The Global Fund to Fight AIDS, Malaria and Tuberculosis is undoubtedly one of the largest global health partnerships. Indeed, its life-saving investment efforts to end the afore-mentioned epidemics faster benefit more than 100 countries around the world particularly in Africa. In 2020, Global Fund’s efforts saved 44 million lives worldwide including 21 million 900 (21,000,900) people living with HIV on antiretroviral therapy, 4 million 700 (4,000,700) people on TB treatment and 188 million mosquito nets distributed.
The 44 million lives also represent 44 million cultural, traditional, religious and linguistic diversity… 44 million people who for sure do not speak the same language. The Global Fund is therefore a real “Tower of Babel” in a sense, as regards the various languages spoken by these many countries, which include, in addition to English, French, Portuguese, Spanish, Russian, and many others. This linguistic diversity is also evident at the donor governments’ level, which includes the United States, France, Canada, Germany, Spain, Italy, Norway, Sweden, Portugal, Japan, the Netherlands, Belgium, just to mention but a few..
Language Barriers a Communication Challenge For Non-Native English Speakers
It is a well-known fact that English is the language par excellence of the Global Fund, and for this reason, almost all of its documents are produced in English. As these documents are often highly technical and contain specialised vocabulary, recipients who do not have a good command of the English language face serious difficulties in understanding them, if the documents are not translated, full participation of key partners and stakeholders could be hindered or delayed. This may include representatives of various constituencies on the Global Fund Board and committees, NGOs from both developed and developing countries, grant implementers and others.
For instance, the Partnership Forum, which is ‘an ongoing process linked to the Global Fund Strategy providing persons and entities concerned about the prevention, care, treatment and eventual eradication of HIV/AIDS, tuberculosis and malaria, a forum to express their views on the Global Fund’s policies and strategies’.
Given that strategy is one of the key elements in achieving the institution’s goals, it is critical that all stakeholders in the Partnership Forum have a sound understanding of the issues at stake to be able to provide significant inputs based on their experience, to inform the orientation and development of Global Fund policy and strategies.
To achieve this, the Global Fund acknowledges that an all-inclusive strategy may be difficult to achieve given the diversity of the languages but they are making all efforts to be increasingly accommodative as far as is possible.
On another front, one of the participants at the WCA Global Fund pre-board meeting organised in Dakar from 25th to 26th October 2021 raised the issue of language barrier during the selection of consultants in Sao Tome and Principe. In support to the drafting of the grant application, the consultant assigned to the country was English-speaking, whereas the country is Portuguese-speaking.
To overcome this challenge, an interpreter had to be recruited on site to facilitate discussions. This led to delays and unnecessary need for increased use of resources, especially on budget allocations, which could have been avoided if English was not considered the de facto language in all countries.
Africa receives more than 70% of the Global Fund’s resources and has the highest burden of disease for two of the three diseases of the Global Fund’s portfolio, namely; malaria at94% ;AIDS at70%, and a significant burden of TB at25%.Four official languages are generally used on the continent, specifically, English, French, Portuguese and Spanish.
These languages need to be taken into account in communication in both written documentation and in oral interactions during the various forums such as Board and Committee meetings, the Partnership Forum and in other convergences.
This would ensure a better understanding of the issues at stake as well as greater, more meaningful, interactions and engagements leading to innovations, especially from the continent in which the Global Fund invests the largest part of its resources. The organization therefore needs to achieve optimal results and great value for their investment in view of the ultimate goal to eradicate HIV/AIDS, tuberculosis and malaria.
Impact of Ineffective Communication on both the Grant Implementation and Implementer Performance
More specifically, communication challenges can have a negative impact on grant implementation and on the performance of implementers due to poor understanding of Global Fund policies, procedures and guidelines on ethics and governance, programmatic and financial risk management, procurement and supply management of health products, etc.
Opportunities that can help countries improve the implementation of their grants for greater impact, such as catalytic investments could also be negatively affected by communication related barriers.
Additionally key stakeholders such as constituency representatives on the Global Fund Board and committees, Country Coordinating Mechanisms, Principal Recipients and sub-recipients, are required to be fully conversant with all of the tools that the Global Fund provides for grant implementation and monitoring.
It is therefore vital that all these actors are given an opportunity to obtain documentation in the language they know best and to be able to express themselves as comfortably as possible.
Avenues to Improve Communication within the Global Fund for Enhanced Grant Impact
To ensure greater impact, the Global Fund should develop external communications strategy that is cognizant of the linguistic boundaries within which they work, in particular those from Africa, the continent most affected by two of the three diseases of its portfolio and which, as mentioned above, receives the bulk of its grants. For this purpose, it is important to rely more on translation and language processing tools. The increasing use of English for international communication purposes can sometimes be seen as an infringement of the rights to work in other languages, as well as a point of conflict with the very reasons of the Global Fund’s existence.
Language issues must therefore be recognised as an important component of the management of an international organisation.
When English is used, documents in French, Portuguese, and Spanish for example should also be made available, as it is understood that releasing documents exclusively in English undermines understanding by all. To meet its goals and sustain its impact within the constituencies, the Global Fund should make increased effort to create a convergence of knowledge and understanding within its stakeholders, where everyone has the opportunity to express themselves in the language they know best, if necessary with the help of an interpreter.
It is equally important to provide interpreters or visual presentations (PowerPoint) for non-English speakers in attendance. Dubbing an oral presentation in English with a PowerPoint in French or another language is a sign of inclusivity and courtesy that can enhance participation, understanding and improve on stakeholder contributions and inputs. This will help the organization work towards optimised interactions during GF Board and Committee meetings and avoid unfortunate scenarios where valuable viewpoints may not be voiced due to the fact that participants are unable to express themselves due to language related barriers.
Another approach is to prioritise multilingual digital communication. The Global Fund’s website could offer several language options in order to reach a wider range of stakeholders. A good practice is to update the different language versions simultaneously and to translate as much content as possible.
Translation certainly has a cost, but doing without translation has an even higher cost. There is evidence that the cost of translation is more than offset by productivity gains, simply because people are more efficient in their native language. It is vital that qualified persons carry out translation work. Translation is obviously risky if it is not done properly, which is why it is important to work with professionals and to ensure the quality of translations, as the corporate image of the organisation could be at stake in cases of improper translations.
It is also good practice to provide multilingual lexicons to harmonise the organisation’s specialised terminology with a view to promote a common understanding by all stakeholders. The organisation could explore products in the market that meet the organization’s established requirements in this area e.g. lexicon, an application whose features make it easier for organizations to share information and to target it to different groups sometimes via intranet keeping it specific to their activities.
The use of simultaneous or consecutive interpretation, as the case may be, is also critical to facilitate communication during meetings or smaller gatherings involving participants from different linguistic backgrounds. Interpreting helps to avoid a situation of inferiority vis-à-vis the native speaker.
We would like to take this opportunity to highlight the support of Expertise France via the L’Initiative, which is aware of this challenge. Indeed, with the funding the organization granted to the African Constituency Bureau, we have been able to better support French-speaking African countries, notably by recruiting French-speaking staff and a translator, but also by holding work sessions in French for ACB Board members.
We hope that this support will be sustainable for the long haul and will inspire other partners to extend their support in this crucial area of ACB’s work.