Why keeping existing health programmes going in the midst of the coronavirus pandemic is imperative to avoid millions of deaths worldwide.
The coronavirus has been spreading rapidly across the world and numbers of confirmed cases and deaths keep rising. As we all witnessed countries shutting down in an effort to slow the progression of the pandemic, questions remain around the implications of such measures on the most vulnerable, especially in low-income countries.
Public health measures
According to the World Health Organisation, preventative measures by individuals and communities and other non-pharmaceutical measures (i.e. handwashing, surface cleaning, isolation of sick individuals, closure of schools, working spaces and social venues etc) remain the most powerful tools against the spread of the virus until a vaccine or treatment is discovered, which could take many months.
But how do you was your hands when you don’t have access to clean water?
How do you stay away from people when you live in an overcrowded refugee camp?
How do you not leave your home when you are the sole breadwinner of an entire family and working from home is not even a concept where you live?
How do you apply confinement measures when your life depends on running away?
These are questions for over 168 million people worldwide.
On top of this, the short and long-term social and economic impacts of these measures are significant, even for high-income countries. We are already seeing the damage inflicted on incomes and economic growth across the globe. In lower income settings, this could be considerably worse.
Redefining the ‘high risk’ group
We know that the COVID-19 virus can infect anyone, and that some groups are at higher risk of severe illness or death (people over 70 and those with underlying health conditions). In lower-income countries, although there is a lower life expectancy, underlying health conditions and comorbidities tend to be very common in the whole population, including children.
In many countries of Africa, Asia and other regions of the world, endemic malnutrition, high prevalence of infectious diseases and increasing non-communicable diseases may completely change the risk profile of the populations. Weak health systems, political instability, high numbers of refugees and internally displaced people, and a lack of social protection are additional factors that further compromise the chances of these regions coping with and recovering quickly from COVID-19.
Maintaining lifesaving health programmes is therefore more crucial than ever to support vulnerable populations. However it is also more difficult to keep operations running in these circumstances.
A challenging time to deliver, but the worst moment to stop
Many countries have closed their borders and restricted travel, making it extremely difficult to deploy staff or supplies where they are needed most. Strict movement restrictions within countries also affect our programme staff on the ground.
The crucial work to strengthen health systems could be seriously impacted, weakening the ability of health workers to provide routine services to the general population and to respond to the pandemic. The impact on water, sanitation and hygiene programmes along with other health promotion activities may also increase the rate COVID-19 spreads among the population.
If programmes that support people’s livelihoods are impacted, it could put their food supply at risk. Labour shortages, transport disruption, and quarantine measures could also affect staple food production and availability, as was the case during the Ebola crisis in 2014 – but this time on a much bigger scale. Moreover, with schools closed, the most vulnerable children are now potentially deprived of their only guarantee of a decent meal for the day.
A call for action…
The challenge is certainly vast and complex but not insurmountable.
While we respond to this new emergency, it is clear that we must also continue to deliver existing lifesaving programmes and ensure no resources are diverted from current operations.
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