A united call for mental health to be at the heart of the Global Fund’s HIV and TB response

Would putting mental health at the heart of the Global Fund for AIDS, Tuberculosis and Malaria new strategy transform the response to the epidemics of HIV, TB and mental ill health? Some 387 signatories from 75 countries think so. They have united behind a call laid out in an Open Letter that the Global Fund has a crucial opportunity to integrate mental health into health systems. Doing so would strengthen health systems, boosting the effectiveness of prevention and treatment programmes, and drastically improving the lives of individuals living with HIV or infected by TB.

We know 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 also know that people with HIV and TB experience higher rates of depression, which has been linked to higher rates of mortality. As the Open Letter to the Strategy Committee outlines, by building 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, the Global Fund can lay the foundations of rights-based, quality universal mental health coverage, and accelerate progress against these epidemics.

Those who signed the Open Letter include many from the hardest hit countries. “We will never reach our set targets if mental health is not integrated into HIV and TB primary care, and the problems will continue to grow and people continue to suffer,” commented one signatory, Zani de Wit from South Africa. Another, Beate Ringwald from Kenya stressed, “A holistic approach is needed to prevent disease and improve health. This includes paying attention to the intersection of infectious and non-infectious diseases, and structural drivers.”  Others also emphasise how embedding mental health into the Global Fund’s new strategy will help reduce the stigma on all sides by making mental health support and funding mainstream.

Our united message to integrate mental health into the HIV/AIDS and TB response is something that major global players, including UNAIDS and the U.S. The President’s Emergency Plan for AIDS Relief (PEPFAR), are already doing. It’s now the turn of the Global Fund to do the same and seize this chance to 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. Such a shift in strategy will aid the Global Fund – and the world – to further ‘bend the curve’ of the HIV and TB epidemics, whilst also improving global access to mental healthcare. Because there can be no health, without mental health.

Find out more about our Open Letter here.