Erin Stuckey is programme officer for polio eradication at the Bill & Melinda Gates Foundation. We interviewed them as part of our #PassTheMic campaign. Here’s some of what they had to say.
We’ve seen the way that COVID has been going around the globe, and actions taken on the individual level and by a country definitely have a ripple effect. It’s scary to see that, but it’s heartening as well, as a reminder of the fact that we’re all connected in this way and that our actions can have an impact.
It’s important that we have global cooperation, because it’s good to be able to see trends and to be able to guide where resources are needed. It’s also important to have coordinated voices from all over, because the way that COVID impacts people in the US is not necessarily the same as in some areas we work in, like Pakistan.
So what social distancing means and what essential services are is going to be context specific. So being able to make sure that that’s being taken into account at the global level is essential.
I think the first thing to recognise is that health systems don’t exist in silos. To get started, it’s important for us to think about the impact, not just on respiratory infections, but what are all of the other knock-on effects? Then, how can these systems be resilient to address the health of populations and not just respond now, but also try to mitigate some of the other impacts in the short and medium term?
Something that we learned from Ebola was that cases of malaria and measles, as well as some other maternal and child health areas, were impacted and actually caused more mortality than Ebola itself. So, with that in mind, how can we, as a global response, really take all of this into account?
Luckily there is a framework to do this. The international health regulations exist and can help us understand where and how countries can be ready to address these things. We’re absolutely going to be stronger if we work on this together.
Also, we need to think about how to approach routine immunisation services. The risk of not having a global response is that those things are uncoordinated, and countries are all trying to figure out individually how to address this. So, being able to lean on the experience and expertise of countries that are at different time points in the pandemic is incredibly important.
When you’re talking about how COVID impacts those routine services, let’s look at malaria. It’s currently not possible to conduct indoor residual spraying or bed net distributions in the same way. So the World Health Organisation has provided some guidance to be able to do this safely. Also, malaria presents with fever, which is one of the symptoms of COVID. Conditions that have fever as a symptom often get misdiagnosed. So it’s really important to have accurate testing and treatment and good triage for how systems can differentiate between these things.
In March, we made the heartbreaking decision to pause the global polio campaigns. There’s some modelling work that’s going on to try to understand more about COVID transmission and the patterns of what the impact is going to be in different settings, but I think there were 176 cases of polio last year. So to be in a place where the whole programme is stopped is hard.
Polio is spread in areas with poor sanitation and so hand-washing (which is really important for COVID) and having safe hygiene systems is going to have an impact on both pathogens.
At the moment polio and the routine immunisation workforce is mobilising to assist with COVID all over the world, but especially in the countries we’re working in where polio is endemic, like Pakistan and Afghanistan.
In Pakistan a polio call center, which now takes calls about COVID, is getting thousands of calls every day. So there’s an immense amount of workforce that is being leveraged right now for COVID that wouldn’t have been able to mobilise as quickly, had the polio infrastructure not been there.
We’re also going to need to think about how to transition back to polio, to be able to finish the job. Now, we’ve seen how quickly governments can mobilise with this severe emergency, — so why not keep that running for polio?
Why not keep that level of focus and attention and urgency to really be accountable to finish the job for polio and other diseases?
These excerpts from the interview were edited for length and clarity.
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