Health and Healthcare Systems

2 ways to minimize the impact of COVID-19 on vulnerable communities

Residents walk through shacks in Cape Town's crime-ridden Khayelitsha township in this picture taken July 9, 2012. At least 11 people have died at the hands of vigilantes in the township since January as angry residents, tired of poor policing, take the law into their own hands. Picture taken July 9, 2012. To match Feature SAFRICA-CRIME/ REUTERS/Mike Hutchings (SOUTH AFRICA - Tags: CRIME LAW) - GM1E87C1UFL01

Image: REUTERS/Mike Hutchings

Mazen S. Darwazeh
Executive Vice-Chairman; President, Middle East and North Africa, Hikma Pharmaceuticals
Alexandre Raffoul
Head, Global Partner Dev. & Regional Business Strategy; Member, Exec. Committee, World Economic Forum
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COVID-19

  • The spread of COVID-19 comes with a tragic outlook for vulnerable communities around the globe.
  • Here are two priority areas for global and regional stakeholders: building trust and awareness; and supporting government response through innovative partnerships.

As wealthy countries with strong healthcare systems struggle to detect and contain COVID-19, the challenge of tackling an emerging disease in low-income countries, as well as in low income community pockets in wealthy parts of the world, could prove to be the challenge of our time.

The global infrastructure for fighting outbreaks is tenuous. The pervasive and widespread nature of the COVID-19 outbreak is forcing governments to build on existing imperfect and often fragile healthcare systems, to which large swathes of the population do not currently have access.

To date, according to Google News, #coronavirus has received well over 1.1 billion mentions, compared to 56.2 million mentions for SARS, 40 million for HIV, 23.2 million for MERS and around 11.1 million for Ebola.

Lost in the ongoing media frenzy and despite the exacerbated risks of infection, vulnerable populations globally have been missing from the coronavirus focus.

Here are here are two priority areas for global and regional stakeholders.

1. Building trust and awareness

If you have recently discussed the spread of COVID-19 with a forcibly displaced person or with someone living in an area hobbled by conflict, you might have come across a relatively stoic, detached answer; “It is God’s will” and “we have bigger issues here” are some of the most typical.

Among the harsh socio-economic realities for refugees, Internally Displaced People (IDP) and the forcibly displaced among other vulnerable communities, the spread of the coronavirus might not necessarily rank highest. A mindset shift is needed. Aid groups, civil society organizations and governments have an opportunity to join and intensify efforts to instil a sense of urgency, engagement and accountability within these communities.

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Designing customized communication campaigns that focus on symptoms identification and provide simple hygiene and sanitation directives - while remaining particularly mindful of local language, culture and customs – would be key for trust and adoption.

The message needs to be carefully tailored to the audience as global prevention advice might not apply to the most vulnerable.

How do you regularly wash your hands if you don’t have access to soap or running water? How do you maintain social distancing and group-size minimums if you live with a family of 7 in a small space?

In terms of delivery, leveraging trusted local-community initiatives, faith and spiritual leaders could help credibly ensure that illiterate people are not left out of critical awareness-raising efforts. Special campaigns targeting children and teenagers should be prioritized as well, as about 50% of the world’s 25.9 million refugees globally are under the age of 18.

It is also crucial to see that people are aware that they can report their own or a neighbours’ symptoms and get access to healthcare without the fear of prejudice, social stigma, deportation or arrest. This would be particularly key in the countries of the Middle East, home to many urban refugees who tend to be more integrated into the local population but with no healthcare access.

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In parallel, most governments are understandably focused on ramping up their local healthcare production and delivery systems, targeting dense urban centres and high traffic areas and infrastructure.

Vulnerable communities can become a second thought for governments focused on dealing with nationals that have not been displaced and whose voices might be stronger at the ballot box when the time comes. With the IMF pledging $50 billion to fight the spread of the coronavirus, the World Bank pledging $12 billion, the International Organization for Migration (IOM) launching a $17 million strategic plan and the Global Fund providing donors with the ability to switch grants towards COVID-19, there is an opportunity to ensure that funds are earmarked for ramping up the prevention and diagnostic efforts in camps in key countries in Asia, the Middle East and Sub-Sahara Africa.

2. Supporting government response through innovative partnerships

Governments around the world have taken a range of macroeconomic measures to cope with the pandemic, providing tax incentives and cash grants to firms, tax rebates to households, cutting interest rates and launching lending schemes and Quantitative Easing programmes.

Global shocks require a global response. As no country has the fiscal capacity to stand alone, an inter-governmental response network should be explored to expand intensive care capacity in areas close to refugee communities. This can be done by repurposing underused buildings as Intensive Care Units where available, supporting the retooling of underutilized manufacturing capacity towards intensive care equipment, or by recalling medical staff out of retirement. Random testing pockets of asymptomatic communities in vulnerable settings would also help ensure that the most exposed don’t fall victim to a second wave of infection.

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Governments cannot work alone in responding to the crisis on behalf of vulnerable communities; they need the support of the private sector now more than ever. Public-private partnerships (PPPs) often produce innovative solutions to pressing global health issues that are more than the sum of their parts.

They can aid in the quick development of work by bringing together the best of what the public and private sectors have to offer, merging expertise from different sectors, driving innovative diagnostic approaches and making resources available that can be used to aid the fight against these emerging threats.

A number of private companies have stepped up efforts to address the spread of COVID-19 with innovative ways to communicate preventative measures and symptoms to the wider public. Customizing the use of existing technologies for the benefit of exposed communities makes sense. An example is the PPP that Hikma Pharmaceuticals formed with the Ministry of Health in Jordan to fund a dedicated COVID-19 hotline offered through a digital health platform connecting millions of users with licensed and certified doctors in real-time for free medical consultation and advice related to the spread of disease.

Tools such as those developed by Bluedot, a Toronto-based digital health company that uses AI to detect the spread of the pandemic, could be scaled up and exploited to better inform predictions of an outbreak in select refugee camps. Veredus Laboratories, a Singapore-based biotech company, could be incentivized to provide its newly developed portable Lab-on-Chip detection kit to vulnerable communities to enable a fast and portable detection solution. With the proper license to operate, companies such as Flirtey – a US-based drone delivery firm – could be leveraged to deliver suveillance and medical test kits, food, medicine and water to particularly vulnerable populations.

Such solutions would require governments to give incentives to the companies involved in producing specialized equipment needed for COVID-19 detection and treatment in fragile contexts and to promote partnerships that devote time and resources towards preparedness and relief for the most vulnerable. Finally, an old English proverb finds itself particularly relevant. “Necessity is the mother of invention”.

This type of innovation and flexibility in responding to the crisis can play a key role in the fight against the spread of diseases in vulnerable communities, providing access to medical consultation at this critical time but without the burden of healthcare costs.

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