The study assessed the experience of sex workers, men who have sex with men, people who use drugs and transgender people in Africa with consultations for the Global Fund, UNAIDS and PEPFAR. An online survey had 99 respondents from 25 African countries, and I spoke with key populations representatives in Cameroon, Kenya, Malawi, Nigeria, Uganda, and Tanzania, as well as a focus group in Malawi. The report was cosponsored and co-authored by AMSHeR, the Africa Sex Workers Alliance, Gender DynamiX, and Transbantu Association Zambia.
42 percent of key populations who responded had been consulted on national HIV strategic plans, 33 percent on Global Fund funding requests, and 19 percent on PEPFAR operational plans
Many complained that consultation was cursory and tokenistic, and few had seen the final plans or budgets to verify whether their input was included
Participation was complex, time-consuming, and unfunded — it often involved taking time off from day jobs, or travel at the respondent’s own expense
Some described retaliation or threats from key actors in their countries if they criticized performance of existing programmes
Despite the challenges, most expressed determination to continue to engage, in order to press for meaningful change.
As we think about future development of mechanisms to manage funds for the Covid-19 response, what works and what does not, it’s important to hear and reflect on these voices. The report includes recommendations, which the report partners discussed in depth with the Global Fund, UNAIDS and PEPFAR at the time.
More broadly, perhaps we should think about a community HIV archive to save reports like these from vanishing…
Data is increasingly important in planning and decision-making, but data can also be biased and shaped by our assumptions and gaps in knowledge. When this gap-filled data is plugged into algorithms, it can amplify existing forms of discrimination.
For example, the global HIV response is being undermined by the fact that many governments deny the existence of the key populations at greatest risk — gay men and other men who have sex with men, sex workers, drug users, and transgender people. Since no data is gathered about their needs, life-saving services are not funded, and the lack of data reinforces the denial. This creates a data paradox which can warp national health priorities and plans.
As this Tedx talk explains, stigma, discrimination and inequality are systematically creating invisibility which can keep marginalized, stigmatized groups uncounted and unserved. To break the vicious cycle of this data paradox, we have to change the power relationships that keep some groups hidden and on the margins.
With restrictions in many countries on nongovernmental organizations, and sweeping new laws coming into play in response to COVID-19, is space closing for civil society, journalists and other whistleblowers in global health? Leading international activists and journalists debated this question from national and international perspectives, on 19 May 2020, as part of the Graduate Institute’s 73rd World Health Assembly week. Co-organised by the Global Health Centre, STOPAIDS and Medicus Mundi International.
Gargeya Telakapalli, Research Associate, People’s Health Movement
Mercy Korir, Medical Doctor; Journalist, KTN News, Kenya
Mike Podmore, Executive Director, STOPAIDS; Chair, Action for Global Health
Nadejda Dermendjieva, Executive Director, Bulgarian Fund for Women
Thomas Schwarz, Executive Secretary, Medicus Mundi International
Moderated by Meg Davis, Special Advisor, Strategy and Partnerships, Global Health Centre
In 2017 I was honored to be one of three recipients of the International Geneva Award from the Swiss Network for International Studies (SNIS). Here’s a 4-minute video interview about that work, now transmogrifying into part of my forthcoming book, The Uncounted: Politics of Data in Global Health. Many thanks to Ruxandra Stoicescu and the SNIS team.
Matt shared his recent study on the impact of the Global Fund on good governance in countries, Dr. Goosby and I shared comments, and we had a rich, focused discussion with some good audience questions. In hindsight, I only wish that I had spoken slower 🙂
Listen to the recording, and see the slides, here.