Country dialogues to identify human rights barriers and responses

A comprehensive situational analysis of health data can help to identify who has, and who is at risk of, a specific health issue in the country, considering information on incidence, prevalence and the coverage, quality and uptake of prevention, treatment, care and support services, including for adolescent girls and young women, key populations and other vulnerable populations. However, it is equally important to consider legal, human rights and gender equality barriers that impact on risk and vulnerability to health issues.

A participative, multi-stakeholder, nationally owned and led country or national dialogue is a critical first step, creating a useful forum for frank dialogue to identify who has and is at risk of health problems and how laws, policies, discrimination, violence, gender inequality and other human rights violations place populations at risk and create barriers to access to health services.

Country dialogues create an open and safe space to bring together a wide range of key stakeholders from government (including health and non-health actors such as law, justice, education, police, prisons and labour), the private sector, non-governmental and civil society organizations representing vulnerable and key populations, faith-based organizations, academia and bilateral, multilateral and technical partners.

This dialogue may then guide the development of national plans, investment cases, Global Fund or other health programme funding requests or other related national policies and strategies, by supporting countries to identify and understand:

  • Who are the key and vulnerable populations whose health is most at risk?
  • What legal, human rights and gender-related inequalities and barriers drive HIV and poor health for these populations?
  • How can countries best respond to address these critical enablers, by creating an enabling legal and policy environment that protects human rights, promotes gender equality, reduces stigma, discrimination, inequality and violence and empowers and includes key and vulnerable populations?

A country / national dialogue can also begin to identify rights-based and gender-sensitive activities, to build commitment and accountability, to form critical partnerships and to design programmes that promote responsibility amongst a broad range of stakeholders for creating enabling legal frameworks to respond to health.

Lessons Learned: Country dialogues and legal environment assessments

Holding a country dialogue or conducting a country-level legal environment assessment (LEA) is a recommended step towards identifying human rights and gender equality issues, including for key populations, and the barriers they create for access to HIV, TB and malaria health services, and programming accordingly.

The process of conducting a country dialogue or an LEA promotes country-led, multistakeholder, rights-based responses to HIV, TB and malaria, helping to:

  • Ensure an evidence informed approach to HIV, TB and malaria that takes into account human rights and gender equality issues facing all key stakeholders;
  • Promote accountability and commitment to rights-based responses to HIV, TB and malaria;
  • Ensure the participation and voices of key populations in programming for law and policy review and reform, access to justice and strengthened law enforcement;
  • Build the capacity of all key stakeholders to participate in interventions to strengthen legal and policy frameworks;
  • Build consensus and promote national advocacy around common priorities; and
  • Lead to the development of national multi-sectoral action plans with integrated, institutionalised responses that work at various levels.

Leveraging regional fora to complement country-level dialogues

In 2019, as part of the Global Fund-funded Africa Regional Grant on HIV: Removing Legal Barriers, UNDP and the Kenya Legal and Ethical Issues Network on HIV & AIDS (KELIN) organized a Regional Capacity Building forum on HIV, TB, Human Rights and the Law. The forum brought together health workers, law enforcement officers and representatives from key populations across Africa to examine how discriminatory practices are fueling the HIV and TB epidemics on the continent and to identify collective solutions. In line with the recommendations of the Global Commission on HIV and the Law, the forum highlighted the urgent need to tailor health services to key populations, and shared examples of good practices from across the region. Read more

Inclusive dialogue processes for Global Fund funding requests

The Global Fund recognises the importance of identifying key and vulnerable populations and the human rights and gender equality barriers they face, when developing a funding request.

Country stakeholders are encouraged to engage with their Fund Portfolio Managers to discuss the availability of technical cooperation from partners, and additional financial support to identify, reach and gather data on key populations from the Global Fund’s special initiatives.

Country stakeholders may wish to undertake capacity strengthening activities and technical assistance, to strengthen partners’ understanding of critical enablers. This helps to promote meaningful country dialogue that includes the participation of key populations, to support effective planning. There is also support to ensure the engagement of key populations in country dialogues, in order to ensure that the design and development of interventions addresses human rights and gender-related barriers affecting key populations.

The Global Fund’s website and the Applicant Handbook describe various forms of resources and technical assistance available during the funding request process.