Blog post by Dasha Matiushina, Advocacy Advisor.
The last meeting of the Global Fund’s Communities, Rights and Gender (CRG) Advisory Group was dedicated to the development of the Global Fund strategy for 2017-2021.
The focus of the discussions was on the way the issues of communities, rights, and gender would be reflected in the new strategy, and on the key performance indicators, which would help to measure the progress of the strategy implementation.
For instance, a key performance indicator on gender and age equality, which one finds in the draft strategy, is “HIV incidence in women aged 15-24”. Will this indicator help monitor the progress in reducing gender and age disparities in health in the context of all three diseases? The role of the CRG Advisory Group is to provide critical feedback on such questions and brainstorm on better indicators.
In the context of CEECA, one of the most interesting and perhaps the most important issues discussed was the quality of epidemiological data. As a rule, the Global Fund makes decisions on country’s eligibility for funding based on 2 factors – country’s economic status (GNI) and disease burden. For generalized HIV epidemics such burden is HIV prevalence among general population. For countries with concentrated epidemics, as all of EECA, this is HIV prevalence among key populations. For concentrated epidemic context, the Global Fund donates funding for upper middle-income countries only if the spread of HIV among drug users, sex workers or MSM is high, that is over 5%. Global Fund uses official epidemiological statistics coming from country reports to UNAIDS or WHO (for details check The Global Fund Eligibility and Counterpart Financing Policy, Annex C).
But what if the data that the Global Fund uses for decision–making is not correct? What if the HIV prevalence among people who inject drugs is underestimated because of suboptimal quality of routine data collection and no research being recently conducted?
Consider the case of Kazakhstan. Due to a reported relatively low HIV prevalence among key populations, the country became ineligible for the Global Fund funding for HIV (moderate disease burden and upper middle income category). Now Kazakhstan has revised its epidemiologic data, and according to a recent study, HIV prevalence among PWID is 7.9% (not because of an immediate rise of new HIV infections, but due to the change in the methodology of data collection – see National report to UNAIDS, 2015). However, it can’t become eligible for the Global Fund funding at once. Kazakhstan will need to prove that its HIV burden is ‘high’ for 2 consecutive years to be permitted to submit a new project proposal to the Global Fund.
This case shows us the importance of using relevant methods of epidemiological data collection, which can have a dramatic impact on the availability of funding for harm reduction.
Do you know your countries official disease burden for HIV? If you have any doubts, check the new Global Fund eligibility list for 2016.
CRG Advisory Group took place in Geneva, 10-11 February 2016. Ms. Daria Matyushina-Ocheret from EHRN, Ms. Hanna Shevchenko from the Ukrainian Network of PLHIV and Ms. Nonna Turuskbekova from the TB Europe Coalition represented the CEECA region during the meeting.