A new philanthropic project hopes to invest $100 million in 10 countries, mostly in Africa, by 2030 to support 200,000 community health workers, who serve as a critical bridge to treatment for people with limited access to medical care.
The Skoll Foundation and The Johnson & Johnson Foundation announced Monday that they donated a total of $25 million to the initiative. The Global Fund to Fight AIDS, TB and Malaria, which will oversee the project, match the donations and hopes to raise an additional $50 million.
The investment seeks to empower the frontline workers that experts say are essential to battling outbreaks of COVID-19, Ebola and HIV.
“What have we found out in terms of community health workers?” said Francisca Mutapi, a professor at the University of Edinburgh, who helps lead a multiyear project to treat neglected tropical diseases in multiple African countries. “They are very popular. They are very effective. They are very cost effective.” On a recent trip to Zimbabwe for research, Mutapi described how a community health worker negotiated the treatment of a parasitic infection in a young child who was part of a religious group that doesn’t accept clinical medicine.
“She’s going to the river, getting on with her day-to-day business, and she notices that one of the children in her community is complaining about a stomachache,” said Mutapi.
The woman approached the child’s grandmother for permission to bring the child to a clinic, which diagnosed and began treating the child for bilharzia. That would not have happened without the woman’s intervention, Mutapi said.
Ashley Fox, an associate professor specializing in global health policy at Albany, SUNY, said evidence shows community health workers can effectively deliver low-cost care “when they are properly equipped and trained and paid – that’s a big caveat.”
Though the current number of these workers is not well documented, in 2017, the Africa Centres for Disease Control and Prevention estimated that the continent required 2 million to meet health targets. Many of these workers are women and unpaid, though The Global Fund advocates for some sort of salary for them.
“It’s hard to think of a better set of people that you would want to be paying if you think about it from both the point of view of creating good jobs as well as maximizing the health impact,” said Peter Sands, the fund’s executive director.
The Global Fund, founded in 2002, channels international financing with the aim of eradicating treatable infectious diseases. In addition to its regular three-year grants to countries, it will deploy these new philanthropic donations through a catalytic fund to encourage spending on some of the best practices and program designs.
Last Mile Health, part of the Africa Frontline First health initiative, has worked with the Liberian government to expand and strengthen its community health program since 2016.
In the early months of the COVID-19 pandemic, former Liberian president and Noble Peace Prize recipient,
Ellen Johnson Sirleaf, convened Last Mile Health and other organizations to grapple with a response.
“We were all kind of seeing the deja vu moment of recalling back to a couple of years ago where Liberia was beset by this tragic epidemic of Ebola,” said Nan Chen, managing director of Last Mile Health. “And as President Sirleaf reminded us: the tide was turned when we turned to the community.”
Along with the other organizations that specialize in the financing, research and policy of public health, they set about designing an initiative to expand community health programs and to capitalize on the attention the pandemic brought to the need for disease surveillance.
The catalytic fund is the result. “I think the pandemic has shone a light on the critical role of these health workers,” said Lauren Moore, vice president of global community impact at Johnson & Johnson.
Don Gips, CEO of the Skoll Foundation, emphasized that these workers also can raise