The MSMGF urges global donors to report investments for most-at-risk populations, ensure funding contributions align with disease burden
New Global Fund analysis of Round 8 budgets shows huge funding gaps for men who have sex with men, sex workers and people who use drugs
Earlier today, the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) released a new report detailing the fund’s investments in populations most at risk for HIV infection, including men who have sex with men (MSM), sex workers, and people who use drugs. The report, entitled Global Fund HIV Investments Targeting Most-at-Risk Populations: An Analysis of Round 8 (2008) Phase 1, reveals huge gaps in funding for populations that represent the majority of people affected by HIV across vast swathes of the globe.
The report analyzed funding for HIV activities specifically targeting most-at-risk populations during the GFATM’s eighth round, which took place in 2008. Of all funding in the HIV budgets for Round 8 — totalling just over US$900 million — only 2.1% of funds specifically targeted MSM, 3.5% specifically targeted people who use drugs, and 3.2% specifically targeted sex workers.
These figures are shockingly low, considering the disproportionate HIV burden borne by these populations in most regions around the world. Research indicates that in 2009 MSM represented an estimated 25% of the 1.7 million people living with HIV in Latin America and the Caribbean; UNAIDS currently estimates that people who use drugs account for 80% of all HIV infections in Eastern Europe and Central Asia; and in parts of Africa, sex workers and their clients are believed to make up as much as half of all infections. HIV prevalence rates in each of these populations exceed those of the general population in nearly every country that accurately reports epidemiological data, including countries with generalized epidemics.
The GFATM is not only one of the world’s largest HIV/AIDS funding mechanisms, it is also uniquely structured to be responsive to needs identified by recipient countries themselves – supporting programs developed by in-country boards in line with national strategic health plans and priorities. The discrepancy between HIV burden among populations most at risk for HIV and funding targeting these groups suggests in-country challenges with identifying need and directing resources appropriately – including ongoing and unaddressed stigma and discrimination against these groups. This is particularly troubling given research released at this year’s International AIDS Conference suggesting that increased coverage of comprehensive HIV prevention and treatment services for MSM results in overall improvements in HIV epidemics for the general population, irrespective of country or epidemic type.
By issuing this report, the GFATM has demonstrated strong leadership, transparency and accountability in its work with most-at-risk populations. These figures will serve as an essential baseline against which to judge future funding trends. The GFATM has already taken additional steps to enhance its impact on high-risk populations by introducing a Strategy in Relation to Sexual Orientation and Gender Identities (SOGI) in 2009 and a subsequent SOGI analysis of Round 8 and 9 proposals earlier this year. Such efforts are steps in the right direction and should be emulated by other major HIV/AIDS funders.
The Global Forum on MSM & HIV (MSMGF) applauds the GFATM’s continued efforts to improve services for MSM, sex workers and people who use drugs. However, as the GFATM notes in its SOGI Strategy, the financing of scalable HIV and broader health-related services can only do so much for those most at risk. These mechanisms must be further supported by political will, robust leadership from civil society, strengthening of community systems and constituency-led responses to create environments that encourage the more equitable access to resources and services. The MSMGF stands eager to support current and future efforts that align resource-allocation strategies of major donor agencies with the needs of MSM and other key populations.
The Global Forum on MSM & HIV (MSMGF) is an expanding network of AIDS organizations, MSM networks, and advocates committed to ensuring robust coverage of and equitable access to effective HIV prevention, care, treatment, and support services tailored to the needs of gay men and other MSM. Guided by a Steering Committee of 20 members from 17 countries situated mainly in the Global South, and with administrative and fiscal support from AIDS Project Los Angeles (APLA), the MSMGF works to promote MSM health and human rights worldwide through advocacy, information exchange, knowledge production, networking, and capacity building.