Programming to strengthen the enabling environment

Programming to strengthen the enabling environment

A number of resources have been developed to assist in the review, design, implementation and evaluation of programs that aim to strengthen an enabling environment.

The Global Fund Human Rights Info Note and UNAIDS Guidance Note on Human Rights and the Law highlight the following process and approaches to HIV, TB and Malaria programming:

  1. Identify who is at risk of the 3 diseases, who has the disease and what activities are needed to address human rights barriers and effectively reach key populations – for example, this can be done via a comprehensive situational analisys and through open, in-depth discussions with a wide range representative of key stakeholders during a County Dialogue:

    a)    Analyze existing and new quantitative and qualitative health and human rights data looking at incidence and prevalence; as well as coverage, quality and uptake of prevention, testing, treatment, care and support for key populations

    b)    Identify activities, form partnerships and design programmes with a human rights approach

    c)    Engage in partnerships using an inter-governmental approach working with health and non-government ministries, NGOs, civil society and development partners to ensure a comprehensive and sustainable response

  2. Remove legal barriers to access through:

    • a)    Legal environment assessments (LEA) of HIV, TB and malaria-related laws, regulations, policies as well as access to justice and law enforcement, in order to identify the extent of the country’s national legal and regulatory framework addresses key HIV, TB and malaria related human rights issues.
    • b)    Policy and law reform based on priorities identified in the LEA; in the case of HIV use the recommendations from the Global Commission for HIV and the Law
    • c)    Legal literacy and legal services that educate communities about human rights and medical ethics; and support access to paralegal and legal services. Some examples include: Supporting the development of community paralegals integrated into peer outreach services;  “Know your rights” campaigns to improve legal and human rights literacy of people living with and affected by the three diseases; and legal services for key populations, people with HIV, TB and vulnerable to malaria – to support them in filing suit if and when access to health care is denied.
      • o    Training for officials, police and health workers that sensitize them on the legal and human rights of key populations. This could include: Sensitization training for police, judges and parliamentarians on HIV, human rights and the harmful effect of enforcing laws that create barriers for key populations; training on HIV, TB and malaria for national human rights institutions; establishment of independent ombudsperson’s offices and complaint mechanisms; and training for health care services providers on confidentiality, non-discrimination, disclosure, and principles of human rights-based interventions to service provision.
      • o    Community-based monitoring on incidences of rights violations, as well as violations of informed consent, medical confidentiality and non-discrimination
      • o    Policy advocacy and social accountability for law and policy reform led by the community and that address complaint and impact litigation. This could include: Implementation of community-based research and advocacy such as The People Living with HIV Stigma Index; Document cases of HIV or TB-related discrimination by health providers, and support regular dissemination of the information with local, regional and national health services; and Support impact litigation aimed at bringing cases of rights violation to court

Global Fund E-learning courses: In efforts to strengthen programming for enabling environments, The Global Fund has developed a series of e-learning courses to support countries with elements around the funding process with practical advice, guidance and resources. A number of the courses are specifically focusing on strengthening communities’ and key population engagement these include:

Key Resources

Legislation and law reform

Creating Enabling Legal Environments: Conducting National Reviews and Multi-Sector Consultations on Legal and Policy Barriers to HIV Services

National Dialogues on HIV and the Law: A Practical Manual for UNDP Regional HIV Teams and Country Offices

UNDP Legal Environment Assessment for HIV: An operational guide to conducting national legal, regulatory and policy assessments for HIV


Reducing stigma and discrimination

The People Living with HIV Stigma Index: An index to measure the stigma and discrimination experienced by people living with HIV

Tackling HIV-related stigma and discrimination in South Asia

South Asia Regional Advocacy Framework and Resource Guide: HIV, Human Rights and Sexual Orientation and Gender Identity


Increasing access to justice and awareness of rights through legal assistance services

Our lives matter. Sex workers unite for health and rights

HIV and AIDS Legal Environment Assessments – Country Reports for Jamaica, Malawi, Seychelles, Democratic Republic of Congo, Malaysia, Myanmar, Pakistan

Toolkit: Scaling up HIV-related legal services


Ensuring appropriate law enforcement practices protect people living with HIV

Police, harm reduction and HIV: A public health fact sheet

Law enforcement and harm reduction manual

Harm Reduction and Human Rights: A Resource Guide


Training for health care workers to prevent stigma and discrimination during health care delivery and services.

Reducing stigma and discrimination related to HIV and AIDS. Training for health care workers

Ensuring Equality: A Guide to Addressing and Eliminating Stigma and Discrimination in the Health Sector

A Human Rights Approach to Healthcare in Conflict