In the right place at the right time

For many years GIZ has been enhancing pandemic preparedness in developing countries. On this basis, it is now implementing swift, efficient emergency measures to stem the spread of COVID-19 in countries with fragile health systems.

The central hospital in Lilongwe, the capital of Malawi, once again has an operational quarantine unit and is equipped to face the COVID-19 pandemic: 18 beds are in place in rooms with separate toilets. The unit was originally used for leprosy patients and had fallen into a state of disrepair. It hadn’t been used for years. The Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH and the Malawi Red Cross Society renovated the building. ‘We worked with the Ministry of Health and Population to ensure that treatment centres are available throughout the country,’ explains GIZ expert Paul Dielemans. He is coordinating measures to stem the spread of the pandemic within the framework of the Malawi German Health Programme. ‘The isolation unit is perfectly situated,’ he adds. ‘It’s slightly separate from the hospital but still very close. In future it can be used to treat outbreaks of a wide variety of diseases.’

Swift solutions with lasting effects – this is more important than ever in efforts to fight the coronavirus pandemic. Countries in sub-Saharan Africa are particularly vulnerable, because their health systems are often fragile. For many years GIZ has been helping improve health systems and pandemic preparedness in developing countries and emerging economies around the world on behalf of the German Federal Ministry for Economic Cooperation and Development (BMZ). BMZ responded immediately to the spread of COVID-19, and initially provided EUR 13.6 million in funds enabling GIZ health projects in many countries to help stem the pandemic with appropriate measures at local level.

What is most needed

Malawi is only one example. A total of 5,5 million people here benefit from immediate measures against the coronavirus. ‘We are flexible and respond to the needs of the districts,’ Kai Straehler-Pohl, Project Manager of the Malawi German Health Programme, tells us. ‘Firstly we are continuing our work to date, and secondly we are adapting our activities to the new challenges. The project actually focuses on improving maternal and neonatal health care.’ Now, however, the team is also preparing hospitals to treat COVID-19 patients, which provides three million people with a better access to medical care. Sometimes, as is the case in Dedza District Hospital, this means restoring the water supply so that fundamental hygiene measures such as washing hands with soap and water are possible. GIZ provides whatever is most needed in the local context: health care professionals who are self-isolating as a precaution are supplied with food, old vehicles are repaired and used for contact tracing, and hospital staff are supplied with personal protective equipment (PPE).

So that patients can receive the best possible treatment and infection chains can be broken, health care staff must also be trained, explains Dielemans. Rapid response teams, for instance, are learning how to deal with suspected cases. Other courses run by the Red Cross in Malawi deal with practical questions including how to identify and isolate suspected cases of COVID-19, how to decide who to test and who needs acute treatment. Along with the local NGO Story Workshop Educational Trust, GIZ is explaining how to trace the contacts of infected individuals and how to prevent infection. It is advising district governments and influential individuals at local level, including church ministers, village heads and leaders of cooperatives. They learn how to explain to the population how dangerous the virus is and how they can protect themselves. Infotainment is used, with drama groups performing plays that explain the essentials. Radio broadcasts too are bringing the information into people’s homes.

Better prepared to deal with highly infectious diseases

All these measures can be implemented so swiftly because GIZ knows what is needed on the ground thanks to its long-standing trustful cooperation with ministries in partner countries. It can draw on an extensive network of partners. The Malawi German Health Programme has been operating since 2004 on behalf of BMZ. It has now been extended to fight the coronavirus pandemic. The same applies to health projects in Ethiopia, Cameroon and Togo, and to cooperation arrangements on pandemic preparedness with the East African Community and the Economic Community of West African States (ECOWAS). The fundamental goal is to ensure that countries are better prepared to cope with highly infectious diseases. It was thus relatively simple for GIZ to move immediately from general prevention to specific measures to address the current crisis.

One example is the digital health monitoring system SORMAS, which is in use in Nigeria and Ghana. The system, developed in 2014, has been monitoring COVID-19 since February. It works on mobile phones and makes it much easier to monitor infections in regions with little in the way of infrastructure. (Read more here.) Expanding the use of  SORMAS is part of a GIZ regional programme. Since 2016, GIZ has been enhancing the pandemic preparedness of the Economic Community of West African States at regional and national level; since 2019, the measure has been co-financed by the European Union. As an emergency measure to stem the spread of the COVID-19 pandemic, GIZ is also supporting the West African Health Organization in providing protective equipment and materials for the 15 ECOWAS member countries, as well as organising training on risk communication, case identification and management, and infection prevention and control along with the World Health Organization (WHO) in Guinea, Liberia, Nigeria, Sierra Leone and Togo. Project Manager Sabine Ablefoni puts it succinctly: ‘COVID-19 has not changed what we do. On the contrary. It has brought home to all parties just how relevant our work is.’

As at: May 2020