Mental health advocates to target the Global Fund

By Anna Watkins


Last week saw the 44th Board Meeting of the Global Fund for AIDS, TB and Malaria (The Global Fund), this event is a key moment for the Global Fund’s strategy development and commitment of financial resources, and also a crucial opportunity to ensure the Global Fund makes mental health a fundamental part of their approach to ending HIV and TB. With the Global Fund entering the final phases of the strategy development it was more important than ever to draw attention to the importance of mental health to the Global Fund’s mission.

Below are three activities from last week, which significantly highlighted the need for The Global Fund to take a leading role in the integration of mental health into HIV and TB approaches and investments across the world.

Mental Health For All Webinar on HIV and TB

The Mental Health for All Webinar on 10th November, chaired by David Bryden, a TB and mental health advocate from RESULTS US, featured panellists from across the globe, all of whom are working on integrating mental health services into HIV or TB programmes.

The testimonies of these panellists really demonstrated the impact of strong mental health services on people living with HIV and TB, as well as gave solid examples to the different ways mental health support can be integrated into HIV and TB services.

Having set up a group psychotherapy programme in rural Uganda, panellist Ethel Nakimuli-Mpungu provided important insights into the benefits of psychotherapy for people living with HIV. Ethel’s research showed that individuals stayed depression free for up to 24 months after treatment from group psychotherapy. Not only did this improve their quality of life, in the long term, treating depression improved adherence and also the viral load. Vongai Munatsi, Mental Health Advisor at Africaid Zvandiri, works on a similar programme with the READY (Resilient and Empowered Adolescents and Young People) Movement that she leads in Zimbabwe, teaching young adults skills in psychosocial support, mental health first aid, and running peer support programmes for young people living with, or affected by HIV. This movement, supported by Frontline AIDS, Global Network of Young People Living with HIV, and others, is a great example of a worldwide movement that aims to combine the best community led mental health and livelihood programming for young people living with HIV, with a commitment to the meaningful leadership and engagement of young people.

Similar examples of community based mental health support for TB patients was also demonstrated, with examples from Pakistan. Aneeta Pasha, a mental health and TB expert from Pakistan, had previously worked with the recipients of a large Global Fund grant, advising them how best to offer mental health support as part of their package of services for TB patients. Research conducted by Aneeta has found that over the course of 2 years, of all the symptomatic patients who completed mental health intervention, 93% completed their TB treatment, compared to 75% for the symptomatic patients who did not complete a mental health intervention.

WHO was represented by Neerja Chowdhary who asserted the importance of including mental health in all HIV and TB treatments and prevention strategies. Neerja drew attention to the multitude of resources that the WHO have produced to encourage full integration of mental health services into every level of the HIV/TB care continuum.

Neerja also previewed the WHO and UNAIDS HIV Implementation Guide, which is due to be published towards the end of the year. This implementation guide will be a hugely useful resource for all those working in HIV programmes, as it will clearly lay out key recommendations, and give concrete examples of how mental health services should be provided alongside HIV services – through both prevention programmes, testing centres, and ART clinics.

You can read the notes, including links to the panellists’ publications and studies; and watch the recording from this session here.

UNAIDS and WHO leaders call on the Global Fund

The case for mental health inclusion in HIV and TB investment has also been made by two of the leading technical agencies on the Global Fund Board on Written by Shannon Hader Deputy Executive Director, UNAIDS and Assistant Secretary-General of the United Nations, and Ren Minghui, the Assistant Director-General at the World Health Organization, the article makes a strong case for mental health to be included in HIV and TB approaches, and particularly highlights the Global Fund’s role in leading this.

Drawing upon the statement made by Peter Sands, Global Fund Executive Director, on World Mental Health Day; that “mental health is inextricably entwined with the fight against these infectious diseases”, DED Hadder and ADG Minhui call on the Global Fund strategy to “lay the foundations for providing funding for mental health services at every stage of the HIV and TB service continuums as part of quality care and support. The upcoming board meeting is a vital opportunity to discuss mental health as an integrated part of the strategy.”

Key Messages

The message from the key stakeholders above align with what we, at UnitedGMH with support from the Global Mental Health Action Network, and other key advocates have been calling for from the Global fund over the past eighteen months.

These key asks of the Global Fund are clearly noted in our submission to the Strategy Open Consultation. For BM44 we have produced this short document, in order to break down our recommendations for Board Members. The briefing features key talking points focussing, not only on why investment in mental health is vital for the Global Fund’s success, but also how mental health can be easily included in pre-existing HIV and TB programmes.

Our key message? Mental health needs to be fully integrated into the 2023 strategy in order to efficiently and successfully fight HIV and TB in the context of the COVID-19 pandemic.

We have been hugely encouraged over the last year by the support we have received from Global Fund Board Members, national advocates, and academics alike. We look forward to seeing the Global Fund Board Meeting documents, and will continue to advocate for mental health to be fully integrated into the Global Fund’s 2023-2028 strategy.