on Thursday, 02 April 2020.

Dear Colleagues,

In the wake of COVID-19 control effort, here is an insightful contribution by Dr David Okello.

“This is a time for prudence, not panic. Science, not stigma. Facts, not fear. Even though the situation has been classified as a pandemic, it is one we can control...” --UN Secretary-General António Guterres.

With the COVID-19 infections now confirmed in African countries, governments have put in place various measures to contain the spread of the outbreak. These measures include screening of suspected cases, contact tracing, public education on hand washing and avoiding touching the face, isolation of confirmed cases, and physical distancing – closure of schools and large public gatherings and complete lockdown of movement of people including curfews. All these measures are normal public health procedures used in disease outbreak control.

As time passes, it has become clear that the ramifications of COVID-19 go well beyond the realms of the health sector. The lockdown of business activities and confining people in their homes is having major social, psychological and economic ramifications. Already, Africa is watching a potential health disaster quickly turn into an economic and social crisis.

Last year the African Centre for Global Health and Social Transformation (ACHEST) concluded a study to assess the status of Inter-sectoral Collaboration (ISC) for Universal Health Coverage (UHC) and achievement of Sustainable Development Goals (SDGs) in Uganda. The study found that although attainment of SDGs is fully domesticated into the National Development Plans (NDPs), it is highly constrained by silos approach to funding and implementation of government programmes. This approach does not facilitate a robust response to the spectrum of disasters posed by COVID-19

As many of our countries are grappling with unprecedented challenges from COVID-19, the strain on governments is extreme and the impact on people all over the world is worrying. This pandemic is breaking down societal norms, economies are stumbling and life styles as we know them today may never be the same again.

As stated by Dr António Guterres, UN Secretary-General, this is the time for prudence, not panic. We need all the resources we have at our disposal to tackle COVID-19. In Uganda, we commend the efforts taken by H E the President by creating a National Multi-disciplinary Taskforce under the Prime Minister, to spearhead response to COVID-19. The response should also embrace civil society organisations, the private sector through appropriate private public partnerships, and the academia. Above all and in keeping with this inclusive thrust, it is critical now to engage a Whole-of-society with full engagement of communities, religious leaders and cultural institutions.

Moving forward, we believe the appropriate role for Government right now is to strengthen ISC that helps create an open space for all especially the communities to actively participate wherever they see government approaches to tackling COVID-19 being implemented. Civil society, citizens and the private sector should work in a collaborative manner with government. To this extent, the following measures to be adapted to respective context of countries are proposed:

• Establish National Multi-sector Task Forces and Working groups to include the UN family and Partners to coordinate and oversee the control of the pandemic so that the whole country acts in unison.
• Establish decentralized governance structures reaching out to all households and communities. These should include relevant government sectors, civil society, cultural and religious representatives.
• Support and facilitate citizen-led community responses, including neighbourhood volunteer groups and neighbourhood associations, economic and social support by religious leaders, teachers or others to inform the public on the risks and needed actions using appropriate local languages. This facilitates prevention of community transmission, case finding, contact tracing and social support.
• Build and sustain trust between government and citizens, through effective proactive communication and focusing on reaching vulnerable communities with the information they need. This addresses misinformation, myths and social online media disinformation.
• Be transparent on data and pandemic trends.
• Establish Digital and media platforms that keep citizens informed, to hold trust and enable coordinated public participation.

No single entity will win alone against the pandemic. A successful response and recovery will require multi-sectoral actions and partnerships at every level -- governments taking action in lock step with commu¬nities; private sector engagement to find pathways out of this crisis. Partnerships based on solidarity will be the cornerstone for progress.

Civil Society, women and grassroots organizations, community-based organizations and faith-based organi¬zations will play a vital role. In assisting the most vulnerable populations, these networks are active in bringing economic and livelihood opportunities and adapting responses to the community context. These organisations, are the first, or only, point of reference for individuals and families as they seek to cope with the impacts of COVID-19 and for the recovery ahead.

Given the nature of this pandemic, inter-sectoral collaboration is mandatory and the only way forward.

What do you think?

By Dr David Okello

Director Health Promotion and Disease Prevention

Comments (1)

  • MIDZI, Stanley Munyaradzi

    MIDZI, Stanley Munyaradzi

    05 April 2020 at 20:29 |
    Dear Dr Okello
    Many thanks for sharing this innovative piece of advocacy highlighting the need for multi-sectoral approaches to combat COVID-19. I cannot agree with you more on the need to utilize the opportune time Africa has been given due to 'time lapse' partly due climate lag between northern hemisphere and southern hemisphere. However this time dividend needs to be appropriately exploited if we are to compensate for the gap in financial and human resources between north and south.
    The suggestion of setting up strong inter-sectoral collaboration (ISC) is a noble one. Offhand the players can be classified into the following groups

    Government (public sector); whole of government approach
    Private sector
    Civil society
    Religious groups
    Cultural institutions
    Your proposal to have a whole-of-society approach with full engagement of communities, religious leaders and cultural institutions cannot be overemphasized as it break constraints brought by operating in silos. In a situation where resources are not in abundance it is prudent to explore pooling resources together in support of the government led structures. However for partners to have confidence in committing their resources there is need to have a transparent coordination structure. This is where ACHEST's proposals outlined below comes in handy.
    I therefore fully support the ACHEST proposal. However I believe these can be further strengthened to improve the governance using some examples countries have proposed or already put in place. We could share the Zimbabwean experience.

    Best regards
    Dr Stanley M Midzi
    Managerial Process for National Health Systems Advisor (MPN)
    World Health Organization: Country Office for Zimbabwe
    P.O. Box BE 773, Belvedere, Harare, Zimbabwe
    Highlands Office, 82-86 Enterprise Road
    Tel: +263772 155 629-632 Tel: +47 241 38166, Ext: 38166
    Cell:+263772 104 254

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