In February 2015, the Office of the U.S. Global AIDS
Coordinator (OGAC) publicly released its PEPFAR
Country/Regional Operational Plan (COP/ROP) 2015 Guidance. This 268-page document
outlines key changes in how OGAC
will allocate funds in coming years, including recommendations for engaging
civil society in PEPFAR funding decisions at country and regional levels. On
February 20th, OGAC convened a webinar
audio) for UNAIDS and civil society organizations to provide an overview of
the new guidance. In the webinar, OGAC emphasized the need to coordinate civil
society engagement with the Global Fund, national governments, bilateral
donors, UNAIDS, and others. This includes the suggestion that countries use
their concept note to the Global Fund to make specific recommendations to
PEPFAR country teams for civil society engagement, where applicable.
These changes to the PEPFAR COP process present both significant opportunities and potential
challenges for advocates, service providers, and community members working
to advance the health and human rights of men who have sex with men (MSM) and
other key populations in the global HIV response. This community update
highlights these opportunities and challenges to inform meaningful action by activists
and organizations in the many countries and regions
where PEPFAR operates.
PEPFAR COP 2015
and Prioritization of Key Populations
The PEPFAR COP 2015 Guidance emphasizes that a new prioritization of resources for epidemic
control will focus on locations and populations with the highest burden of
disease, with a goal of assisting host country governments to reach 80%
coverage of people living with HIV in these locations and populations by
September 2017. To make these prioritization decisions, PEPFAR country teams
will regularly collect and analyze demographic and epidemiological data to
divide program activities geographically and by site into “core, near-core, and
non-core,” with core activities receiving funding priority. Of particular
relevance to civil society, the Guidance requires PEFPAR country and regional
teams to collect data on HIV prevalence and population size estimations among
MSM, female sex workers, and people who inject drugs, if and when it is safe to
In addition, the 2015 COP Guidance outlines three key areas for
achieving PEPFAR’s human rights agenda: 1) Reducing stigma and discrimination
in HIV service delivery/health care settings; 2) Ensuring that data for
decision-making is gathered to optimize patient care; and 3) Supporting patient
rights and access to quality services. To meet these goals, required actions for PEPFAR country
teams include a.) conducting non-discrimination trainings; b.) preparing a
Legal Environment Assessment of laws, regulations, and policies that support or
hinder the epidemic response; and c.) submitting a two-page assessment of country
processes to report stigma/discrimination and violations of patient rights
affecting access to services.
The PEPFAR COP 2015 Guidance includes new requirements for increasing civil society engagement in the
development of each Country Operational Plan. These include four steps required
of each PEPFAR country team in the COP planning process: 1) Development of a
civil society COP engagement plan; 2) Convening engagement meetings between
PEPFAR teams and civil society organizations; 3) Solicitation of written
feedback from civil society organizations to PEPFAR teams; and 4) Submission of
written feedback back to civil society organizations. The guidance stresses
that civil society consultations should occur through a formal structure on a quarterly basis, that a diverse range of
civil society organizations including representatives of key populations should
be included, and that PEPFAR teams are required to submit civil society
recommendations and country team feedback as part of their COP submission.
The Global Forum on MSM & HIV (MSMGF) commends OGAC for
its vision and leadership in making policy changes to increase civil society
engagement and pursue a human rights agenda through the PEFPAR COP development
process. The MSMGF furthermore calls on OGAC to assure that key populations are
meaningfully included in civil society consultations and that sufficient
funding is allocated to act upon civil society recommendations made in each
country and region where PEPFAR operates.
Specifically, the MSMGF calls for OGAC to:
Ensure that MSM and other
key populations continue to be prioritized for programming within all PEPFAR
recipient countries, irrespective the availability of data. Unavailability of
reliable data should not preclude the provision of acceptable, accessible, affordable
and safe programs for MSM and other key populations.
As PEPFAR allocations are
re-prioritized, provide sufficient funding for each PEPFAR country to ensure data
collection on MSM and other key populations is conducted in close consultation
with members of those communities, and in a manner that protects the safety and
confidentiality of research participants supplying data.
Commit to securing country
buy-in in the COP development process for MSM- and key population-focused work.
Ensure that community-,
MSM-, and other key population-led program representatives are meaningfully
included in civil society consultations and that these consultations are both
transparent and substantive.
Commit to adequate
allocation of funds, particularly to smaller, community-, MSM-, key
population-led organizations, to meet targets and goals proposed by members of
MSM and key population communities in the COP development process.
The MSMGF encourages advocates, service providers, and
community members of key populations in PEPFAR countries to engage
meaningfully in civil society consultations for the PEPFAR COP 2015 development
process. As COP submission deadlines are rapidly approaching in April and May
2015, these consultations are likely to
be held in the coming weeks. OGAC has highlighted and the MSMGF re-affirms
several ways for activists and organizations to play a key role in the
development of PEPFAR Country Operational Plans:
Contact PEPFAR country
teams via your local U.S. Embassy and
request information on the specific schedule for civil society engagement
meetings in the COP 2015 planning process. Note that OGAC has assigned PEPFAR country
teams a COP 2015 submission deadline of either April 3rd or May 1st.
As these are both very near-term dates, we
emphasize the urgent importance of making contact as soon as possible to confirm specific schedules for civil
society consultations in your country.
Contact civil society
networks, coalitions, and coordination platforms working to develop
consolidated recommendations for PEPFAR country teams. This is of particular
importance to ensure that concerns of MSM and other key populations are included.
Where relevant, one potential approach is to use recently submitted Global Fund
concept notes to inform the PEPFAR COP.
Provide written requests to
PEPFAR country teams for information and data relevant to key populations to be
included in the COP submission.
The MSMGF will continue to provide additional information on
how to engage with the PEPFAR COP 2015 process as we receive it in the coming
weeks and months. We also urge you to
report to us any problems or obstacles you may experience, which we can
document and report to our contacts at OGAC and with PEPFAR country teams. Please
write to the MSMGF’s Senior Policy Advisor Nadia Rafif at email@example.com with any questions or
problems you may have.