How civil society organizations can help tackle pandemics

Kamal Sanas, a 56-year old sugarcane grower, receives a dose of COVISHIELD coronavirus disease (COVID-19) vaccine manufactured by Serum Institute of India, at a primary healthcare centre in Limb village in Satara district in the western state of Maharashtra, India, March 24, 2021. Picture taken March 24, 2021.

A woman receives a COVID-19 vaccine at a village healthcare centre in Maharashtra, India. Image: REUTERS/Francis Mascarenhas.

Prakash Tyagi
Founder-Director, GRAVIS Hospital; Executive Director, GRAVIS
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  • Low and middle income countries such as India have been heavily impacted by the COVID-19 pandemic.
  • Vulnerable people have been particularly hard hit and they remain exposed to future waves of disruption.
  • Capacity building of community-based organizations can enable better access to education and vaccination programmes.

COVID-19 has been the foremost global health challenge over the last year and a half and has affected all spheres of life and development. As of 7 July 2021, the world has registered a total of over 184 million COVID-19 cases, while confirmed deaths worldwide have been reported at over 3.99 million.

It is envisaged that the Low and Middle Income Countries (LMICs) have been and will continue to be hit harder by the pandemic as a result of limited healthcare capacity and inadequate infrastructure, as well as difficulties in maintaining social distancing. Apart from its direct health consequences, COVID-19 has left communities in LMICs with dire economic consequences. The World Bank estimates that about 120 million people have been pushed into poverty due to COVID-19 in the last year or so.

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India is a recent example of the kind of massive devastation COVID-19 can cause. It witnessed a deadly second wave of COVID-19, leading to a nationwide public health crisis. The second wave led to a spike in new cases, from a 15,442 seven day average of daily cases on 1 March 2021 to over 400,000 on 30 April 2021 – with a staggering increase in deaths from 112 per day to over 3,100 per day, according to JHU CSSE data.

According to Government of India statistics, over 30.7 million COVID-19 cases have been registered so far and over 405,000 COVID-19 deaths are confirmed. In contrast to the first wave of COVID-19 in India during 2020, the second wave has hit rural areas more severely. India has administered over 364 million vaccines to date, however rural areas are lagging behind. There are also indications that a third wave is likely in India very soon, leaving little time for filling in the gaps.

COVID-19 explosion in India between March and May 2021. Source: John Hopkins University & Medicine, Coronavirus Research Centre.
COVID-19 explosion in India between March and May 2021. Source: John Hopkins University & Medicine, Coronavirus Research Centre.

The pandemic has exacerbated pre-existing inequities in healthcare access for vulnerable groups, and those gaps keep widening as COVID-19 continues to spread. The inequities are starker in older people, women, disabled people and in populations living in remote and rural areas. During the current crisis, the health and wellbeing needs of millions of migrant workers, and of socially marginalized groups including “backward castes” and marginalized groups in different parts of the world, have been neglected.

There is a sense of collective failure, a lack of functioning mechanisms to reach the most vulnerable at the last mile, as a result there may be setbacks on the achievements of the 2030 sustainable development agenda. If not addressed immediately, this current setback will have a lasting impact on the progress of SDG 3 related to health, and on other SDGs related to poverty, hunger, gender equality and clean water and sanitation.

Although COVID-19 caught the global community off guard, a continued lack of preparedness in different parts of the world (particuarly in LMICs) has caused a lot of avoidable damage as further waves and variants arrived. It’s been reported that access to hospital beds and additional health infrastructure decreased in India after the first wave of COVID-19 subsided when vice-versa was expected. Only 2% of Indians were fully vaccinated by 21 April 2021 – another factor that may have contributed to the exponential rise of infections in the second wave. A lot of death, morbidity and distress could have been prevented with coordinated preparedness.


What is the World Economic Forum doing about access to vaccines?

The interval between waves – with lower case load and reduced scarcity of resources – cannot be a time for complacency. Instead, this time must be optimized to strengthen the capacity of response and for forming and revitalizing multi-sectoral partnerships. Within these partnerships, the Civil Society Organizations (CSOs) can play a vital role, so far their response during the pandemic has been under-utilized.

CSOs in different parts of the world have been implementing various interventions to support COVID-19 relief and preparedness. In India, the government had acknowledged the importance of over 92,000 registered CSOs earlier this year, encouraging their participation in COVID-19 response. A number of CSOs in India, including GRAVIS in the Thar Desert, have focused their efforts on:

  • Supporting the needs of vulnerable populations with supply of food and hygiene kits in rural and remote areas.
  • Providing treatment and home-based care facilities to mild and moderate COVID-19 patients and facilitating hospital care to severely ill patients.
  • Preparedness measures including vaccination facilitation, ongoing community education and recovery of lost livelihoods.

Within implementation of these efforts, the CSOs have been actively engaging with local Community Based Organizations (CBOs).

The meaningful efforts of CSOs are a small representation of a capacity which has not been optimized due to the lack of a clearly defined engagement strategy. There is a need to form and strengthen multi-sectoral partnerships where CSOs can play the last mile delivery roles. CSOs have both the credibility and capacity to bridge COVID-19 inequities by ensuring that vulnerable populations are not left behind in important mitigation interventions, including vaccination outreach and education. CSOs can play multiple roles at a community level with great efficiency.

A first step would be to address the education needs of rural communities with an extensive campaign to reach remote areas, particularly around “COVID-19 appropriate behaviour” – this is still a major obstacle in controlling the pandemic. The second step could be to target testing for rural people in need, and accelerate vaccination coverage in remote areas. The digital divide is also a major challenge in vaccination outreach, as well as limited transportation to vaccination centres, which could be addressed by CSOs.

The CSOs network has access to the most remote areas and can work with the government and private entities to bridge the gaps. Thirdly, as the pandemic and its impacts continue we will need to enhance food and nutrition security and reinvent and strengthen livelihoods. Both short-term relief activities such as distribution of food supplies, as well as long-term interventions to revitalize the economy will be of great importance. CSO networks in many parts of the world have what it takes to address these gaps.

The battle against COVID-19 is far from over. To win this battle we must form partnerships that recognize civil society’s potential and optimize capacity without delay – it will be a worthy endeavor and a rewarding investment.

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