Protecting Vulnerable Beneficiaries of Global Fund Programs

Strengthening safeguards, reporting mechanisms, and victim support systems is paramount in combatting sexual misconduct in Global Fund programs. Read more on mitigating sexual exploitation, abuse and harassment.

Sexual exploitation, abuse and harassment (SEAH) is devastating to the people involved and destroys community relationships and trust, posing material threats to the Global Fund mission.

Our investigations in Ghana, South Africa, Uganda and Zimbabwe between 2021-23 have revealed that risks are heightened in programs that target key and vulnerable groups such as adolescent girls and young women, or sex workers. Given that these groups are usually also disproportionately severely affected by the three diseases, inherent SEAH risks could prevent intended beneficiaries of Global Fund programs from accessing services. These cases highlight the instances of delayed reporting that lead to insufficient victim support for vulnerable beneficiaries of Global Fund programs.

Ghana

Investigation Report ENGLISH or FRENCH

Executives at a Global Fund implementer and sub-sub-recipient of grant funds abused their positions of power and fostered a culture of sexual and financial exploitation, demanding sex acts and money from people living with HIV as a condition of access to benefits that include support, education and advocacy services.

On multiple occasions, program beneficiaries reported issues of sexual and financial exploitation to the executives and others in positions of power. Their reports were either ignored or not met with any kind of serious inquiry. These allegations were only shared with the Global Fund during the OIG investigation.

Failed training and awareness on SEAH and a lack of safe reporting channels contributed to the late reporting which prevented sufficient victim support.

South Africa

Investigation Report ENGLISH or FRENCH

The Global Fund grant in South Africa was designed to provide health services to sex workers and address their human rights concerns. An investigation uncovered that a sub-recipient executive had been sexually exploiting and abusing both staff and program beneficiaries. This abuse included coercion, threats of physical harm, false promises of payments, and using access to program benefits and employment as leverage.

Driven by a lack of understanding of the prevention and protection against SEAH, both the Principal Recipient and the sub-recipient failed to take appropriate action against the executive and did not promptly report these allegations to the Global Fund. In doing so, they prevented adequate support to an already vulnerable group, sex workers. Furthermore, they did not ensure that their staff and beneficiaries were sufficiently educated on how to prevent and report such misconduct.

Uganda

Investigation Report ENGLISH or FRENCH

In Uganda, the Principal Recipient oversaw the sub-recipient program, which implemented several health initiatives, including those focused on Adolescent Girls and Young Women.

Investigation by the OIG discovered that a Project Officer doled out certain favors, like participation in events, that provided experience and monetary benefits to those who were receptive to his sexual advances.

The coercive practices within this program had led to the sexual exploitation and abuse of these vulnerable beneficiaries, who are disproportionately severely affected by the three diseases.

In this case, the OIG again only learned of these allegations over a year after the abuses had occurred. Defective reporting channels and limited awareness and education contributed to the lack of timely reporting. This prevented sufficient victim support and caused trauma among the vulnerable beneficiaries.

Zimbabwe

Investigation Report ENGLISH or FRENCH

A hospital staff member, funded by a Global Fund grant in Zimbabwe, abused his position to sexually exploit a patient at a government hospital. The victim, an expectant mother, had come to the hospital for medical care and services. These patients often rely on family for food and supplies because the hospital does not consistently provide them, and hospital staff may exploit this by exchanging food for sex. This case illustrates how certain circumstances, such as extreme poverty and high-risk pregnancy, increase a patient’s vulnerability to exploitation.

Although there was evidence indicating that the hospital administration was aware of the situation, they claimed no knowledge during the OIG investigation, revealing a serious lack of accountability. The protracted delay in addressing the issue, due to several inadequate investigations at the country level by the Principal Recipient, allowed the subject of the investigation to remain employed in the hospital as part of the Global Fund-supported program. This put numerous vulnerable young women at risk.

Mitigating SEAH

In all investigations, the victims were left without the critical support they urgently needed, due to delayed reporting. Accountability was notably absent until the Global Fund’s OIG conducted its work.

Subsequent to the investigations, one Principal Recipient and two sub-recipient employees are no longer involved in Global Fund grants. Throughout the investigations, the OIG team worked closely with the Global Fund’s Victim Advocate and In-Country Support Coordinators to ensure that the victim/survivor was offered support.

These investigations have revealed that SEAH risks are heightened in programs that target key and vulnerable groups, such as girls and young women, or female sex workers. This increased risk could prevent intended vulnerable beneficiaries of Global Fund programs from accessing services and support.

To remove any such access barriers to care, the Global Fund and implementers must ensure that its victim-centric approach is applied across these programs – with zero tolerance for SEAH, aligning with the principle of “do no harm”. Strengthening safeguards, reporting mechanisms, and victim support systems is also paramount in combatting sexual misconduct in Global Fund programs. The Global Fund’s Framework on Protection from Sexual Exploitation and Abuse provides the foundation for this prevention.

Identifying Sexual Exploitation, Abuse and Harassment

To empower individuals and organizations with the knowledge and skills needed to detect the signs of SEAH, we offer helpful resources to support implementers and partners to conduct their vital work in a safer way.

Explore our e-lessons page, where you can access essential insights and guidance on identifying red flags.