More Advocacy Required for Adequate Inclusion of MSM in PEPFAR Processes

Published: November 11, 2015

Advocacy Still Required to Ensure Men Who Have Sex with Men and other Key Populations Are Adequately Considered in PEPFAR Processes

October 7, 2015On September 17th, the Executive Director of the Global Forum on MSM & HIV (MSMGF), Dr. George Ayala, met with Ambassador Deborah Birx and other officials from the Office of the U.S. Global AIDS Coordinator (OGAC) in Washington, D.C. to address ongoing revisions to PEPFAR processes. The MSMGF attended in partnership with a coalition of global civil society organizations, including Health Gap, AVAC, amfAR, Sister Love, and the African Services Committee, with the input and support of community organizations from Cameroon, Ghana, Kenya, Malawi, Mozambique, Uganda, and Zimbabwe.

MSMGF and its partners raised numerous concerns with PEPFAR processes regarding key populations, including: 1) Lack of technical strategy for prevention and treatment with key populations in PEPFAR’s global COP guidance, modeled on normative guidance issued by the World Health Organization and other global health agencies, 2) Failure to engage grassroots, community-based organizations representing key populations in service delivery and data collection activities, 3) Unambitious national prevention coverage targets, 4) Inadequate commitments to ensure country-level key populations data is made public, and 5) In many countries, lack of transparency regarding how grassroots, community-based organizations can make contact with PEPFAR country teams. The coalition’s complete feedback document, prepared by Health Gap with inputs from partners, can be consulted here.

In response, Ambassador Birx and the OGAC team committed to integrating civil society concerns in the current round of revisions to PEPFAR processes. The OGAC team provided additional details on several PEPFAR processes, including: 1) For Quarterly Reviews, in-country civil society will be provided program data two weeks in advance of an in-person meeting with the PEPFAR country team to provide feedback, 2) Global guidance for the PEPFAR 2016 COP Process will be released in January or February 2016, 3) COP submission will likely occur in May 2016, 4) Regional reviews will likely occur in May/June 2016, and will likely be shortened to 2-2.5 days total, with civil society invited for 1-1.5 days per review.

As the Quarterly Reviews begin this month, we remind our civil society partners of the crucial and urgent need to:

  1. Engage with your PEPFAR country team, which can be reached via your local U.S. embassy (Important: please inform us if you experience difficulty obtaining contact information from your U.S. embassy)
  2. Ensure that you receive a final version of your country’s approved COP directly from your PEPFAR country team
  3. Plan to participate in the first PEPFAR quarterly review civil society meetings, set to take place in October 2015, and insist that the PEPFAR country team provide key populations data a minimum of 2 weeks in advance of the meeting
  4. Continue to communicate with other major donors and key stakeholders, such as the Global Fund and the local Ministry of Health, to align priorities for key populations programming
  5. Communicate with OGAC, either via your PEPFAR country team or through global civil society like MSMGF, to provide input on improvements to the civil society engagement components of the COP review process

Note that your local U.S. embassy can also provide guidance on additional small grants that may be available through programs such as the U.S. Ambassador’s Small Grants Program. For background on the new PEPFAR COP process requirements, please consult our March, April, and June community updates.

As always, we greatly value receiving your thoughts and feedback, which help reinforce our advocacy efforts at local, regional, and global levels. We would appreciate hearing your perspectives on how PEPFAR engagement is going at country level, including examples of successes, positive experiences, and ongoing challenges. Please communicate your feedback and any questions/concerns you may have to Nadia Rafif, Senior Policy Advisor, at We thank you kindly for your much-appreciated engagement with this critical process.

A downloadable PDF version of this community update is here.

Kind Regards,



About Us: MSMGF has worked since 2006 to encourage targeted, tailored, better-resourced, and rights- based sexual health services for gay men and other men who have sex with men (MSM) worldwide through its advocacy and technical support work. As a global network, MSMGF has successfully influenced HIV responses at the local level through shifts in global-level policies and has effectively utilized public health as an entry point for advancing the human rights of LGBT people. MSMGF currently supports programs in 15 countries.

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Jack Mackenroth 

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