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The Inclusion of Refugee and Internally Displaced Persons in Global Fund Applications 2020-2022 Last Updated: December 16th, 2022

Malaria, HIV/AIDS and tuberculosis (TB) present unique risks to refugees and internally displaced persons (IDPs) around the world. High levels of mobility, inadequate living conditions with increased exposure to diseases or vectors, and reduced access to health services due to ongoing conflict and socio-economic, cultural, language, or gender barriers, all contribute to increased risk of exposure. Furthermore, sustained conflict and crisis can cause the collapse of primary health systems, limit activities to prevent the transmission of malaria, TB, and HIV, and disrupt the delivery of vital medical commodities.

As one of the largest financiers of global health programs, The Global Fund to Fight AIDS, TB and Malaria is a vital source of support to ensure refugees and IDPs have access to quality disease prevention, treatment and care services.

The United Nations Foundation and the United Nations High Commissioner for Refugees (UNHCR) reviewed the inclusion of refugees and IDPs in Global Fund applications for the 2020-2022 funding cycle. Global, regional, and country results can be found below.

Downloadable scorecards have been developed based on the analysis of the 2020-2022 funding cycle HIV, TB, and malaria applications for each of the following regions:

Disease and Country Specific Results

Documents containing the overall results, displacement x disease data maps, and details on methodology and eligibility requirements can be downloaded below.

Malaria

Refugee and IDP inclusion in malaria funding requests has improved substantially since the previous funding cycle. The inclusion of activities for refugees has increased from 36% to 81%. The inclusion of activities for IDPs has increased from 17% to 69%.

The inclusion of specific activities for refugees and IDPs in malaria funding requests has increased substantially. Virtually no malaria funding requests mentioned displaced populations without detailing targeted activities for them. Though the proportion of countries not mentioning refugees in their malaria funding requests did not change, there was a notable decrease in the proportion of countries failing to mention IDPs.

Much of the positive progress stems from an improvement in the proportion of countries that mention displaced populations but do not include specific activities for them in their malaria funding requests – only two of the 63 applications mentioned refugees and IDPs without detailing specific programming to address their needs. Most countries with very large refugee and IDP populations that were eligible for this study included specific programming for these populations in their funding request.

HIV/AIDS

The inclusion of both refugee and IDP populations in HIV/AIDS funding requests has improved substantially since the previous analysis. For HIV, the inclusion of refugees has improved from 15% to 60% of all funding requests. For IDPs, inclusion has increased from 12% to 45%. The proportion of HIV funding requests that failed to mention displaced populations decreased by a large margin. However, refugees and IDPs are still not mentioned in approximately one-third and one-half of all HIV/AIDS funding requests, respectively.

Fewer funding requests mentioned refugees without detailing specific activities targeting this population; however, this effect was less pronounced than in the malaria analysis. Though several countries with very large numbers of refugees and IDPs still did not mention these populations in their most recent funding requests, many that previously failed to mention these populations not only included them during this funding cycle but also detailed specific activities to address their needs.

Tuberculosis

The inclusion of displaced populations in TB funding requests has improved substantially since the previous analysis. The inclusion of refugees has improved from 50% to 69% of all funding requests. For IDPs, inclusion has increased from 26% to 71%.

The proportion of TB funding requests that did not mention refugees or IDPs decreased considerably compared to the previous funding cycle. Fewer funding requests mentioned refugees without detailing specific activities targeting this population; however, this effect was less pronounced than in the malaria analysis. Though a few countries that previously failed to mention displaced populations in their previous funding requests included specific activities for them in this cycle, many countries with large numbers of refugees and IDPs still did not mention these populations, including several that had previously mentioned them and/or included targeted activities for them in past funding requests.

Recommendations:

For Countries:

  • Conduct conversations about refugee and IDP inclusion in national plan creation, grant proposal development, and implementation processes. Include representatives of displaced populations and humanitarian agencies in these conversations.
  • Measure key intervention coverage of displaced populations, identify financial and programmatic gaps, and ensure that data are provided to/linked with national program data.
  • Utilize information on refugee and IDP population size and mapping of displacement versus malaria prevalence to target interventions for these populations in their concept notes.
  • Countries with existing and new displaced populations should adapt their previous activities and interventions for these populations in their new funding applications to account for population changes.
  • When refugees and IDPs are included specific attention is required to ensure effective inclusion and coverage of vulnerable and marginalized populations by addressing socioeconomic, cultural, language, gender and other barriers.

For Countries with displacement between grant cycles:

  • Make a request for reprogramming or to the Global Fund's emergency fund.
  • Draw on experiences and lessons learned from other countries that have recently responded to the needs of newly displaced or migrant populations.
  • Work with humanitarian actors to include additional funding requests for HIV, TB, and or malaria services in Humanitarian Response Plans and appeals so that the interventions, services, and commodities being provided to host populations mirrors those being provided to newly displaced populations.

For The Global Fund:

  • Based on these results, create a list of priority countries to engage with on this issue for maximum impact.
  • Create peer learning opportunities for countries that have recently improved their inclusion of displaced populations to share their experience with priority countries.
  • Continue to ensure that Technical Review Panel (TRP) and Grant Approvals Committee (GAC) members reference information on refugees and IDPs, such as humanitarian response plans when they review funding applications.
  • Work with country teams and UNHCR to track shifts in refugee and IDPs populations and encourage countries to include them in their application throughout country dialogue, the application process and grant implementation.
  • Support policies and procedures exist that allow for the procurement and delivery of evidence-based adaptable interventions for displaced populations (ex. insecticide-treated blankets).

For more information about this analysis or resources, please contact:

Katherine Mergen – Associate, Global Health kmergen@unfoundation.org

Sandra Harlass – Senior Public Health Officer harlass@unhcr.org

Last updated: December 16, 2022