There is a need to prioritise and focus on strategising the work for and with key populations globally, in order to accelerate action for KP programming based on where infections are happening and aligning resources and capacity. This is one of the recommendations from an independent evaluation of the UNAIDS Joint Programme’s work with and for key populations at the country level that was recently completed.
The purpose of the evaluation was to assess the relevance, coherence, effectiveness, and sustainability of the Joint United Nations Programme on HIV/AIDS (Joint Programme) support for key populations at the country level. UNAIDS currently defines “key populations” as female and male sex workers, men who have sex with men, transgender persons, people who inject drugs and prisoners.
A theory of change developed during the inception phase provided the broad analytical framework and informed the evaluation protocol and development of ten evaluation questions. Evidence was generated at the global and regional level and through six country case studies undertaken in Cameroon, Kenya, Peru, Thailand, Tunisia, and Ukraine, countries with varying HIV epidemiological contexts. The global study was led by Dr. Lawrence Gelmon (from PHDA), Clare Dickinson, and Parinita Bhattacharjee (also from PHDA) led the Kenya country study. At both the global and national levels, the evaluation included the collabroration of representatives of local key population and PLHIV communities.
Some of the key findings from the evaluation include:
- The Joint Programme is recognised and respected for supporting key population responses. However, advocacy aimed at defending the human rights of key population groups needs to increase further.
- Key population programming needs prioritising to address the high rates of new HIV infections and the inequalities facing key populations in accessing services. Joint Programme resources should be aligned with evidence of where high incidence among key populations is occurring.
- Inclusive annual planning processes based on the strategic priorities and increased targeting of specific key population groups will enhance the relevance. Clear definitions of key population groups compared to other priority vulnerable populations are needed to focus resources on key population groups.
- The financial sustainability of key population responses is a strategic gap. Therefore, investments are needed in HIV specific programming for key populations, integrating HIV services and making Universal Health Care (UHC) work for different key population groups.
- The Global AIDS Strategy 2021-2026 tasks the Joint Programme with stepping up support for community-led responses. The next step is to understand what this means in practice and how this will be realised across cosponsors.
- The Joint Programme’s monitoring and reporting system needs an overhaul to enable a stronger ‘line of sight’ between investments, progress, and results of the Joint Programme’s work for different key population groups.
Some of the recommendations given in the brief include:
- There is a need to increase the prioritisation and strategic focus of the work for and with key populations. This includes clear definition across the Joint Programme for the differentiation of key populations from ‘other vulnerable populations, scaling up advocacy for key populations, and prioritising key population funding.
- Strengthen support for community-led programming by formulating guidance that addresses the diversity of key population groups, developing clear guidance, internal policies and oversight mechanisms, broadening engagement with and scaling up technical support for community-led implementors. This also calls for increased accountability to key populations through monitoring community engagement and influence.
- Intensify support to ensure financial and programmatic sustainability of key population responses by increasing involvement and dialogue with UHC, strengthening guidance, increasing technical support and incorporating sustainable systems developed and implemented during the COVID-19 epidemic.
- Accelerate data generation for key population programming, including through the Joint Programme Monitoring System.
Read the whole evaluation brief here