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Published: 17 October 2023

Gender Equality

The Challenge

In every region of the world, gender remains a key factor in health and well-being.

Women and girls often face higher risks and vulnerability to infection, barriers to health information and services, and a lack of decision-making power and control over resources. In addition, rigid gender norms and roles and relationships around masculinity and femininity contribute to worse health outcomes for men and boys as well as women, girls and gender-diverse communities. Key and vulnerable populations, who are already at greater risk, often face additional discrimination that is compounded by harmful gender norms and gender inequality.

Gender inequality in particular has long been recognized as a powerful driver of the HIV epidemic. Adolescent girls and young women are still disproportionately affected: In sub-Saharan Africa, 6 in 7 adolescents aged 15-19 who are newly infected with HIV are girls. Gender differences and inequalities can also influence tuberculosis (TB) outcomes. While women generally face greater barriers to TB care, men are more than twice as likely than women to have active TB. Harmful gender norms around masculinity may also lead to greater exposure to risk factors for men, like smoking and working in high-risk occupations, as well as a lower likelihood to seek care. Gender roles, relations and dynamics have an impact on the malaria epidemic as well. Women’s limited economic and decision-making power may impede their ability to access insecticide-treated nets, attend antenatal care and receive malaria prevention, or seek treatment for febrile children.

Ending HIV, TB and malaria as epidemics cannot be achieved through biomedical interventions alone. We must confront the injustices that make some people especially vulnerable to diseases and unable to access the health services they need. We cannot end HIV, TB and malaria as epidemics without prioritizing gender equality.

Our Response

The Global Fund is committed to addressing gender inequality in all the work that we do – not only through specific support related to gender equality and health (for example, changing harmful gender norms, tackling gender discrimination and gender-based violence, supporting comprehensive sexuality education) but also in the way we work with our partners to increase gender equality and ensure that people's gender-related needs are met. It is a way of analyzing, prioritizing and learning that should be applied across all programs and all three diseases.

Through our 2023-2028 Strategy, our approach will go beyond responding to gender differences and will aim to help transform social and cultural norms, as well as address discriminatory laws, policies, and practices that contribute to gender inequalities and increase vulnerabilities to HIV, TB and malaria. Our key priorities are to scale up programs to remove human rights and gender-related barriers to health; support comprehensive sexual and reproductive health and rights; develop programs that amplify the voices and priorities of young people, particularly adolescent girls and young women; and collect, analyze and use age- and sex-disaggregated data to identify drivers of inequality and inform responses. As part of our commitment to advancing gender equality, we have also adopted a Gender Equality Marker. This is meant to not only provide transparency on our funding and measure how well our funding is working, but also to advance gender equality and highlight where we can strengthen and improve our efforts.

Our Breaking Down Barriers initiative supports countries to design, fund, implement and scale up programs that use community data and feedback to identify and remove human rights-related barriers to HIV, TB and malaria services, including gender discrimination. Through this initiative we have provided grants and technical support to drive the development and implementation of country-owned programs that provide a comprehensive response to the barriers that continue to threaten access, uptake and retention in HIV, TB and malaria services. The initiative also supports the collection of data and evaluates the progress made by the programs.

When it come to health, gender equality means that everyone has equal rights and access to the highest standard of health care. Health equity is an approach to achieving gender equality, which recognizes that people who are marginalized often need more resources and additional support in order to have the same health outcomes as others. The Global Fund is committed to this equitable approach, and is taking deliberate steps to invest in, prioritize and work with marginalized communities so they can achieve equitable access to health.

Adolescent girls and young women remain a key focus of the Global Fund’s response to HIV. Between 2018 and 2020, Global Fund investments in HIV prevention and testing for adolescent girls and young women increased by 107% within the 13 priority countries where the HIV burden is highest, and in these countries the HIV incidence rate among adolescent girls and young women has dropped by 56% since 2010.

To end HIV as a public health threat, we must also work with boys and men to transform cultural and social norms that perpetuate gender inequality and continue to drive infections.

Find out more

We support the HER Voice Fund, which provides small grants to organizations in 13 priority countries (Botswana, Cameroon, Eswatini, Lesotho, Kenya, Malawi, Mozambique, Namibia, South Africa, Tanzania, Uganda, Zimbabwe, and Zambia) to amplify the voices of adolescent girls and young women to inform the decisions that affect their lives, including through training, mentoring and involvement in advocacy campaigns. We also support the VOIX EssentiELLES fund, in collaboration with Fondation CHANEL, to help women and girls in West and Central Africa organize and engage in decision-making around health policies and programs.

Harmful gender norms and ideas around masculinity harm men’s health too. Through the Tuberculosis in the Mining Sector in Southern Africa Programme, the Global Fund is supporting mineworkers and their families across 15 countries affected by TB. The project aims to significantly decrease the incidence of TB in the mining sector, including by tackling gender barriers such as masculine norms that affect men’s health-seeking behavior, as well as addressing gender inequalities that result in a lack of women-centered services.

In challenging operating environments – countries or regions that experience infectious disease outbreaks, natural disasters, armed conflicts or civil unrest, weak governance, climate change-related crises and/or mass displacement – gender inequities are often particularly pronounced. The Global Fund supports sexual and gender-based violence prevention services in these environments, as well as services for post-violence care, protection and access to justice to help ensure equal access to HIV, TB and malaria services and better health outcomes overall.

Conflicts, Crises and Displaced People: How the Global Fund Works in Challenging Operating Environments [ download in عربي | English | Français | Italiano ]

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