Communities living with and impacted by the three diseases and civil society have been at the heart of everything the Global Fund does from the very beginning. Indeed, it was the grass-roots efforts of thousands of community and civil society groups around the world advocating for increased resources for the response to HIV that led to the creation of the Global Fund in 2002.
Since that time, communities and civil society have played an active role at every level of Global Fund operations, from policy development to implementation. They continue to advocate for a rights-based and gender equitable response to the three diseases.
Communities and civil society actively participate in governance at the international level. Of the 20 voting seats on the Global Fund Board, ten are allocated to implementer constituencies – of which three are held by community and civil society representatives. One seat represents nongovernmental organizations from the developed world, one represents nongovernmental organizations from the developing world, and the third seat represents communities living with or affected by the three diseases. As voting members on the Board, they play a critical role in the development and evolution of organizational strategy, the funding model, the work of the Secretariat and policy.
At the country level, community and civil society representatives participate actively in the decision-making process through membership in the Country Coordinating Mechanism, the national body that is responsible for creating the requests for funding and overseeing implementation. While it is still a challenge to ensure that everyone is able to contribute in a meaningful way, these organizations are increasingly making their voices heard.
In addition to participation in the Country Coordinating Mechanism, community and civil society play a key role in ensuring a thorough and empowering country dialogue around the responses to AIDS, TB and malaria.
Community and civil society organizations also play an important role in influencing how government budgets address health and in delivering messages that hold governments accountable and transparent. In both donor and implementing countries, communities and civil society are an important partner in advocating for increased government health spending and resource mobilization. The Global Fund follows country health financing trends and creates ways for civil society to more deeply understand the current state of domestic financing for health, including as those trends relate to countries’ co-financing commitments to the Global Fund.
Community and civil society organizations also play a central role at the local level. Community-based and civil society organizations serve as implementers of Global Fund grants and are often best placed to work with populations marginalized and excluded from mainstream health services. There is ample evidence demonstrating that programs implemented by communities and civil society are fundamental to ending the three diseases. These organizations also play a critical role in representing the needs and interests of key and vulnerable populations in the design and implementation of programs, and in monitoring for quality and equitable access, to ensure that programs are implemented as intended.
On a more political level, community and civil society play a crucial role in advocating on behalf of the Global Fund, both in raising awareness in implementing countries and as part of larger fundraising efforts with donor governments.
They are also critical voices in advocating for human rights, gender, inclusion of key populations and community systems strengthening, which are all key elements of the Global Fund Strategy 2017-2022. From time to time, their advocacy is focused on the Global Fund itself - pushing it to be more effective in addressing these and other areas. Many civil society organizations are members of the Global Fund Advocates Network (GFAN), which builds on and brings together the structures, expertise and experience that has been developed since 2002 to support the Global Fund. GFAN works with advocates, activists and affected communities in both the global south and the global north, as well as with Friends of the Fund organizations.
“Civil society” is the term the Global Fund uses to designate all those stakeholders who are neither government bodies nor private sector enterprises – groups such as international and national nongovernmental organizations, advocacy groups, faith-based organizations, networks of people living with the diseases, and so on.
“Communities” is used to refer to people who are connected to each other in varied and distinct ways, such as people who are particularly affected by a given health problem or people who share particular characteristics or vulnerabilities due to gender, identity, geography, behavior, ethnicity, religion, culture or age. Community groups are also part of broader civil society.