Protection from Sexual Exploitation, Abuse and Harassment

The Challenge

People are less likely to seek out the goods, services and health care they need if sex becomes the price of entry.

If we are going to end HIV, tuberculosis (TB) and malaria as epidemics, it is essential that the programs the Global Fund supports deliver services in as safe a manner as possible and protect people from sexual exploitation, abuse and harassment (SEAH). Protection from SEAH, or PSEAH, is a critical element of achieving our mission.

The root causes of SEAH stem from an imbalance and abuse of power, which can create an environment where those in positions of power feel entitled to exploit, abuse, or harass those with less power, such as when providing services to beneficiaries of Global Fund-supported programs. The individuals providing these services inherently hold power due to their access to medication and other necessary services, while beneficiaries in need of these services are in a vulnerable and dependent position that can be exploited for sex acts.

Broader societal power imbalances can also contribute to SEAH. For example, social and cultural norms that perpetuate gender-based power imbalances and promote harmful ideals of gender expression can create a culture in which SEAH is normalized or excused. Although SEAH is widely perceived to be a “women’s issue,” it is crucial to understand that people of any gender, including men and boys, can also be victims of SEAH, regardless of their sexual orientation, and they may face additional barriers to reporting.

Addressing SEAH is vital to ensure that beneficiaries can access Global Fund-supported programs and services in a safe and inclusive environment, free from the threat of sexual exploitation, abuse, and harassment. Tackling SEAH effectively involves a combination of prevention, readiness and response strategies that are tailored to the unique needs of individuals and communities. Incorporating these strategies into our existing processes means adapting Global Fund policies, advocacy and awareness.

Our Response

The Global Fund has developed a number of measures grouped under the umbrella term “protection from sexual exploitation, abuse, and harassment,” or PSEAH. We use the words “protection from” deliberately because it incorporates both “prevention of” and “response to” sexual misconduct.

Our approach to PSEAH is deliberately designed to promote shared responsibility and accountability. It’s the role of the PSEAH Coordination Unit (PCU) to develop, establish and coordinate all of our efforts. To put it simply, none of us can do this alone. The PCU was set up in 2021 to develop and coordinate the integration of PSEAH practices into our established ways of working, both at the Global Fund Secretariat and in the countries where we invest. This work can be categorized into three main buckets: prevention, response readiness and actual response.

The Global Fund’s prevention activities currently include:

• Training, education and awareness activities specific to individual roles for all relevant stakeholders.
• PSEAH communications specifically designed to support and empower the most vulnerable beneficiary populations.
• Integration of safer recruitment practices to prevent sexual offenders from rehire.
• Continued development of policy and procedure documents, such as codes of conduct, and compliance monitoring of Principal Recipients.
• Implementer PSEAH capacity assessment and capacity building around organizational infrastructure.
• Highly tailored SEAH risk mitigation efforts to integrate safer interventions into grant design and implementation.

Our response readiness activities involve:

• Development of PSEAH focal points among Principal Recipients and Country Coordinating Mechanisms (CCMs).
• Local coordination between these focal points with existing PSEAH networks and support service providers.
• Enabling effective, fit-for-purpose and trusted reporting channels.
• Technical support for CCMs and implementers in navigating a victim/survivor, trauma-informed response to SEAH allegations, including:
• Implementer capacity building in SEAH investigation/case management and victim/survivor support.
• Creation and implementation of a Global Fund victim/survivor support fund (VSSF).
• Maintenance of a Global Fund SEAH risk index that helps us identify the areas of highest SEAH risk and those populations most at risk for serious harm.

Our actual response activities include:

• Taking a multi-disciplinary team approach, designed to ensure that victim/survivor support needs and investigative needs are met wherever appropriate.
• Working hand-in-hand with the Office of the Inspector General (OIG) and in-country partners on all grant-facing allegations of SEAH and the related abuse of power.
• Offering and facilitating support for victims/survivors with help from the Global Fund’s Victim Advocate and In-country Support Coordinator.

We aim to prevent any kind of sexual misconduct and related abuse of power in connection with Global Fund-supported activities. However, since we recognize that our efforts to mitigate the risk won’t ever be 100% successful, we must have the systems and capacity in place across our partnership to be ready to respond to any reports of SEAH quickly and sensitively. Those systems deliver a victim/survivor-centered, trauma-informed response to each and every allegation of SEAH and the related abuse of power.