SKPA-2

SKPA-1 promoted HIV prevention services for key populations. The aim of SKPA-2 is to improve the sustainability of evidence-informed prioritized HIV services for key populations in Bhutan, Malaysia, Mongolia, the Philippines and Sri Lanka.

Key populations bear the greatest burden of HIV in the countries in which SKPA-2 operates. Key populations are defined as:

• Gay men and other men who have sex with men
• Transgender people
• Female, male, and transgender sex workers
• People who inject drugs
• People in prison and other closed settings

It is critical that key populations are identified by their governments and within National Strategic Plans to ensure that appropriate community and peer-led services are scaled up and sustainably funded.

Ensuring the above is achieved is key as countries shift towards middle-income status their eligibility for international development funding reduces. Middle-income countries are expected to fully fund health and HIV programs domestically. However, funding services for key populations remains a contentious in many countries. This is because stigma and discrimination continue to act as barriers to prevention and treatment service provision. Human rights and gender related barriers including criminalization, religious laws, cultural norms, and violence also prevent key populations from accessing services.

As a result of these sensitivities, domestic government spending on key populations remains minimal. SKPA-2 aims to change this.

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A Theory of Change underpins SKPA-2 which outlines the application of a series of interventions that will institutionalise and scale up prioritised HIV services for key populations with domestic co-financing.

Health Equity Matters is accountable for achieving SKPA-2 objectives and provides strategic, programmatic, and technical leadership and coordination across the program. Health Equity Matters manages performance, monitoring and evaluation, and liaises with the Global Fund, technical partners, and key stakeholders. Health Equity Matters leads a consortium of organisations to implement the program.

In year 1, a comprehensive baseline assessment was  conducted in each country. This assessment helped partners to understand the financial landscape, political economy, strategic information needs, operational policy and regulatory barriers, and human rights and gender situation in each country. It also assessed the extent to which each country is prepared for financial sustainability of services for key populations and the extent to which key populations and people living with HIV are meaningfully engaged in their country’s national HIV responses.

The baseline assessment has  provided a blueprint to support national HIV programs and community-based partners to develop long-term, evidence-based HIV investment and sustainability plans. This is especially important as new National Strategic Plans will be developed during the grant period in most SKPA-2 countries.