From Invisibility to Influence: The evolution of participation of people who use drugs in the Global Fund
Participating in the Global Fund national processes is an important step towards achieving and directing funding towards more rights-based policies and programmes that meet the needs of people who use drugs. While in some regions and countries huge progress has been made, in others, drug user-led networks are still not included as part of CCMs and therefore have little recourse to influence decision-making. There remains resistance and a lack of political will and understanding to meaningful involvement of people who use drugs.
This case study tells a story of the challenges drug user-led networks face nationally to participate in Global Fund proposal development and decision-making. It highlights the progress that has been made with support from the Community, Rights and Gender (CRG) Strategic Initiative (SI). It also showcases the progress, impact and outcomes of people who use drugs participating in the Global Fund, showing the value and effectiveness of both national drug user-led organizations and the key role of the global network in facilitating successful engagement in Global Fund processes. Ultimately, it shows how with the right support, those often left behind can move from invisibility to influence.
INPUD implemented the CRG-SI programme from November 2017 to the end of 2020. The programme was first implemented together with regional networks in Latin America (LANPUD), Eastern Europe (ENPUD) and Asia (ANPUD). In 2020, INPUD received a top-up grant from CRG-SI to provide intensive technical support and national grants to six drug user-led networks in Kyrgyzstan, Tanzania, Zanzibar, Indonesia, Pakistan and India to enhance their engagement in the Global Fund 2020-2022 allocation cycles. Together this constituted 11 countries in Eastern Europe, 7 countries in Asia-Pacific, 7 countries in sub-Saharan Africa, 5 countries in middle east and north Africa and 9 countries in the Latin America and Caribbean region.
The objective of the programme funded by CRG-SI were to:
- Strengthen HIV key population networks, in particular people who use drugs with global reach, to support their country level constituencies to effectively engage in Global Fund-related processes during the whole grant cycle
- Develop the capacity of marginalized and criminalized people who use drugs networks and communities to effectively and safely engage in all Global Fund related processes
- Strengthen the capacity of people who use drugs networks to advocate for increased investment in rights-based and community responsive programs, as well as effective community led, human rights and gender related programming within Global Fund grants
The key lessons learned from reviewing the results of the programme and this case study were:
- Having dedicated human and financial resources available for capacity building for drug user-led networks makes the difference between aspirations of reaching those hardest to reach and actually reaching those hardest to reach. Invariably drug user-led networks face enormous challenges to exist and implement ranging from structural barriers such as stigma and discrimination to barriers such as education and skills.
- Building capacity requires consistent support over time. This includes support to set up networks with strong governance and principles and support on skills around organisational development, advocacy and communications.
- When drug-user led networks are engaged meaningfully in the Global Fund and the national response to HIV, responses are more effective
- Technical assistance from INPUD and other global key population networks is key to meaningful participation and engagement.
- Where key population networks come together, education and awareness within key population networks increases as does legitimacy – this is particularly powerful for drug user-led networks who often struggle to be seen as legitimate by policy makers.
- Funding through small grants enables support for core salaries and for simple and yet effective activities such as commmunity consultations and trainings on the GF.
- COVID-19 presented an opportunity across many countries to work together as groups of key populations with CCMs to ensure prevention and treatment was continued to the community of people who use drugs
- Stronger drug-user led networks are based on the foundation of strong organisations, advocacy, leadership and legitimacy.
- Recognising people who use drugs as experts and professionals should be a key Global Fund strategy to ensure resources are effectively allocated to address the needs of people who use drugs, ideally through separate funding streams.