Global Fund – Breaking Down Barriers Initiative :: Summary of Key Findings of the Baseline Assessments in 20 Countries

Health, Human Rights

Removing Human Rights Barriers to Health: Findings and Lessons
Global Fund 04 November 2020
Programs to remove human rights barriers to HIV, TB and malaria services are essential to increasing the effectiveness of Global Fund grants. Such programs help to ensure health services reach those most affected by the three diseases. The Global Fund Strategy 2017-2022 recognizes and reaffirms this through its human rights objective.
Breaking Down Barriers initiative

As part of attaining this objective, the Global Fund’s Breaking Down Barriers initiative aims to dramatically scale up programs to remove these obstacles. The Global Fund has now published a summary of key findings of the baseline assessments undertaken as part of the initiative:
Breaking Down Barriers Initiative: Summary of Key Findings of the Baseline Assessments in 20 Countries [download in English]


Global Fund – Breaking Down Barriers Initiative :: Summary of Key Findings of the Baseline Assessments in 20 Countries
8 JUNE 2020 :: 14 pages GENEVA, SWITZERLAND
Acknowledgement: With regard to the research and writing of this report, the Global Fund would like to acknowledge the work of Dr. Joanne Csete of the Mailman School of Public Health at Columbia University.
4. Findings of the Baseline Assessments
Cross-cutting findings
4.1 Barriers to health services are many and severe.
4.2 There is high intersectionality of barriers to health services.
4.3 Programs to address human rights-related barriers exist but are small, inadequately supported, not coordinated and not evaluated.
4.4 Programs to remove human rights-related barriers to services are not sufficiently integrated into or linked to the prevention, treatment and key population programming they are meant to support.
4.5 Capacity of and support for key population-led organizations is insufficient.
4.6 There is need for adequate support to and roll out of increased monitoring and evaluation efforts.
4.7 Costs for comprehensive programs are not being met.
4.8 The range of donors available to support programs is limited.

5. Findings Related to Particular Program Areas
5.1 One-off activities are inadequate to lead to sustained change or to create local cadres of expertise.
5.2 There is lack of sufficient attention to barriers in prisons and other closed settings.
5.3 Members of key populations do not have sufficient access to justice.
5.4 Gender inequality and gender-based violence that lead to vulnerability to HIV, TB and malaria are not being sufficiently addressed.
5.5 There is insufficient attention to and understanding of human rights-related barriers to TB services.
5.6 The understanding of human rights-related barriers to malaria services is in its earliest phase.

7. Conclusion
The baseline assessments in the 20 countries of the Breaking Down Barriers initiative are an important source of new and practical programmatic information on human rights-related barriers to HIV, TB and malaria services; the populations affected by them; recent or current programs to address these barriers; and ways in which all 20 countries could realistically consider mounting a comprehensive response to reduce these barriers. In most countries, the baseline assessments informed the development of proposals for the catalytic human rights funding that is part of the initiative. In all countries, the baseline results have helped to shape subsequent discussions among all stakeholders of strategies and actions for developing a scaled-up, comprehensive response to human rights-related barriers to health services.