Challenges in developing strong Global Fund proposals related to sexual minorities (and what to do about these barriers)

About CVC CVC is a coalition of organisations and individuals working in rights-based HIV prevention, care, treatment and support in the Kreyol, Dutch, English, French and Spanish speaking Caribbean.

CVC Especially Vulnerable Populations subject to hostile stereotyping unable to challenge their status possess little or no social protection systems to remedy the way they are treated

CVC Focus Populations Drug Users Sex Workers Prisoners Men who have Sex with Men and Transgender People

Three challenges and actions to address them 1.Who convenes, coordinates, and leads in the development of proposals? Global Fund partners, especially UNAIDS cosponsors, should facilitate civil society organizing. 2.Who advises on evidence-based needs assessments and technically-sound approaches? Global Fund partners should support technical input. 3. Is the proposal development process accountable to programmatic considerations rather than political and institutional interests? Global Fund partners can review and advise on programme design and budgetary allocations (e.g. mock TRPs).

1. Who convenes and coordinates?  Caribbean Broadcast Media Partnership (CBMP)  Caribbean Drug Abuse Research Institute (CDARI)  Caribbean Forum for the Liberation of All-Sexualities, and Gays (CARIFLAGs)  Caribbean Harm Reduction Coalition (CHRC)  Caribbean Sex Worker Coalition (CSWC)  Caribbean Treatment Action Group (CTAG)  CVC Access to Treatment Working Group  CVC Human Rights Working Group  Centro de Orientación e Investigación Integral (COIN)

Global Fund partners should facilitate civil society organizing Barbados: Sterling Mungal Belize: Caleb Orozco Curacao: Dudley Ferdinandus, Mario Kleinmoedig Dominican Republic: Carlos Adón, Robert Paulino, Santo Rosario, Leonardo Sanchez, John Waters, Nairobi Grenada: Andre Blackman, Nigel Mathlin, Anita Radix Guyana: Miriam Edwards, Stacey Gomes, Donna Snagg Haiti: Harry Beauvais, Steeve LaGuerre Jamaica: Princess Brown, Robert Carr, Howard Gough, Rohan Lewis, Deborah Manning, Jason McFarlane, Ian McKnight, Karlene Williams-Clarke Saint Lucia: Veronica Cenac, Marcus Day, Joan Didier Saint Vincent and the Grenadines: Charles Woods Suriname: Juanita Altenberg, Milton Castelen, Soca Trinidad and Tobago: Dona da Costa Martinez, Denis James International: UNDP, UNAIDS, UNFPA, PAHO

2. Who provides technical input? Documented high HIV prevalence and high HIV exposure among prisoners, drug users, sex workers, and men who have sex with men throughout the Caribbean

Technical input about interventions Objective: Objectively Verifiable Indicators (OVI) 1. Members of the four most-at-risk populations will increase their access to, and utilization of, appropriate ongoing interventions for HIV prevention, treatment, care, and support. (SDA: Behaviour Change Communications) Number of individuals in targeted networks reached with a defined comprehensive set of interventions by demonstration programmes (Centres of Excellence) providing peer outreach, counselling, case management, health services (including HIV VCT), & health referrals.

Technical input about policy Objective: Objectively Verifiable Indicators (OVI) 2. Evidence-based health and human rights policies, practices, and interventions related to most-at-risk populations proposed and supported by individuals with direct experience with those most-at-risk populations. (SDA: Policy Development) 2.1: Number of individuals regionally trained and supported to address and promote human rights and sexual and reproductive health of most-at-risk populations. 2.2: Number of regional policy reports and other publications produced from the perspective of most-at-risk populations to support evidence-based policies, practices, and interventions.

Technical input about capacity Objective: Objectively Verifiable Indicators (OVI) 3. CVC, as a coalition of most-at-risk populations and their advocates, will support innovative programming, disseminate evidence and best practice, and participate in regional HIV planning and evaluation. (SDA: Strengthening of civil society and institutional capacity building) 3.1: Number of people participating in regional networks aimed at facilitating regional exchange and dissemination of best practice. 3.2 Number of individuals experienced of prisoners, drug users, sex workers, and MSM populations leading regional HIV grantmaking initiatives. 3.3: Number of individuals participating in CVC governance as a regional coalition of vulnerable communities.

3. Who holds process accountable? PANCAP Regional Objectives Expected Results and Regional Public Goods Objective 2.6: Facilitate further involvement of PLHIV, CSOs, NGOs, CBOs and FBOs in the HIV response Objective 3.3: Achieve Universal Access to targeted prevention interventions to reach and support MARPs. Objective 4.1 Expand access to treatment, comprehensive care and services Objectives 1.1, 1.2, 5.1, 6.2: Remove barriers to access; ground HIV responses in human rights and gender equality and equity; develop appropriate evidence- based policies, practices and interventions. ER 1.1, 1.2, 5.1, 6.2: Model legislation, policies and systems for social protection, policies for access, policies on stigma and discrimination, gender equity and equality, evidence-based policy. ER 2.6: Support groups and other networks for MARPs to become advocates for their own needs; capacity of MARPs to be involved in the HIV response ER 3.3, 4.1: Targeted BCC & VCT, improve national policies affecting prevention, develop peer education programs, train providers, decentralise services)

External review (e.g. mock TRP) Sufficient five-year budgetary allocation? Programme staffing Management and administrative staffing Contracted technical / training support Trainings/meetings Subcontracts Communications/media/web Monitoring and evaluation Overhead and indirect

Key Points Value of regional approach Focus on structural issues as well individual outreach Community-led strategy development –Policy, interventions, capacity Using existing entry points Ensuring budget allocations enable success

Thank you Sam Avrett Robert Carr