Informed By COVID, a Coalition of Funders Backs Community Health Workers in Africa

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The world has already lost more than 6.4 million lives to COVID, which has caused traumatic social and economic disruptions around the globe. So it’s hard to make a case that the pandemic’s been anything other than an unmitigated disaster. Yet some of the realities it revealed point to ways to reconsider who and what is truly essential to building long-term and sustainable equity.

A broad coalition of funders is aiming to do just that with a catalytic investment, which they hope will reach $100 million to support a cohort of people who proved essential during the darkest days of the virus: community health workers. Once the application process is complete, funding is expected to reach up to 10 African countries.

Here’s more on who’s helping, and how professionalizing community health work can reduce the burden of disease for millions going forward, while changing their futures.

Creating a fund

The Africa Frontline First Catalytic Fund, or AFF-CF, was created by the Global Fund to Fight AIDS, Tuberculosis and Malaria. The broad-strokes goal is to provide financing to expand the number of front-line community healthcare workers while sustaining domestic financing for practitioners.

Created by the United Nations in 2002 and endowed by the world’s wealthiest nations, the Global Fund raises and invests more than $4 billion a year in the movement to eradicate some of the world’s deadliest infectious diseases, like malaria, HIV and TB. The model it’s employing for AFF-CF mirrors its general approach by working across government, the private sector, civil society and the workers themselves.

AFF-CF is “under the championship” of Ellen Johnson Sirleaf, the former president of Liberia, who’s been convening an organized response to COVID from the get-go, grounded in knowledge gained during her work during the Ebola epidemic that “the tide was turned when we turned to community.”

A broad coalition

AFF-CF quickly drew support from two major foundations. The Johnson & Johnson Foundation contributed $15 million, while the Skoll Foundation contributed $10 million, for a total of $25 million. The Global Fund intends to match these and other commitments to meet an overarching goal of $100 million.

Other collaborators include the Financing Alliance for Health (FAH), Last Mile Health, the Community Health Acceleration Partnership (CHAP) and Community Health Impact Coalition, which works to professionalize community health workers in 40 countries. 

Front line and backbone

While community health workers proved themselves as both the front line and backbone of pandemic response, the plaudits they’ve received have failed to translate economically. More than 85% of workers in Africa are not compensated for this kind of work. The majority are women. 

AFF-CF will seek to professionalize community health work by compensating and training workers, and integrating them into larger healthcare systems.

Joaquin Duato, CEO of Johnson & Johnson, said the company’s foundation support is aimed at a group Johnson & Johnson considers to be “the cornerstone of care,” and that funding will help ensure the “delivery of effective, efficient and equitable care at the front lines.”

Skoll steps up

The AFF-CF was an easy fit for the Skoll Foundation, which takes a proximate approach to funding, one that places emphasis on lived experience and equity. The investment aligns with a number of Skoll’s strategic priorities, including strengthening health systems and building inclusive and sustainable economies.

Don Gips, CEO of the Skoll Foundation and former ambassador to South Africa, is enthusiastic about the collaboration. “This is such an exciting partnership, uniting those closest to the problem during the pandemic and the trusted community members who were able to continue providing service,” he said. “In too many places, workers were not paid or integrated into the healthcare system.”

Gips said Peter Sands, executive director of the Global Fund, has “caught onto the power” of breaking down silos. “We need an integrated system that works in concert,” Gips said.

AFF-CF also encompasses the work of three longtime Skoll partners, including this year’s Skoll Award winner, Financing for Health, or FAH, an African-led organization that works with governments to develop policies and strategies to support investment and secure a place in national budgets.

Timing and leveraging

Global Fund teams are currently working with countries to gauge interest and community health priorities. From there, they’ll determine which countries are the best fit for the fund, based on factors like demand levels and how much governments have already committed to community health. Gips said allocations and country selections will be finalized by the board toward the end of the year. Funds will start flowing in 2023.

Gips is also excited about an upcoming leveraging opportunity involving 10 countries that will match each philanthropic dollar raised by at a factor of at least “three to four, to one.”

“With everything going on in the world,” Gips said, “philanthropy should always be concerned with the number of governments making significant commitments to go forward.” He appealed to “anyone reading this” to join him and Skoll in their support. “We need every dollar,” he said.