Africa Frontline First (AFF).

Community health is founded on the belief that where one lives should not determine whether one lives.

We are at a pivotal moment in human history. COVID-19 has caused over six million direct deaths worldwide. Millions more have died from disrupted health services. A Global Fund Report found that compared to pre-COVID periods, Malaria diagnosis fell by 31%. HIV testing fell by 41%. TB referrals declined by 59%. Antenatal care visits fell by 43%. Our growing reality is that we may have lost decades of progress in public health delivery!

However, the Independent Panel for Pandemic Preparedness and Response found that community health was a hallmark of many successful COVID-19 responses and declared it critical for preventing future pandemics. Evidence shows that community health programs save lives, especially when they are part of an integrated health system. Ebola and COVID-19 have confirmed that professional community health workers (CHWs) are essential frontline health workers, early sentinels of epidemic events, and a trusted bridge between health systems and communities. They extend life-saving care to the unreached and to the most vulnerable populations, equipped with the tools to tackle the leading causes of death and prevent future pandemics. And yet, primary health care at the community level, including CHW programs, remain underfunded with a $4.4 billion dollar annual funding gap.

This is compounded by inefficiency of existing financing due to fragmentation across disease programs and siloed projects leading to low value for money for all funders. Practically this means that too often, despite proven value, CHWs are uncounted, unpaid, unprotected, and unsupported.

Africa Frontline First (AFF) unlocks the power of community health workers to save lives at scale. They drive smarter, more effective financing to bring lifesaving care to millions across Africa.

AFF is an Africa-led partnership from the Community Health Impact Coalition, the Financing Alliance for Health, and Last Mile Health, under the championship of H.E. Ellen Johnson Sirleaf. AFF works in partnership with governments, donors, implementing partners, and regional institutions to close the community health funding gap in Africa and reach 100 million people with essential care by 2030.

Over the past two decades, their co-founders have been championing the lifesaving work of community health workers, who are often the first point of care for vulnerable and underserved populations and have a strong track record of success. However, financing has limited the ability of community health workers to achieve their full potential at scale – directly impacting the lives of patients. With an estimated $4.4 billion funding gap for community health in Africa, we need new approaches to tackle this enormous challenge. 

AFF was founded to change this reality, as these three organizations joined forces to leverage their expertise and vision to forge a new partnership. This collaboration comes at a vital window of opportunity, with over 40 countries across Africa now committing to professionalize community health workers. AFF exists to make financing more available and effective for countries, enabling national community health worker programs to deliver at scale. This will contribute towards the African Union’s 2 million CHW campaign and Africa CDC’s New Public Health Order.

Their Approach:

For too long, governments have been the deal-takers when it comes to community health. AFF envisions a future where governments are the deal-makers – working directly to ensure community health workers have the resources they need to save lives.  Their three-part approach enables governments to build and sustain community health programs that deliver high-quality primary care at scale.

Here’s how they’re making it happen:

• Catalyzing Funding: increasing and improving the quality of financing for community health.
• Empowering Countries: providing technical assistance to 16 African countries to strengthen community health systems.
• Advocating for better policy: collaborating with Africa-wide institutions, heads of state, and other high-level champions to mobilize active political support for strong community health systems.