From the newsletter
A new agreement between UNAIDS and the Africa CDC will support the sourcing, training, reskilling and deployment of over two million community health workers across Africa. This will support access to care in hard-to-reach rural and emergency settings. It targets outreach to populations most at risk of being left behind during climate crises and emergencies.
The Johnson & Johnson Foundation has also pledged $5 million to the Global Fund to accelerate the scale-up of professionalised community health workers across Africa.
Community health workers (CHWs) are key to tackling climate-related health challenges in Africa. They act as the first point of contact in vulnerable communities and promote climate resilience through education and essential services delivery.
More details
The agreement was signed on 26 September 2025 during the United Nations General Assembly in New York. It aims to strengthen health security in Africa and increase disease response even at the community level. Leaders from both organisations stressed that climate change and rising health threats can only be addressed with strong community systems and epidemic preparedness.
“By joining forces, we can strengthen community health workforces, advance local manufacturing, and secure sustainable financing for health services,” said Winnie Byanyima, Executive Director of UNAIDS. “Together, we are laying the foundation for healthier, more equitable societies across Africa.”
The agreement focuses on four areas: expanding the community health workforce, improving preparedness for epidemics and pandemics, supporting African countries to finance sustainable health responses and developing joint projects to mobilise resources. It builds on the African Union’s goal of deploying two million community health workers, announced by Heads of State in 2017.
At the same event, the Johnson & Johnson Foundation announced a $5 million pledge to the Africa Frontline First Catalytic Fund (AFF-CF), under the Global Fund. The pledge will accelerate the scale-up of professionalised community health workers across Africa.
Community health workers (CHWs) are key to tackling climate-related health challenges in Africa. They act as the first point of contact in vulnerable communities. They can also play a role in promoting resilience through education and providing essential services during extreme weather events or even collect data for early climate-health warning systems.
Studies across East Africa show CHWs are vital in tackling infectious and chronic diseases worsened by climate pressures. They are important in response to HIV, TB, diabetes and hypertension care and also in flood and drought-affected regions.
Evidence shows that CHWs strengthen epidemic preparedness through real-time community data collection. They have tracked vaccination gaps, malnutrition risks, outbreaks of waterborne diseases and acted as first responders. Such work ensures health systems respond faster to climate-sensitive threats and protects those often left behind.
Yet gaps remain. Many CHWs lack fair pay, supervision, and integration into national health systems. This leads to burnout and low motivation. WHO stresses that salaried and skilled CHWs are essential for climate-resilient health systems. Investment now is key to building stronger, adaptable care.
Our take
While CHWs are recognised for their role in strengthening community health systems in Africa, only 14% of them receive stipends, about $35 on average
Most of their work is purely voluntary. Some use their personal resources to reach out and engage community members like travel to patients’ homes or personal cell phones for communication without full reimbursement.
The core issue is that pay structures are inconsistent, with many programs relying on volunteer labor or insufficient incentives. This leads to exploitation and financial hardship for CHWs.