McLeod Group guest blog by Clark Soriano and Rhonda Gossen, March 25, 2020
With a global health emergency now declared and COVID-19 present in most countries on earth, we need to ask: How should international assistance be used in this health emergency, beyond the usual items such as immediate humanitarian funding for supplies, equipment, and surge staff? Both humanitarian and development agencies need to act fast across multiple organizational mandates and in a coordinated way to support poorer countries with weak health systems. They need to combine grassroots action, policy support, capacity development and recovery planning in a humanitarian-development nexus approach.
The global lessons of the 2014 Ebola Crisis in West Africa and the somewhat belated COVID-19 response in China offer a roadmap. China’s recent grassroots, multi-stakeholder response echoes efforts to contain the Ebola virus in West Africa half a decade earlier. Here are six lessons that focus simultaneously on emergency response and longer-term capacity and recovery:
1. Decentralize resources and information to communities. Community engagement from the beginning is the #1 lesson. Give the community the right information and put resources in their hands and they will work hard to fight the disease. This critical lesson should also drive recovery planning. Ensuring women are engaged in all aspects of the response is essential to success.
2. Strengthening leadership and coordination at the operational level. A good model to come out of Liberia was reliance on operational leadership structures supported by a high-level policy forum, rather than on traditional ministerial hierarchies. This model ensured that frontline leadership had resources and authority to act, securing an enabling policy environment and promoting interagency coordination.
3. Strengthen systems early and build on this capacity for long-term development. The significant capacities accumulated and strengthened to respond the Ebola crisis were used for recovery and transition and to develop their health care systems. In China, every province, city and community is escalating investments in acute-care beds and public health capacity while undertaking the emergency response. To prevent another catastrophe and to strengthen a country’s resilience, sustainable systems need to be in place at all levels. In Sierra Leone, working through Government systems and partnership between humanitarian organizations and government systems enabled a faster response.
4. Begin economic and political reforms that sustain recovery, reduce vulnerability and enable inherent resilience of communities. Many of the Ebola-affected countries adopted multitrack approaches that enabled them to respond immediately, recover from the crisis and begin working on structural reforms. China is already working to bolster its economy and reopen its schools even as it works to contain the remaining chains of COVID-19 transmission. In Liberia, the World Bank, the African Development Bank and UNDP collaborated in transforming development tools, such as budget support, to address humanitarian needs. This flexibility ensured that frontline health workers continued to be paid and supported during the humanitarian crisis.
5. Prioritize support for low-income countries to enable their response and to facilitate access to diagnostics, potential vaccines and therapeutics. For example, African countries need to be supported to act now on COVID-19. Capacity-building and training efforts that the Africa Center for Disease Control and WHO are conducting should be “cascaded immediately down the health system pyramid in each country”. One of the early mistakes in Ebola was to shift everything to the epidemic response. It is also important to support programs after the crisis is over, including psychosocial support for survivors, affected families and responders; upgrading of health facilities and infrastructure to conform with international standards; competitive remuneration for health care workers; and the need to attract the diaspora in specialized areas and health reform.
6. Support strong coordination of the multilateral response to health situations. Such coordination requires significant interference in international traffic (refusal of entry or departure of travellers, cargo), working in close collaboration with the World Health Organization. Under the leadership of WHO, UNDP is accessing and strengthening all of its procurement chains including for future shocks. Share information and research on new or recurrent viruses and their full potential for human-to-human transmission and treatment.
Half a decade ago, in Liberia, the collective outcomes for the aid community working with the Government and partners were straight forward: save lives, prevent the virus from spreading and track its spread. In response, UN agencies quickly redirected their development programs, recruited surge staff and introduced innovative changes in processes. Simultaneously, the UN Peacekeeping mission there (UNMIL) directed assets to the Ebola response. It supplied trucks, deployed officers to manage the logistics warehouse and used its community radio network to communicate in ten local languages. Its military observers surveyed all government health facilities. The mission’s quick impact program was used for the response and UNMIL’s field offices became hubs for coordinating UN agencies and NGOs.
These lessons demonstrate that building on existing development programs and assets to address an emergency response works. The key is a strong grassroots multi-stakeholder movement coupled with compelling communications and leadership that is adaptable, willing to innovate and learn from setbacks – and guard against actions that promote stigma, fear and discrimination.
Clark Soriano, a UN Leadership and Career-Life Coach, worked with UNDP as Senior Advisor on the Liberia Ebola Response. Rhonda Gossen is a consultant on early recovery for the UNDP Crisis Bureau and a former employee of Global Affairs Canada.