PEPFAR COP/ROPs 2021: Top Tips for Key Population Advocates

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The 2021 PEPFAR Country/Regional Operational Plan (COP/ROP) planning process is markedly different than that of previous years. Instead of a week-long, in-person negotiation in Johannesburg, the 2021 planning process is entirely virtual. The process kicks off on April 1, 2021 and features a Preparation Phase (April 1-14); a Planning Phase (April 15-29), and a Completion Phase (May 3-21). Most notably, the centerpiece of any COP/ROP process – the planning meeting – has been significantly truncated: each Country Team will only be given a total of eight hours (spread out over two days) for their planning discussions.

This year’s virtual format poses many challenges for advocates, especially key populations (KPs), for whom in-person diplomacy and “corridor advocacy” during the tea breaks between official meeting sessions have been important instruments for finding common ground and reaching agreements with government and PEFPAR partners in our COPs advocacy over the years. The absence of these informal spaces is a major setback and will require adjustment.

The scheduling poses another set of obstacles: PEPFAR countries have only recently been informed of the dates of their COP/ROP planning meetings, with many taking place concurrently (scroll to the bottom of this page for all PEPFAR Country planning meeting and approval meeting dates). In previous years, staggered negotiations took place over the course of three different week-long periods, which enabled lessons learned by advocates in the first week to be passed along to those whose country negotiations were taking place in subsequent weeks. This knowledge-sharing will be difficult given the compressed virtual format of this year’s planning process in which many negotiations will be taking place simultaneously.

Furthermore, the shortened meeting period poses challenges for digging deep into key populations’ priorities. Though each Country Team has been encouraged to draft their own meeting agenda that reflects the priorities of their country, a two-day meeting – with just a four hour agenda each day – is a major reduction in the amount of time that can be spent on any topic.

Despite the limitations inherent in this year’s process, MPact encourages gay men and other men who have sex with men, sex workers, people who use drugs, transgender people and their allies to bring forward their top priorities through whatever avenues are possible. Bring your creativity and energy to the planning process. Below, find our Top Tips for Advocates for the COP/ROP 2021 process:

How Do I Get Engaged in COP21?

  1. Mark your calendar! Owing to the ongoing COVID-19 pandemic, the 2021 COP/ROP process is entirely virtual. Find out the date of your country’s two-day planning meeting here. Read up on the three-phase process in the 2021 COP/ROP Virtual Handbook.
  2. Plug in to country communications. Each Country Team will be discussing and sharing COP/ROP documents with civil society representatives as part of the planning process – including the planning meeting agenda, as well as required tools such as the FAST, Supply Plan Tool, and Data Pack in advance of the planning meeting. It is up to each Country Team to communicate this information as they see fit – which could be via email, a website, or possibly even WhatsApp groups or Google Drive. Contact your Country Representative to make sure you are included on the relevant list.
  3. Get your priorities on the meeting agenda. The COP meeting agenda template circulated by PEFPAR leadership in the handbook (pp 25-26) indicates that very little time is allocated to civil society presentations (10 minutes on day one, as part of a larger session shared with government and multilateral stakeholders). Write to your Country Chair to ask to see the draft agenda, and suggest changes and modifications to get your top priorities put on the agenda.
  4. Knock on every door. Pursue all avenues to share your priorities including both official and unofficial channels. The official COP/ROP planning meeting may only be two days long, but advocates can share their priorities, perspectives, and data throughout the process. Share your community monitoring results, your community reports, your feedback, and your recommendations with PEPFAR Country Teams and country partners. Request a one-on-one meeting with the Country Chair of your COP process, ahead of the two-day planning meeting. Attend the Global Townhall that PEPFAR is planning to hold with civil society (details forthcoming soon).

What do I want to see for KPs in COP21?

  1. High-quality Community-Led Monitoring (CLM). Community-Led Monitoring cannot be one-size-fits all. It needs to be independent; relevant to each specific context and group of people it is designed to serve; and key population communities must be at the helm to define priorities, establish norms, and analyze trends and lessons learned that emerge from the data.
  2. Sustainable programming. “One-size-fits-all” sustainability plans do not work. Key populations are often left behind when donors withdraw funding. Programs for key populations in most PEPFAR countries rely heavily on PEPFAR or other external donors – rather than national governments – for financial support. As external funding is reduced, key populations are left behind for any number of reasons: a lack of political will within the country to prioritize their needs; restrictive laws or punitive policy environments; challenges with establishing or using social contracting mechanisms to channel government funds directly to KP-led civil society organizations; and limited financial experience or capacity among grassroots civil society organizations. Insist that key populations be prioritized in any sustainability plan and request specific details on how funding will be provided to KP-led programs and organizations that are leading the HIV response.
  3. Adequate Funding. Tell PEPFAR Country Teams to hold community-based, key population-led programs harmless in budget cuts.KP-specific prevention, testing, treatment, and adherence programs are fundamental to the success of any PEPFAR program and must be continued and brought to scale, even in the face of wide-ranging budget cuts.
  4. A new five-year strategy. Demand a new, five-year global strategy to invest in reaching key populations that is co-created with the full participation and input of KP communities. The $100 million Key Populations Investment Fund (KPIF) has had important wins in its efforts since 2019 to dismantle structural barriers for KPs, including stigma, discrimination, and violence. However, it has so far failed to reach its full potential and it has left some KP community partners feeling tokenized, left out of decision-making processes, denied a meaningful role in program planning, and too often just sub-contracted as implementation partners by large international INGOs that rely on grassroots KP partners to meet KP testing and treatment targets. Urge PEPFAR to learn from the KPIF experience and build on lessons learned to create the next era of strategic engagement with KPs. It is essential that this investment be maintained as a separate budget stream (apart from COP/ROP) with its own KP-specific strategic focus.
  5. A dedicated COVID-19 response. Bring attention to the disproportionate impact of the COVID-19 pandemic on KP communities worldwide. Make PEPFAR leaders aware of new forms of discrimination against KP communities as they are made scapegoats for the spread of COVID-19, especially the LGBTI and sex worker communities. This may make it harder for those communities to get the HIV resources they need and access life-saving services. In other cases, KP-focused HIV programming budgets may be sacrificed in national planning processes in light of the financial stresses brought about by the pandemic.
  6. Realistic size estimates. Refuse to accept inaccurately small and misleading population size estimates of key populations, and replace them with realistic and reliable size estimates. PEPFAR’s official KP size estimates have been notoriously low over the years, particularly when compared with community-derived population size estimates. Because PEPFAR relies on size estimations to justify targets and funding, low KP population size estimates have a domino effect, leading national programs to underestimate community needs, set (and easily exceed) low targets, and therefore underfund KP services.
  7. Action against stigma and discrimination. There is a welcome expanded focus on stigma and discrimination in the 2021 COPs Guidance, which is particularly relevant for addressing the many forms of homophobia, transphobia, anti-drug use, and anti-sex work-related discrimination, harm, exclusion, and violence faced by key populations worldwide. Communities must be front and center in designing strategies, writing curricula, leading trainings, implementing programs, and other interventions to fight the stigma and discrimination that undermine PEPFAR program performance and effectiveness.
  8. Comprehensive prevention including PrEP.Countries must move beyond PrEP pilot programs and towards scaling up comprehensive PrEP programs for gay, bisexual, and other men who have sex with men. These scaled up programs should include components such as demand generation, risk reduction counseling, literacy, adherence, and support. Additionally, prevention programs beyond PrEP should address upstream factors and support tailored strategies for community mobilization.
  9. Evidence-based responses. Urge governments to keep an unwavering focus on key populations. Gay men, people who use drugs, sex workers, and transgender people remain at disproportionately high risk for HIV acquisition and onward transmission. We must follow the science and keep our focus on prioritizing the needs of these vulnerable groups.