacts of HIV, and impact of GBV Strong gender-sensitive proposals    Monitor Fund Portfolio Managers Keep stakeholders informed of outcomes Set out activity costs and funding for gender

Example 1: country dialogue

2.



Alignment of the Global Fund’s process to existing country dialogue

The process is built on broad and comprehensive representation of participants, including government, civil society, and women living with HIV and key populations  The dialogue is designed and implemented to reflect a broad range of perspectives, including those of people living with and affected by HIV and key populations, with specific attention to women and girls  Gender dimensions reflected in the report of the dialogue – including analysis of the gender dimensions of disease and recommendations

Example 2: concept note

3. Design and submission of a concept note

 Gender assessment/analysis is completed  The concept note includes recommendations for improving attention to gender dimensions of the three diseases  An investment case has been made for integrating gender-responsive programming into NSP  Explicit attention has been paid to addressing the needs and rights of women and girls  Concept note has focused on gender inequality influencing vulnerabilities of women and men, girls and boys & key populations  A gender sensitive approach has been used in policies and plans for prevention, treatment, care and support  Linkages between GBV and HIV are addressed based on bidirectional understanding of HIV and GBV as causes and consequences as one another

Lessons learned from Zimbabwe

    The country was also able to organize a pre-country dialogue “women’s caucus” meeting and a consultation with female sex workers.

They were able to identify priority issues for women and girls to be taken into consideration during the country dialogue meeting. There also was an enabling environment, such as the national HIV strategic plan which recognizes gender and gender based violence as priority issues.

Women’s representatives were part of the core team developing a concept note.

Questions and comments?

Key resources

Key Resources

     On Course: Mainstreaming Gender into National HIV Strategies and Plans UNDP. Available at: http:// on.undp.org/xOcTL (EN, FR, SP)

What Works for Women and Girls

( whatworksforwomenandgirls.org

) Gender assessment tool for national HIV responses UNAIDS . Available at: http://ow.ly/xOd1W Compendium of indicators of gender equality and HIV. MEASURE, UN Women, USAID, et.al. Available at: http://ow.ly/xOdlj Women4GF http://women4gf.org

UNDP’s “Roadmap”

A step-by-step guide to:   support efforts to systemically integrate gender issues, factors and concerns into national HIV strategies and plans develop indicators and track progress in the integration of gender issues in national HIV strategies and plans Use of the Roadmap   formulate gender-responsive NSPs fine-tune and advance plans to reduce gender inequality and its effects on HIV

What is in the Roadmap?

   Specific recommendations for integrating gender equality into strategies and plans, and to monitor progress, organized in specific steps that align with a programming cycle Methods for designing and costing funding and budgeting processes, including ToRs and M&E tables Step-by-step guides to: 1.

2.

3.

4.

respond more effectively to risks of vulnerable groups identify and eliminate barriers to gender-sensitive planning and implementation design and cost gender-responsive budgets develop gender-sensitive monitoring and evaluation systems

What Works for Women & Girls

28

   Compile evidence on interventions - related to HIV outcomes - that address the needs of women and girls Translate the evidence into information that may be useful for programming Allow access to the evidence by a wide range of stakeholders

29

What Works provides:

   The broad intervention and whether the evidence base falls into “works” or “promising” The geographic spread of the intervention (regions/ countries)

References

 For each study/evaluation under the intervention: the country, date, methodology/sample size, the intervention, the outcomes and the strength of evidence (modified Gray Scale)

What Works Examples: Violence and HIV

What Works:  Community-based participatory approaches to create gender equity (Abraham et al, forthcoming – SASA; Jewkes et al., 2006; Colvin 2010).

Promising strategies:  Provision of comprehensive post-rape protocols, which include post-exposure prophylaxis and emergency contraception (Kim et al., 2009a; Kilonzo et al., 2009a)   Microfinance programs integrated with training on HIV, gender, violence (Kim et al., 2009c).

Training teachers about GBV (James Traore et al., 2004).

UNAIDS Gender Assessment Tool

UNAIDS gender assessment tool (2)

Purpose:  To assist countries to assess their HIV epidemic, context and response from a gender perspective  Identify and develop priority intervention to make HIV responses more gender transformative  Inform submissions to country investment cases and GF NFM The Tool is aligned to national processes like MTR or development of new NSP, or now to the NFM concept note development.

UNAIDS gender assessment tool (3)

STAGE 1: Preparing for the Gender Assessment of the national HIV response STAGE 2: Knowing the national HIV epidemic and context STAGE 3: Knowing the national HIV response and identifying gaps STAGE 4: Analyzing the findings of the assessment and identifying interventions for a gender transformative HIV response

Gender and HIV indicators compendium

What is the indicators compendium?

    Purpose: to provide programme managers, organizations and policy makers with a menu of gender/HIV indicators in order to:    Strengthen national and subnational stakeholders’ understanding of their HIV epidemic and response from a gender equality perspective Monitor progress towards eliminating gender-based inequities in HIV responses Monitor and evaluate programmes that address specific types of gender equality interventions in the context of HIV Divided into programmatic areas Indicators already exist Can be measured using existing data collection and information systems

Conceptual framework

Questions and comments?

United Nations Development Programme, April 2014