2020 has taken each one of us aback. COVID-19 struck and disrupted health, school, businesses, travel, play, prayer, and livelihoods. We have had to make decisions that affect our health in a way only seen and done in health facilities. While going out to the shop, we have to wear a mask and sanitize and the body temperature had better be right. COVID-19 has reminded us basic facts – that we must first secure our health and then we can deal with other facets of our lives. Public health is a pre-requisite to social, economic and political stability.

Gradually, and gladly so, the lockdown measures are easing. One major move to ease the lockdown is the announcement by the Cabinet Secretary of Education Prof. George Magoha on the re-opening of schools. Great news indeed. There are health risks related to schools being closed. For some children, schools are nutrition centers that also offer psychosocial support. For some girls, being out of school can mean greater risk of sexual exploitation, early pregnancy, forced marriage and HIV infection. The longer a girl is out of school, the less likely that she will return. Education, like health, narrows inequalities, is a driver for sustainable development, breaks down cycles of poverty and opens up a world of possibilities.

As COVID-19 fades away, the aftermath will remain with us for years to come as intensive efforts to find therapeutics, treatment and a vaccine continue. When Kenya was put in lock down, access to healthcare services dwindled. People were afraid of going to health facilities when they fell ill for fear of having COVID-19 and for fear of related stigma. This has resulted in the possibility of increased incidence of other killer diseases such as HIV, TB and malaria presenting fresh and unprecedented health challenges.

A modelling report by the Stop TB Partnership indicates that as a result of the COVID-19 pandemic, global TB incidence and deaths in 2021 would increase to levels last seen in between 2013 and 2016 respectively – implying a setback of at least 5 to 8 years in the fight against TB.

We must see the fight against COVID-19 and other diseases such as HIV, TB and malaria as one fight. Measures to mitigate the impact of COVID-19 on HIV, TB and malaria should involve a combination of intensive community engagement and maintaining awareness of the importance of services to defeat the three diseases while emerging from the COVID-19 response. Programs must identify and address gender inequalities in their design and response. One approach is to meaningfully engage women, supporting primary healthcare services needed to reduce child and maternal mortality; and supporting caregivers, who are mostly women, caring for those who fall ill from COVID-19 or other causes. Gender barriers to health must be removed.

Further, as we tackle COVID-19, health advocates, partners and our Government must ensure that the response to COVID-19 includes lessons learned from the fight against HIV, TB and malaria. Human rights be protected; stigma and discrimination must be addressed. The available COVID-19 resources be shared equitably. When treatment and a vaccine is found, it should be available to everyone, one everywhere for free. So that no one is left behind.

Lastly, COVID-19 will not be the last pandemic. The next pandemic must find Kenya better prepared, ready with strong and resilient health systems with a strong focus on primary healthcare founded on strong community health systems. A rights-based, equitable, people-centered system that is conscious of other factors that affect health and wellbeing such as climate change, food and housing.

To achieve these successes, I urge the Government to invest additional domestic resources for health to build back better for a healthier future for all Kenyans. That health is one of the pillars of the Big 4 agenda is a sign of President Kenyatta’s commitment to health. Health is an investment in human capital and a key factor to the development of our country.

I urge for efficient, effective and affordable healthcare for every Kenyan, wherever they are.

Maurine Murenga is the Executive Director of Lean On Me Foundation

On the occasion of the 6th Global Fund Replenishment Conference, held in Lyon (France) on October 10, 2019, the Ambassador of France to Ghana visited a facility that benefited from the Global Fund (Maamobi General Hospital), met with members of the Country Coordinating Mechanism (CCM) and beneficiaries.

The French Ambassador, Anne Sophie AVE, went to the Maamobi General Hospital in Accra where she was welcomed by the Director, Dr. Dorcas ANFU OKINE and various care staff of the establishment as well as the CCM Chair, Ms. Cecilia SENOO. She was able to meet with the National Disease Control Programs (NACP), the National AIDS Control Program (NACP), the National Tuberculosis Program (NTP), and the National Disease Control Program (NTP). She also visited the maternity ward where she met pregnant women and young mothers receiving Global Fund-funded treatment.

She then met with members of the CCM as well as representatives of the Ministry of Health and the Ghana Health Service to discuss the modalities for strategic management and monitoring of grants.

The end of the morning was dedicated to a meeting with direct beneficiaries of the Global Fund. H.E. the Ambassador AVE was able to speak with Mrs. Comfort ASAMOAH-ADU, Executive Director of the WAPCAS (West African Program to Combat AIDS and STIs), the main recipient of the Global Fund. This sequence was an opportunity to discuss with different beneficiaries and affected communities about their backgrounds and the challenges they face.

The Global Fund has several objectives: maximizing the impact of actions against HIV / AIDS, tuberculosis and malaria; building resilient and sustainable health systems; promotion and protection of human rights and gender equality and the mobilization of resources.

Since 2002, when it was created, more than $ 40 billion has been allocated to 140 countries to fight these three pandemics. By 2018, programs supported by the Global Fund to Fight HIV, Tuberculosis and Malaria have saved 32 million lives worldwide.
Ghana, the first recipient of a Global Fund grant, has received cumulative disbursements of US $ 817 million since 2002, including about US $ 110 million from France.

Malaria remains a leading cause of death in Ghana, but since 2006 significant progress has been made in reducing prevalence, incidence and mortality. Tuberculosis is treated successfully in 85% of cases, but screening coverage is still low, as is the case for HIV. HIV / AIDS remains a significant cause of death and prevalence is high among key populations (sex workers, men who have sex with men). New HIV infections do not decrease (19,100 cases / year in 2017), the number of people living with HIV is estimated at 320,000 in 2018.

On October 10, 2019, France hosted the 6th Global Fund Replenishment Conference in Lyon, meeting the financial needs for the 2020-2022 periods with a financial target of $ 14 billion to help save $ 16 million lives and avoid 234 million new infections in 2030.

The States present at this Conference have met their commitments: the Fund has collected $ 14.02 billion in pledges, including $ 1.4 billion from France, which remains the second largest contributor to the Global Fund since its creation in 2002, after the United States.

Global Fund resources alone will not be sufficient and the Government of Ghana will undoubtedly need strengthen its efforts through increased health budgets to eradicate the 3 pandemics.

Commonwealth Health Ministers meet every year. This year, the meeting took place virtually on 14 May 2020. The theme of the meeting was delivering a coordinated Commonwealth COVID-19 response. The meeting was timely as Governments the world over were caught out when COVID-19 struck. As the meeting took place, Global Fund Advocates Network – Africa members sent solidarity letters to their Ministers for health and to Her Excellency Amira El Fadil the Commissioner for Social Affairs at the Africa Union Commission

In the letters, Civil Society noted with concern the economic, social and health disruptions caused by COVID-19. They acknowledged and appreciated the efforts that the Governments, private sector, donors and individuals are putting in place to protect citizens from COVID-19 to save lives, mitigate its impact and sustain livelihoods.

They asked that the Ministers for Health ensure that: Governments continue to provide comprehensive healthcare services and remains focused on defeating other life threatening diseases as it battles COVID-19; Escalate engagement of community health systems so that communities are at the heart of the COVID-19 response especially in prevention, contact tracing and surveillance; Enhance multi-disciplinary partnerships for robust coordination at national, regional and global level.

Civil Society advocates from Kenya, Burkina Faso, Cameroon, Zimbabwe, Rwanda and Eswatini joined in this activity.

In 1897 Ronald Ross working in India discovered that culicine mosquitoes transmitted the avian malaria parasite Plasmodium relictum and suggested that human malaria parasites might also be transmitted by mosquitoes.
The world marks World Mosquito Day on 20 August.
This year, GFAN Africa and the Civil Society for Malaria Elimination (CS4ME) mobilized partners on World Mosquito Day to join in social media action; And to emphasize the need for countries and regional partners to work towards the elimination of malaria amid COVID -19. This is in consideration of the knock on effect that COVID-19 will cause to malaria elimination as a result of disruption of prevention, treatment and care services. Partners from the following countries joined in the twitterthon: Tanzania, Kenya, Nigeria, Zimbabwe, Burkina Faso, Sierra Leone, Cameroon and Ghana.

While urging for sustained unrelenting efforts to end malaria, the key messages emphasized

1. That Governments must ensure provision of needed malaria control services amid COVID-19 to save lives
2. The need for mass vector control to help end malaria while ensuring the protection of health workers and communities from COVID-19
3. That our leaders must increase their allocation of domestic resources for health to help end malaria and other life threatening diseases and ensure quality healthcare for all

According to the World Health Organization’s malaria report, most malaria cases in 2018 were African Region (213 million or 93%). Then there is urgent need to minimize disruptions to malaria prevention and treatment services during the COVID-19 pandemic to avoid slipping back and having increased numbers of malaria relate deaths.

Indeed, we UniteToFight COVID-19, malaria, and all life threatening diseases.

On 10 – 11 February 2020, GFAN Africa leaders from across the continent held their strategy meeting in Nairobi, Kenya. It was a reunion to take stock of 2019 and plan for 2020 going forward.

Acknowledging and appreciating the great efforts and partnerships in the work towards the 6^th replenishment of the Global Fund, participants agreed to sustain the moment in 2020. Click here for a summary of our activities for 2019.

The rallying call was on the need to be in intentional in urging implementing countries to invest increased resources in health for health systems strengthening, to defeat diseases, and to save lives.  This work should encompass broad health investments which are of high impact.

In her remarks, Ms Linda Mafu, the head of Civil Society and Political Advocacy at the Global Fund reminded participants on the dire need to invest in criminalized populations and young women and girls. “Girls aged 15 – 24 years are most affected by HIV with an unacceptable high number of new infections” She noted with deep concern. She urged for all efforts to stop the new infections. She added that interventions and information for young girls and women as well as criminalized populations must be packaged in a way that is appropriate for them.

In planning for 2020, participants agreed to build on the successes of 2019 which were realized through strong team work, meticulous planning and a strong desire for better health outcomes. It was agreed that there is need for broader engagement with continental and regional blocks such as AfDB SADAC, COMESA, ECOWAS and the EAC. Key moments, disease days, regional and global meetings will be avenues for advocacy towards increased domestic resources for health to achieve universal healthcare coverage and Sustainable Development Goal 3 on the health and wellbeing for all.

Other key activities for 2020 are training of Civil Society health advocates on budget advocacy; reaching out to governments so that their pledges towards the 6^th replenishments are converted to contributions. And ensuring that implementing countries give their matching funds to achieve the desired results.

While agreeing that the 7^th replenishment of the Global Fund is only 3 years away, participants agreed to take time to plan on replenishment activities and to actively participate in the upcoming development of the Global Fund strategy.