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In eastern and southern Africa, adolescent girls and young women (AGYW) account for 30% of new HIV infections. CEPA was commissioned by the Global Fund to fight AIDS, Tuberculosis and Malaria (the Global Fund) to conduct an operational review of Global Fund-supported HIV prevention programs for AGYW across 13 priority countries in sub-Saharan Africa. In these countries, the Global Fund has invested US$250 million since 2017 to support combination HIV prevention options to reduce new infections among AGYW. The review objectives were to:

• Assess the extent to which the design, implementation and results of Global Fund AGYW HIV prevention investments for the 2020-2022 cycle were positioned to maximise impact as well as cost-effectiveness and sustainability.
• Draw lessons learned by identifying enabling/ hindering factors in the design, implementation and results measurement of AGYW HIV prevention grants and develop actionable recommendations to inform any adjustments to the current cycle, and to guide the development of Grant Cycle 7 investments.

The review methods included document review, data analysis, and stakeholder consultations at the global, regional and national levels within the 13 countries, and included engaging with key partners such as PEPFAR, UN agencies, implementing partners, CBOs, and government stakeholders. The review generated lessons from across the 13 priority AGYW countries and provided recommendations to strengthen the Global Fund’s current and future allocation cycles.