Community-led responses: a missing issue at the World Health Assembly?
By Sebastian Rowlands, Frontline AIDS
This year at the 72nd World Health Assembly (WHA), the focus was firmly on universal health coverage (UHC) and ramping up political momentum towards the UHC High Level Meeting in September. PITCH was represented by a team of programme staff and PITCH partners representatives: David Ruiz (Aidsfonds), Grace Kamau (African Sex Workers Alliance, Kenya), Rico Gustav (Global Network of People living with HIV/AIDS), and Sebastian Rowlands (Frontline AIDS).
Two key agenda items up for discussion were UHC and primary health care, and their delivery by community health workers. For PITCH, this was an opportunity to bring attention to the important role of community responses within UHC, beyond those of community health workers,.
UHC has been high on the World Health Organization’s (WHO) agenda since the new Director General, Tedros Adhanom Ghebreyesus, was elected in 2017. This attention has been critical to galvanising member state support for UHC, and throughout the WHA this year, it was the rhetoric which dominated all discussions.
Importance of community-led responses unrecognised
Whilst there were some moments of attention to community-based health responses at the WHA, overwhelmingly these conversations centred on the role of community health workers in delivering or making resource gains for primary Healthcare.
The event failed to recognise the value of less formalised community-led responses, or how these can be vital for the marginalised populations PITCH works with.
This would appear to be symptomatic of a general lack of understanding of how non-medical services like prevention, activities to address structural barriers and social protection, and advocacy, are critical for the success of UHC.
Making voices of the marginalised heard
During the WHA, PITCH held an official side event together with the Global Network of People Living with HIV (GNP+) and PITCH partners to raise the voices of partners from marginalised communities, including the LGBT, sex workers, people who use drugs and people living with HIV.
The side event succeeded in sharing positive examples of community-led responses and approaches that work. The message to scale up community-led responses was heard by WHO’s Director General, who joined the panel and spoke strongly on the need for inclusive health for all.
Countries must invest to close health gap and put people and their communities at the centre of strengthening health systems.
Tedros Adhanom Ghebreyesus, Director General, World Health Organization
Monique Kamphuis, First Secretary to the Permanent Mission of the Kingdom of the Netherlands, also gave strong support for the growing evidence that not reaching out to communities means we will never change mortality rates.
Next steps for community responses for health
Overall the support and engagement at the WHA was encouraging, but only the initial step. This is why PITCH, with the Free Space Process, has created an advocacy brief on Community Responses for Health, to push this message further with the country missions in Geneva and beyond.
It was clear that understanding of community-led responses remains lacking and it is critical that we continue to mobilise for greater recognition, support and investment in community responses for health.