AU urgent call to deploy two million health workers by 2020 to fight HIV’s right step

Tuesday February 06 2018

HIV testing booths at the University of Nairobi, Kenya during the World's Aids Day event on December 1, 2017. PHOTO | AFP


Africa is the world’s youngest continent. By 2050, there will be 452 million people under the age of 25. Unlocking the energy, creativity and passion of these young people and creating a “youth dividend” is one of our continent’s greatest responsibilities and opportunities.

Key to unlocking this dividend is improving the health and wellbeing of young people. After all, healthier populations are more productive and drive economic and social development — all while reducing healthcare costs for governments. This is one of the cornerstones of the African Union’s (AU) Agenda 2063 growth and prosperity ambitions. And we need to get it right.

An important step in making this a reality took place this week. On the sidelines of the 29th AU Summit, First Ladies and advocates from across the continent are coming together to launch the Organisation of African First Ladies Against HIV/Aids in Africa’s (OAFLA’s) “Free to Shine” campaign. This campaign will highlight the importance of ending mother-to-child transmission of HIV, and creating an Aids-free generation.

Saving lives

I am proud to say I am part of that fight. My story is frustratingly far too common — diagnosed with HIV during my first pregnancy, I kept my status a secret and struggled to maintain my treatment. As a result, my twin babies contracted the virus, with one passing away after four months, and the other becoming gravely ill.

But my life changed when an organisation called mothers2mothers (m2m), which is working to end mother-to-child transmission of HIV, started its programme at the Kamuli hospital in Uganda. Their work is based on a simple yet hugely effective model — employing HIV-positive women as frontline healthcare workers in critically understaffed health centres and within communities.


They are saving lives and changing communities and from a single site in South Africa, m2m has scaled to work across eight African nations today.

These mentor mothers have changed the way care is delivered. Acting as peer mentors, they play a vital role as a link between families, communities and healthcare facilities. They offer advice and counselling, and help pregnant women disclose their status, stick to their treatment and feed their children safely after birth. The results are remarkable.

In 2016, the mother-to-child transmission rate for m2m clients was just 1.6 per cent across the eight countries we operate in — compared with national rates of up to 11 per cent.

This model works because mentor mothers truly understand what their clients are going through, having walked the path themselves. Their unique and intimate understanding of the social and cultural challenges of living with HIV in their own communities helps them create connections between vulnerable people and healthcare systems, and means they can help families to thrive, not just survive.

But more needs to be done to create an HIV-free generation. In 2016, 790,000 people were newly infected with HIV in Eastern and Southern Africa, while 420,000 passed away from Aids-related illnesses. This is unacceptable, especially for this day and age.

No silver bullet

There is no silver bullet. Instead, we need an integrated way forward that involves different players in different areas and with different expertise. Community health workers — such as m2m’s mentor mothers — are a unique and powerful resource that has yet to be fully tapped.

These professionals are the grassroots drivers of development and health outcomes. They are the vital missing link between major national initiatives and the people they serve. Because of their versatility and broader focus, they are capable of addressing multiple health problems and can drive gains on numerous fronts.

They need to be part and parcel of this approach, and so I am glad their role is being highlighted as part of the OAFLA campaign.

Ethiopia has made great strides in this area for instance by deploying 42,000 health extension workers from rural communities, a majority of whom are women. They are now serving as the backbone of the country’s landmark national health extension programme.

I am well placed to know the difference community healthcare workers can make. Since my first engagement with m2m and their ongoing support, I have been blessed with three HIV-free children, and my surviving twin is HIV-positive but healthy.

I decided to join m2m as a mentor mother, and with the money I earned, I have put myself through university and advanced my career. I have become a role model, a spokeswoman and a pillar of hope to my community. I want more women to have these opportunities.

This is why myself, and the other 1,600 mentor mothers, fully support the AU’s call to rapidly recruit, train and deploy two million community health workers in Africa by 2020, and we are adamant that the majority of these must be women.

I am grateful for the continued involvement of the African First Ladies in the fight to end paediatric Aids by 2030 and I am energised to continue working even harder.
If we get this right, we will be able to deliver on our responsibility to our young people. At the moment, we are not doing that.

Thirty adolescents are still infected with HIV every hour.

We can create health and happiness while delivering employment opportunities and improved living standards. The dream of an HIV-free generation and all its benefits is within our grasp — let’s empower women as community healthcare workers to make it a reality.

Juliet Nalumu is mentor mother with Africa-based NGO mothers2mothers, that employs HIV-positive women to create a generation free of HIV.