“If community health workers are strengthened, all our aspirations in public health will be better served” – Dr. Sania Nishtar, CEO of Gavi
Dr. Nishtar’s inspiring call to action echoed what many leaders emphasized at the 78th World Health Assembly: professional community health workers are critical to solving pressing global health issues, and we must double down on our support for them. Whether it’s strengthening primary healthcare, addressing workforce shortages, or reducing the burden of non-communicable diseases, community health workers are at the center of the solution. To be successful, community health workers must be treated as professionals equipped with rights, protections, and career pathways. They are the workforce of the future, especially in countries where primary health care systems remain fragile. Amidst reductions in foreign aid globally, they need continued and sustained investment to create the change we want to see.
Here’s what stood out from our time at the World Health Assembly, and how these lessons are driving our work into the future:
We cannot improve what we don’t measure—we need to invest in building data on community health programs
We were honored to team up with our partner Africa CDC to convene key stakeholders, including leaders from UNAIDS, the World Health Organization, Gavi, the Global Fund, UNICEF, and the Global Financing Facility to discuss results from a new continental survey on community health. The survey found that while an estimated 1,005,007 community health workers have been deployed across 46 member states, over 80% of member states rely on the Official Development Assistance to fund their community health worker programs. This underscores the risks that community health worker cadres can face, they require sustained financing alongside a clear government commitment. In addition, this calls for additional investment to ensure we stay on track to meet the African Union’s two million community health worker goal by 2030.
The session was a reminder on how we can leverage data to drive accountability, policy change, and further government commitment. This urgency was echoed by our Co-Executive Director, Nan Chen, who said, “A lot of talk happened this week—but it’s data and accountability that people actually want.” During the side event, leaders reviewed the survey findings, which exposed major structural gaps—like the lack of sustained financing, weak policies, and fragile systems, that continue to undermine community health worker programs. These barriers prevent community health workers from receiving the salaries, supplies, and support they need to deliver quality care. As noted by Marijke Wijnroks, Head of Strategy, Investment and Impact at the Global Fund, “Our investments are aligned with national plans, to ensure community health workers are remunerated, trained, supervised, supplied and integrated.”
To help fill the structural gaps, Africa Frontline First will work with Africa CDC, governments, and funders to translate the survey findings into action. The data will directly inform a new community health financing framework we plan to launch ahead of the UN General Assembly in September. This framework will offer governments and partners a practical roadmap to close financing gaps, align funding with national priorities, and ensure community health workers are fully integrated and supported within national health systems. As Alex de Jonquieres, Director of Health System and Immunization Strengthening at Gavi, said, “Getting to 2 million CHWs is a laudable goal, but we need to get to 2 million CHWs who are salaried and fairly compensated. That is the only way to ensure sustainable and equitable care for all.”
Countries want to invest in community health workers, but the financing gap and recent aid cuts remain an obstacle.
At an event organized the Community Health Impact Coalition, government leaders expressed their willingness to support community health workers but emphasized that financing is a barrier to achieving that goal.
Leaders from Africa Frontline First in a group photo with participants at the CHIC event. Photo credit: Community Health Impact Coalition
As the Minister of Health from the Central Africa Republic, Dr. Pierre Somse, said, “We know community health workers add value. Give us the investment case and support on how to finance.”
This call by countries has never been more urgent in the light of the recent global aid cuts. Our analysis shows that approximately 50% of community health programs are at risk due to the abrupt termination of USAID. Africa Frontline First is supporting countries to meet this moment by reimagining how community health is financed. Our approach focuses on enhancing coordinated financing, integrating community health workers into health systems, complementing external aid with increased domestic financing, and developing cost-effective essential service packages that can be delivered by community health workers.
As Sudan’s Minister of Health, Dr. Haitham Mohamed Ibrahim, said, “Government doesn’t have enough fiscal space. We need external financing support and technical assistance for the community health program.”
To strengthen community health systems, funders must move beyond fragmented, project-based approaches and align behind national priorities and country-led programs.
One of the week’s most inspiring moments was listening to the conversation between Dr. Sania Nishtar, CEO of Gavi, and Millicent Miruka, a Kenyan community health worker supported by Lwala Community Alliance. When asked what Dr. Nishtar can do to support community health workers in her role as the CEO of Gavi, Millicent replied, “We want to be paid fairly and treated as professionals.” These conversations matter. They bring community health workers directly into the rooms where decisions are made—and remind us that dignity and fair pay for community health workers must be non-negotiable.
Gavi CEO, Dr. Sania Nishtar in a discussion with Kenyan CHW, Millicent Miruka at WHA. Photo credit: Community Health Impact Coalition
That’s why Africa Frontline First rallies funders around country-led programs, unlocking the resources countries need to advance their policies and plans to train, scale, and support community health workers. Our ongoing work with the Global Fund exemplifies this approach—to date, we’ve unlocked over $200 million from the Global Fund to strengthen community health worker programs across 17 countries, setting countries on the path to sustain and scale community health worker programs.
We’re seeing this model in action in Guinea. After receiving an initial $18 million catalytic funding from the Global Fund to strengthen their community health program, Guinea is now piloting an initiative to support community health workers through municipal and local budgets. With support from Integrate Health and Africa Frontline First, Guinea is showing how smart financing, committed national leadership, and effective technical partnerships can drive lasting improvements in community health, creating a model for other countries to adapt and scale. Learn more about it here.
Looking forward
The 78th World Health Assembly underscored how we can use data and more coordinated investments to strengthen health systems, close financing gaps, and create dignified jobs for community health workers.
Our Co-Executive Director, Nan Chen, in a panel discussion at an event hosted by Devex and McKinsey Health Institute. Photo credit: Devex.
That commitment will drive our work in the months ahead. From technical support to countries, to rallying funders around country-led programs, to our ongoing advocacy with the Africa CDC—we’re focused on turning data into action. With findings from the continental community health survey, we’ll press for accountability from governments, regional institutions, and partners to operationalize policies to sustainably finance community health programs among member states. As our Co-Executive Director Nan Chen said at a side event hosted by Devex and the McKinsey Health Institute, “At the end of a training, does a community health worker want a hat or a t-shirt? No—they want a career.” He continued, “Training is one piece of the puzzle, but we also need better policy and financing in place to make sure these health workers have dignified jobs to provide care.”