Gabrielle O’Malley, an Associate Professor of Global Health and Director of Implementation Science for the International Training and Education Center (I-TECH), received a $4,394,756 award to continue strengthening human resources for health in Malawi for HIV epidemic control and improved health outcomes of people living with HIV (PLHIV).
“Over the past 10 years I-TECH has been working closely with the Malawi Ministry of Health (MOH),” O’Malley explained. “The primary purpose of this grant is to directly support the MOH of Malawi HIV/AIDS Department, the National Tuberculosis Program, and the Lighthouse Trust (a local non-governmental organization) to control the HIV/AIDS epidemic by translating evidence into optimal service delivery and using data to iteratively improve services.”
Of the countries most affected by the HIV/AIDS epidemic, Malawi ranks near the top. Adult HIV prevalence in Malawi is approximately 10.6%, ranking ninth on the list of countries most affected by HIV. One of the biggest challenges to the provision of strong HIV/AIDS health services in Malawi (and hence controlling the epidemic) is the lack of human resources. Malawi has approximately 4,800 nursing and midwifery personnel, 500 laboratory workers, and 260 physicians for 18 million people; a provider/patient ratio far below the target density of 2.28 skilled health workers per 1,000 considered adequate for basic healthcare coverage.
The project, funded by the U.S. Centers for Disease Control and Prevention through the President’s Emergency Plan for AIDS Relief (PEPFAR), supports Malawi’s efforts to reach the UNAIDS 95-95-95 targets to end AIDS by 2030 by aiming to enable the MOH to identify 95% of PLHIV in Malawi, facilitate the development and operation of MOH systems that monitor and achieve viral suppression in 95% of PLHIV on antiretroviral therapy, and support evidence-based decision making to ensure the sustainability of national health programs in Malawi.
I-TECH provides technical expertise for this grant in the form of highly experienced senior staff working at the national level. These senior staff, referred to as Technical Advisors, are embedded within the Malawian Ministry of Health and other Malawian organizations. They draw on a wide evidence base and facilitate national guideline development, customize known interventions, and develop standard operating procedures to suit the Malawian context. In addition to providing technical expertise, Technical Advisors exercise their diplomatic skills to coordinate the efforts of multiple stakeholders juggling competing priorities.
“Data and evidence are cornerstones of effective global health interventions. However, they are not sufficient to achieve impact in what is almost always a dynamic and very messy reality, composed of a diverse range of stakeholders often with competing priorities. These types of large-scale technical assistance projects require a large degree of flexibility, resilience, determination, and humility, as well as technical expertise in order to be successful,” said Dr. O’Malley.
Dr. O’Malley specializes in HIV prevention and treatment, reproductive health, and women and girl’s empowerment, among other things. Her work as an applied researcher and evaluation professional spans over 25 years, both domestically and abroad.