ABOUT AFRICAN CONSTITUENCY BUREAU FOR THE GLOBAL FUND (ACB)

The Global Fund to fight HIV/AIDS, Tuberculosis and Malaria (GFATM) has two constituencies representing Africa namely the Eastern and Southern African (ESA) and West and Central Africa (WCA) constituencies. The two constituencies took a joined-up approach in 2012 with a twofold intent: to ensure that constituency priorities are reflected in Global Fund strategy and operational plans; and to strengthen the presence, voice and contributions of the constituencies, through their delegations, in all Global Fund processes. The constituencies adopted a new governance framework that amongst other things introduce the concept of establishing a joint ESA and WCA Bureau to support the Board members, alternates, committee members and delegates representing countries from these two constituencies. The Constituencies comprise a total of 47 countries.

The ACB, based in Addis Ababa, Ethiopia, ensures effective engagement, representation and participation of African Constituencies, ESA and WCA, in Global Fund Board processes.

Background to this Opportunity

The Global Fund, the biggest multi-lateral mechanism is at the centre of the global community’s efforts to end AIDS, TB and malaria by 2030. The fund is in the process of developing its post-2022 strategic plan. There is so much at stake for this plan given it will be the last before the 2030 goal of ending the three epidemics. It cannot be business as usual and the margin for error is therefore extremely limited.

Africa bears the biggest share of the global burden of malaria and HIV and a considerable burden of TB. As the epicenter of the epidemics, it is critical that the continent is at the forefront of developing evidence-based interventions that will turn the tide of these epidemics and engage in discussions on the Global Fund’s next strategy. This will be a huge demonstration of the continent’s ownership of global strategies towards ending the three epidemics in 2030.

Climate change and environmental degradation are among the main threat to sustainable development, including to the eradication of the three epidemics. It was also acknowledged in 2004 by the UN High level on Threats, Challenges and Change as a threat to a more secure world. UNEP (2008) identified three key issues in the interaction between the epidemics and climate change that include food security, vector borne diseases and governance, conflict and poverty. Developing a deeper understanding of these issues remains critical in helping locate the Global Fund’s strategy post 2022 within the reality of the complexity and a constantly changing world.

The interaction between climate change, the environment and its impact on the epidemics is complex, multi-directional and also remains to be a nascent area of research evidence by limited literature on the subject (UNDP, 2004). While the impacts of climate change on the epidemics may seem far-fetched there is existing empirical evidence on how climate change impacts outcomes for HIV, TB and Malaria and how these epidemics in turn impact on climate change and the environment.

Droughts occasioned by climate change impacts on food security. Without adequate nutrition those infected with HIV will regrettably transition to AIDS and eventually death at a rapid rate even with the availability of life saving ARVs. Morbidity related to HIV and AIDS also means that household labor will not be able to adequately mitigate impacts of climate change effectively. A Lesotho case study for example found that women aged 15-24 in areas affected by drought were likely to have earlier sex debut, transactional sex and were less likely to stay in school increasing their chances of HIV infection (LePHIA, 2017).

Climate change is likely to affect populations typically free of Malaria and subsequently lead to an increased burden of malaria due to biome shifts and contribute to poor HIV outcomes. As an example, the cyclones that hit Mozambique in 2019 resulted in 50,000 cases of malaria. Malaria poses a threat to persons living with HIV especially pregnant women whose immunity wanes during the period of their pregnancy thereby threatening care and treatment outcomes for HIV and TB. The cyclones also devastated the health systems affecting supply chain and interrupting treatment for patients under care.

Climate change will have an impact on natural and physical capital which in turn have an impact on the epidemics. Natural disasters dissipate physical capital where people derive their livelihoods forcing them to be economic migrants. Stresses related to loss of capital and economic migration is associated with transactional and coercive sex, poor nutrition affecting PLWHA and interrupted treatment for those with HIV and TB. Climate change may exert colossal opportunity costs both at the household and country levels as health spending is diverted to avert climate change related crises.  As a result, care and treatment for the three epidemics may be invariably deprioritized.

The interaction between climate change and the three epidemics is far from exhaustive and needs to be further fleshed out, analyzed and understood in order to meaningfully demonstrate how climate change and environmental vulnerabilities hinder effective response to the three epidemics. The ACB therefore seeks to hire a consultant to provide this context through rigorous analysis of the interaction between climate change and the environment on one hand and HIV, TB and malaria on the other hand in order to meaningfully inform a new paradigm for the global Fund’s post-2022 strategy.

scope of work:

Below is the expected scope of work under this assignment:

• The consultant is expected to undertake a desk review of the latest available evidence on the interaction between climate change and HIV, TB and Malaria including from peer-reviewed and published articles, normative evidence from leading technical organizations and think tanks, evaluation and reviews from the Global Fund, technical organizations like  WHO, UNEP, UNAIDS, UNDP, etc. The consultant will be expected to share these resources for the ACB’s intranet.
• Analyze existing key global and African legal, policy and institutional frameworks towards addressing the impact of climate change and environment on health in general and the three epidemics in particular and vice-versa
• Document key prevailing initiatives in integrating climate change and the environment thinking into existing health, HIV, TB and malaria responses including what’s working, what’s not working, key bottlenecks, gaps, best practices, key enablers of service uptake, etc.;
• Where possible, the consultant shall be expected to interview and engage with key stakeholders to probe for, and validate, research findings. This shall include participating in the planned Constituency engagement sessions being organized by the ACB to identify the continent’s priority health issues and interventions, as part of a process to provide input to the next strategy for the Global Fund; and
• Make evidence-informed and clear recommendations on how the Global fund’s post-2022 strategy can re-imagine, re-design and incentivize investments for HIV, TB and Malaria responses to account for climate change and the environment.

Deliverables

• Under this assignment, the consultant is expected to deliver the following deliverables:
• Provide an inception report detaining how the work will be conducted. This should be provided one week after signing the contract.
• A draft report detailing priority issues identified as strategic to Africa towards the next Global Fund strategy, the key findings and recommendations in word format.
• A final report, no more than 50 pages[1], and making use of annexes, detailing the key findings, including:
• A 3-paged Executive Summary of the research providing a synopsis of the key findings and recommendations;
• Document some best practices globally and in Africa in particular
•  Recommendations relevant for African countries towards integrating climate change and environment thinking as part of efforts to end the three epidemics by 2030. The recommendations
• A PowerPoint presentation detailing the key findings and recommendations of the desk review.

Terms of the appointment

The successful consultant will be expected to complete this assignment within 30 calendar days and should be willing and available to participate in a dissemination meeting with various stakeholders, including countries, technical partners and funders.

QUALIFICATIONS

• An advanced university degree in health policy, public policy, public health, climate change, environmental health, epidemiology, social sciences, or infectious diseases.
• A PhD in a relevant field will be an added advantage.

EXPERIENCE:

• Preferred: a climate change and health subject matter expert with a minimum of 10 years of relevant experience, including program design and implementation, research and policy development in Africa.
• Experience with undertaking evaluations of climate change and environment and/or health programs in Africa;
• Proven experience in conducting qualitative assessments including policy analysis;
• Experience with publishing peer-reviewed scholarly articles, including on various aspects of climate change and health;
• Experience with disseminating research findings and making conference presentations with relevant stakeholders; and
• Good presentation skills.