GFAN AP Webinar: Mental Health Series #1

The Global Fund Advocates Network Asia-Pacific (GFAN AP) hosted a webinar on 27 June 2024 co-organised with United for Global Mental Health and the Seven Alliance with the following objectives in mind:

1. To provide an overview of the bidrectional relationship between HIV, TB and mental health;
2. To make a case for the programmatic and economic benefits of addressing the mental health needs of individuals living with HIV and/or TB; and
3. To situate the issue of mental health within the GF strategy and identify opportunities within the GF grants for the integration of mental health services for key populations.

The webinar was moderated by Jennifer Ho, Operations Manager of GFAN AP and attended by over 30 participants. The session opened with the Rachel Ong, Regional Coordinator of GFAN AP; Yves Miel Zuniga, Policy and Advocacy Advisor of United for Global Mental Health; and Francis Joseph, Regional Coordinator of NAPUD on behalf of the Seven Alliance welcoming participants to discuss and explore effective strategies on the pressing mental health issues affecting key populations and communities living with and/or affected by HIV and TB, as well as foster deeper understanding and inspire actionable steps that can be taken within our respective fields of work to make a meaningful difference.

1. Overview on HIV, TB and Mental Health

Yves kicked off the webinar with a presentation providing an Overview on HIV, TB and Mental Health and stressing that there is currently a dilemma around the shortage of available professionals that could cater to the mental health needs not only for people living with and/or affected by HIV and TB, but also for those that are facing different co-morbidities. The bi-directional relationship between HIV, TB and mental health means that those who are actually diagnosed with mental health conditions are at a higher risk of developing or being at risk of HIV and/or TB and could negatively impact global targets both on HIV and TB. Yves shared that a 10% increase in progress for SGD target 3.3.1 could avert close to one million HIV cases by the year 2030, and a 20% increase in progress could aver 14 million cases of TB by 2030. This would translate to returns on investments and strengthens the point that it is cost-effective for investments to be made in mental health.

Yves also shared that integrating mental health services across HIV and TB programmes can be done at no additional cost and there are useful resources to contextualise this, including the collaboration with the Global Fund which developed an e-learning module on mental health, HIV and TB. A toolbox was also developed to support national-level stakeholders – including the country coordinating mechanisms, different disease programme managers, etc. The toolbox also covers the different practice sheets to establish a relationship between HIV, TB and mental health. Yves also provided an overview of the documentation of the Wave 10 TB Reach programme that are facility-based or community-based in countries such as Nigeria, Liberia, Pakistan, India and Vietnam; as well as the challenges and opportunities. United for Global Mental Health developed the toolbox to support national-level stakeholders to engage in the Global Fund country dialogue and position mental health as core to improving HIV and TB programme effectiveness.

Yves concluded the presentation sharing next steps where a more robust review is underway in collaboration with partners; a technical toolbox refresh to capture available technical assistance opportunities at the country level; and the need for continued advocacy and engagement across global, regional and national levels.

2. Integrating Mental Health Support to HIV and TB Programmes

Hye-Young Lim, CRG Advisor for the Asia-Pacific region from the Global Fund focused on the Global Fund strategy and how it is integrating mental health support in its work through the modular framework and shared information on how we can integrate mental health support through Global Fund funded programmes. She started the presentation introducing the strategic framework of the Global Fund, which does not mention mental health explicitly, but when we look at the reinforcing contributing objectives can see that mental health should be and is integrated throughout the Global Fund strategy and stressed that the importance of delivering holistic packages of services in the context of HIV, TB and malaria to people to address the health needs.

Addressing mental health is a human rights issue and it is fundamental to the Global Fund to provide people-centred service delivery ensuring the leadership of the community in its approaches. From the perspective of the Global Fund, mental health is part and parcel of a vigilant health system and should not only provide mental health services to the clients of HIV, TB and malaria programmes, but also to the partners on the ground that are engaged in delivering programmes – including peer educators, outreach workers, health workers and community health workers.

Looking at the modular framework of the Global Fund, there is clear language on integrating mental health support for human resources for health, including community health workers. We can also understand the mental health needs through monitoring evaluation systems of quantitative and qualitative evaluation systems of understanding access barriers to mental health needs. She stressed the importance of community-led monitoring that plays a critical roles for us to understand where the needs are and how we are meeting them. In all the prevention modules for key populations, there is also the language on psychosocial support and mental health support. These areas do see increased language in funding requests to the Global Fund on mental health support to clients, but there is a need to also increase the narrative for the support to mental health service providers.

Hye-Young also pointed to the various documents of the Global Fund that can provide information on how to integrate mental health services for communities and health workers in activities and ensure that these are systematised and structurally integrated. Hye-Young added that ongoing collaboration with various partners will provide better information on being able to understand the different levels of investments through the Global Fund for mental health, and there is ongoing work around GC7 to better understand this.

2. Mental Health and Key Populations – Experience of Sex Workers in Thailand

Attakorn Somwaeng, Project Officer of Service Workers in Group Foundation (SWING) in Thailand, provided insights on their work on mental health and key populations, specifically for sex workers in Thailand. Attakorn provided an overview of the situation of Sex Workers in Thailand including the impacts of COVID-19 as well as the barriers that prohibit sex workers in seeking health services – including mental health services.

Attakorn presented the impact of COVID-19 on mental health of sex workers with data collected from Bangkok and Pattaya from 900 people. The assessment found that mental health of sex workers were severely affected by COVID-19 and saw 19% of sex workers detected with depression. Attakorn then also relayed how through the assessments, they were able to refer affected sex workers for counselling and relevant services. Attakorn also introduced the mental health outreach activity of SWING that supports the promotion of mental health to help key affected populations in understanding their basic mental health needs and rights, especially amongst populations that might suffer from self-stigma. 

The webinar concluded with appreciation to participants for their time and interest in around the topic of mental health related to the HIV and TB. As part of the series of webinars, there will be two more webinars in relation to this topic that would be held in the coming months and welcomed participants to participate in the upcoming series to hear more from colleagues of their in-country work around mental health supported through Global Fund grants.