This case study has been prepared by MPact to analyze community approaches used to increase meaningful engagement in Global Fund processes to ensure access for key populations.
Being implemented in 23 countries and across 6 regions, the Global Fund (GF) technical assistance program aims to increase meaningful engagement of Key Populations communities in GF processes through a series of community meetings and consultations/training workshops; peer-to-peer coaching; tools development; watch-dogging HIV program implementation; facilitating partnerships between community actors and national decision makers; and integrating human rights-based strategies into national AIDS plans.
This program aims to achieve:
- Well-supported key population membership on County-Coordinating Mechanisms (CCMs);
- Stronger community engagement in concept note development;
- Development and implementation of HIV-related programs tailored to the needs of gay men and other men who have sex with men, transgender people and other key populations;
- Ongoing monitoring of Global Fund-funded program implementation to ensure alignment with normative guidance issued by UN agencies, including the WHO; and
- Transition and sustainability readiness.
The following summary was the result of in-depth questionnaires, interviews, and reviews with our partner at Gays of Lesbians of Zimbabwe:
Founded in 1990, Gays and Lesbians of Zimbabwe (GALZ) is the oldest organization in the country focusing on promoting the rights of LGBTI people. Given the punitive laws in Zimbabwe and the risks for persons who are openly gay, GALZ has had to develop strategies to ensure that issues related to key populations – particularly gay and bisexual men – are kept on the agenda in Global Fund planning processes.
Due to homophobic attitudes and fear of reprisal from the government, many lower level officials are reluctant to engage with GALZ directly. One strategy used by GALZ is to form broad stakeholder networks which are less intimidating for the officials to engage with. By inserting themselves in these networks, GALZ has been able to introduce key population issues and concerns and expand their voice though association with other community based organizations and networks. This alliance-building strategy is core to the way GALZ operates.
In April, 2018, GALZ hosted a training session on the Global Fund and PEPFAR, which involved 12 participants representing LGBTI communities. The training helped communities to engage in the organizations’ processes and provided opportunities for membership, advocates, ministries, and CCM members to gain an in-depth understanding of key population issues and develop working relations. GALZ worked closely with the civil society rep on the concept note writing team and was eventually asked to join the team to ensure key population issues were adequately addressed. The 2018-20 grant includes funding for two GALZ partners as sub-recipients. Another major success following on the GALZ training was that in June, 2018 Zimbabwe elected new civil society representatives which includes an adolescent girls and young women representative and an LGBTI rep on the CCM Technical Working Group.
Building alliances to overcome homophobic attitudes
In 2017 and 2018, GALZ, in collaboration with Zimbabwean government agencies, health professionals, key population networks and MPact, organized a workshop to adapt the WHO MSM Impementation Tool (MSMIT) for the local context. The MSMIT was critical in shaping program activities and implementation plans for MSM under the Global Fund grant cycle 2018-2020. The effort also resulted in a minimum service package for key populations being developed by the Ministry of Health and Child Care. GALZ faced considerable resistance due to homophobic attitudes of middle level bureaucrats. The obstacle was overcome due to support and buy-in from senior health officials. However, GALZ staff noted that in the future more time needs to be spent in overcoming stigma through deeper engagement with senior officials.
The gains that GALZ has made in inserting human rights and LGBTI concerns into Global Fund grants needs to be sustained and intensified. To achieve this, GALZ will focus on improving their research and data analysis capacity during the 2021 to 2023 grant cycle. Without the data to back up demands, funding for human rights and LGBTI programming will dwindle. GALZ will also ensure that they have sufficient lead time to obtain strong advocacy support from senior officials to overcome resistance by lower level officials.
In 1990, GALZ was the only organization with a human rights and LGBTQ focus; there are now 12 organizations with similar mandates across the country. GALZ will lead capacity-building for the newer organizations and ensure that a common message is articulated. With a concerted, coordinated effort involving multiple partners, key population issues will remain in focus for the National AIDS Council and responsible authorities in Zimbabwe.