A well-known proverb says: If you want to go fast, go alone. If you want to go far, go together. In 2023, Africa Frontline First prioritized long-term impact and radical collaboration. We chose to go far and to go together. By partnering with regional institutions, country governments, major public and philanthropic donors, technical implementers, and advocates we ended the year with unparalleled levels of commitment to increase and improve financing and championship of integrated national community health programs. A step closer to our vision of 200,000 professionalized community health workers by 2030. In addition to this, we shared the stage with community health workers such as Prossy Munyingo, Bupe Sinkala, John Wabire, and Margaret Odera as they told the world how they extend health services to their communities. Hearing from them as they share their realities is what fuels the work we do at Africa Frontline First – to work towards changing those realities for community health workers in Africa.
Historic Joint Commitment to Fund Community Health
Following a year-long consultative process that concluded at the Reaching the Last Mile Forum, twelve partners: Global Fund, CIFF, ELMA Philanthropies, the Johnson & Johnson Foundation, the Skoll Foundation, the Mastercard Foundation, The Rockefeller Foundation, PEPFAR, PMI, USAID, and UNICEF pledged to accelerate support for professional community health workers, including a US $ 900 million investment from the Global Fund with 74% earmarked for Africa in the next three years. Despite the established lifesaving value and ambitious country plans to scale community health workers, Africa faces a US $ 4.4 billion annual funding gap. For too long, this gap has been further exacerbated by fragmented, vertical, and inefficient funding schemes. We wanted to challenge the status quo and collectively reimagine what partnership and transparency in funding could look like – to forge a collective, coordinated and unified financing agenda for community health programs in Africa. This significant milestone inches towards the vision of fully funded community health programs.
“In my role as President of Liberia, I have seen the darkness that disease outbreaks can bring to a country. I have also witnessed the light that community health workers bring to the health of a nation. Today’s commitment represents a strong step in our journey to bring health to all.” H.E. Ellen Johnson Sirleaf, Former President of Liberia
Strong Financing for Strong Community Health Programs
Africa Frontline First is supporting Ministries of Health to demonstrate the power of financing in enhancing community health programming. Working hand-in-hand with our implementing partners, we have provided technical assistance to 11 African countries, unlocking more financing from the Global Fund through Project BIRCH. Together we are ensuring these funds are allocated towards impactful community health priorities, helping countries to build integrated community health programs.
“Project BIRCH has provided funds and technical assistance in strengthening community health priorities for Zambia. It has provided a platform for knowledge exchange and skills transfer as we operationalize and institutionalize community health programs.” Zimba Christopher, Community Health Technical Advisor, Ministry of Health, Zambia
Project BIRCH is funded by the Global Fund and builds from the US $100 million mobilized through the Africa Frontline First Catalytic Fund which is set for implementation in 2024.
Increasing Political Will for Community Health Programs
Building strong financing for strong community health programs requires integrating professional community health workers into national health systems with the support of political leaders, influencers and decision-makers. Sadly, this is not the case for many countries in Africa. Africa Frontline First’s approach to achieving this is by elevating the community health agenda in the corridors of political leaders, regional health organizations and influencers.
- In March, we participated in the 3rd International Community Health Workers Symposium hosted by the Government of Liberia. This symposium achieved two significant milestones:
- A pledge by the Liberian government to invest USD$1.8 million in the country’s CHW program, and
- The launch of the Monrovia Call to Action which demands decision makers across sectors to fund, scale and strengthen community health programs.
- In November, we attended the 3rd International Conference on Public Health in Africa. Amb. Lewis Brown II, Senior Advisor to H.E. Ellen Johnson Sirleaf, provided keynote remarks encouraging Member States and partners to leverage community-based services to achieve universal health coverage. And our executive team shared the lessons learned and challenges to improve the flow of resources for country-led community health programs at different events during the week.
“Developing the needed human capital must go hand in hand with the resources that will be required. For example, at the community level, community health workers, most of whom are women and require additional training to provide much-needed life-saving services, have done so for years with passion and determination.”- Amb. Lewis Brown II, Special Aide to H.E. Ellen Johnson Sirleaf
Technical Support for Strong Integrated Community Health Programs
Increased resources and advocacy for community health are not enough to achieve equitable access to care for everyone. It must be complemented with proper tools, programs and networks of support to maximize the transformative work being done at the country level. In 2023, our partnership with Africa CDC delivered technical assistance to the Ministries of Health, and partners, in South Sudan and Sierra Leone under the Joint Country Support Capacity Plan.
- The Ministry of Health in Sierra Leone adopted the Freetown Recommendations on Accelerating Implementation of the Community Health Programme.
- The South Sudan Ministry of Health developed and validated, jointly with partners, a country support plan for Community Health.
To conclude the year, we joined Africa CDC to launch the first Continental Community Health Coordination Mechanism to oversee the Institutionalization, Integration and Coordination of Community Health Worker Programmes in the continent. Africa Frontline First has been selected alongside Mr. Olasford Wiah, Director of the Community Health Services Division at the Liberia Ministry of Health, to co-chair the community health financing and sustainability sub-group.
“Community health workers deserve better than what they have, not because of charity, but because of justice. As Africa CDC launches its Continental Coordination Mechanism, Africa Frontline First will continue to work collaboratively to operationalize this initiative by extending the needed technical assistance and financial resource mobilization” – Nan Chen, Co-Executive Director, Africa Frontline First
What to expect in 2024?
2023 has been an extraordinary year for Africa Frontline First. While we celebrate our wins, we believe our work has just started. In 2024, we will:
- Formalize our collaboration with donors and partners to agree on shared transparency and data principles to improve financing efficiency
- Continue to support more countries through BIRCH expansion to improve the quality and implementation of their national programs
- Continue to work with Africa CDC to strengthen continental coordination on community health
- Build an advocacy campaign to prioritize community health at the country and regional levels