Consultants Terms of Reference

Date of Contract: for completion by May 2018

Number of Days:10 days

Project Aims:

  • To generate an analysis of the HIV focussed global health architecture (the Global Fund, WHO, UNAIDS, UNITAID, PEPFAR, USAID, World Bank) and how it is working, including the level of political and financial support for community led responses.
  • To generate key questions to contextualise future discussions around the global health architecture and how it delivers for civil society organisation (CSOs) and communities.

This work is supported by STOPAIDS, International Civil Society Support and STOP AIDS Alliance.

Background:

In 2015, member states committed to end AIDS, tuberculosis, malaria and neglected diseases and to achieveUniversal Health Coverage by 2030 as part of the Sustainable Development Goals (SDGs). The global health ecosystem is now adapting itself to a changing political and financial context in which the SDGs are being implemented. In this challenging context it is important to take stock of how this architecture is both working, how it should be working, how it is changing and where the gaps are. Community needs and involvement must be central to any such discussion.

The global health architecture has been critical to mobilising the political and financial resources needed to achieve the MDG health related targets. This architecture is made of WHO, UNAIDS and its co-sponsors, The Global Fund to fight AIDS, TB and Malaria andUNITAID.

CS and key population representatives have been included in some of the governance structures within multilateral institutions and numerous national accountability mechanisms have been created with the active engagement of civil society, including the Global Fund Country Coordinating Mechanisms (CCMs)and the National AIDS Commissions among others.CSOs also receive funding from multilaterals and bilaterals, and in few cases from domestic sources.

CSOsand communities play a critical role in the global HIV response and will be key todelivering on the SDGs. The importance of community led service delivery was recognised in the 2016 Political Declaration on HIV and AIDS which includedthe commitment ‘to build people-centred systems for health by strengthening health and social systems’ and‘expand community-led service delivery to cover at least 30% of all service delivery by 2030’[1].Yet the community-led response to health (service delivery and advocacy) is inadequately funded and supported globally despite a growing body of evidence that demonstrates the efficacy and cost-effectiveness of community led service delivery and accountability[2]. Marginalized populations continue to be left behind and face multiple barriers(human rights violations, lack of adapted policies and services…) to accessing the services they need. Furthermore, spaces for civil society and community in governance and within the response are often shrinking at alarming speed.

The focus of this project is two-fold. Firstly, the project will look at how the different components of the global health architecture fit together currently andhow this is functioning. The second and equally central part of this piece is to examine how this architecture serves civil society and particularly communities.

Key Questions:

Structure

  • What is the global health architecture currently (in the context of/serving to HIV?)? How do the different actors fit together?What gaps exist? (What are the opportunities to better integrate HIV?)
  • Based on current trends and global discussions, what are different models proposed for global health architecture? And where does HIV response fits in within those models?
  • How is and should civil society and communities be involved in the national, regional and global governance structures of global health multilaterals?
  • What are the current global commitments and “standards” supporting community responses for health: are there mechanisms in place to support those commitments? (Community responses: (i) advocacy, campaigning and participation of civil society in decision-making, monitoring and reporting on progress made in delivering HIV responses; (ii) direct participation in service delivery; (iii) direct participation in research; (iv) community financing).

Funding

  • At a global level what financial support is available to CSOs, including for engagement in the architecture?
  • How can we ensure increased funding for CS, particularly in UMICs and transitioning countries?

Project Detail:

Suggested Methodology:Key interviews with multilateral civil society delegations and others, desk review, and validation with a ‘CSO Steering Committee’.

Key audiences for this project are CSO activists working on global health, key multilateral staff, donors and member states including multilateral Board Members.

The work will be used as a think piece and key questions identified will be used in a wider consultation meeting with civil society.

Previous Work to Reference:

Chatham House undertook extensive work with a slightly wider scope in 2015. This involved a series of papers on:

  1. Mapping Global Health Architecture to Inform the Future (Jan. 2015)
  2. Analysing Proposals for Reform of the Global health Architecture (Aug. 2015)
  3. Rethinking the Global Health System (Sep. 2015)

A large part of the desk review for this piece is likely to be analysing this previous work to see if it is applicable to the HIV specific global health architecture and how it needs updating. The Chatham House work does not cover the section of this project on political and financial support forcivil society and communities.

Outputs:

  • In depth analysis on how the global health architecture is functioning, including its level of political and financial support for civil society and community responses.
  • Key questions, with background, to consider for a consultation meeting.
  • Executive Summary of the above.

Payment:

Payment will be made on receipt of an invoice upon completion of the project.

Expressions of Interest:

Please include:

  • No more than two pages outlining approach and evidence of experience
  • C.V. and contact details for a referee.

Expressions of interest should be emailed to Robin Jakob at STOPAIDS () by28th February 2018. If you would like to discuss the terms of reference please contact Robin.

[1]

[2] “Communities Deliver”. UNAIDS and Stop AIDS Alliance. 2015