Nonprofits launch $100 million plan to support local health workers

By THALIA BEATY, Associated Press

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 gateway to treatment for people with limited access to medical care.

The Skoll Foundation and the Johnson & Johnson Foundation announced on Monday that they have donated a total of $25 million to the initiative. The Global Fund to Fight AIDS, Tuberculosis and Malaria, which will oversee the project, has matched donations and hopes to raise an additional $50 million.

The investment is aimed at empowering frontline workers who experts say are critical to fighting the outbreaks of COVID-19, Ebola and HIV.

“What have we discovered in terms of community health workers? said Francisca Mutapi, a professor at the University of Edinburgh who helps lead a multi-year project to address neglected tropical diseases in several African countries. “They are very popular. They are very effective. They are very profitable.

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On a recent research trip to Zimbabwe, Mutapi described how a community health worker negotiated treatment for a parasitic infection in a young child who was part of a religious group that does not accept clinical medicine. .

“She goes to the river, going about her daily business, and she notices that one of the children in her community is complaining of stomach pains,” Mutapi said.

The woman approached the child’s grandmother for permission to take the child to a clinic, which diagnosed and began treating the child for schistosomiasis. It wouldn’t have happened without the intervention of the woman, Mutapi said.

Ashley Fox, an associate professor specializing in global health policy at Albany, SUNY, said evidence shows that community health workers can effectively provide low-cost care “when properly equipped, trained and paid – c is a big warning”.

Although the current number of such workers is not well documented, in 2017 the Africa Centers for Disease Control and Prevention estimated that the continent needed 2 million to meet health targets. Many of these workers are women and are unpaid, although the Global Fund advocates for some sort of salary for them.

“It’s hard to think of a better group of people than you would want to pay if you think about it both from the perspective of creating good jobs and maximizing health impact,” said Peter Sands. , executive director of the fund. .

The Global Fund, founded in 2002, channels international funding with the aim of eradicating treatable infectious diseases. In addition to its regular three-year grants to countries, it will deploy these new philanthropic gifts 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 been working with the Liberian government to expand and strengthen its community health program since 2016.

During 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 try to find an answer.

“We were all seeing the deja vu moment of remembering a few years ago when Liberia was beset by this tragic Ebola outbreak,” said Nan Chen, CEO of Last Mile Health. “And as President Sirleaf reminded us: the tide turned when we turned to community.”

Along with the other organizations specializing in public health funding, research and policy, they set out to design an initiative to expand community health programs and capitalize on the attention the pandemic has brought to the need for surveillance of diseases.

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, pointed out that these workers can also trigger early warnings that benefit people around the world.

“It’s essential not only to provide healthcare in Africa, but it’s how we’re also going to catch the next set of diseases that could threaten people around the world,” said Gips, who is also the former United States Ambassador to South Africa.

Last Mile Health won a major gift from the Skoll Foundation in 2017 and has also received major donations from TED’s Audacious Project and Co-Impact, another fundraising collective. The organization’s co-founder, Raj Panjabi, now serves in the Biden administration.

“What philanthropy noticed about Last Mile Health is that we weren’t just directly addressing the problem by actively running community health worker programs, but seeing our innovation adopted into policy. national scale,” said James Nardella, the organization. program leader.

Fox and other SUNY experts say connecting the work of community health workers to the national health system is a priority, while ensuring sustainable funding for their programs.

The Global Fund said it will help countries design the proposed expansions of community health workers over the next year.

Chen acknowledged that there is no magic bullet for the issue of sustainability.

“Part of the job that organizations like Last Mile Health have to do is sit in this discomfort and struggle with it, with our partners, with donors, until we gradually find the solution here,” said Chen said.

Mutapi said governments eventually have to fund the programs themselves and she argued that the experiences of places like Zimbabwe and Liberia with community health workers could also benefit people in other settings.

“Having actually lived on Scottish islands, which are inaccessible,” she said, the community health worker innovation is “something that can actually be exported to remote western communities because that link between a provider and the local community is really important for compliance and for access.

The Associated Press’s coverage of philanthropy and nonprofits is supported by the AP’s collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content. For all of AP’s philanthropy coverage, visit

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