Parliamentarians and Advocates Unite to Tackle TB, Mental Health, and Domestic Financing Gaps

At a time when global health financing is under unprecedented pressure, parliamentarians, civil society leaders, and global health experts gathered in Nairobi to confront one of the most pressing and often neglected intersections in public health: tuberculosis (TB), mental health, and sustainable financing.

The engagement was anchored by Hon. Dr. Josiah Makombe, Chair of the Zimbabwe TB Caucus and Chair of Zimbabwe’s Health Portfolio Committee. The roundtable brought together 22 representatives from communities and civil society organizations (CSOs) from Kenya, Uganda, and Rwanda, alongside a mental health expert from Africa CDC and a representative from the African Union Commission based in Ethiopia.

Hon. Makombe, didn’t mince words: “The honeymoon for Africa is over.” He noted that 50% of Zimbabwe’s health commodities are funded by donors, and the recent aid cuts have sparked urgent national conversations. He called on African parliamentarians to take the lead in closing funding gaps, championing mental health integration, and protecting gains made in TB response.

Zimbabwe has taken meaningful steps in this direction:

• Introduced taxes, with motions to reinvest funds in health services targeting NCDs and mental health.

• Engaged medical aid societies and Treasury to earmark new funds for mental health.

• Reinvigorated the TB Caucus and proposed the creation of a dedicated Mental Health Caucus in Parliament.

• Advocated for the reinstatement of mental health desks in public institutions and the establishment of mechanisms for health bond financing backed by Zimbabwe’s mineral wealth.

TB and Mental Health: A Dual Crisis Demanding Integration

Throughout the discussions, participants emphasized that TB cannot be addressed in isolation from mental health.

Evaline Kibuchi, National TB Coordinator at Global TB Caucus, shared:

At a recent county-level TB data review, a devastating pattern emerged—every presentation was accompanied by at least one reported suicide case. Over 90% of those were men, many battling alcoholism. This is a wake-up call. Are we truly tackling the root causes, or just treating the symptoms?

Key recommendations from the dialogue included:

• Integration of mental health into general triage and TB screening

• Dedicated funding for mental health, including counseling services for TB patients

• Capacity-building for CSOs to enable mental health support at the community level

• Mental health training and engagement for TB champions and caucus members across countries

The Africa CDC was directly called upon to strengthen parliamentary and civil society capacity on mental health advocacy, ensuring sustained momentum and informed policymaking.

David Kabera (WACI Health) and Sam Makau (Coalition for Health Research and Development) spotlighted another critical gap: research and development (R&D).

Africa contributes less than 1% to global health R&D despite carrying a disproportionate burden of disease. The current funding climate—especially during a Global Fund and GAVI replenishment year—poses serious risks to future innovation and access.

They recommended accelerating the use of AI and traditional medicine, supported by enabling policies such as tax reductions and subsidies, and called for stronger government procurement of locally developed innovations to ensure both scale and sustainability.

The meeting concluded with strong consensus:

• Mental health must be mainstreamed into TB response and national health strategies

• Data must lead investment—what isn’t documented, isn’t funded

• Political leadership must remain central—without parliamentarians, lasting change is unlikely

As May marks Mental Health Awareness Month, the Global TB Caucus reaffirms its commitment to strengthening parliamentary leadership, supporting community-centered advocacy, and building multisector coalitions that prioritize mental health as part of a holistic approach to TB care.

We remain steadfast in working with leaders in Kenya, Zimbabwe, and beyond to advance policies that reflect the lived realities of affected communities—and to ensure that health is no longer left behind in budget rooms, boardrooms, or political agendas.