Policy Research on Delivery of HIV, TB, & Malaria Services in Regions Affected by Displacement, Fragility & Instability

at The African Constituency Bureau to the Global Fund
Location Addis Ababa, Ethiopia
Date Posted August 8, 2020
Category Business Development
Job Type Full-time
Currency ETB



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 governance deliberations and processes. The constituencies adopted a new governance framework that amongst other things, established a joint ESA and WCA Bureau – the African Constituencies Bureau, ACB – a policy think tank that support ESA and WCA Global Fund board members, committee members and delegations. Its primary functions include ensuring effective engagement, representation and participation of African constituencies in Global Fund processes. It also seeks to enhance the capacity of the African constituencies to shape Global Fund policies and processes. 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.

The Global Fund adopted the terminology of Challenging Operating Environments (COEs) to refer to countries as a whole, but also to unstable parts of countries or regions, experiencing sustained crises such as disease outbreaks, natural disasters and armed conflicts that require interventions both within and across national borders. Crises in COEs may involve large numbers of refugees, internally displaced persons (IDPs) and migrants.

Countries faced with displacement, fragility and instability (COEs) are characterized by weak institutions and governance, poor access to health services, fragile structures protecting human rights, absolute poverty, limited procurement and supply chain capacities, accessibility constraints and an increased disease burden. They account for two-thirds and of the Global Fund’s portfolio for malaria and a quarter for HIV and TB portfolios and for 26.8% of the 2017-2019 Global Fund Allocation investments. COEs have been classified in two categories: complex emergency and chronic unstable contexts.

COEs are likely to face the hardest challenges to achieve the Sustainable Development Goals, as they lack the robust institutions, the social cohesion and the financial means needed to overcome the systemic exclusion and inequality that keep them unstable and underdeveloped.

In May 2019, an Office of the Inspector General (OIG) report showed that 70% of West and Central Africa (WCA) countries have a low utilization of Global Fund allocations due to a number of inherent operating challenges for implementing grants and achieving optimal portfolio performance. These challenges included:

  • High fragility and instability: The WCA region has been heavily impacted by numerous revolts, coups, regional conflicts and full scale civil wars. Eighteen (18) out of the 23 countries have experienced one of these events. As of 2019 there are still 3 fully fledged active conflicts in the region. Thus, the Ebola epidemic in Guinea, Liberia and Sierra Leone killed over 11,000 people and significantly damaged the health sector.
  • Weak health systems: Human resources for health are three times lower than in the rest of Africa. The World Bank ranks 17 of the 23 countries in the WCA region in the bottom quartile (worst performing) in terms of Government Effectiveness.
  • Limited Fiscal Space: WCA countries have a total GDP 6.5 times smaller than in the rest of Africa with 13 of the 23 countries are classified as Lower Income countries, with GDP per capita of under US$1,000 and five countries have experienced significant economic recessions in the last 5 years.
  • Low Health Financing: Government health expenditure per capita is 3 times lower than the rest of Africa and Out-of-pocket payments on health are proportionately 36% higher than the rest of Africa.
  • Funding Gap: The region has an overall funding gap of 50% across the three diseases. The Global Fund is the largest funder in the region, representing 55% of TB, 45% of Malaria and 32% of HIV funding

COEs are particularly critical to the Global Fund mission and objectives. Global Fund investments in COEs aim to increase coverage of HIV, TB and malaria preventive and therapeutic services, to reach key and vulnerable populations, and to save lives. However, investments during emergencies are typically more limited in scope. As with the rest of the Global Fund portfolio, investments will cater to each country’s unique stage along the development continuum, and based on country context, will aim to build resilience through stronger community and health systems; and to address gender-related and human rights barriers to services. Global Fund policy investments in COEs are based on three principles i.e. flexibility, partnerships and innovation.

The ACB is therefore seeking to hire a consultant that will support the organization to conduct a deep dive into countries affected by displacement, fragility and instabilities and their ability to end HIV, TB and malaria by 2030 and provide evidence-informed guidance on how the region should influence current and future Global Fund investments in areas affected by displacement, fragility and instability.

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 countries faced with displacement, fragility and instability (COEs) and implications of this phenomena on delivery of HIV, TB and malaria programmes. The consultant must review applicable literature from peer-reviewed and published articles, normative evidence and guidance from leading technical organizations and policy and research think tanks, evaluations and reviews such as the Global Fund, technical organizations like the World Bank, WHO, UNHCR, etc. and other organizations such as the African Union. The consultant will be expected to share these resources for the ACB’s intranet which countries can access to further their work around COEs.
  • An in-depth mapping of countries affected by displacement, fragility and instability in Africa detailing the key trends, the progress and gains being made to meet objectives against HIV, TB & malaria, what’s working and what’s not working, remaining gaps and bottlenecks, best practices, enablers and the opportunities for streamlining HIV, TB and malaria programming in these regions;
  • Identify key global and African commitments relevant to displacement, fragility and instability;
  • Identify, review, analyze and compare applicable policies (similar to the Global Fund’s COE policy) from relevant organizations working in environments fraught with displacement, fragility and instability;
  • 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 recommendations on how Africa can maximize investments towards ending Malaria, TB and AIDS in regions affected by displacement, fragility and instability. The recommendations must address strategies, gaps, opportunities, enablers and actions needed to be taken by the Global Fund in its post-2022 strategy to streamline implementation of HIV, TB and malaria programs.


  • 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.

Job Requirements


  • 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.


  • 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.

Applying Instructions

Interested consultants are requested to submit a technical and financial proposal for undertaking this 30-day desk review.

Proposal for this Consultancy should be directed to Info Mind Solutions acb@zebrajobs.com on or before August 30th 2020

Only short-listed candidates will be contacted.
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