The Role of the Global Fund to Fight AIDS, TB and Malaria in Delivering Gender Equality

Today there remains a disproportionate impact of HIV, TB and malaria on women and girls. The Global Fund to Fight AIDS, TB and malaria (the Global Fund) is the leading multilateral organisation investing in the three diseases. Since its creation in 2002 the Global Fund has helped to save 27 million lives and supported efforts to dismantle the gender and human rights barriers that fuel the three diseases.

It is the single most important mechanism for donors, recipient countries, civil society, the private sector and other stakeholders to unite in their response to these epidemics and has repeatedly proven to deliver high value for money.  To achieve a fully funded Global Fund that can deliver on closing that gap and working towards ending the epidemics, strong and ambitious pledges will be needed to reach and go beyond the $14 billion replenishment target.  GFAN believes we will need to reach an 18 billion target, 4 billion more than the Global Fund’s own replenishment target, in order to meet global need. 

The Disproportionate Impact of HIV, TB & Malaria on Women & Girls

Women and girls continue to be disproportionately affected by HIV, TB and malaria. HIV is the leading cause of death of women of reproductive age in low-and middle-income countries and nearly 1,000 adolescent girls and young women are infected with HIV every day worldwide.

Whilst TB generally affects more men than women, it remains among the top five causes of death for women aged between 15 and 44 in low-and middle-income countries. Pregnant women are particularly susceptible to malaria, they are four times more likely to suffer symptomatic malaria than other adults5, which can potentially be fatal for both mother and child, causing miscarriages, low birth weight and premature births.

The Global Fund’s Focus on Women & Girls

The Global Fund continues to increase its investments in programmes supporting women and girls, with 60% of current total spending being directed to achieving results for women and girls. Between 2002 and 2017 this resulted in a total investment of approximately US$18 billion.

Tackling Gender Inequality

The Global Fund recognises that structural change (social, political and cultural) is needed to end HIV, TB and malaria and supports a number of programmes supporting this transformation. As gender inequality continues to fuel the spread of the three diseases, the Global Fund is committed to promoting gender equality as a strategic pillar of its work, outlined as a core objective of its 2017-2022 strategy. This includes investment to reduce health inequalities and gender-related disparities with a target of 90% of women and girls living free from gender inequality and gender-based violence to mitigate the risk and impact of HIV by 2020.

Spotlight on HIV & Young Women
Girls and young women aged 15-24 years in sub-Saharan Africa are up to eight times more likely to be HIV positive compared to boys and men of the same age. This age group is expected to double in sub-Saharan Africa in the next decade and therefore urgent action is needed to end the epidemic and prevent a resurgence of HIV.

In stepping up its work against gender-based health inequalities, the Global Fund has more than quadrupled investments to reduce new HIV infections for adolescent girls and young women in sub-Saharan Africa with strong community-based prevention programmes. The Global Fund has also recently set a bold target to reduce the number of new HIV infections among adolescent girls and young women by 58% in 13 African countries by 2022 as part of their HER: HIV Epidemic Response campaign. 

In recognition of the need for collective action, the Global Fund is building on the work of the U.S. President’s Emergency Plan for AIDS Relief and the DREAMS Partnership, with support from private sector to expand HIV prevention programmes for adolescent girls and young women with a girl-centred, rights-based approach. These programmes provide condoms, PrEP, HIV testing services as well as life skills and financial literacy education.

Strengthening Healthcare Systems & Improving Sexual, Reproductive, Maternal & Child Health

A key objective of the Global Fund’s current strategy is to ‘build resilient and sustainable systems for health’, to not only end the epidemics, but as a critical step to attain universal health coverage. This includes supporting reproductive, women’s, children’s, and adolescent health, and platforms for integrated service delivery by working closely with key partners including GAVI, GFF, UNFPA, UNICEF and WHO.

The Global Fund has supported the integration of reproductive, maternal, newborn, child and adolescent health services in countries such as Kenya to scale up integrated service delivery as part of achieving universal health coverage by 2022. This includes support for antenatal clinics which serve as “one-stop shops” for pregnant women to provide a range of health services including sexual and reproductive health and cervical cancer screening. The Global Fund also works closely with UNFPA to provide equitable access to integrated and gender-responsive sexual and reproductive health services to prevent new HIV infections, eliminate stigma
and discrimination, as well as to prevent malaria and TB mortality, especially among pregnant women.

Spotlight on Pregnant Women & Malaria
Malaria death rates worldwide have dropped by 60% since 2000 and in 2017, 6 million pregnant women received preventive treatment for malaria through the Global Fund, the leading international funder of the malaria response. The Global Fund is currently implementing a number of programmes to support pregnant women, including a pilot of the Malaria Matchbox, a new tool analysing gender-related barriers to accessing services, particularly for pregnant women, as well as investing US$35 million in catalytic funding to pilot new mosquito nets.

Integrating Education

Services for adolescent girls and young women spanning both health and education are an emerging priority for Global Fund with strong evidence showing that staying in school reduces girls and young women’s vulnerability to HIV infection. One study shows students in Botswana who stayed in secondary school for an additional year had an 8% lower risk of HIV infection a decade later.

Programmes funded by the Global Fund such as Keeping Girls in School in South Africa provide counseling, HIV prevention education and academic support to more than 61,000 girls who are at a great risk of dropping out of school. Incentive programmes have proven to be effective in removing barriers to education such as the cash and care programme in Swaziland offering economic support as well as psychosocial services to girls and young women living in areas of high HIV prevalence.

In Malawi, a Global Fund programme offering in-school and out-of-school clubs saw the number of girls who left school due to pregnancies reduce from 57 to 3 between 2016 and 2017. Access to education for adolescent girls can also lower the risk of being exposed to cervical cancer, TB, malaria and gender-based violence. A recent study found that Global Fund investments in malaria control campaigns had a significant impact on reducing delays in attending school.

Building on progress & Turning Commitments into Action

Strong investments in the Global Fund are critical to maintaining programmes aimed at women and girls.  The Global Fund has a history of doing extraordinary work: few investments have had the impact that the Global Fund has in saving lives, preventing infections and creating strong and resilient health systems. We are at a critical moment where the minimum will not be enough to prevent us from sliding back.  Increased investments are needed to get us back on track and end the epidemics. 

What You Can Do

• Use your platforms and networks to show your support, sign and share the GFAN Call to Action and Pledge Your support for the Global Fund. 

• Follow #stepupthefight #GetBackonTrack #EndtheEpidemics and share @gfadvocates posts across your social media channels

• Make use of GFAN tools and resources including our latest tools for the last 100 Days to Replenishment

Thank You

The above text was based heavily on a piece written by Jenny Vaughan, Senior Advocacy Advisor at STOPAIDS – jenny@stopaids.org.uk and Courtenay Howe, Multilaterals Engagement and Liaison Officer.  Much appreciation and thanks to her and STOPAIDS for their hard work and permission to share. 

Additional Resources: 

The Global Fund (2017) The Global Fund Strategy 2017-2022.
http://www.theglobalfund.org/media/2531/core_globalfundstrategy2017-2022_strategy_en.pdf

The Global Fund (2019) Sixth Replenishment Investment Case.
http://www.theglobalfund.org/media/8279/publication_sixthreplenishmentinvestmentcase_report_en.pdf?u=636898877700000000

The Global Fund (2019) Women & Girls. http://www.theglobalfund.org/en/women-girls/

Kvinnoforum & The Roll Back Malaria Partnership (2005) A Guide to Gender and Malaria Resources.
http://www.k4health.org/sites/default/files/gm_guide-en%5B1%5D.pdf

The Global Fund (2019) HER: HIV Epidemic Response.
http://www.theglobalfund.org/media/6794/her_hivepidemicresponse_brochure_en.pdf

The Global Fund (2017) Focus on Women and Girls.
http://www.theglobalfund.org/media/1296/publication_womengirls_focuson_en.pdf?u=636917026580000000 Cameroon, Uganda, Kenya, Tanzania, Malawi, Mozambique, Zambia, Zimbabwe, Botswana, Namibia, Eswatini, Lesotho and South Africa

The Global Fund (2015) Maximizing the Impact of Global Fund Investments by Improving the Health of Women and Children. http://www.theglobalfund.org/media/5955/publication_ierg2015_report_en.pdf?u=636917016080000000

The Global Fund (2019) Malaria. http://www.theglobalfund.org/en/malaria/

The Global Fund (2018) Results Report 2018. http://www.theglobalfund.org/media/7741/corporate_2018resultsreport_report_en.pdf

The Global Fund (2019) Step Up The Fight Against Malaria.
http://www.theglobalfund.org/media/7491/publication_malaria_focuson_en.pdf

The Global Fund (2018) More Efforts, Funding Needed to End Malaria. http://www.theglobalfund.org/en/news/2018-11-19-more-efforts-funding-needed-to-end-malaria/

The Global Fund (2018). Focus on Health and Education.
http://www.theglobalfund.org/media/4804/publication_educationhealth_focuson_en.pdf

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