Sierra Leone Telegraph: 12 July 2018:
The Global Fund partnership is putting a sharper focus on challenging operating environments such as Sierra Leone, to improve the effectiveness of health investments and reach key populations.
During the peak of the Ebola outbreak, the Global Fund mobilized an emergency fund to support an antimalarial mass drug administration to reduce malaria cases and decongest health centres overwhelmed by Ebola cases.
Sierra Leone had made hard-fought gains in public health, including improving maternal care and reducing child mortality caused by malaria, when the Ebola virus outbreak erupted in 2014.
The disease, which killed nearly 4,000 people, overwhelmed the country’s health systems, interrupting prevention and treatment for HIV, tuberculosis and malaria, and increasing the number of deaths from these diseases.
Global Fund investments are supporting the country’s Health System Recovery Plan to rebuild resilient and sustainable systems for health, with a focus on training and deploying health workers, improving procurement and supply chains and implementing a more effective community approach to fight HIV, TB and malaria.
Between 2016 and 2018, the Global Fund will invest US$103 million to strengthen health systems and fight the three diseases in Sierra Leone.
Building Resilient and Sustainable Systems for Health
Sierra Leone is using investments by partners such as the Global Fund to invest in the health infrastructure, train health workers, improve laboratory capacity, build stronger data and surveillance systems and develop an effective community approach to the three diseases.
With the support of the Global Fund, Sierra Leone is putting in place a strategy to more effectively train and deploy the country’s 15,000 community health workers.
Better surveillance and data will help detect future outbreaks more quickly, while community health workers deliver crucial services to children and pregnant women.
Malaria
Before Ebola struck, Sierra Leone had made significant progress against malaria, thanks to the expansion of access to insecticide-treated nets, diagnostic testing for children and preventive treatment for pregnant women.
Between 2000 and 2015, the malaria mortality rate fell by 89 percent, while malaria deaths among children under 5 declined by 47 percent; all new cases of malaria fell by almost 30 percent.
But services for malaria fell into disarray when Ebola hit, leading to reduced access to diagnostic and treatment services.
Malaria remains the most common cause of illness and death in Sierra Leone, accounting for 38 percent of deaths among children under five.
HIV
Overall, HIV prevalence among the country’s general population is relatively stable, at 1.5 percent, although it is much higher among key populations, such as men who have sex with men (14 percent), and female sex workers (9 percent).
Between 2000 and 2015, the number of new HIV infections in Sierra Leone had declined by 51 percent thanks to expanded prevention services, but the Ebola outbreak caused many clinics to close and interrupted routine health delivery services, including HIV testing, and hampered diagnosis and treatment.
Global Fund investments aim to nearly double the number of people on antiretroviral treatment for HIV to 25,550 people, representing 46 percent of people living with HIV in Sierra Leone.
Global Fund investments are also boosting prevention activities among men who have sex with men, female sex workers and people who inject drugs.
Community-based organizations are at the forefront of the fight against HIV in Sierra Leone. They provide out-of-clinic prevention, care and treatment, and expand access and break down human rights-related barriers to health services, particularly for key populations who still face stigma and discrimination.
Tuberculosis
Between 2000 and 2015, the number of people dying of TB fell by 9 percent. However, the Ebola crisis reduced access to health services so many people interrupted treatment. Thanks to community nurses, many patients were tracked down at their homes and persuaded to resume treatment.
The Global Fund will invest US$1.5 million in Sierra Leone to introduce treatment for multidrug-resistant TB, and is working to increase case notification of regular TB.
Challenging operating environments
The Global Fund partnership is putting a sharper focus on challenging operating environments such as Sierra Leone, to improve the effectiveness of health investments and reach key populations.
During the peak of the Ebola outbreak, the Global Fund mobilized an emergency fund to support an antimalarial mass drug administration to reduce malaria cases and decongest health centres overwhelmed by Ebola cases.
With the support of UNICEF and WHO, the effort reached 95 percent of targeted households in Ebola hotspots.
Sierra Leone is an important implementer of grants supported by the Global Fund partnership.
Since its inception, the Global Fund has invested US$202 million in the West African country to fight HIV, tuberculosis and malaria and build resilient and sustainable systems for health.
About the Global Fund
The Global Fund is a 21st-century organization designed to accelerate the end of AIDS, tuberculosis and malaria as epidemics.
As a partnership between governments, civil society, the private sector and people affected by the diseases, the Global Fund mobilizes and invests nearly US$4 billion a year to support programs run by local experts in more than 100 countries.
The Global Fund’s operating costs are just 2.3 percent of grants under management, reflecting an exceptionally high degree of efficiency.
TB Community health workers are not treated nicely, and there has been reduction in their quarterly payment.