WRITTEN EVIDENCE BY RESULTS UK TO THE INTERNATIONAL DEVELOPMENT COMMITTEE INQUIRY ON HUMANITARIAN CRISES MONITORING: IMPACT OF CORONAVIRUS
ABOUT RESULTS UK
RESULTS UK seeks to mobilise the public and political will to end extreme poverty. We undertake strategic policy advocacy, work closely with parliamentarians engaged in international development issues and campaign publicly through our nationwide grassroots network and international partners. Our work covers three key determinants of poverty: economic opportunities, health and education, with a key focus being placed on child vaccinations, tuberculosis (TB), education and nutrition.
This submission will explore the following points, as outlined in the inquiry’s Terms of Reference:
● The direct and indirect impacts of the outbreak on developing countries
● The impact of the outbreak on the Department for International Development’s (DFID) operations
This submission will begin by setting out some of the broader challenges COVID-19 poses to health before looking at TB, immunisation and nutrition individually. As a member of both Bond and Action for Global Health, RESULTS UK endorses their submissions to this inquiry.
● A combination of malnutrition, other infectious diseases, overcrowded living conditions, poor access to quality healthcare, and to clean water and sanitation, as well as misinformation about COVID-19 will aggravate the crisis among the poorest and most vulnerable. Those living with respiratory conditions such as TB are particularly vulnerable.
● Previous outbreaks, such as the 2014-16 Ebola outbreak, demonstrate that deaths from other conditions can increase during a pandemic. The secondary impacts of COVID-19 could prove more deadly than the disease itself, with an additional 30 million children’s lives put at risk due to increases in other diseases and conditions such as malnutrition.
● Manufacturing capacity and, supply and procurement systems for diagnostics and drugs, are being severely impacted by lockdowns, posing risks to the availability of medical commodities globally.
● The redirection of funding to COVID-19 responses means that both domestic and international funding for health will be significantly lower than expected in the long term, at a time when it is most needed.
● Developing countries’ National TB Programmes (NTPs) are diverting vital TB programme funding and infrastructure, such as respiratory specialists, personal protective equipment (PPE) and diagnostic tests, to COVID-19 responses with an alarming impact on access to TB services as a result.
● RESULTS UK is deeply concerned about the impact of COVID-19 on routine immunisation in the least developed countries and humanitarian settings. It is crucial that routine immunisation services are maintained during the COVID-19 response to prevent further illness and loss of life from secondary outbreaks of other vaccine-preventable diseases such as measles.
● Organisations such as Gavi, the Vaccine Alliance (Gavi), the Global Fund to Fight AIDS, TB and Malaria (the Global Fund) and the Global Polio Eradication Initiative (GPEI) are playing a crucial role in the global response to COVID-19. It is crucial that these organisations have the resources and expertise to respond dynamically to the COVID-19 outbreak.
● Gavi, which has its replenishment in 2020, must be fully-funded to ensure continued support for health systems in the world’s poorest countries and the rollout of a COVID-19 vaccine in Gavi-supported countries once available.
● The pausing of polio eradication campaigns and responses to focus resources on COVID-19 response, heightens the risk of increased spread of both wild and circulating vaccine-derived polioviruses, and the number of children paralysed as a result.
● The COVID-19 pandemic is impacting livelihoods of the poorest in many developing countries and is projected to have a severe impact on nutrition and food security while lockdowns are simultaneously making interventions to tackle malnutrition more challenging.
● Despite the challenges associated with programme delivery during a pandemic, DFID must either scale up or maintain key health and social protection measures in order to protect the most vulnerable.
● DFID should adapt its programmes so that they can continue while adhering to restrictions in place to prevent the COVID-19’s spread.
● DFID should ensure that key multilateral partners and grantees have the additional and flexible funding they need to respond to the COVID-19 outbreak.
● DFID should regularly review operational guidance on maintaining essential health services, for example from the WHO, and issue such guidance to its country offices to ensure programmes can continue.
What are the immediate effects of COVID-19 on those living with TB, TB programming, and health systems in developing countries?
● DFID should issue rapid guidance to its country offices to ensure essential routine health programmes, including TB programmes, are sustained during the COVID-19 response.
● DFID should provide additional flexible funding to key multilateral partners responding to COVID-19, including the Global Drug Facility, which works to coordinate TB drug supply and procurement, and prevent stock outs around the world. It should also ensure the Global Fund receives additional resources to replenish any funding made
available to countries responding to COVID-19.
● Ensure any expansion of capacity within national respiratory health systems as a result of COVID-19, including the expansion of diagnostic facilities, scale-up of digital health technologies and increased laboratory capacity, are leveraged and built on as part of a long-term health systems and pandemic preparedness plan.
How is COVID-19 impacting immunisation?
● To support Gavi in their vital work in responding to the COVID-19 outbreak, we urge the UK government to make an ambitious pledge to Gavi ahead of the Global Vaccine Summit 2020 and continue to press other international donors to make early and ambitious pledges.
● The UK should highlight the importance of maintaining immunisation systems during and after the COVID-19 outbreak to prevent further loss of life and disease outbreaks and mitigate the secondary impacts of disruption to immunisation services.
● DFID must highlight the importance of maintaining availability of key immunisations assets including trained health workers, availability of supply chains and disease surveillance in order to support resilient health systems needed to withstand the primary and secondary effects of COVID-19.
What are the specific impacts of COVID-19 on polio?
● In order to reduce the severe impact COVID-19 will have on the spread of polio, DFID should call on GPEI to ensure eradication efforts are re-started as soon as it is safe to do so, and support countries in this process.
● DFID should request GPEI to fully assess the programmatic and financial impacts of the response to COVID-19, and clearly and continuously communicate to donors and partners about how these will be addressed.
● The UK should use its leadership position within GPEI to strengthen the partnership’s engagement with Gavi in order to ensure that delivery of the Inactivated Polio Vaccine is fully funded and that where necessary GPEI functions as services are taken forward by Gavi when domestic governments lack capacity.
How is COVID-19 affecting nutrition?
In order to continue vital nutrition programmes, DFID should:
● Ensure community health workers have appropriate PPE and are able to implement no-touch techniques, such as using dolls, to safely demonstrate to parents how they can screen their own children for malnutrition.
● Incorporate social distancing measures into programmes wherever relevant.
● Enable parents to treat malnourished children while in self-isolation by ensuring they are able to access relevant medication and nutrition related health products; and ensuring breastfeeding mothers know what to do if they fall ill with the virus.
● Ensure life-saving activities, such as the distribution of food, nutrition related health products and cash, are classified as essential and exempt from restrictions by authorities.
● Anticipate supply chain problems and help governments to pre-position stocks of food and supplements.
● Ensure that the DFID staff who are still in country are sufficiently briefed on nutrition, given that many DFID staff have returned to the UK, including those with responsibility for nutrition.
● To mitigate the effects of COVID-19 on health and nutrition, DFID should strengthen existing community health services in order to ramp up screening for malnutrition, together with screening for COVID-19 symptoms and to promote social distancing and hygiene messages. This will prevent a surge in malnutrition cases and reduce the spread of the virus in a cost effective and timely manner.
● To mitigate the effects of COVID-19 on incomes, livelihoods and food security, DFID should expand food assistance and social protection measures, including rolling out cash transfer schemes.
● DFID should support local food production and transportation and, where needed, ensure people have physical access to food, including through blanket feeding. DFID can do this by working with country governments to ensure continuity in value chains and support farmers to ensure the continuity of food production. DFID should also support countries to monitor food prices and markets to help mitigate price rises.
 World Vision, Covid 19 Aftershocks: Secondary Impacts Threaten More Children’s Lives than the Disease Itself, https://www.wvi.org/sites/default/files/2020-04/World_Vision_COVID_secondary_health_impact_FINAL.pdf, accessed 16/04/20.
 World Health Organisation, COVID-19: Operational guidance for maintaining essential health services during an outbreak, https://www.who.int/publications-detail/covid-19-operational-guidance-for-maintaining-essential-health-services-during-an-outbreak, accessed 16/04/20.
 WHO, 2020. Data available online at https://extranet.who.int/polis/public/CaseCount.aspx
 POB Statement, April 2020. Available online at: http://polioeradication.org/news-post/call-to-action-to-support-covid-19-response/
 World Food Programme, Number of hungry people spikes in Central Sahel as COVID -19 looms, https://www.wfp.org/news/number-hungry-people-spikes-central-sahel-covid-19-looms, accessed 16/04/20.