Worldwide, two billion people lack access to primary healthcare—a crisis that is especially acute in poor, rural, and remote communities. For many families, reaching the nearest health center requires a journey of hours or days across difficult terrain by foot, and may include river crossings with fees they can’t afford.

Paid, professionalized community health workers offer a powerful solution to this urgent problem. Trained in an essential package of primary care skills, they deliver preventive, curative, and referral services to their neighbors. They provide routine visits such as pre- and post-natal checkups, screen for and treat diseases like malnutrition and malaria, and connect patients to health facilities for childbirth and serious illnesses. Alongside closing the distance to care, they play a critical role in preventing, identifying, and responding to emerging disease threats including epidemics and pandemics.

Studies have shown that professional community health workers reduce child mortatily, improve maternal health outcomes, and provide essential surveillance and response during disease outbreaks. They are also highly cost-effective, with up to a 10:1 return on investment.

Scaling this proven, lifesaving intervention starts with investing in community health workers as a professional workforce. In order to achieve their full potential, community health workers must be skilled, salaried, supervised, and supplied by a well-functioning community health system operating at national scale and integrated into broader public systems via data and financing. We call these the Six Ss.