Advocating for Global Health in a Time of Crisis


COVID-19 has impacted daily life on nearly every continent of the planet. As we know now, the highly infectious virus poses an array of significant economic and societal challenges in addition to the medical emergency that many countries around the world continue to grapple with. 

While the situation is critical and largely unprecedented for Canada and other western democracies, arguably the stakes are even higher in developing nations with less money and medical infrastructure.

Carmelle Barnabé, CPA, CA grew up in a small rural town in Southern Manitoba and now works at The Global Fund to Fight AIDS, Tuberculosis and Malaria in Geneva, Switzerland. Her career has taken her to countries across Europe and Africa. In a previous role for the World Health Organization she was on the ground in Brazzaville, Congo during the Ebola crisis. You can read more about those experiences in this article, but we caught up with her to better understand how COVID-19 is impacting her organization’s mission and her life in Geneva, Switzerland. 

“Just like many other people I’m sharing a working space with my partner and a busy toddler,” Barnabé says. Her office and most establishments including daycares and schools closed mid-March when Switzerland had the second highest COVID-19 infection rate per capita in the world, behind Italy (the infection rate has since significantly declined). 

“In close collaboration with partners such as the WHO, UNAIDS, PEPFAR, the RBM Partnership to End Malaria, Stop TB, Africa CDC and others, the organization’s primary objective is to provide financial assistance and technical guidance to countries fighting three diseases: malaria, tuberculosis and HIV/AIDS. We work with a country’s own systems, such as the ministry of health or finance or civil society partners represented by local and international NGOs to help support a more robust response to the three diseases and build resilient and sustainable systems for health,” explains Barnabé.

However, like many things these days, that mission has been significantly impacted due to the ongoing coronavirus pandemic.

“We are working with countries and organizations that do not have sufficient work-from-home capabilities. Individuals are either not equipped with home computers or work laptops, and residential internet is unreliable. Furthermore, some interventions like mass long-lasting insecticidal net campaigns require people to be physically present in order for the activity to proceed. If people and organizations cannot attend work to perform these key activities, undoubtedly it increases the risk that the incidence of these diseases will increase,” she says.

These challenges have forced Barnabé to make decisions with less information than she typically has – which can impact key programs. 

Although COVID-19 is at the forefront of people’s minds, the diseases that Barnabé and the Global Fund are focused on eradicating could make a resurgence if proper attention and on-going programs aren’t maintained. Tuberculous continues to be one of the biggest killers worldwide each year.

“We have noticed that health product supply chains are affected. Orders for key medical supplies need to be placed earlier for them to arrive on time. This creates procurement and budgeting challenges for us. The situation amplifies the need for our partners on the ground to implement mitigating measures to reduce the impact of COVID-19 on case detection across the three diseases, a key intervention for slowing the spread and effectively managing the diseases.”

The Global Fund has recently committed US$1.0B to help developing countries manage their response to COVID-19. This money is going towards acquiring and delivering personal protective equipment like masks and gloves as well as rapid response interventions, among others. 

“Education and information sharing is as crucial as ever. For example, unlike in developed countries, refrigeration is a luxury in many places and so leaving your house for food and water each day becomes a necessity. In those situations, washing your hands and ensuring a safe distance between you and others is critical. As we grapple with these issues, it highlights the strong linkage between health care, education and food security.”

The situation is made more precarious by the fact that many of these countries have populated rural areas which do not have access to a robust health care system.

“You can’t help feeling responsible for the health of the people who live in the countries we support. Our management team has been great by providing country teams with guidance on how to manage the situation. Working from home has also allowed us to be with our families and do everything we can to stay safe while still supporting our critical mission.”

With nearly eight years of experience working on global health, Barnabé believes that a more international focus is required.

“A global health perspective is our best defense. COVID-19 is a prime example of how diseases do not have borders, and how focusing solely on the strength of your own country’s healthcare system will not protect you from all possible dangers.”

A recent example demonstrating the advantages that working more closely together can have is the Western African Ebola virus epidemic (2013-2016). The spread of this virus was largely contained to three countries because of coordination amongst African nations and international bodies. Despite 11,323 deaths, the rest of the African continent (and world) was spared.

“Because Ebola was a known disease with a high mortality rate, responses to the outbreak were relatively quick. Although devastating, the outbreak certainly could have been worse but ultimately a unified global response effort reduced further spread,” Barnabé notes. 

Comparing that response to the politically charged atmosphere that COVID-19 has created in some places underlines a big difference in how this epidemic has played out so far.

“One thing I hope we all learn from COVID-19 is that we need to ensure better international cooperation and that we will have greater success in stopping the spread of viruses and diseases if we act as a unified global community. It is also more important than ever to invest in the strengthening of health care systems around the world as viruses and diseases do not respect borders,” she says.

Barnabé’s work highlights the versatility of the CPA designation and the significant work that CPAs do every day. She was previously featured in a member profile published in the October 2017 eNews. You can read more stories on our Member Profile page.