Key harm reduction messages for the replenishment conference

In advance of the Global Fund Seventh Replenishment Conference to be hosted by President Biden in New York on September 19, 2022, the Network of People who use Drugs (INPUD), the Eurasian Harm Reduction Association (EHRA) and Harm Reduction International (HRI) developed key harm reduction messages for the Global Fund Replenishment Conference, implementation of the new Global Fund Strategy and the Global Fund’s New Funding Model (NFM4) cycle.

Harm reduction investment from international donors and governments in low and middle-income (LMI) countries totalled US$131 million in 2019 – just 5% of the US$2.7 billion UNAIDS estimates is required annually by 2025 for an effective HIV response among people who inject drugs. The Global Fund is the largest donor for harm reduction, providing at least 60% of all international donor support. The outcome of the replenishment will have significant consequences for harm reduction. The protection and scale-up of harm reduction programmes in low- and middle-income countries requires a fully funded Global Fund. An underfunded Global Fund will result in service closures, a reversal of gains made in HIV prevention among people who use drugs and ultimately, lives lost.

INPUD, EHRA and HRI urge the Global Fund and the wider donor community to be proactive in protecting harm reduction within all replenishment scenarios, in implementation of the Global Fund Strategy 2023-2028 and during the NFM4 cycle. Their recommendations centre on the following five areas:

  1. Harm reduction funding must be protected from any replenishment shortfall
  2. Catalytic investments for harm reduction and key populations must continue regardless of replenishment outcome
  3. Funding for community-led responses must be prioritised within NFM4, both for harm reduction and pandemic preparedness and responses
  4. Funding for efforts to increase domestic investment in harm reduction, and broader key population programming must be increased
  5. Funding for harm reduction in crisis must be protected and prioritised

The document with full explanation of the recommendation is available following this link>>>.

 

The Global Fund 7th Replenishment

The Global Fund raises funds in three-year cycles known as Replenishments. This year, the Global Fund are entering into Seventh Replenishment cycle, covering the period 2023-2025.

The Global Fund’s Seventh Replenishment is the world’s opportunity to rise to the challenge and take bold action. We can turbocharge progress in the fight against HIV, TB and malaria, regaining ground lost during the pandemic and getting back on track toward finally ending these three pandemics by 2030. We can also deliver a step change in pandemic preparedness, strengthening the overall resilience of systems for health by investing in their capacities to prevent, detect and respond to new health threats. By taking an integrated approach to the pursuit of these two complementary objectives, we can maximize the impact of every dollar.

(From the Investment Case for the Seventh Replenishment)

 

 

The Global Fund’s target for the Seventh Replenishment is to raise at least 18 billion USD to fight HIV, TB and malaria and build stronger systems for health. It is estimated that one-third (6 billion USD) will be investments in health systems that both support the ongoing fight against HIV, TB and malaria and reinforce pandemic preparedness.

These funds will be used to:

  • Help the world #GetBackOnTrack to end AIDS, TB and malaria as epidemics, and save 20 million lives between 2024 and 2026.
  • Reduce the death toll across the three diseases to 950,000 in 2026, down from 25 million in 2020.
  • Avert more than 450 million infections through reducing the incidence rate by 58% across the three diseases by 2026.

The civil society is coming together to celebrate The Global Week of Action.  It is co-organised by the Civil Society for Malaria Elimination (CS4ME), Global Fund Advocates Network (GFAN), GFAN Africa, and GFAN Asia-Pacific (GFAN AP), and follows the #LoveMoreGiveMore campaign carried out with partners during the Sixth Replenishment in 2019.

This Global Week of Action is hoping to mobilise communities and civil society collectively to:

  • Create momentum around the Seventh Replenishment of the Global Fund at the national, regional, and global levels through gathering communities and civil society to come together collectively through action.
  • Raise awareness through the diplomatic channels of donor embassies of the Global Fund for the Seventh Replenishment using key messages of the Investment Case presented at the Preparatory Meeting.
  • Build and/or strengthen partnerships nationally, including with donor embassies.

 

Montenegro: Benchmarking sustainability of the HIV response among Key Populations in the context of transition from Global Fund support to domestic funding

The Eurasian Harm Reduction Association (EHRA) published document “Benchmarking sustainability of the HIV response among Key Populations in the context of transition from Global Fund support to domestic funding” within the framework of the regional project ‘Sustainability of Services for Key Populations in Eastern Europe and Central Asia’. This publication was prepared by Mr. Vladan Golubović, EHRA Consultant

The aim of this analysis is to assess the fulfillment of the commitments given by the Government of Montenegro aimed to ensure the sustainability of the HIV response among KPs in the context of the country’s transition from Global Fund support to national funding. The results of the assessment are expected to be used to assist CSO’s, key affected communities and partners to remain more informed and engaged in the monitoring of the transition process from donor to domestic funding and to thereby advocate for the implementation of activities that will lead to the sustainability of the national HIV response.

This assessment was conducted using the Methodological Guide and Transition Monitoring Tool (TMT) developed by EHRA. A number of national commitments contributing to ensuring sustainability of the HIV response were identified and prioritised and subsequently analysed based on available data, as well as information from key informants. The assessment was conducted and led by two national reviewers with the support of local HIV experts and representatives of affected communities from organisations involved in advocacy and service delivery for KAPs and PLHIV (the national reference group).

The analysis is available following this link>>>.

 

Global Fund Board Approves New Strategy 2023-2028

From the EECA Regional Platform for Communication and Coordination communication

The Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria approved the new Global Fund Strategy: Fighting Pandemics and Building a Healthier and More Equitable World. The new Strategy places people and communities front and center of the fight against HIV, TB, malaria and accelerates the shift to more integrated, people-centered models of prevention, treatment and care. Strengthening the leadership and engagement of communities living with and affected by the diseases will reinforce this unique strength of the Global Fund partnership and tackle barriers to effective participation and leadership.

In addition, the Board approved the planned operating expenses (OPEX) budget of US$322 million for 2022 bringing the total OPEX investment to US$930 million for the 2020-2022 cycle to sustain achievements and transition to the new Strategy cycle, and a new global disease split for the 2023-2025 allocation methodology. At amounts for country allocations up to and including US$12 billion, the split of 50% for HIV, 18% for TB and 32% for malaria will be applied. A new split of 45% for HIV, 25% for TB and 30% for malaria will be applied to additional amounts above US$12 billion.

The Board also approved the new model for the Global Fund Independent Evaluation Function which establishes an Independent Evaluation Panel (IEP) and creates a Chief Evaluation and Learning Officer (CELO) function.

Recognizing the significant impact of COVID-19 on the Global Fund’s operating environment and risk landscape, the Board recalled its ultimate responsibility to the Global Fund’s stakeholders for overseeing the implementation of effective risk management. While supporting the increased risk appetite, Board members stressed the importance of actively mitigating risk, especially at a country level, and instructed the Secretariat to provide greater granular reporting on emerging risk trends and the effectiveness and results of the assurance measures, including the assurances put in place.

Ahead of the Global Fund’s Seventh Replenishment next year, and less than a decade to the United Nations Sustainable Development Goals, the Board called the entire partnership to mobilize to increase financial resources to fight the three diseases. The grants based upon the new Strategy will start in January 2024 with funds from the upcoming Seventh Replenishment.

For more details, please follow this link>>>.

 

New Global Fund’s Technical Assistance Program

From the EECA Regional Platform established by the Global Fund

The Global Fund’s Community, Rights and Gender (CRG) Technical Assistance (TA) Program started it’s new phase of the implementation as a part of the Global Fund’s CRG Strategic Initiative.

You may find all relevant information about this short-term technical assistance program available at the new page at the Global Fund’s website following this link>>>.

Please, be informed that the CRG Department updated the list of CRG technical assistance providers for the 2021-2023 implementation period. Also, new CRG TA Request Form is available (the old one is not applicable anymore) as well as an example of the High-quality TA Request.

The CRG technical assistance is available in 3 main areas of work:

  • Situational analysis and needs assessments
  • Country dialogue
  • Supporting design and implementation arrangements.

For more details please see the CRG Technical Assistance Guidance Note.

CRG Technical Assistance does NOT support:

  • CCM strengthening (e.g. training of CCM members in their roles and responsibilities);
  • Long-term capacity development of civil society networks and organizations (e.g. organizational development, support to become a Global Fund recipient);
  • Development of stand-alone tools that lack a focus on community engagement;
  • Funding request writing.

The short-term nature of technical assistance foresees that community experts can be deployed for approximately 30 days over a period of up to three months.

Also, if you have any questions regarding the CRG TA Program or you need any assistance with development of the request – please feel free to contact Ivan Varentsov at ivan@harmreductioneurasia.org as the coordinator of the EECA Regional Platform for Communication and Coordination supported by the Global Fund.

 

Request For Proposals for EECA HIV multi-country grant

The Eastern Europe and Central Asia (EECA) is one of the three regions globally where the HIV epidemic is increasing. In 2019, the incidence/prevalence ratio was higher than in any other part of the world: 10.1. The number of people living with HIV in the region was 1.7 million; the number of new HIV infections was 170,000 and the number of AIDS-related deaths – 35,000. In 2019, according to the data for testing and treatment cascade, 70% of people living with HIV knew their status, 44% of people living with HIV were on treatment, and 41% of people living with HIV were virally suppressed.

The HIV epidemic remains concentrated in key populations in EECA countries. Key populations and their sexual partners are disproportionately impacted, accounting for 99% of new HIV infections in 2019. Addressing the HIV epidemic would require an interlinked set of measures focused on improving sustainable access of key populations to quality prevention, diagnostics, treatment and care; improving efficiency and quality of HIV service delivery models; and building financial sustainability of provision of services tailored to the needs of key populations

The Global Fund to Fight AIDS, Tuberculosis and Malaria (the “Global Fund”) is seeking proposals from regional stakeholders to implement a multicountry program under Catalytic Investments for the 2020-2022 allocation period.

The multi-country grant should contribute to sustainable and significant reduction of infections, illness and death by HIV/AIDS in EECA, with a clearly described theory of change and proposed specific actions and performance metrics.

Of the US$ 50,000,000 made available for this strategic priority area, this RFP refers to the US$ 13,000,000 made available under the multicountry priority area “Sustainability of services for key populations in Eastern Europe and Central Asia region”.

To read applicants guidelines for this request, please follow this link>>>.

 

Global Fund COVID-19 Response Mechanism allocations in SEE

The Global Fund is providing immediate funding to help countries fight COVID-19, mitigate the impacts on lifesaving HIV, TB and malaria programs, and prevent fragile health systems from being overwhelmed, through grant flexibilities and the COVID-19 Response Mechanism.

Grant flexibilities allow countries with current grants to use up to 5% of their current grant value if there are savings, and/ reprogram up to 5% of the value of a grant to meet immediate COVID-19 response requirements. The COVID-19 Response Mechanism (C19RM) can be used across the three diseases and the health system, even if a country only has a single Global Fund grant for one component.

The Global Fund published the information about allocations so far on 27 October 2020. From the COVID-19 Response Mechanism a total of 592,493,744 USD was allocated for mitigating COVID-19 impact on HIV, TB and malaria programs, reinforcing national COVID-19 response (other response and COVID-19 diagnostic tests) and urgent improvements in health and community systems.

Out of this amount, four SEE countries and the Multi-country HIV East Europe and Central Asia #SOS_project received

In addition, from the Grant Flexibilities 216,092,754 USD was approved to 107 countries and multicountries out of which three countries and the Multi-country project received:

 

 

See better in the document we created following this link>>>.

 

Joint input into the Global Fund Strategy Development from CEECA region

On September 1st the document named “Joint input into the Global Fund Strategy Development from key affected communities and civil society from CEECA region” was send to the Global Fund in a response to an earlier invitation from the Global Fund to join the Open Consultation to Inform the Development of its new Post-2022 StrategyStrategy.

Discussions were organized by the Eurasian Harm Reduction Association (EHRA) and involved key regional networks that unite key affected communities and civil society organizations working in the Central and Eastern Europe and Central Asia (CEECA) region. Initial focus-group discussion was held on June 25th during the Regional Partners’ coordination call organized by the Regional Civil Society and Community Support, Coordination and Communication Platform – Eastern Europe and Central Asia (EECA).

The resulting draft document was circulated for comments during August 2020 among the leaders of the following nine regional networks and organizations of civil society and key affected communities that unite hundreds of national community-based entities as well as civil society groups in 29 countries of the region:

  • Eurasian Harm Reduction Association (EHRA)
  • Eurasian Coalition on Health, Rights, Gender and Sexual Diversity (ECOM)
  • TB Europe Coalition (TBEC)
  • Center for Health policies and Studies (Center PAS)
  • Alliance for Public Health (APH)
  • Eurasian Key Populations Health Network (EKHN)
  • AFEW International
  • Regional Expert Group on Migration and Health
  • Sex Workers’ Rights Advocacy Network (SWAN)
  • Eurasian union of adolescents and young people Teenergizer

 You may find the resulted document following this link: https://eecaplatform.org/en/joint-input/.

Addressing HIV and TB in Prisons, Pre-Trial Detention and Other Closed Settings

From EECA Regional Platform for Communication and Coordination

The new technical brief describes how HIV and TB interventions for people in prison and other closed settings can be incorporated into funding requests to the Global Fund to Fight AIDS, Tuberculosis and Malaria. The Global Fund supports evidence- and rights-based interventions aimed at ensuring access to HIV and TB prevention, treatment, care, and support for key populations, including people in prison.

Global Fund resources should be used to fund interventions that are in line with internationally agreed standards and technical guidance and have a significant impact on the HIV and TB epidemics in a country. Global Fund policy requires upper-middle income countries to focus 100% of their funding on programs benefiting key and vulnerable populations, lower middle income countries must demonstrate that 50% of funding is focused on the same. Low-income countries are also strongly encouraged to target resources to those at highest risk. Global Fund resources can also be used to advocate for laws and policies that enable an effective human-rights-based HIV and TB response and the removal of policies and laws that present obstacles to this.

  • Section 1 of this brief outlines the vulnerability of people in prison to HIV, TB, viral hepatitis and other infectious diseases. 1 UNAIDS (2015). UNAIDS Strategy 2016-2021. 2 WHO (2016). Global Health Sector Strategy on HIV, 2016-2021. 3 WHO (2015). WHO End TB Strategy. 4 Global Fund (2015) Global Fund Support for Co-morbidities and Co-Infections
  • Section 2 outlines guiding principles for designing and implementing programs.
  • Section 3 outlines the comprehensive package of interventions for HIV, TB, and other health issues recommended by WHO, UNODC, and other partners.
  • Section 4 describes approaches to incorporating prison harm reduction programs within funding proposals, and the health components and strategies for an enabling environment that should be included.
  • Section 5 offers examples of promising practices from around the world.
  • Section 6 lists further publications that may be of assistance in compiling proposals, as well as for technical support in programming. Publications on specific areas are also mentioned throughout this brief and referenced in the footnotes.

The technical brief is available following this link>>>.

Global Fund support for fighting COVID-19

The Global Fund, the largest multilateral funder of health systems worldwide, is providing immediate funding of up to US$1 billion to help countries fight COVID-19, mitigate the impacts on lifesaving HIV, TB and malaria programs, and prevent fragile health systems from being overwhelmed, through grant flexibilities and the COVID-19 Response Mechanism.

 

Grant flexibilities, announced on 4 March 2020, allow countries with current grants to: 1) use up to 5% of their current grant value if there are savings, and/or 2) reprogram up to 5% of the value of a grant to meet immediate COVID-19 response requirements. Repurposing equipment already purchased through a Global Fund grant is also an option to respond to COVID-19.

Total available funding for flexibilities is up to US$500 million. As of 5 May 2020, funding has been approved for 73 countries and five regional grants for a total of US$109 million. Among them Albania got US$80,400 of support, Kosovo EUR 91,733 and Romania EUR 316,255. This information is updated regularly through the Situation Reports on the Global Fund website. Eligibility: Countries and multi-country grants with current grants from the 2017-2019 allocation period.

Application process: For the use of savings and reprogramming, the Principal Recipient issues a request to the Global Fund’s Fund Portfolio Manager. Preferably, it is endorsed by the CCM. The Global Fund responds within five working days.

The request should include a brief budget, describe the activities to be funded, how it will fit into the national response, and outline potential consequences to and mitigants for HIV, TB and malaria programming.

Implementation: Global Fund financed activities must be implemented by an existing Principal Recipient (and/or existing Sub-Recipients). The main investment categories are (a) protecting Global Fund disease program against negative impact of COVID, (b) direct responses against COVID, and (c) address immediate gaps in health and community support systems. Guidance on eligible activities is available on the Global Fund’s website.

Funding Source: Countries can use savings or reprogram current grants, up to 10% of the grant value.

More information is available here>>>.

 

The COVID-19 Response Mechanism (C19RM), approved in April 2020, authorizes US$500 million in funding in addition to grant flexibilities. C19RM can be used across the three diseases and the health system, even if a country only has a single Global Fund grant for one component. The CCM will assess the most urgent needs and direct activities through one or more of the principal recipients.

Total available funding: USD$500 million, initially. Public and private donors are able to direct additional resources to the Global Fund through C19RM to scale up the COVID-19 response and support systems for health across the grant portfolio.

Eligibility: Countries with a Global Fund allocation for the 2020-2022 period can access an amount equivalent to up to 10% of their allocation. This ceiling includes the use of savings and reprogramming under existing grants.

The immediate additional amount of funds available for each country is 3.25% of the 2020-2022 allocation period, provided the country has not yet used savings and reprogramming exceeding 6.75% of this allocation.  Application Process: The application is submitted through the CCM or the regional coordinating mechanism preferably by 31 May and no later than September 2020 so that emergency funding can reach countries as soon as possible.

The funding request is divided into two parts:

  • Priority 1 for the most urgent activities. This is capped at 3.25% of the 2020-2022 country allocation. The Global Fund will respond within 10 days to this request.
  • Priority 2 for supplementary interventions. This is capped at 10% of the 2020-2022 country allocation minus the amounts already requested for C19RM Priority 1 and approved grant flexibilities/reprogramming. These supplementary requests could be awarded later if more funds are made available.
  • All applications should demonstrate that an inclusive engagement with civil society and key affected populations took place to formulate the demand. C19RM funds are additional and will not be deducted from the 2020-2022 allocation. Funding must be fully utilized by June 2021.

Instructions to apply can be found here>>>.

Implementation: C19RM funds must be implemented through an existing country grant and principal recipient, regional and multi-country grants. It can be used for three areas, to:

  1. Mitigate the impact of COVID-19 on current HIV, TB and malaria programs.
  2. Reinforce the national COVID-19 response
  3. Invest in urgent improvements in health and community systems