Dear forum members,

I would like to thank GF for participation  in commenting on Draft of the Gender Equity Strategy of the GF

Country Coordinating Mechanism

1-How can CCMs be encouraged to ensure meaningful representation of women with skills and voice amongst membership and leadership, including those from beyond the health sector? 

The country coordinating mechanisms can attract skilled and knowledgeable senior officials from ministries dealing with women, women network  include non health focused organizations or associations working on women empowerment, NGOs and civil society.

2-How can the Global Fund build the capacity of CCMs so that gender equality issues are understood and appropriately managed within the proposal development process through access to high quality gender expertise?

 - Continuous capacity building through GF to collaborate with organizations such as WHO,UNIFEM, UNFPA  among others who provide gender-sensitization training.

 -Support CCM with gender-expert during proposal development phase.

The technical review of proposals

1-Should gender and age disaggregated data be required in the epidemiological background provided by applicants in proposals to the Global Fund ?

-Yes, this is relevant and important for the work to be accountable to the objective and the goal of gender equity in the GF programs.

. Diagnostic researches can be done in different countries within the existing funding to get better mechanisms.

2-How should the Global Fund ensure that the TRP is appropriately resourced with recognized gender expertise?

-Proposal scoring on the basis of gender equality (‘mock TRP’); or formal introduction of gender-scoring sheet for the TRP.

-The TRP should be able to revise its proposal review and selection criteria, and include gender analysis and program as part of criteria for selection.

- The TRP need to develop a data based on Gender expertise-at regional and global level. 

3-Should the TRP review criteria be revised to put more emphasis on gender equality elements of programs and interventions?

- TRP & TERG could include mandatory maternity services procurement, equipment& product procurement, socio-economic indicator analysis for health care delivery, health system strengthening , procurement of Gender (Women & girls), data for providing basic health infrastructure provision linked with  education.

-TRE & TERG could develop specific gender treatment protocol, blood transfusion , voluntary testing, vaccination motivation with specific gender clinical, statistical and laboratory representation.

4-What should be the consequences for a proposal that does not sufficiently address gender, but in all other respects is ‘technically sound’?

- There should be satisfactory response from countries for funds to be released. Thus, sound proposals should be given a chance to revise and integrate gender issues in their interventions. They should be encouraged to have a gender expert in the preparation and revision of the proposal

Monitoring, evaluation and reporting

1-What gender equality service delivery areas should become available for Global Fund grants (e.g. gender-based violence, micro-finance etc)?

- The GF grant consideration for funding decision could include Gender Equity strategy to address right to health ( treatment  & services ), nutrition , family planning & micro-insurance , employment, female education , health related systems( agricultural, rural ,social , community system ) grass route solution , gender fact, grant consolidation, health system strengthening & sexual minority strategy could decide appropriate gender equality strategy based on country principles related  to social and cultural factors ,  Behavioral change communication Service delivery, Gender- Based Violence , Micro finance,  Promotion of Maternal Health, Skills Empowerment , Capacity building ,  Elimination of All Forms of Discrimination Against Women,   Promotion of women participation in politics …etc  

GF should be able to grant fund for the research on the link of Gender and HIV as there is lack in existing data, so the funding of research in this area will be important

 2-Should the Global Fund require reporting of sex and age disaggregated data for its key indicators?

Yes the inclusion of this data is important and relevant to the issues on Gender, in addition it will build the capacity of the ministry and other local and international organization to collect and document data on gender issue as this will be part of the capacity building process and  role of WHO and other bilateral and multilateral support should be mobilized by the GF.

3-How can country reporting systems be best supported to include better gender and age evaluation and analysis (role of partners, evaluations, and operational research agenda)?

--The GF should discuss with major funding partners and the Government to revise the existing monitoring and evaluation system to include gender specific indicators- which should also be reflected on the reporting guidelines, and then it will be possible for the GF to measure success and to get gender and age disaggregated data and analysis.

-GF can work with UNAIDS and WHO and the Government at country level including other multilateral funders and discuss monitoring and evaluation framework that exist at country level. The inclusion of a gender expert in the monitoring and evaluation of the GF programs is also important.   

 4-Should the Board provide an extra funding line for countries to access at Phase 2 in order to improve the gender equality orientation of existing grants?

-Yes,  as phase 2 funding is based on overwhelming implementation of financial instrument, fund raised and spent , innovative finance and distribution of funding for resources mobilization & addressing universal coverage for every one ( prevention of specific disease globally), Gender equity strategy could be involved for countries with balanced manner component in case of availability of additional financial resource.

Partners and networks

1- Are there mechanisms other than MOUs and agreements which to hold partners accountable for their role in supporting programs that address gender inequalities in Global Fund?

GF can cooperate with other partners  i.e WHO , UNAIDS, UNICEF, UNDP , World Bank …etc that are involved also in addressing the issue of gender inequalities to provide Technical Expertise, quantitative (statistical) &   qualitative ( products & services ) ,  strengthening of health sector as well as solutions to socioeconomic subjects especially in developing countries.  

Advocacy and communications

1-Should the Global Fund communicate all massages on gender sensitive programming at all times and play a strong advocacy role or should it adjust its massage to different political and social contexts and stick closely to country led principle?

GF should develop different kind of messages and have a sound strategy on Gender programs for the three diseases targeting different partners and audiences. The GF should play a strong advocacy role and should support the countries to develop their advocacy strategies. Communication efforts should be in accordance with country led principles i.e social, constitutional and political values that may vary from community to community. GF cannot / should not dictate or enforce a strict policy so long clearly identified population groups are being addressed appropriately. However, monitoring and evaluation strategies should ensure that no one in need is left out.

 May Farag

Responses from the International Center for Research on Women, Washington DC and New Delhi  to the questions posed about the Draft Gender Equality Strategy, Global Fund to Fight AIDS

Country Coordinating Mechanisms [Read background],

1.        How can CCMs be encouraged to ensure meaningful representation of women with skills and voice amongst membership and leadership, including those from beyond the health sector? 

Just as the draft strategy observes that there has been tokenism with regard to representation of people living with AIDS on CCMs, it is important that the GF guard against tokenism against representation of women on CCMs. We believe that the issue is much more about the quality of input with regard to gender issues to CCM deliberations, than about the quantity of women represented.  Not all women will bring a deep level of gender awareness to the CCMs. It is far more important to ensure that CCMs include people (men or women) with strong expertise on gender issues in their country context, which would imply not only an understanding of  the vulnerability of women and girls to HIV, but also an understanding of the vulnerabilities of men and boys to HIV due to harmful gender norms; the unequal power dynamics between men and women that influence the vulnerability of both sexes, but particularly girls and women; the different experiences of sexuality as between men and women and among young people; issues of sexual violence, coercion and exploitation; and the need to promote social dialogue and debate on HIV, sexuality, sexual violence, and gender norms. It may well be that individuals with this expertise would not be found in the health sector, so it may be necessary for CCMs to look broadly for this expertise, possibly by engaging relevant bodies, such and  women’s ministries and civil society organizations with experience in gender in other sectors, such as livelihoods, labor, women and children, youth and governance.    Therefore, we would suggest that incentives such as funding, not be aimed at 50 percent parity of men/women on CCMs, bur rather on getting a high level representation of gender experts.

2.        How can the Global Fund build the capacity of CCMs so that gender equality issues are understood and appropriately managed within the proposal development process through access to high quality gender expertise?

We agree with the draft strategy that there should be training and sensitization of CCMs on gender issues. To strengthen understanding of gender and its practical application among CCMs, the gender and HIV assessment should be an accompanied process, closely assisted by an experienced gender and HIV specialist. The gender and HIV specialist should provide capacity-building to strengthen CCM members’ understanding of the issues concerning gender equality, gender and HIV programming, sexuality, a rights-based approach, creating an enabling environment, and stigma and discrimination related to HIV, sex and sexual orientation, and class status also affects gender dynamics. Capacity-building should also focus on how to apply a gender analysis framework to policies and programmes, and ways to ensure accountability, for example through gender audits or gender budgets. Whenever possible, capacity-building efforts should be complemented by the provision of country-specific gender tools, rather than generic gender tools.  To the extent possible, this training and sensitization should be standardized for all CCMs, although adapted where necessary for the local context.  One way to achieve this would be to convene capacity building workshops convened just prior to each funding round.

The technical review of proposals [Read background]

3.        Should gender and age disaggregated data be required in the epidemiological background provided by applicants in proposals to the Global Fund?

Absolutely. Given the evidence that women and girls are contracting HIV at a higher and increasing rate compared with men and boys , particularly in Africa,  the Global Fund should establish this requirement as a clear goal and set a timeline for countries to be able to meet this goal, providing support for the development of data systems, where necessary.   The collection of sex- and age-disaggregated data is a basic part of sound public health practice, and will assist countries to ‘know their epidemic’ and ensure programming meets the needs of citizens equally.

4.        How should the Global Fund ensure that the TRP is appropriately resourced with recognized gender expertise?

Again, we would argue in favor of promoting gender knowledge and expertise among TRP members, rather than striving to achieve balance between the number of men and women as the primary means of achieving greater gender sensitivity.   Self-assessments by TRP members is likely to provide an insufficient measure of the level of gender sensitivity that exists, given the degree of subjectivity potentially involved. Instead, we suggest an objective tool be developed outside the TRP (perhaps by the Gender Champion?) to assess expertise of TRP members on gender.

5.        Should the TRP review criteria be revised to put more emphasis on gender equality elements of programs and interventions?

As the draft mentions, references to gender equality should be strengthened with definitions. While reviewing proposals, the TRP should apply a gender perspective to the review critera, especially the first and third review criteria – soundness of approach and potential for sustainability and impact. The TRPs could be provided with guidelines to do so, to ensure a comprehensive, objective and unbiased review.

6.        What should be the consequences for a proposal that does not sufficiently address gender, but in all other respects is 'technically sound'?

If failure to adequately address gender will lead to less than optimal impact of the program being proposed, then, yes, the TRP should return the proposal for clarification or resubmission especially if, as mentioned in the draft, the process is being adapted so as to shorten the time period between proposal submission and funding. This is why it is so critical that the TRP include meaningful gender expertise – the gender implications may not be immediately obvious to those without practical knowledge of gender issues in the context of HIV epidemics. Furthermore, sending a proposal back to countries for this reason would send an important signal to CCMs and grantees about the seriousness with which the Global Fund regards gender issues. 

Monitoring, evaluation and reporting [Read background]

7.        What gender equality service delivery areas should become available for Global Fund grants (e.g. gender-based violence, micro-finance etc)?

Certainly gender-based violence is critically important as a key factor in increasing vulnerability to infection, which should qualify for Global Fund grants.   Other key priorities should include consideration of the following evidence-based best-practices, based on an understanding of the social, political, economic and epidemic context:

1) economic empowerment – not simply microfinance, but combination approaches, such as the IMAGE project (which combined micro-finance with an HIV education and violence reduction program – see Pronyk et al 2006), or other strategies that enable women to earn income and lessen their economic dependence on men for basic survival, which may lead to risky behavior. This would include property and inheritance rights, and livelihood skills training (see Kelley Hallman, “Gendered socioeconomic conditions and HIV risk Behaviors among Young People in South Africa,” African Journal of AIDS Research, 2005; Richard Strickland, “To Have and to Hold: Women’s Property and Inheritance Rights in the Context of HIV/AIDS in Sub-Saharan Africa,” Washington: ICRW, 2004). At the same time, there is a strong need to expand operational research to more closely explore the precise nature of the relationship between poverty/economic status and HIV infection in different settings;

2) education, given the persuasive evidence that higher education levels are associated with lower HIV incidence in some settings, and the need to reach young people and girls in schools with information and education about HIV.    (See Hargraves et al 2006 for an evaluation of the impact of secondary education on HIV vulnerability in South Africa).

3) male norms and attitudes that affect male behavior, ranging from acceptance of violence to the expectation that men have multiple sexual partners, which may increase the risk of infection for men or their partners.   An example of a program that has been successful in changing male norms across a range of settings is Program H (see: Gary Barker, Dying to be Men: Youth, Masculinity, and Social Exclusion, Routledge,2005). Another issue to explore relates to the gender imbalances between men and women for care and support of those living with HIV and AIDS.

8.        Should the Global Fund require reporting of sex and age disaggregated data for its key indicators?

Yes, for key indicators, sex and age will be essential for examining the gender and age differential of the epidemic; the Global Fund should develop a standardized gender- and age- disaggregated data base system. Again, funding and capacity-building assistance should be provided where necessary to permit the establishment of appropriate data collection systems.   Ideally, the Global Fund should move beyond sex and age disaggregation to include outcome and impact indicators that capture changes in factors that affect vulnerability of women and men (e.g., changes in attitudes or norms related to domestic violence or cross-generational sex, reductions in incidence of transactional sex, etc.)

9.        How can country reporting systems be best supported to include better gender and age evaluation and analysis (role of partners, evaluations, and operational research agenda)?

There is an urgent need for operational research and evaluations that can examine more deeply and more broadly the gender dimensions of the AIDS epidemic.   We would strongly encourage the Global Fund to respond to this need and to set aside specific funds that countries can be used only for this purpose. In addition, the Global Fund could support capacity building for research and evaluation of appropriate institutions in recipient countries, -- a strong need especially in Africa -- perhaps by global partners with this expertise. 

10.     Should the Board provide an extra funding line for countries to access at Phase 2 in order to improve the gender equality orientation of existing grants?

Yes, Phase 2 should incorporate a meticulous tracking of interventions, which should be supported by dedicated funding.

Partners and networks [Read background]

11.     Are there mechanisms other than MOUs and agreements with which to hold partners accountable for their role in supporting programs that address gender inequalities in Global Fund grants?

The Global Fund might consider periodically commissioning a national or international organization to perform a “gender audit” of its portfolio in a recipient country that will assess the various dimensions of gender integration outlined in the gender equality strategy. It might be part of the detailed evaluation every 1-2 years that is under consideration, or it could be a separate process.   The final audit could be submitted to the Global Fund board. The criteria for the audit could be widely circulated, so that all partners would know the factors on which they are being judged. 

Advocacy and communications [Read background]

12.     Should the Global Fund communicate all messages on gender sensitive programming at all times and play a strong advocacy role or should it adjust its message to different political and social contexts and stick closely to a country led principle?

Despite the tension between the GF’s country-led principle and the role of strong advocate in favor of gender-sensitive programming, we do believe it is essential for the Global Fund to communicate in very clear terms the priority it assigns to gender equality.   This is necessary given the lack of priority that many countries give gender equality, with serious consequences for women and men alike. In some settings it might be helpful if the gender equality principles are couched in human rights terms. In other settings, it may be necessary to couch these principles in terms of sound public health practice. To the extent possible, the GF should identify and support gender champions among partners and government officials within recipient countries, to ensure that messages promoting gender equality are coming from inside as well as outside the country.  

To,

Draft of theThe  Gender Equality Strategy of the GF,

Technical review proposals-

1.Gender & age disaggregated data based on gender education,skills,
reproductive health& employment status in less GDP countries
could give evaluation of constrained factors attributed gender
diseases to TRP&TERG.On the basis of aggregated& disaggregated
data,TRP&TERG could develop specific country's GF-TRP framework
for gender equality strategy& provision of funding allocation
based on gender facts.
In GF mechanism, Technical review panel(TRP)is also an important
component for evaluation of constrained factors attributed diseases.
TRP & TERG could include mandatory maternity services procurement,
equipment& product procurement,socio-economic indicator analysis
for health care delivery.
2-
In less GDP & less health infrastructure countries ,TRP & TERG
could integrate with Community System Strengthening component like
Gender fact,affected population,health system strengthening for
procurement of Gender(Women & girls)data for providing basic health
infrastructure provision linked with occupation,working,&service
conditions,primary education to higher education,unorganised service,
rural community structure.TRP should appropriately resourced with
country's specific gender expertise.
3-The TRP& Proposals should be based on gender specific program&intervention.
TRP could develop an independent specific gender component for
monitoring acquired,genetically,differential resistance,
nutritive& bio-availability factors for prevention of gender specific
diseases.
TRP& TERG could develop treatment protocol & algorithm for specific
gender including blood transfusion,prevention of haematological
abnormalities,PCR methods,voluntary testing,community action
cycle,rural GF's specific guide,GF's vaccination motivation,GF's
specific gender treatment,clinical,statistical,lab,representation
according to country constitution.
4-Technical review panel& TERG are technical concepts for addressing
technical issues.TRP&TERG should develop intra-TRP & intra-TERG
framework within countries.These framework should be linked
with GF nodal TRP&TERG mechanism for right assessment of
countries technical priorities,products& services procurement
according to country's social expectation& gender specific basic
health infrastructure& requirement.Above exercise could avoid
shortcoming in understanding of technical priority based on gender
facts for specific countries.

Thanking you

ASHISH SRIVASTAVA
ex-International Marketing
CCM(SEAR-INDIA)8127

To, The draft of the Gender Equality Strategy of the GF.

Advocacy & communication
The GF has international expertise health & development framework with policy ,technical issue,professional learning ,survey& research& international monetary structure for resources mobilization,disbursement of fund,funding decision& community system
strengthening. Many countries do not have these formal international framework & mechanism for addressing number of major human development &ecology issues & survival of essentials. At all times gender sensitive program communication should depend upon country's social& political accountability,commitment for gender facts.Definitely GF has strong advocacy &improved international communication framework in the form of CCM,CSS,e-forum,for global participation,GF could play an important strong advocacy role for gender equality strategy globally by providing different political& social institution participation/ contribution/ communication/ human development/ participation of political activist/ faith leaders for awareness,international health guidelines for gender facts/ framework for mass campaign against number of diseases based on gender facts,global partnership for gender related development& empowerment measures. The GF has strong economical advocacy framework for strategic intervention in the form of CSS,GF advocacy in the areas of education, &economic opportunity for women & girls could reduce risk of exploitation,inhuman approaches,& diseases.GF advocacy could include importance of investing more in gender education,skills,reproductive health & employment.

Thanking you

ASHISH SRIVASTAVA
ex-International Marketing
CCM(SEAR-INDIA)81237

To,
The draft of the Gender Equality Strategy of the GF.

Partner & Network
The GF grants consideration in many countries,internal assessment of partners participation (Governance,national plan,public-private partnership,contribution,country's corporate financial contribution relationship,consumption pattern)within countries could analyse internal constraints of addressing gender inequalities. Other mechanism could be involved in country's community structure with constitutionally formed formal voluntary organisation,social institution,research institutional mechanism, community based organisation favoured gender sensitive approaches,GF has focused disbursement of funds,grants agreement,resources mobilization mechanism.Country's own social,economical,&cultural network capacity &accountability of addressing gender inequalities could give aggregated& disaggregated data to CSS for funding grant agreement based on gender facts.
Several external partners like (WHO,UNAIDS,UNICEF,UNDP,UNITAID-CLEAN SPACE MECHANISM,MDG,WORLD BANK,MNCs product&services)have also given intervention strategies for universal coverage, for addressing gender inequalities.These international& external partner could give qualitative(statistical)&qualitative(products& services)with rational use support,ant-discrimination provision,gender empowerment,solution for socio-economic subjective objections in less GDP countries for
addressing gender inequalities.

Thanking you

ASHISH SRIVASTAVA
ex-International Marketing
CCM(SEAR-INDIA)81237

To,

The draft of the Gender Equality Strategy of the GF

Monitoring,evaluation & reporting -

1-
The GF grant consideration & funding decision could include Gender
Equality Strategy for addressing right to health(treatment&services)
nutrition,family planning,social & micro insurance,employment,
female education,health related system(agricultural,rural,social,
community system,industrial social responsibility).
In CSS, grass-root solution,gender fact,grant consolidation,health
system strengthening& sexual minority component could decide
appropriate gender equality strategy according to need & social
expectations rather than more & excess funding maladjustment.
Socio-economic indicator,& general equilibrium analysis could be
involved in GF grant consideration based on gender equality strategy.
In less natural& economical resources,less GDP countries, gender
equality strategy could require above indicators & analysis for
adequate measures, for grant consideration based on gender facts.
2-
For above strategy,GF could use GF information system which consist
of specific country reporting system based on gender facts,state&
peripheral data,behaviour data,equilibrium data,provision of survey
with country constitutional feasibility for providing adequate
data for funding decision based on equitable access of treatment&
services according to need.Distribution of funding component could
use above differential data for formation of gender based portfolio
for determining gender equality.
3-
The GF mechanism has GF principles& CCM,country reporting system
could link with above principles& mechanism, country reporting
system should consist of capable social institution for addressing
gender sensitive implementation& basic health information system,
including rural& community connectivity,expanded surveillance system revised methodlogy,based on national & state research institutes for
tabulation& analysis of gender survey& age evaluation data.
4-
The objective of phase-2 funding is based on overwhelming implementation of financial instrument,fund raised & spent,innovative
finance,& distribution of funding for resources mobilization& addressing universal coverage for every one(prevention of specific
diseases globally).
Gender Equality strategy could be involved in CSS,CCM,for specific
countries with balanced manner component & availability of additional
financial resources.In the above process ODA( official development
assistance)could develop additional financial resources for
gender equality strategy of the GF.

Thanking you

ASHISH SRIVASTAVA
ex-International Marketing
CCM(SEAR-INDIA)81237

CCMs

1. For the GF to ensure meaningful representation of women with skills and voice among membership / leadership issues, there would be cogent need to carryout recruitment Process from experienced NGOs/CSOs that are reaching the grass root.  Again, those that show some degree of interest but lack the necessary skills should be properly empowered through skills and capacity building to carry them along.

2. For the GF to build the capacity of CCMs to understand and manage gender equality issues, there would be need to build the capacity of the actors very well to enable them function well. Use gender expertise to carryout capacity building for CCMs. 

TRP

3. Using gender and age as a yardstick for proposal approval will not make very positive impacts.  The MDG 3 talked of promoting gender equality and women empowerment.  However, there are 7 other goals all working in one area or the other hence organization may involve in one, two or more of the goals.  Secondly, the issue of age should not be a barrier.  Both old and young have something to contribute to the attainment of the MDGs.

4. For the TRP to be appropriately resourced, there would be need for detailed evaluation process that will ascertain the level of experience and expertise. 

5.   Taking into consideration, what is obtaining as at the moment, the review criteria could be revise as this will go a long way in positioning organizations aright for better achievements and possible attainment of the GF Objectives.

6. A technically sound proposal must address gender.  The MDGs does not only focus on gender issue.  This is just one out of eight and for it to be achieved, organizations are to involve in either of the MDGs hence proposals that focus on other areas and meet the requirements (based on MDGs) is worthy of consideration. 

M,E&R

7. Gender Equality services delivery areas should include and not limited to Gender-Based Violence, Micro finance, Promotion of Maternal Health, Skills Empowerment, Capacity Building on the approaches to Elimination of All Forms of Discrimination Against Women, Promotion of Women Participation in Politics etc.

8. Well, there is need for age and sex in reporting instruments.  The reason is because this can prove whether or not the gender equality issues are being addressed in programs. 

9. Country reporting systems can be supported to include gender and age analysis through building the capacity of key actors in the area of ICT, Infrastructural equipment for detailed data capture and collection.  Again, there would be need to design and administer data capture instruments in that regard.

10. This is very important as noted above because it will surely position organizations well to address the gender equality issues. 

PARTNERS AND NETWORKS

11. MOUs and Agreement are paper works.  CSOs work has gone beyond armchair thing.  It involves and goes beyond routine visits, spot checks and visits to project sites as verifiable evidences and approaches.

ADVOCACY AND COMMUNICATIONS

12.  The GF on her own should communicate all her messages on gender sensitive programming at all times, and play a strong advocacy role. No adjustment please.