Context to Research
The Global Fund to fight HIV, TB and malaria defines Challenging Operating Environments (COEs) as countries or regions “characterized by weak governance, poor access to health services, and manmade or natural crises” in its COE policy adopted in April 2016. Currently, 27 countries in the Global Fund portfolio are classified as COE. Among them, 10 are in the West and Central region (Chad, Central Africa Republic- CAR, Democratic Republic of Congo-DRC, Guinea, Guinea Bissau, Liberia, Mali, Niger, Nigeria and Sierra Leone) and two are in East and Southern Africa region (Burundi and South-Soudan). Both ESA and WCA compose the African Constituencies of the Global Fund.