By Chioma Okafor, Global Technical Assistance Team Lead
After having been virtual for the last couple of years due to COVID-19, the CORE Group Global Health Practitioners Conference was back in person this year. This year’s conference focused on “Transforming the Global Health Landscape,” and started with a rousing plenary speech given by Dr. Samuekeliso Dube, Executive Director of FP 2030. She emphasized the integral role of community-led partnerships and development in the achievement of global health goals. From there, the three takeaway messages from the rest of the conference were:
- Prioritizing community health and community health workers (CHWs),
- Rethinking global health and addressing Global North privilege, and
- Collaborative competition as a tool to enhance global health.
Prioritizing community health and community health workers (CHWs) as the core of global health
Community driven solutions are not only very sustainable, but they also promote locally led development. CHWs are key actors in the facilitation of country owned health initiatives; hence it is important that the role of community health workers be strengthened in order to continue building resilient health systems. With the COVID-19 pandemic, we have seen the integral role CHWs have played in ensuring that essential health services reach the populations they serve, serving as the liaison between the patients and the health system. It is important that global health implementing partners and donors support CHWs through investments in compensation, dedicated supervision, continuous training, and performance management.
We must also work to make CHWs not just a temporary solution during a health emergency, but a critical part of the public health ecosystem by building meaningful and strategic partnerships between CHWs, communities, and policy makers to address the existing structures of health inequity. For example, CHWs should be invited to and financially supported to attend global and regional conferences to get front line perspectives on country health needs and priorities, while sharing best practices and improving their own technical knowledge.
Rethinking Global Health and addressing Global North Privilege
We have seen the rising call for the decolonization of the global health agenda particularly with the COVID-19 pandemic and Black Lives Matter movement creating the avenue for important discussions on the issues around power and privilege prevalent in the sector. Most recently, we witnessed the global rush for COVID-19 vaccines, where the West bought the bulk of the world’s vaccine supply while vaccination rates in most African countries remained low. We must begin to look at ourselves to see how we have (consciously and unconsciously) perpetuate asymmetries and work to use our privilege by empowering and decentralizing global health research and practice and embracing true diversity and inclusion in the way we work. A great point by Dr. Dube that drives this home is the need to be less focused on targets and more focused on prioritizing people. Additionally, we should revise labels, such as “hard to reach populations,” that remove the responsibility from the systems and organizations that have failed to prioritize these populations.
The privilege also occurs in the medicalization of global health which shifts the public health agenda towards medical and technical solutions while neglecting the necessary community, social and political actions that could alleviate health inequities and save lives. This approach neglects the important role of advocacy groups and civil society groups in providing essential services as well as holding governments accountable. Therefore, we must continue to push to strengthen civil society groups, local organizations and institutions to build sustainable solutions with long term impact.
Collaborative Competition creates a better world
The COVID-19 pandemic has shown us infectious diseases do not recognize geopolitical borders. Our world has become and will continue to become more connected. This connectivity can create more strategic opportunities to utilize our collective power to address global health crises when they occur, and hopefully, to help prevent them in the future by continuing to strengthen public health capacity through partnerships, trainings and investments in the global primary healthcare system.
We must continue to encourage intersectionality that promotes public private partnerships that are unique and complementary to achieving global public health goals. This cannot be limited to just donations and funding but also working to develop effective systems, including the monitoring and evaluation of disease programs to highlight the progress of our interventions and its impact on the community. The Global North must invest in capacity development of Global South health workers and implementing partners to ensure they possess the right skills to deliver quality services to their communities. These peer-to-peer collaborations should utilize a multitude of training approaches to build the capacity and expertise of the health workforce and create integrated support for health systems, such as national and institutional health strategies and protocols including health management information systems.
A good example of this investment is the recently concluded Comprehensive Training to boost COVID-19 vaccine demand and improve routine immunization by building in-country capacity. Karna helped support this training that was hosted by GAVI in a multi-agency collaboration with the World Health Organization, US Centers for Disease Control and UNICEF and provided over 600 participants in 92 countries with the latest tools, resources and expertise to design effective interventions adapted to their needs of their respective communities. Such trainings are concrete examples of ways to engage with implementers and partners on the ground to improve service delivery and health outcomes. Global health practitioners must continue to emphasize solutions that are community developed and owned as a way to build trust among partners and allow program goals to encompass the needs of all partners and most importantly the needs of the community.
Finally, transparency and accountability must be at the core of all public-private partnerships and they must work to not undermine the role of community partners. Currently, Karna through the Task Force for Global Health is supporting the CDC’s Global Immunization Division in developing a technical assistance (TA) consultation system to strengthen the capacity of its country partners implementing immunization programs globally. This system will ensure TA solutions are contextual to the country and evidence based in order to build confidence in health care workers, health institutions and national health agencies in regards to vaccines.
As we move forward in achieving our global health commitments, it is incumbent on all of us, particularly in the Global North to set out clear goals for improving global health equity that prioritize country ownership in order to transform the global health landscape.