OIG Advisory Review on Removing human rights-related barriers: Operationalizing the human rights aspects of Global Fund Strategic Objective 3

Stigma, discrimination and punitive laws and practices have long blocked national responses to HIV, TB and malaria. Recognizing that maximum impact in the fight against the three diseases cannot be achieved without taking the human rights of beneficiaries into account, the Global Fund has elevated its commitment to removing human rights-related barriers to accessing services to the highest level as a strategic objective; the 2017-2022 Strategic Objective 3 is to Promote and Protect Human Rights and Gender Equality.

In November 2019, the Office of the Inspector General (OIG) published an Advisory Review on Removing human rights-related barriers: Operationalizing the human rights aspects of Global Fund Strategic Objective 3 (available in English and French). Here are some of the key points:

  • It is estimated that US$123 million of Global Fund funding has been invested to remove human rights-related barriers in the current 2017-2019 allocation cycle. This represents an over 4-fold increase for middle-income countries, and an over 7-fold increase for countries eligible for human rights matching funds, compared to the last cycle. I highly recommend looking at slide 12, which has details on the amounts invested in the human rights module, by country and by disease component.
  • There is a need to strengthen the collective and coherent understanding of what it means specifically to “remove human rights-related barriers”, in comparison to promoting “health as a human right” more broadly. Similarly, there can be a confusion around what constitutes “human rights activities” and what constitutes “key population activities” (the TRP found this to be a point of confusion in the matching funds request in 2017-2019). 
  • 40% of the OIG sampled countries did not fully identify human rights barriers in the funding requests, resulting in grants not including any programs to address them. For example, in four cases, funding requests identified key populations but did not specify any, or only very few, human rights-related barriers for these key populations.
  • A Human Rights Strategic Initiative of US$1.74 million (from unallocated matching funds) has been established to support the “Breaking down barriers” initiative, with technical assistance and support for multi-stakeholder meetings and mid-term assessments. Support to the 20 countries has been divided into “proactive” and “reactive” support. 12 countries will receive “proactive” support. 
  • The review raises concern that the 20 focus countries in the Global Fund’s “Breaking Down Barriers” Initiative excludes some mission-critical portfolios. Later on, it specifically highlights India, Nigeria and Ethiopia as countries with worryingly low investments in human rights programs, especially given their high disease burden and prevalence of human rights-related barriers such as stigma and discrimination.