How Ebola prepared us for COVID-19

By: Amy Davis

As the world grapples to cope and respond to COVID-19, effect:hope is adapting existing networks and resources to continue protecting vulnerable communities.

In this piece, guest blogger Amy Davis from the Canadian Network of Neglected Tropical Diseases highlights our program in Liberia and discusses how organizations focused on neglected tropical diseases are uniquely primed to quickly pivot to address COVID-19 challenges.

The COVID-19 pandemic presents extraordinary challenges for people living with neglected tropical diseases (NTD) and the programs that address their spread and impact in the community.

In April, the World Health Organization recommended that core elements of NTD programs – such as community- and school-based mass drug administration, training for health care workers, and community-based surveys – be postponed due to COVID-19. Their initial guidance was followed up by two further communications on community-based health care and essential health services.

How effect:hope adapted in Liberia

effect:hope has been helping people affected by neglected tropical diseases in Liberia since 2012, in partnership with the country’s Ministry of Health.

Liberia is one of the poorest countries in the world with limited access to general health care, including affordable treatment for chronic manifestations of NTDs. effect:hope’s program equips health workers with basic knowledge to identify a person living with an NTD so they can receive help from a health facility for treatment. This reduces critical barriers to care and prevents long-term disability and stigma.

effect:hope developed its current approach to COVID-19, in part, from lessons learned during the 2014-2016 Ebola virus epidemic in Western Africa. Their active role and partnership with the Liberian government proved that working quickly and supporting health systems to provide quality care could minimize the impact of a disease outbreak.

effect:hope’s revised approach in Liberia during the COVID-19 pandemic adapts current program activities to minimize disruption and risk to healthcare workers and program staff and supports new activities that leverage the reach and expertise of the NTD program to support a COVID-19 response.

With this approach, effect:hope has boosted its focus on community-based health services, recognizing that travel to healthcare facilities further away is not possible for people needing continued treatment or diagnosis. The NTD program has been raising awareness of COVID-19 within the communities it reaches; training community health workers on COVID-19 and the safe use of personal protection equipment.

The communication and engagement channels used by the effect:hope NTD program have been immensely valuable and have been re-purposed to increase community understanding about COVID-19.

The effort involved to pivot and adapt to COVID-19 comes at a cost. In order to include these activities, effect:hope has reprogrammed funds to ensure primary health care services and communities are equipped with the tools and information they need to respond to COVID-19. The need for additional equipment creates an additional financial burden to ensure an adequate supply of hand washing and sanitation kits and thermometers. And while movement is restricted, setting up mobile airtime and internet packages for community-based follow up of NTD patients has been a necessary added expense.

What’s next?

These are challenging times for NTD organizations, programs, and staff. Predictions about the spread and impact of COVID-19 are constantly changing and the virus is not likely to disappear soon. NTD programs and community health workers are trying to adapt to a “new normal: which includes the risk of COVID-19. In addition, there are challenges of re-prioritized budgets, closure of facilities and the need for PPE. All these challenges are added to the pressing health needs of the community, some of which have been exacerbated by the pandemic and the cessation of regular health care provision.

Despite these many challenges, NTD programs are in a strong position to demonstrate their value in health systems strengthening more broadly during this crisis. effect:hope’s work in Liberia demonstrates that the tools, structures and approaches that have been built through integrated NTD programs can be leveraged to support the COVID-19 response. By working responsively and collaboratively, NTD programs and their partners provide a unique opportunity to support countries in responding to the threat of COVID-19.

Amy Davis is the Advocacy and Policy Officer at the Canadian Network for Neglected Tropical Diseases of which effect:hope is a partner.

"effect:hope’s work in Liberia demonstrates that the tools, structures and approaches that have been built through integrated neglected tropical disease programs can be modified to effectively support the COVID-19 response."