Amref success story in war against TB, malaria

Mosquito. Amref has established 1,933 CHUs which provide malaria prevention and control services.[iStockphoto]

The Global Fund, established in 2002, has been a game-changer in the fight against HIV, Tuberculosis (TB), and Malaria, saving over 59 million lives through strategic investments and partnerships.

At the heart of this effort is a dual track financing approach, engaging both government and non-government Principal Recipients (PRs) to maximize impact. Among the PRs is Amref Health Africa in Kenya, which has been a crucial player in implementing TB and Malaria grants since 2011.

Over the years, Amref has managed substantial grants, disbursing numerous sub-grants to civil society organizations that drive community-level interventions.

Under the TB grant, Amref, working with the Ministry of Health and partners,  has achieved remarkable milestones, expanding its scope from community-based activities to include health and community systems strengthening.

One key initiative has been training over 7,000 community health promoters (CHPs), who have screened more than one million household contacts for TB. This grassroots approach has been instrumental in raising awareness about TB Preventive Therapy (TPT) and improving early detection.

A standout initiative is the Kenya Innovation Challenge for TB, which has identified over 4,300 TB cases through active community case finding. This initiative has increased community referrals for TB from 4 per cent in 2011 to 11 per cent in 2023. Another important program is the Public-Private Mix initiative, which engaged private health providers to screen over seven million people, diagnosing and treating more than 20,000 TB cases.

Amref has also pioneered strategic interventions like the Pay for Performance results-based financing mechanism and streamlined the delivery of monthly social support to individuals on treatment for Drug-Resistant TB through the Tibu Cash system. These efforts ensure that funds reach beneficiaries directly, enhancing the efficiency and impact of support mechanisms.

In partnership with the Ministry of Health, Amref has procured critical TB diagnostics, including GeneXpert and TrueNat machines, and LF-LAM test kits. These tools have strengthened TB testing, especially among severely ill people living with HIV.

Amref’s impact on malaria control is equally impressive. By strengthening community health systems in 12 counties, Amref, working with the Ministry of Health and partners, has established 1,933 Community Health Units, providing malaria prevention and control services. The training of 18,444 CHPs on Community Case Management of Malaria has extended health services to over nine million people.

The reduction in malaria prevalence in the lake endemic zone from 38 per cent in 2010 to 19 per cent in 2020 is a testament to the effectiveness of Amref’s interventions. Amref has supported the development of key policy documents, including the community case management of malaria guidelines, training curricula, and manuals.

As Amref embarks on a new cycle of the Global Fund grant from July 2024 to June 2027, the organization’s resolve to combat TB and malaria is unwavering. This new phase will see continued collaboration with national and county governments, civil society organizations, and other stakeholders to build resilient health systems and drive sustainable health outcomes.

The success of Amref’s initiatives underscores the critical role of community-based interventions in tackling TB and malaria. However, the fight is far from over. We call upon governments, private sector, and the global community to continue supporting these efforts. Your contribution can help save lives, strengthen health systems, and bring us closer to a world free from TB and malaria.

-Dr Githuka is Programme Director, Disease Control and Prevention, and Dr Wanjuki is the Country Director, Amref Health Africa in Kenya