This story is part of our ongoing “People of PATH” series, in which we highlight a team member who’s moving humanity forward.
From an early age, Pauline Irungu wanted to shape the way people saw the world. When she started her professional life in the late 1990s, she began as an intern with a local television station before shifting her focus to book publishing.
One day, a friend suggested an editing and information management job at a local HIV organization. Pauline thought it could be a good way to share practical knowledge with local communities, but as she learned more about HIV through the publications she was editing, her interest quickly shifted to advocacy. And Pauline was quickly promoted. It was the year 2000.
“I found myself working in advocacy by accident,” she says. “But that accident is now 20 years old.”
As she settled into her new career, Pauline grew frustrated with the lack of HIV treatment services in Kenya and with the increasing prevalence of the disease, particularly among young women. According to a Joint United Nations Programme on HIV/AIDS (UNAIDS) Epidemic Update at the time, women in Africa were at least 1.2 times more likely to be infected with HIV than men, and in Kenya, approximately 10 percent of all pregnant women were HIV positive.
Her frustration grew into a lifelong passion in 2003 with the 13th International Conference on AIDS and STIs in Africa. There she discovered that, despite the widespread availability of HIV treatment services in Europe and North America, fewer than one in three African countries had created national plans for dealing with the HIV epidemic. And of the countries that had plans, only 11 were actually implementing them.
“That was the moment that really transformed me into an advocate,” Pauline says. “I started to see how policy could have a far-reaching impact—in a really positive way or a really destructive way.”
From advocacy to policy implementation
In 2006, Pauline received a newsletter highlighting PATH’s Global Campaign for Microbicides (GCM)—an initiative working to increase access to women-initiated HIV-prevention options. Enamored with PATH and with the campaign, she joined as an HIV prevention research advocate that same year. At the time, she was the only GCM advocate in Africa and worked across multiple countries.
“I love a good challenge,” she says. “If you’re in policy, you have to learn to be a patient person, but also very tenacious. Change doesn’t happen overnight.”
When GCM came to an end in 2012, Pauline transitioned from HIV to maternal and child health. In her HIV advocacy, accessibility had been the central issue, but in maternal and child health, Pauline found herself advocating for drugs and treatments that were readily accessible. They just weren’t being provided to women and children who needed them.
“If your health system can’t deliver these basic services, how can it ever respond to more complex problems?”
After the Newborn, Child and Adolescent Health Policy was approved in Kenya in 2018, much of Pauline’s work shifted from getting policies passed to making sure they were implemented at the subnational level.
“I’m trying to make sure that the government allocates the money and designs the right systems to give women and children the services they need,” she says.
Thinking strategically in a pandemic
COVID-19 has introduced a whole new set of challenges: essential health services have slowed, some health workers have been redistributed, people are reluctant to seek care because of fear of infection, school closures have contributed to a rise in gender-based violence and teenage pregnancies. The list goes on.
Despite these setbacks, the pandemic has created new opportunities for advocacy in Kenya and around the world. COVID-19 has shone a light on the weak links in every health system and raised awareness about the need for change.
In particular, it has highlighted the need for all governments to put people first, invest in essential services, and be accountable for implementing health policies that promote health equity.
“You can’t have health equity if you aren’t accountable,” Pauline says. “Many times, the voices of end users are left behind. We need to put people at the center.”