A growing body of evidence suggests that human rights barriers can drive people away from health-seeking behaviour, thereby fuelling the spread of the three diseases. These barriers can include, among others, stigma and discrimination, punitive legal and policy frameworks, lack of informed consent, mandatory testing, and gender-based violence. As a result of gender-based discrimination, women and girls are disadvantaged when it comes to negotiating safe sex, and accessing HIV prevention information and services. However, despite recognition of this reality and substantive guidance on the importance of programmes to combat human rights and gender-related barriers, a Global Fund analysis found that many grants do not include this programming, or, if they do, it is included at very low levels (~1percent of total grant budget). A UNAIDS report found that “Social enablers—including advocacy, political mobilization, law and policy reform, human rights, public communication and stigma reduction—should reach 6% of total expenditure by 2020.” 

This section of the Manual includes links to the existing and substantial policy and programming guidance, as well as practice pointers to implement programmes to address human right barriers and promote gender equality at various points in the grant life cycle. It is not meant to be an exhaustive section of the guidance and resources available, but rather a guide to help programme and policy staff to develop, implement and evaluate programmes that seek to promote an enabling environment.

A key goal of this section is to facilitate an understanding of human rights, the needs and vulnerabilities of key populations and women and girls, and the interrelatedness of these areas in the context of achieving positive health outcomes for HIV, TB and malaria, and to prepare Country Offices (COs) to advocate for, and effectively implement and evaluate, programmes to promote and protect human rights and gender equality. Recognizing that these are issues which can often be misunderstood or deprioritized, it is strongly recommended that relevant Project Management Unit (PMU) staff closely consult with their contact in the UNDP Global Fund/Health Implementation Support Team to answer any questions, provide guidance, and to ensure that they have access to the most up to date policies. To support the introduction of this work, the HIV Health and Development Group has developed a vetted roster of qualified consultants who can help with policy and programme work to support design, implementation or evaluation of human rights, key populations and gender interventions.