Mental health in the spotlight at the Global Fund
By James Sale, Director of Policy, Advocacy and Financing, United for Global Mental Health
Last week, on a crisp day in Geneva, representatives from the Global Fund board, UN agencies, civil society, governments and the private sector gathered for a session on ‘Better Mental Health for HIV and Tuberculosis’, held during the pre-day of the biannual Global Fund board meeting.
Dr. Mubasher Sheikh (WHO) opened the meeting with what continued to be a theme for all speakers: the 2030 targets will not be met without adequate attention to mental health.
Pushing for Integrating Mental Health
Ani Shakarishvili (UNAIDS) and Dr Lucica Ditiu (StopTB) respectively covered how HIV and TB share social determinants with mental health. Additionally, Anu detailed the evidence of the comorbidity associated with HIV and mental health conditions. Lucica stressed the importance of a whole person response rather than just a biomedical approach to prevention. She also talked about a new stigma tool, with an index, which will look at how to better address mental health in TB prevention and treatment.
Danny Graymore (DFID) – who penned the original letter to the Global Fund this year calling for mental health to be integrated into HIV services – highlighted the need for rights-based, holistic services for people at risk of contracting or living with HIV.
Danny showed that integrating mental health services into HIV treatment and prevention is highly cost effective and can be done throughout the healthcare continuum. Finally, he praised Ambassador Deborah Birx for making mental health a new focus area in PEPFAR’s support to countries during her stewardship of the program.
Lessons from HIV in Framing
Delving into the history of the global HIV response, Mike Podmore (Developing Countries NGO Delegation) recounted that previously psychosocial interventions were called Care and Support. However, it was very difficult to get traction on this third pillar relative to the other two: Prevention and Treatment.
Since then, the 90-90-90 targets have been developed, with an all-encompassing 4th 90 – quality of life. Achieving the other 90s relies on a broad set of interventions to ensure good quality of life for people living with HIV and at risk of contracting HIV. This framing could inspire the global mental health community as they consider how to present their issues as vital to making progress in fighting other diseases.
Kate Thomson (Global Fund) went on to suggest that reframing mental health in terms of quality of life, care and support services might avoid the potential for double stigma. Kate also emphasised the importance of donor alignment and strong collaborations among stakeholders.
Next Steps by the Global Fund and French Government
The meeting is set to inform and align with a number of upcoming activities. For example, Stéphanie Seydoux flagged that she is keen to incorporate these issues into the agenda of the 2020 French Global Ministerial Mental Health Summit, which she is working to organise. Annette Reinisch drew attention to the Global Fund’s informational materials on mental health prepared for the next allocation period, which speak to the importance of focusing on rights-based community systems in the wider implementation of universal health coverage.
We were privileged to have the session closed by Lady Roslyn Morauta, Vice-Chair of the Global Fund Board. Welcoming the mental health side event at the board meeting, Lady Ros thanked panellists, organisers and attendees for initiating the discussion inside the Global Fund on the links between mental health and HIV and TB. She highlighted how the Global Fund has invested in community support workers who are able to support people’s mental health, and underlined the importance of addressing mental health in the fight against HIV and TB. Concluding remarks looked forward to continuing the conversation, and to broader consideration of how approaches to mental health can help end the epidemics.
This meeting was organised by United for Global Mental Health together with the UK Department for International Development, STOPAIDS, Stop TB, UNAIDS and the WHO. The agenda and key messages can be found here.