Country dialogue and funding request development

Country dialogue and funding request (previously called ‘concept note’) development are especially critical points during the grant cycle and present an opportunity to consult widely with a range of stakeholders—key population and women’s networks, networks of people living with HIV, communities, civil society, government, technical partners—to advocate for inclusion of activities to promote an enabling environment. These partners should ideally be involved at every stage of the grant cycle.

A wealth of guidance documents exist to support development of these interventions. The Global Fund HIV Information Note provides guidance to Global Fund applicants on employing strategic investment thinking when developing funding requests for HIV related programming. A thematic section on addressing human rights and gender related barriers is included. Similarly, The Global Fund Tuberculosis Information Note and The Global Fund Malaria Information Note include disease specific information and include sections on addressing rights and gender related barriers.

1. Identify human rights barriers

   • Define the epidemic, as well as the specific needs and vulnerabilities of women and girls, key populations and other marginalized groups, as identified in the needs assessment (see here).
   • Define the activities.
   • Define the financial gap to implement the activities.
   • Define the partnerships needed to execute activities (civil society organizations (CSOs), community groups, technical partners, etc.).

2. Design disease programmes using a human rights-based approach

   • The process is built on broad and comprehensive representation of participants, including government, civil society and people living with and affected by HIV, TB and malaria.
   • Consult closely with populations who will use health services.
   • Based on these consultations, design disease programmes with testing, prevention, treatment, care and support services that pay special attention to challenges, barriers, and outreach opportunities in order to meet the needs of those who will use the services.
   • Ensure that a gender-sensitive approach has been used in policies and plans for prevention, treatment, care and support, including the linkages between gender-based violence and the three diseases are addressed, as appropriate.
   • Form intersectoral partnerships between ministries of health and other parts of government to better embed HIV, TB and malaria concerns.
   • Ensure that an adequate budget has been allocated to ensure implementation of prioritized responses aimed at addressing the gender, key populations and human rights-specific dimensions of the disease being addressed.
   • The UNAIDS guidance document Fast-Track and human rights offers practical advice on why and how efforts to Fast-Track HIV services should be grounded in human rights principles and approaches. It includes three checklists to support and guide the design, monitoring and evaluation of HIV services in order to realize human rights and equity in the AIDS response.
   • The Global Fund technical brief HIV, human rights and gender equality supports grant applicants to include programmes to remove human rights and gender-related barriers to HIV services. It also gives advice on implementing human rights-based and gender-responsive approaches to HIV.
   • The Global Fund guidance brief Human rights and gender programming in challenging operating environments (COE) provides guidance for the operationalization of the Global Fund’s COE policy in ways that are consistent with its human rights and gender strategic objective. In particular, it suggests ways in which specific programmes can be undertaken to address human rights and gender related risks and barriers to services, as well as to ensure rights based and gender responsive approaches to services, which are imperative for ensuring optimal impact of HIV, TB and malaria programmes.
   • The Global Fund technical brief Tuberculosis, Gender and Human Rights assists Global Fund applicants to consider how to include programmes to remove human rights and gender related barriers to TB prevention, diagnosis and treatment services within funding requests and to help all stakeholders ensure that TB programmes promote and protect human rights and gender equality.
   • The Global Fund technical brief Equity, Human Rights, Gender Equality and Malaria assists applicants to consider how to include programmes to remove human rights and gender related barriers to malaria prevention, diagnosis and treatment services within funding requests and to help all stakeholders ensure that malaria programmes promote and protect human rights and gender equality.

Practice Pointer

• In many countries open dialogue and discussion on the needs of key populations is often not accepted. Interventions to promote an enabling environment more palatable include use of terminology, i.e. instead of men who have sex with men, ‘men at risk’. The latest epidemiological evidence should always be cited as a starting point for these discussions. Use of trained facilitators to guide the discussion on sensitive issues is also encouraged, as well as providing a ‘safe space’ for KPs. UN houses can often provide such space for KP dialogues.
• The country dialogue should follow a four-step process to prioritize the components of a country’s response to the three diseases, based on country context, to provide a sound investment case. An investment case requires attention to the strategic value of HIV, TB and malaria interventions with attention to “equity, efficiency and evidence”.
• Decisions about which interventions respond best to gender, key populations and human rights concern, needs to be guided by the findings from the needs analysis of the national HIV response. It is not enough to simply analyse and present the analysis. Evidence-informed priority actions must be defined and costed, and funds must be allocated to them. Indicators must then be defined and utilized to monitor actions and their impact as well for the reporting of results.

For instance, examples of effective gender-programming are provided from sources such as: What Works for Women and Girls: Evidence for HIV/AIDS Interventions web site and UNAIDS/WHO's programming tool for addressing violence against women in the context of the HIV epidemic.

• UNAIDS Human Rights Costing Tool provides guidance on key interventions and methods to estimate costs.

Programme reviews, assessments, or evaluations are an important part of assessing impact against grant objectives for grants in which progress cannot be measured through standard indicators at impact, outcome, and coverage levels, i.e. grants related to promoting an enabling legal and policy environments and to strengthening community systems. In these situations, evaluations, assessments, and thematic reviews offer periodic qualitative insights which cannot be captured by routine reporting. Programme evaluations specifically aim to assess the effectiveness of interventions targeting disparities in HIV, TB, and Malaria. They seek to understand why certain strategies succeed or fail, and determine which interventions should be scaled up, revised, or discontinued. These evaluations focus on addressing disparities and overcoming gender and human rights barriers in HIV, TB, and Malaria programmes, guiding decisions to enhance programme effectiveness and equity. Thematic reviews focus on specific implementation and operational challenges, aiming to identify best practices and solutions for programme improvement. Gender and Human Rights assessments uncover barriers related to these issues in HIV, TB, and Malaria services, informing the development of strategies to reduce disparities. By addressing these barriers, programmes can implement more effective and equitable interventions. Generated information and recommendations inform necessary course corrections on existing strategies and interventions thereby redirecting existing and new programmes to be more impactful in maximizing equity, gender equality, and human rights. Country Offices (COs) are encouraged to ensure that adequate budgets are allocated to fund a baseline and endline evaluation and, should savings be available, a ‘lighter’ midterm review as well.

The UNDP Global Fund Partnership and Health Systems Team (GFPHST) and the HHG can be requested to provide examples of/support development of terms of reference (TORs) for these reviews, evaluations or assessments.

Additional guidance to support this area of work are also available through resources listed below:

• Global Fund guidance on Human Rights