A call for Sex workers’ health equity at the Global Fund 7th Replenishment Meetings.

Modeste MAMBO AMISI who is the Executive Director of a sex workers-led organisation namely Homme Pour Les Droits Et La Sante (HODSAS) in the Democratic Republic of Congo (DRC) attended the 7th replenishment preparatory meeting in Nairobi Kenya in the lead up to the Global Fund’s Seventh Replenishment Conference which will be held in the United States in September 2022.

HODSAS was joined by the DRC Ambassadors of France and Switzerland and India Council to advocate for ‘’the power of more, fight for what counts, meet the target, get back on track and better together’’ in the fight for HIV, Malaria and TB response. Modeste called for funding on health equity for sex workers in Africa.

History of the Global Fund

The Global Fund to Fight AIDS, Tuberculosis and Malaria was created in 2002 to raise, manage and invest the world’s money to respond to three of the deadliest infectious diseases the world has ever known namely HIV, TB and malaria.  The mission of the Global Fund is to invest the world’s money to defeat these three diseases.

Find the Global Fund’s ambitious new Strategy

The Global Fund Advocates Network (GFAN)

The Global Fund Advocates Network (GFAN) was established in 2011 to unite voices and efforts from all over the world to support a fully funded Global Fund to Fight AIDS, Tuberculosis and Malaria. GFAN is hosted by WACI Health in Nairobi, Kenya.

What is Global Fund replenishment?

The Global Fund replenishment is a funding mechanism that raises money on a three-year cycle known as Replenishments. This fundraising structure began with the First Replenishment, held in 2005 to raise funds for 2006-2007. Prior to 2005, all funding came from ad hoc contributions. At the Sixth Replenishment, hosted by President Emmanuel Macron in Lyon, France, in October 2019, the Global Fund received an unprecedented amount of US$14 billion in pledges to fund grants over the three years 2021 to 2023.

7^th Replenishment

The Global Fund’s Seventh Replenishment is a fundraising structure that aims to raise at least US$18 billion between 2024-2026. There have been 6 replenishments that Global Fund used to fundraise for HIV, TB and Malaria response.

The targetted US$18 billion is the minimum required to get the world back on track toward ending HIV, TB and malaria, to build resilient and sustainable systems for health and strengthen pandemic preparedness, making the world more equitable and safer from future threats.

The Global Fund’s Seventh Replenishment Conference will be held in the United States in the second half of 2022. This Pledging Conference will be held in September 2022.

7th Replenishment Preparatory Meeting

The Preparatory Meeting was hosted virtually by 5 countries: the DRC, Kenya, Rwanda, Senegal and South Africa, on Feb 23-24, 2022.

During the Preparatory Meeting, the Global Fund Secretariat released its Investment Case for the 7^th Replenishment. The Investment Case is an important document that sets the tone and frames the conversation until the pledging Conference in September 2022. Just as importantly, it contains the Ask of the Global Fund.

Global Fund Replenishment Round Table Meeting To Showcase Global Fund successes

The Global Fund Replenishment round table meeting was organised to showcase Global Fund successes in the fight against HIV,TB and Malaria.During the meeting,sex workers were represented by Sex Workers Outreach Program (SWOP) AMBASSADORS,Bar Hostess Empowerment and Support Program (BHESP) and HIV and AIDs People Alliance of Kenya (HAPA-Kenya).

HAPA Kenya Programs Officer Kevin Mwendwa thanked the Global Fund for funding sex workers program.He further asked that the Global Fund should provide sustainable and core funding to sex workers health programs.

7 Asks for the 7th Replenishment

What Civil Society Wants to See in the Investment Case.

1. BOLDNESS & AMBITION: The Investment Case needs to include a bold and ambitious Ask. The Ask is at the center of the document, and needs to be commensurate with the task at hand, which is truly unprecedented. We estimated the need for response to the three diseases over the upcoming implementation period to be $28.5 billion in our Civil Society Ask. In order to meet this need, public and private donors need to increase their commitments significantly. 
2. PEOPLE-CENTERED APPROACHES: Centralized, top-down responses to COVID-19 have been in the limelight for two years. We know these approaches do not work to effectively respond to HIV, tuberculosis and malaria. Health issues are best addressed holistically, and in a spirit of partnership. This is the spirit the Global Fund must keep putting forward, even if it means going against global trends. This is why GFAN advocates for at least $4.5 billion to strengthen community-led responses for the next replenishment.
3. TOWARDS SUSTAINABLE DOMESTIC RESOURCE MOBILIZATION: Robust Domestic Resource Mobilization (DRM) predictions, grounded in realistic and explicit assumptions. Implementing countries face a triple COVID economic threat – a rise in COVID-related health costs, a COVID-created economic recession, and increased debt burdens. Any DRM projection needs to be cognizant of these stresses. DRM projections were a weakness of the last Investment Case that needs to be addressed in the upcoming one.
4. CLARITY ON PANDEMIC PREPAREDNESS: the object of the Replenishment is to raise funds to end AIDS, tuberculosis and malaria. The Investment Case should not include additional funding to help the Global Fund fulfill a dedicated role in the emerging pandemic preparedness consensus; regardless of how important this role can be. It has to be funded separately, and there should be no room for ambiguity on the matter. At the same time, under COVID, the same funds for HIV, TB and malaria do not get us as far as they could. The cost of service delivery has been higher during the pandemic and that challenge needs to be discussed in the Investment Case.
5. PROTECT THE RIGHTS OF KEY & VULNERABLE POPULATIONS: The strength of the Global Fund is its partnership, featured prominently in its strategy for 2023-2028. Central to the success of the partnership has been key and vulnerable populations. In a global context where health is talked about as a security issue, we want to see the Global Fund’s commitment to partnership with marginalized and vulnerable folks reaffirmed. In the same vein, civil society needs to know it can count on the support of the Global Fund, especially in hostile and unsupportive environments. The past two years have seen rising threats against human rights, in particular those of LGBTQI+ people. Many need to know the Global Fund would stand behind them even if no one else would.
6. HEIGHTENED FOCUS ON PRIVATE SECTOR AND FOUNDATIONS: The Investment Case needs to clearly spell out the value proposition to the private sector of eliminating infectious diseases; there are many lessons from the last two years to underscore this point. It is critical that existing private sector and foundation partners of the Global Fund step up and face the challenge to raise a much more significant portion of the $28.5 billion. It is also critical that new partners join their ranks. 
7. ATTAINING THE 2030 AGENDA: The 2023-2028 Strategy discussions highlight the importance of aligning Global Fund objectives and needs with global plans, reflected by the Sustainable Development Goals and reaffirmed for each of the three diseases in international commitments. Alignment with these plans and objectives needs to be reflected in the Investment Case, which means that the ask must account for the full need and demand to achieve the goals we have set for ourselves for the three diseases.

Replenishment	Year Launched	Funding Period
First Replenishment	2005	2006-2007
Second Replenishment	2007	2008-2010
Third Replenishment	2010	2011-2013
Fourth Replenishment	2013	2014-2016
Fifth Replenishment	2016	2017-2019
Sixth Replenishment	2019	2020-2022
Seventh Replenishment	2022	2024-2026

Sex workers in Africa join the Global Fund and Global Fund Advocate Network to;

1. Maximizing people-centered integrated systems for sex workers health to deliver impact, resilience and sustainability.
2. Maximizing the engagement and leadership of sex workers communities to Leave No sex workers behind.
3. Maximizing sex workers health equity, gender equality and human Rights.

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