Women & Girls

Women and girls continue to be disproportionately affected by HIV, TB and malaria. Gender inequality, discrimination, violence, limited access to education and a lack of tailored services inhibit women’s and girls’ access to health care and fuel new infections.

Unite to fight for women and girls

Despite great progress made against HIV globally, adolescent girls and young women continue to be disproportionately at risk of new HIV infections. Worldwide, approximately 850 young women and girls are infected with HIV every day. In sub-Saharan Africa, adolescent girls account for more than 25% of HIV infections, despite making up only 10% of the population. They are more than twice as likely to acquire HIV than their male peers.

The COVID-19 pandemic and subsequent lockdown measures, including school closures have put girls even further at risk. It is estimated that more than 5 million girls globally may not return to school after leaving due to COVID-19 closures. Evidence also shows that school closures during crises can lead to an increase in teen pregnancy – in some cases by as much as 65%. We must unite to fight for women and girls during this global pandemic.

The hidden tragedy of COVID-19

Follow 24-year-old Grace Ngulube as she takes us through the intimate lives of adolescent girls and young women affected by the COVID-19 pandemic and subsequent school closures in Malawi. “Restrictions on movement and school closures – while successful in halting the spread of COVID-19 – contributed considerably to fueling a pandemic of violence against adolescent girls and young women behind closed doors, threatening to reverse decades of progress in the fights against HIV and gender inequality.” Grace's story

The power of school

If we invest in girls’ schooling, health benefits will follow. A better-educated girl is less likely to get HIV, and more likely to have control over her body and be able to make her own choices about when or if she will marry or have children. And it not only makes a difference for her, it makes a difference for generations to come. Her children are more likely to survive infanthood, more likely to be vaccinated and more likely to go to school themselves.

Raising HER Voice

HER Voice is a fund established in 2018 based on the principle that adolescent girls and young women (AGYW) have a vital role to play in driving and shaping the HIV response in Africa. Their realities, experiences and needs must be central to policy making, program design, implementation and oversight.

In 13 priority countries, small grants are available to overcome barriers to meaningful participation in key Global Fund and related processes. HER Voice Fund Ambassadors have also risen to become influential advocates in their countries. The fund is implemented by Y+ Global with support from ViiV Healthcare Positive Action and the Global Fund.

Women and decision-making

The Global Fund strongly supports efforts to address gender inequalities. This starts with an analysis of the role of gender in the epidemics and in each country context as an obligatory part of the funding request. We are seeing a significant improvement in how countries are addressing gender-related barriers to health.

More women are getting involved in the design and implementation of programs. At the country level, more than 40% of decision-makers in grant committees are women. Country Coordinating Mechanisms have guidelines for expertise on gender and for striving toward equal representation of men and women in Global Fund-related decision-making.

Understanding the risks

While TB generally strikes more men than women, it remains among the top five causes of death for women between age 15 and 44 in low- and middle-income countries. As for malaria, pregnant women are particularly susceptible to the disease. Potentially fatal for the woman, it can also cause miscarriage, low birth weight or premature births.

Biomedical interventions such as access to treatment and mosquito nets, while urgent and necessary, are not sufficient to reduce women’s vulnerability to HIV, TB and malaria. Only structural transformations – social, political and cultural – will end the spread of the diseases.

Saybatou's life mission

Malaria is the biggest killer of children under the age of 5 in sub-Saharan Africa. During the rainy season – July to October – Saybatou Moussa and other community health workers go door-to-door to give preventive antimalarial medicine to young children in the city of Maradi, Niger. Saybatou's video story

Investing in women and girls

Addressing gender and human rights barriers is an integral part of the Global Fund strategy. In 13 countries in sub-Saharan Africa we increased our investments to reduce HIV incidence among adolescent girls and young women by more than five-fold. An innovative matching funds program launched in 2017 used US$55 million to support countries to invest an additional US$140 million toward programs aimed at addressing structural barriers, promoting behavior change and increasing access to biomedical interventions among adolescent girls and young women.

Our investments support women and girls in gaining access to health services. In Afghanistan, the Global Fund is investing in female community health nurses, supporting them to deliver TB prevention and care to women in remote communities who otherwise cannot visit health facilities without the escort of a male relative. In Lesotho, the Global Fund has invested in the development of National Guidelines for Prevention of Mother-to-Child Transmission of HIV, as well as in integrating sexual and reproductive health with HIV services so that women can access both services in one place. Our investments in comprehensive sexual health education have increased significantly with investments of over US$35 million in nearly 40 countries.

Private sector partners and foundations play an important role in supporting our investments in adolescent girls and young women. Comic Relief UK, Comic Relief U.S., Absa, (RED), Plan International and Fondation CHANEL, for example, are leveraging their resources, industry expertise and innovation to help tackle the pressing health issues facing women and girls, while Project Last Mile is supporting groundbreaking work to drive behavior change in Eswatini.

Learn how communities advocate for women and girls

Community Responses & Systems

Published 09 March 2021