Our proposals

The consortium lost no time in submitting proposals to DFID outlining how it could utilise the programme’s expertise and capability, known as ‘flexing’, to help mitigate the effects of the pandemic. To do this, we worked with ministries of health, national task forces and partners to prepare a plan for each country and were able to deliver proposals in just 10 days.

We are proud that the main activities Ascend West and Central Africa is, and will be, supporting include:

• Mass media behaviour change communication – We are working with ministries and partners to develop appropriate communication materials for the COVID-19 response. These will include tackling misinformation as well as messaging on prevention behaviours such as hand hygiene, physical distancing and wearing masks. People living in remote communities often have less access to formal health services so we try to reach them in alternative ways, such as posters in public places, local radio ads and via WhatsApp. The behaviour change materials have a particular focus on reaching vulnerable groups, including children, people with disabilities, rural and border communities, and minority groups. Messages will be accessible and culturally appropriate, tailored to local languages.
• Training – We will train community volunteers, community leaders and district heads to spread and reinforce key messages to communities.
• Supporting supervision at national, regional, district and community level – For example in regional health directorates and health districts in Côte D’Ivoire, and monitoring implementation at county and district levels in Liberia.
• Strengthening surveillance – We do this by training health workers, volunteers and contact tracers. In Guinea-Bissau we’re training health information system officials, and in Ghana we are training health workers in disease surveillance in target border facilities.

Challenges

As anticipated, there are still some areas of concern we are dealing with.

For instance, reports from the WHO and other UN agencies have shown that people with disabilities are being disproportionately affected by COVID-19, not only because of increased risk for those with existing health conditions, but also because of discrimination in the health, social and economic crisis responses. We have made sure the Ascend West and Central Africa programme is including people with disabilities in its design, delivery and evaluation.

We also do not know yet what the full impact COVID-19 will have on Ascend West and Central Africa’s drug supply chain. Issues are already emerging in drug manufacturing and delivery as options are restricted. Plus, drugs that are already in country but are not being used due to paused programmes, are at risk of expiring.

Encouragingly, the programme has already begun to prepare for when safe mass drug administration can resume. However, it is unlikely that these mass treatment campaigns will look the same. The Ascend West and Central Africa programme is fully engaged with the WHO, governments and partners in outlining how to restart these activities whilst ensuring social distancing measures.

To this end, Sightsavers, in close collaboration with governments, partners and donors, developed a ‘resume activity matrix’ risk assessment tool. This ensures decisions made to resume NTD work outweigh the risk of spreading COVID-19 in targeted areas. This risk assessment also factors in the health system’s capacity to effectively conduct safe and high-quality health interventions in the context of the COVID-19 pandemic.