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Even as we continue to learn more about COVID-19 and its secondary impacts on people’s lives, it is abundantly clear by now that the pandemic’s impacts are not equally distributed. People living in poverty, those without adequate employment or shelter, those with an underlying health condition, people with disabilities, indigenous communities, the elderly, women and children, among others, face a range of vulnerabilities that compound the impact of the global crisis.
Pandemic response plans must adopt a multi-disciplinary approach with multi-stakeholder input that consider the added impact of poverty, gender inequalities, and discrimination among other factors. This is a core message of the Civil Society’s COVID-19 Calls to Action developed by the Civil Society Engagement Mechanism for UHC2030 (CSEM) in consultation with members. Yet even when political leaders align with a rhetoric of “leave no one behind,” many governments are making decisions without community and civil society representatives at the table and missing opportunities to truly respond to the needs of vulnerable populations.
In a global survey by the CSEM and UHC2030 Social Participation Technical Network (SPTN), more than half of the 200 civil society respondents reported minor or no involvement of CSOs and communities in their governments’ COVID-19 responses. (1) Most COVID-19 task forces do not include civil society, risking national response plans that do not adequately take stock of the pandemic’s disproportionate impacts. (2)
Despite the failure in formal engagement, civil society organizations have continued to be an integral part of protecting the health and well-being of the most vulnerable during the pandemic. CSOs are delivering life-saving medications despite lockdowns and supply chain disruptions, ensuring food supplies to those experiencing shortages, offering psychosocial support and housing, developing public information campaigns, and more. These activities that respond to community needs and protect the right to health for all must be integrated into national plans and scaled up as a core part of the larger COVID-19 response.
Governments cannot afford to wait until the end of their emergency response modes to engage with civil society and seek their leadership. As political leaders convene again at UNGA, one year after the UN High-Level Meeting on Universal Health Coverage, they must re-commit to their promise for universal coverage of quality health care for all. Any delay in listening to community voices can backtrack progress made in universal access, result in more individuals experiencing poverty, worsen case rates for other diseases, and continue to exclude marginalized communities. These costs can have ramifications for years to come.
To truly leave no one behind in the COVID-19 response, civil society organizations must be central to the response and recovery at all levels — and they should be included now. This commitment to civil society is important to:
- Identify the needs of communities. A critical role for CSOs play is bridging the information gap between governments and groups that are vulnerable. For example, in Botswana, the grassroots youth-led organization Success Capital outlined the specific needs for LGBTIQ+ youth during COVID-19 through consultations with the community. The findings not only included gaps in access to healthcare but also the critical need for connectivity and internet access, mental health support, and employment opportunities. (3) It is only with this information that advocates and political leaders can begin to address the unique challenges faced by this population.
- Develop accessible information and knowledge. Access to information in understandable terms and actionable ways, shared without stigma and discrimination, is essential for an effective pandemic response and individual behaviour changes. However, this can be challenging for some communities and further limit their inclusion. Community-driven messaging that speaks the language of the people is most likely to resonate. Youth in Action (Y-ACT), a network of youth advocacy organizations in Kenya, responded to the information challenges of the COVID-19 pandemic by creating an innovative ‘info-site’ that is built by and for Kenyan youth (4). In addition to resources and webinars about COVID-19 and its impact, the portal includes employment opportunities and protection services for young people that directly respond to their asks. The team is also creating a platform for youth to co-create solutions for a post-pandemic future, providing appropriate knowledge and sparking change that is most relevant to the community.
- Ensure accountability and build public trust. Social accountability that relies on civil society engagement improves health systems and increases their responsiveness to community needs. In Zimbabwe, CSOs have been conducting community monitoring of COVID-19 responses to better inform health policies and planning. They have also been engaging in advocacy that feature the voices of vulnerable groups with specific needs and highlight the impact of the gaps in the social safety net. Through public awareness-raising, CSOs have noted the exacerbation of social inequalities and supported a more transparent pandemic response.
Looking forward, WHO is soon to publish a ‘Handbook on Social Participation for UHC’ which will provide specific best practice guidance to policymakers on how to effectively and meaningfully engage with populations, civil society and communities for policy- and decision-making.
The COVID-19 pandemic is multidimensional and requires a renewed emphasis on social solidarity. Young people, those from marginalized communities, and those facing multiple vulnerabilities during this crisis should be at the forefront of policy-making spaces to develop solutions that are inclusive and equitable. For political leaders, this is not the time to hesitate in fully investing in the meaningful engagement of civil society and communities in decision-making at the national, regional, and global levels. Only together can we ensure that no one is left behind.
CSEM Secretariat with information from CSEM Advisory Group members: Itai Rusike (Executive Director, Community Working Group on Health, CWGH – Zimbabwe), Evalin Karijo (Project Director, Y-ACT, Youth in Action – Kenya), Dumiso Gatsha (Founder, Success Capital – Botswana).
2) Rajan D, Koch K, Rohrer K, et al, Governance of the COVID-19 response: a call for more inclusive and transparent decision-making, BMJ Global Health 2020;5:e002655.
Photo: Amref Health Africa in Zambia supported the development of COVID-19 materials in braille to reach individuals who are visually impaired.
Copyright: Amref Health Africa/2020