UNAIDS and CSD endorse creation of 2 million CHWs in support of 90-90-90
On February 9, 2017, UNAIDS, the Center for Sustainable Development (CSD) at the Earth Institute, Columbia University, and the Grand Duchy of Luxembourg co-hosted an expert consultation at Columbia University to advance 90-90-90 and Sustainable Development Goal (SDG) 3. The 90-90-90 agenda was launched by UNAIDS in 2014 to end the AIDS epidemic. The concept is that, by 2020, 90% of all people living with HIV will know their status, 90% of all HIV-infected people will be on antiretroviral treatment, and 90% of people receiving antiretroviral therapy will achieve viral suppression. 90-90-90 is a core strategy for furthering SDG 3 – “to ensure health lives and promote wellbeing for all at all ages” – and essential for achieving SDG target 3.3. – “to end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases” by 2030.
Dr. Michel Sidibé, Executive Director of UNAIDS, and Professor Jeffrey Sachs, Director of CSD, convened the meeting of renowned health economists and public health experts from around the world to deliberate on a strategy for increasing global commitment and funding to end the AIDS epidemic. Specifically, the expert consultation focused on the economic and public health case for creating 2 million community health jobs. Reaching the 90-90-90 target requires overcoming a health workforce shortage in most parts of the world. Trained Community Health Workers (CHWs) can play a critical role in bridging the health workforce gap, reaching marginalized communities, and strengthening primary health care systems around the world. Through the strategic use of CHWs, HIV testing and treatment programs can extend the reach of available services, reduce service costs, improve service quality and health outcomes, and reach vulnerable communities that have been marginalized by the mainstream health care system. The estimated added resources needed are roughly US $10 billion, which includes commodities as well as a rapid mobilization of at least 2 million Community Health Workers. CSD’s One Million Community Health Workers (1mCHW) Campaign has been leading the effort to strengthen CHW programs across sub-Saharan Africa since 2013 and is proud to join UNAIDS in this initiative.
Despite inclement weather, approximately 30 people were in attendance. Participants included economists and public health experts from UN agencies, universities, foreign ministries of health, NGOs, and donors from the private and public sectors. The consultation explored the costs of employing and supervising 2 million CHWs to expand HIV services to communities; described modalities for recruiting, training, and deploying 2 million CHWs by 2020; identified the broader economic benefits and social dividends of the strategy; and discussed options for mobilizing resources and institutional support for the CHWs.
The meeting strongly supported the establishment of a new international coalition of CHWs by mid-2017 that will spur the creation and support of national CHW systems. UNAIDS will lead global efforts to mobilize resources and the group will present its recommendations to the UN Secretary General.