United Nations General Assembly 80.

PROCHW Movement at UNGA80

The Agenda.

The 80th United Nations General Assembly convened world leaders in New York City from September 17-27, 2025, during a pivotal moment for global health. Rising non-communicable diseases (NCD), mounting financing needs, and funding cuts have created new pressures to reimagine health systems.

Community Health Impact Coalition‘s mission is to make professional community health workers (proCHWs) the norm worldwide by changing guidelines, funding, and policy. UNGA 80 provided an opportunity for us to shape narratives, influence commitments, and secure support for proCHWs. Despite current financial constraints, this year, we witnessed organizations displaying their strong support for proCHWs, and showing that they are committed to ensuring they are salaried, skilled, supervised, and supplied. Through language and financial commitments, the Global Fund, Gates Foundation, Johnson & Johnson, the US State Department, and the Africa CDC, among others, have shown they know proCHWs are the best return on investment.

While global health systems strain under multiple crises, a solution already exists in communities worldwide. Millions of community health workers serve as bridges between health systems and communities, responding to frontline emergencies and growing NCDs. Yet most remain unsalaried, unskilled, unsupervised, and unsupplied—excluded from the formal health systems they sustain. The evidence is clear, community health workers work.

Throughout UNGA week, we showcased the latest evidence, listened to compelling firsthand accounts, and convened countless collaborators to bear witness to the impact that is possible when we back proCHWs. Read on for highlights from UNGA week.

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“When CHWs are paid, trained, and integrated, we extend reach, we keep people in care, we sustain trust. We help every dollar go further—not just by saving money, but by multiplying impact, stretching scarce resources, and building durable platforms that make health systems resilient.”

Margaret Odera, CHW, Nairobi, Kenya

Coalition UNGA Side Event

Smart investments in tough times: financing CHWs for maximum impact

To kick off UNGA 80, the Coalition hosted “Smart Investments in Tough Times: Financing CHWs for Maximum Impact.” We heard from frontline CHWs, advocates, and policymakers about evidence making CHWs an obvious priority for achieving health for all.

The evidence is clear.

Dr. Ahmed Ogwell, CEO of VillageReach, and Ash Rogers, Co-CEO of Lwala Community Alliance and CHIC Advisory Board member, set the stage for understanding why sustainable CHW financing is critical. Rogers articulated the fundamental contradiction at the heart of global health systems.

“Community health workers are woefully under-supported. We rely on them in pandemics and crises, and yet many go unpaid,” Rogers noted, highlighting the disconnect between CHW value and investment. Dr. Ogwell emphasizes that “embedding CHWs into emergency preparedness frameworks isn’t just smart policy—it’s a strategic imperative for resilient health systems that serve everyone, everywhere, and especially the most underreached.” This reality becomes particularly stark during funding cuts, when the communities most dependent on CHW services face the greatest disruption.

Professional CHWs are an economically sound investment. They reduce system and patient costs, boost employment, and deliver a return of up to $10 for every $1 invested. This isn’t wishful thinking; it’s backed by rigorous economic evaluation studies spanning a decade of research across multiple health areas and geographic contexts.

Key findings:

Dr. Madeleine Ballard, CEO of CHIC, delivered a compelling talk on the undeniable economic case for CHWs, drawing on groundbreaking research from 255 studies covering 380 CHW program scenarios. Over the past two years, the research was gathered and synthesized by over 30 researchers and CHWs across five continents. A review of the research clearly demonstrates that CHWs are not a budget burden but a budget breakthrough, providing evidence-based justification for smart investments during challenging financial times.

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Cost-effective in 80% or more of cases:

CHWs consistently outperform facility-based care and alternative delivery models when properly supported with salaries, skills, supervision, and supplies.

2

The best-performing models across RMNCH, NCDs, HIV / TB / Malaria:

Programs targeting maternal and child health showed cost-effectiveness in up to 93% of cases, HIV / TB / malaria in up to 88%, and NCDs and mental health in up to 85%.

3

Delivering results at just $10.03 per person:

The median cost per person served is only $10.03 for comprehensive primary care, covering everything from vitamin A supplementation to treating life-threatening malaria cases.

4

Bringing care where others can’t:

CHWs reach where others can’t. In many countries, they bring HIV care to pregnant women and remote communities, delivering better outcomes than clinic-based programs, at lower cost.

She emphasized that integrated CHW programs linking workers with health facilities, using digital tools, paying salaries, and addressing multiple diseases at once prove far more cost-effective than fragmented, vertical approaches—making them the smartest investment for resilient health systems. The results are clear. As Dr. Ballard made clear, “When properly supported, CHWs don’t just match facility-based care and alternative delivery models—they outperform them. Consistently. Delivering stronger health results, wider coverage, and better value for every dollar spent.”

“Community health workers don’t just deliver care. They deliver proximity. They deliver cultural fluency. They deliver… Staying power. Something an algorithm might find difficult to replicate.”

Dr. Madeleine Ballard, CHIC, CEO

From Policy to Practice.

The transformation of community health systems requires more than research and advocacy. It requires political will, strategic financing, grassroots organizing, and scaling what already works. Across the world, we’re witnessing how sustainable policy changes that embed professional community health workers into national health systems, utilizing domestic resources, are revolutionizing healthcare for all.

During CHIC’s side event, a panel of speakers highlighted the pathways to success in four countries— Kenya, Mozambique, Peru, and Guinea—each demonstrating what happens when power is put in the hands of those with the greatest stake in the issues.

Scaling.

Kenya exemplifies how CHW organizing meets government commitment to create transformative change. The country has hired 107,000 salaried community health promoters under the Primary Health Care Act, with Parliament embedding CHWs structurally into the health system using domestic resources.

This success didn’t happen in isolation. Margaret Odera, a CHW from Kenya, testified at UNGA 80 about the recent funding crisis: “In March 2025, fear became real. Our HIV services—patients began receiving only 1 month of antiretroviral, instead of the usual 6 months. Viral load testing kits ran out.” But her message was clear: “We did whatever we could to keep the line from breaking. But emergency improvisation is not a health system. It is a warning.” Her leadership through ACHVO-K (Association of Community Health Volunteers of Kenya) shows the power of grassroots organizing. Margaret’s advocacy and organizing through ACHVO-K ensured sustainable change. Dr. Ouma Oluga, Principal Secretary of Health in Kenya, emphasized the government’s commitment: “We have found this to be the foundation of resilient healthcare systems, and for us it is something that we are not going back on. That is why we have now salaried 107,000 community health promoters—and we are not going back.”

At the county level, Kisumu demonstrates how local leadership drives sustainable investment. Dr. Gregory Ganda, County Executive Committee in Kisumu, Kenya, shared Kisumu’s journey from zero funding to nearly $4 million annually invested in CHWs. Through local policies, cost-sharing, digitization, and innovative financing models, such as HPV self-screening and telemedicine, the county transformed care delivery. Kenya’s example shows how local leadership and CHWs can drive sustainable investment.

“Political support, good financing models, and strong partnerships allow us to deliver community health and improve primary healthcare systems.”

Dr. Gregory Ganda, County Executive Committee in Kisumu, Kenya

Domestic Financing.

Mozambique demonstrates how political will at the highest levels can create systemic change through effective domestic resource mobilization. Hon. Ussene Hilário Isse, Minister of Health, made clear the government’s priorities: “In [Mozambique], we have a strong political commitment from the President of the Republic. The community subsystem is considered a pillar of government. These community workers have a major role in prevention and promotion within primary healthcare.”

This isn’t just policy rhetoric—it’s budgetary reality. “The training of these CHWs is no longer ad hoc; we want them to be state employees, properly paid with domestic resources, to further strengthen the system.” Mozambique is formally integrating and compensating CHWs through domestic financing, demonstrating that countries can prioritize CHW investment when political will exists.

“The training of these community agents is no longer ad hoc; we want them to be state employees, properly paid with domestic resources, to further strengthen the system.”

Hon. Ussene Hilário Isse, Minister of Health, Mozambique

Community-driven.

Carmen Vilela Vargas, a CHW from Peru, embodies the power of CHW organizing to drive legislative change. Her closing call at CHIC’s side event captured the essence of the movement: “This is a call for change. Enough of volunteer work. Community health agents, we must organize. For those who aren’t here, for those who are here, and for those who will come.”

Carmen’s organizing philosophy drives sustainable policy change: “We demand recognition, value, fair pay, and inclusion in the health system. Recognizing our work is not an expense. It is an investment.” Her work is driving meaningful legislative advocacy efforts in Peru.

“Because we are one of the fundamental pillars of the health system, yet invisible. By claiming our rights, we improve the health system. And we make our communities healthier. Only by organizing will we achieve these changes,” Carmen emphasized.

“This is a call for change. Enough of volunteer work. Community health agents, we must organize. For those who aren’t here, for those who are here, and for those who will come.”

Carmen Vilela Vargas, CHW, Peru

Jennifer Schechter, Co-founder and CEO of Integrate Health, explained how Guinea’s decentralized, CHW-led solutions create sustainable financing models. The government created a strong professional CHW policy permitting payment administered by local communes, empowering decentralized government ownership. Through Integrate Health’s “Chunk It, Cost It, Test It” approach with generous support from the Global Fund’s Project Birch, local communes are now successfully paying CHW salaries.

Jennifer went on to explain the approach: civil society’s role as a “learning lab” with authentic partnerships, taking risks, and co-generating evidence with governments to strengthen national systems. The result is proof that decentralized, sustainable financing is effective when it aligns with government priorities and fosters local ownership.

proCHWS lead the way.

The most powerful progress comes from CHW voices themselves gaining platforms and driving policy conversations. Margaret’s testimony captured both the crisis and the solution. Beyond her warning about emergency improvisation, she offered hope: “When CHWs are paid, trained, and integrated, we extend reach, we keep people in care, we sustain trust. We help every dollar go further—not just by saving money, but by multiplying impact, stretching scarce resources, and building durable platforms that make health systems resilient.”

Her call for sustainable change was clear: “My hope is simple, that we commit to professional, salaried community health workers and sustainable financing, so that what happened in March should never happen again.”

Carmen Vilela Vargas articulated the movement’s power: “A movement includes community agents, politicians, donors, and technical teams. We all play an important role.” Her emphasis on CHW organizing power demonstrates how CHWs understand their role as leaders within the system, not just service providers.

The organizing philosophy is transformative. Carmen’s message was clear: “Together we can transform possibilities into policies, and policies into progress.”

Just a few years ago, the UNGA conversation about CHWs centered on if they should be paid or institutionalized. Today, the question has shifted from if to how—and better yet, CHWs who were once excluded from the room are now leading the change. And policymakers and leaders echo their sentiment: if we are serious about health for all, we must invest in CHWs.

“Recognizing our work is not an expense. It is an investment. Doing so means closing the gap between the right to health and real access to health.”

Carmen Vilela Vargas, CHW, Peru

The movement that works.

Smart investments in tough times mean backing movements that work. The CHW movement is working. The question for funders, policymakers, and global health leaders is straightforward: Will you invest in the communities and leaders who are already delivering results, or will you continue to bet on systems that leave half the world without access to essential health services?

The evidence is overwhelming, the examples are proven, and the leaders are ready. Join the movement by becoming a member or ally, getting CHW advocacy training, or donating to CHIC.

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Community Health Impact Coalition exists because community health workers work. We are creating a world full of professional CHWs who are salaried, skilled, supervised, and supplied. Our vision is quality care for all, including those who provide it. Learn more through the resources below.