A unique opportunity to put mental health at the heart of the Global Fund’s bold new strategy

The Global Fund’s 6th Partnerships Forum taking place this month is looking to collect ideas, different perspectives and evidence to feed into the building of a bold, ambitious and agile post-2022 strategy to cover the work of the Fund from 2023-2028. This is a unique opportunity to ensure that mental health, a missing piece in the current Global Fund strategy, becomes an integral part of the global response to HIV and TB — from prevention, to testing, to treatment and care –  and to address stigmas related to mental health, HIV and TB.

Why? Because it has long been established that HIV, TB and mental and substance-use disorders are inextricably linked – poor mental health is a risk factor for HIV and TB infection and, once infected, having HIV and/or TB is a huge risk factor for developing mental disorders. We know that people with HIV and TB experience higher rates of depression, which has been linked to higher rates of mortality. And there are economic reasons to employ such a strategy too. Every US$ 1 invested in mental health, HIV, and TB programmes, can reap an economic return of US$ 4US$ 6.40 and US$ 43 respectively. Other global players, including UNAIDS and the U.S. The President’s Emergency Plan for AIDS Relief (PEPFAR), have already aligned their policies and guidance in line with recommendations from WHO and other institutions on integrating mental health in their response to HIV/AIDs and TB. The Global Fund now needs to do the same.

So as the new strategy for the next 5 years (2023-2028) is being developed, we and many others are calling on the Fund – in an Open Letter to the Fund’s Strategy Committee – to seize this moment and integrate mental health into health systems. Doing this will strengthen health systems and boost the effectiveness of prevention and treatment programmes. It will also promote, and protect human rights by significantly improving the quality of life for millions of individuals living with, or at risk of, HIV and/or TB infection. Indeed, the intrinsic value of doing this was highlighted by the Global Fund’s Executive Director, Peter Sands, who has signalled a commitment to championing mental health in the Global Fund’s work in his powerful address on World Mental Health Day 2020. He stressed:

“If we don’t deal with mental health we will not deliver the SDG 3 ambition of health and wellbeing for all”.

We believe it is imperative that the Global Fund’s new strategy builds in explicit funding for mental health services and psychosocial support at every stage of the HIV and TB service continuum as part of quality person-centred care. By placing mental health at the heart of HIV and TB approaches, through primary and community level health care, the Global Fund can lay the foundations of rights-based, quality universal mental health coverage, and accelerate progress against these epidemics. As we #UniteToFight we are urging the Fund to seize this chance to do things differently, update its policies and practice in line with other global health organisations,  and transform the response to the co-epidemics of HIV, TB and mental ill health and the futures of those affected.