COVID-19 offers opportunities for Africa’s food systems
I have been participating in some of the recent COVID-19 Open Online Briefings which reinforce my un…
Reflections are articles written by members of the 4SD team, the 4SD academy and the wider 4SD network. They reflect the opinions and perspectives of the author as part of their own sense-making efforts towards systems change. If you have been involved with or have been following our work at 4SD and you would like to write a reflection, please reach out to us via the contact form.
I have been participating in some of the recent COVID-19 Open Online Briefings which reinforce my un…
Covid-Care @Home is an innovation challenge by The George Institute India Health Accelerator Programme covering an ideathon and hackathon aimed at developing innovative solutions for managing covid-19 at home with a focus on rural areas.
The winner from each category will be awarded INR 50,000 and will be provided mentorship by leading industry experts as part of the TGI Health Innovation Fellowship
A reflection by Dr Oommen John is a physician researcher and digital health expert. He works at The George Institute for Global Health India and a Professor at Prasanna School of Public Health, Manipal Academy of Higher Education.
In early April 2021, as the number of persons with COVID-19 were rising exponentially in India, the healthcare delivery systems began to crumble. As a health professional, I dreaded every phone call that I would receive during those days, on the other side would be a friend or acquaintance gasping for breath and pleading for help in finding a bed. As the pandemic surged, the frantic calls for help kept increasing beyond my capacity to respond and the guilt growing to the extent of needing to sedate my conscience and switch off the phone. While you can cut off communications, the subconscious mind keeps processing those faint voices crying for help. As a public health professional I was desperate and looking for oxygen that could make the health systems stay alive, taking to social media to vent the frustration at the lack of systems approaches to addressing public health crisis.
The algorithms read between my words and led me to COVID-19 Open Online Briefings with Dr. David Nabarro hosted by 4SD. It was a transformative experience being part of the discussion led by David, driving home the key message around the pivotal role of systems approach for comprehensive COVID-19 response. I was invited to share my experiences from the ground, which provided an opportunity for experts from other regions to share what worked for them. In summarizing, David drove home the point that the ongoing pandemic is likely to linger for a long time and highlighted the need for systems thinking and whole of government response.
My participation at the Open Online Briefings and guidance provided by David got me thinking on how public health response in India and south east Asia could be augmented and prepared for this long haul.
I was reminded on an earlier instance of a prior humanitarian crisis that followed the massive earthquake in Nepal, where in a very short span of time we were able to develop and deploy an innovative solution to support health professionals who were involved in the relief work. “QuakeCare” was designed as a point of care decision support tool that provides evidence based guidance for triage and management of crush victims and initiate early treatment interventions to prevent complications. Why not a health innovations challenge for COVID-19?
This got us excited at the George Institute India Health Accelerator Programme, we sought input from innovators and start-ups being mentored by us. We also conducted a telephonic survey to understand the unmet needs from healthcare providers, people affected by COVID-19 in regions with limited healthcare delivery capacity in India and south-east Asia region.
While planning for the health innovation challenge, I contacted David and despite his busy engagement as Special Envoy of the World Health Organization (WHO) Director-General on COVID-19 while the world health assembly being in session, I am honoured and overwhelmed at the support and guidance provided by him and the team at 4SD to support the [email protected] Health Innovation Challenge.
This article is a reflection by Dr Oommen John following the COVID-19 Open Online Briefings of Dr. David Nabarro. Dr Oommen John is a physician researcher and digital health expert. He works at The George Institute for Global Health India and a Professor at Prasanna School of Public Health, Manipal Academy of Higher Education. He is an elected fellow of the International Academy of Health Science Informatics.
Trained as an internist, he has worked in primary care settings in resource-limited contexts across LMICS and has extensive field level experience in designing, implementing and evaluating innovative solutions and its applicability in health service delivery. He has served with WHO in Immunization Strengthening and Vaccine Delivery, Research and Development at WHO SEARO. At George Institute for global health India, he leads the India Health Accelerator Programme. His research involves evaluating the role of digital health interventions in improving clinical outcomes. He serves on the expert advisory panel for the Market Access Programme of National Health Authority, India.
He is a member of the scientific advisory committee at Foundation for Innovative Diagnostics (FIND), advisory board of Commonwealth Centre for Digital Health. He has contributed to WHO Digital Health Guidelines development group. Follow @Oommen_john and @GeorgeInstIN to keep up-to-date on social media.
In 2020, two interconnected pandemics claimed global attention. COVID-19 exposed the fragility of our health care infrastructure. And it brought to the forefront the dire consequences of our inaction to address obesity. Obesity is both a risk factor for severe outcomes of COVID-19, and a consequence of the disease. Now, more than ever, obesity treatment and prevention must be prioritised as a gateway to health; in doing so, the social, economic, environmental, and biological drivers of both obesity and COVID-19 need to inform decision-making processes.
After COVID-19 was declared a public health emergency of international concern, on March 11th, 2020, it soon became clear that people living with obesity were more susceptible to severe SARS Coronavirus 2 (SARS-CoV-2) outcomes. We now know that the risk for hospitalization for people living with obesity is increased by 113%, whilst the risk of death is 48% higher when compared to individuals of normal weight.[i] Adding to growing concerns are the lockdown restrictions and mental health consequences of the pandemic that threaten weight maintenance and weight-loss efforts, with increased levels of physical inactivity worldwide. Obesity is thus considered an effect of the pandemic and cannot be ignored in both developed and developing countries that bear the highest burden of the disease.
We have nine years to meet the UN global development targets, also known as the Sustainable Development Goals(SDGs). We must act swiftly if we are to do so and fix the catastrophically off-track global obesity targets that are further threatened by the COVID-19 pandemic (SDG3.4, SDG3.8, SDG2). Why so? A lack of progress on obesity jeopardizes achievement of the World Health Organization (WHO) Triple Billion Targets that promises 1 billion people living healthier lives.
As an optimist, I do believe that within a crisis, lie seeds of opportunity. There is hope.
But what is the solution?
From the early days of the COVID-19 outbreak in Wuhan, I followed prevalence trends and response priorities. Having finished my MPH two years ago I never imagined living through a pandemic, at least just yet. Dr. David Nabarro’s Open-Online Briefings provided a platform for interactive discussions and a community to grow with. It exposed me to complex systems thinking – a framework to identify and account for interacting influences on COVID-19 and obesity that will be key to progress.
‘Holding the virus at bay requires following the well-established disciplines of disease outbreak control. There are no shortcuts and no quick fixes. Different systems need to be woven together at a local level and be well supported by both national authorities and international programmes. There is a need to do it all and do it well.’ Dr. David Nabarro rightfully says.
What is the missing piece of the puzzle? Youth Voices!
Young people have the innate capacity to see the ‘bigger picture’. They can discover complex interdependencies, including the components of a system that may affect and interact with each other. Their critical tendencies can help us identify barriers in implementing policies, including the incentives and stakeholders that need to be brought to the table. Youth have always been at the forefront of movements for justice and social change, including the Black Lives Matter and Climate Justice movement. They have shown their commitment to activities and improving lives for all.
‘Confronting Obesity: co-creating policy with youth’ (CO-CREATE) a project funded by the European Commission works for youth, with youth. By using a systems approach, the project addresses the unresolved challenges around childhood obesity. Just recently, the perceptions of 257 adolescents (16-18 year old) on the drivers of childhood obesity across Portugal, Poland, Norway, the Netherlands, and the UK were explored.[ii] Collectively youth identified marketing, access to food (both availability and price), stress, anxiety, depression, and low body positivity as factors contributing to the obesity epidemic. Not only did they identify such factors, but they also used a process of ‘mapping’ to illustrate how they are causally related to each other and obesity (see figure 1).
Figure 1 – Commercial Drivers of Obesity. Eur J Public Health, ckaa251, https://doi.org/10.1093/eurpub/ckaa251
We must listen to, and work with the important but often most neglected population group in obesity and COVID-19 research. It will build capacity and support decision-making on key issues that are ahead of us:
We have all lived with COVID-19 for a year now. The virus is here to stay for the foreseeable future. Equally, not one person has been untouched by confinement, and the hardships that the pandemic has given rise to. If not directly, then indirectly due to the lack of support from neighbouring countries during a local emergency. But this makes us powerful!
We are more united than ever, and It is time to take action as a collective. To engage and support one another for equity and justice for the planet. Every Body needs everybody to address obesity & COVID-19, and this includes youth.
Are you struggling to see systems and appreciate them? Dr. David Nabarro provides excellent guidance here. You can also watch the 4SD narrative on COVID-19 and systemic inequality here.
And remember – ‘Great things are not done by impulse, but by a series of small things brought together’.
[i] Popkin, BM, Du, S, Green, WD, et al. Individuals with obesity and COVID‐19: A global perspective on the epidemiology and biological relationships. Obesity Reviews. 2020; 1– 17.
[ii] Savona, N., Macauley, T., Aguiar, A., Banik, A., Boberska, M., Brock, J., Brown, A., Hayward, J., Holbæk, H., Rito, A., Mendes, S., Vaaheim, F., van Houten, M., Veltkamp, G., Allender, S., Rutter, H. and Knai, C., 2021. Identifying the views of adolescents in five European countries on the drivers of obesity using group model building. European Journal of Public Health,.
This article is a reflection by Claudia Batz following the COVID-19 Open Online Briefings of Dr. David Nabarro. Claudia is an emerging public health professional and a youth advocate with 2 years of experience in global and public health, Currently a Policy and Projects Coordinator at the World Obesity Federation and a Core Team Member of Young Leaders for Health.
At WOF, she supports the dissemination, communication, and utilisation of outputs from 2 EU consortium childhood obesity projects (CO-CREATE & STOP), and the development of youth-friendly materials, briefings, and resources to help policymakers and others seeking to implement obesity-related policies in their countries. Her previous role involved supporting the enhancement and delivery of the Strategic Centre for Obesity Professional Education(SCOPE).
Claudia is keen to improve health literacy and strives to elicit and bring the perspectives and skills of young people into the strategic design and delivery of health-related programs and policies through her engagements.
I have been participating in some of the recent COVID-19 Open Online Briefings which reinforce my understanding of how the COVID pandemic is far from over and can have further repercussions in the countries in the Global South, especially in Africa. In the Briefings we often talk about the importance of involving community actors and decisions makers in the response. My recent article published as a column in the December 2020 issue of the Dutch magazine ‘Vork’ below dives into these issues.
Concerted efforts are required to mitigate the many consequences brought about by COVID-19. This piece enlightens particularly involving African youth and intellectuals as main drivers of sustainable agricultural transformation based on small-scale farming for poverty reduction, enhanced food and nutrition! security, resulting in “Global Health”.
This article was originally published on 18 of December 2020 in Dutch magazine, ’Vork’.
Africa can develop herself
COVID-19 has revealed several cracks in the globe-spanning agri-food system. Lockdowns have restricted trade flows, compromised access to essential inputs such as quality seed and increased vulnerabilities to external shocks. In Africa, this situation has been further exacerbated by the loss of earnings from migrant workers, due to unemployment caused by the COVID-19 pandemic. The loss of these payments, which are often substantially higher than all development assistance budgets together, with the lack of local employment and massive crop losses due to locust attacks, has been a heavy blow.
Over the years, many African countries have minimized the role of local food systems and sustainable family farming. Instead, various nations now deliberately prioritize the export-oriented production of industrial crops, especially as primary raw materials, to then draw upon the resulting foreign currency to meet primary food needs. In such agri-food systems that are geared towards exports and that extensively rely upon extractive farming practices, the steady degradation of natural capital and net outflows of nutrients have brought about a progressive loss of ecological resilience. COVID-19 has painfully revealed the weaknesses of this production model and illuminated how Africa’s farmers are especially vulnerable to the vagaries of the international market. Indeed, multiple facets of today’s farming model increase the risks of food system collapse and full-blown social crises.
Africa should take agricultural development into its own hands
The course of Africa’s food systems needs to be properly charted. Food production in Africa requires investment in technological development, innovation tailored to local (agro-ecological, socio-economic) contexts, and a deliberate focus on smallholder agriculture. If Africa wants to gain a strong position, it must shed its image as a marginal continent where western nations can easily source low-cost primary produce and dump their (subsidized) farm surpluses. One of Africa’s key assets is its young, dynamic and hard-working population, many of whom live outside of urban areas, inhabiting fertile farmland and with boundless natural resources at their fingertips. Hence, Africa’s investments need to be tailored to smallholder family farming and to agri-food systems that are protective of human and environmental health.
It is high time to strengthen Africa’s agricultural and food self-reliance, improve food and nutrition security and mitigate the environmental footprint of agriculture. In addition, well-educated Africans, like the many tens of thousands of agronomists, deserve more respect, better paying jobs and a “hand at the helm”. They have unique insights into the relative strengths and weaknesses of local agriculture and are pre-eminently qualified to contribute to the formulation of a national agricultural policy, which should become the basis for investment plans. The experience of some Asian countries, e.g. China, Vietnam, Bangladesh or Indonesia, has shown how targeted investments, pro-poverty research and farmer empowerment can unlock sustainable economic growth while safeguarding the environment.
As such, agriculture in these countries was recognized as the “backbone of the economy”, steady flows of safe and nutritious farm produce were generated, and large sectors of the population were lifted out of poverty. Due attention to farmer education, ‘One Health’, and an ecological intensification of agriculture have proved to be essential in this regard.
The COVID-19 pandemic now provides the momentum to shape such transitions, giving a new impetus to Africa’s economic development. The traditional partners can act as co-financiers instead of direct benefactors. The ambitious youth – who all too often beckon to Europe – must be actively engaged. Their leadership is crucial to reduce hunger and malnutrition, build a dynamic agricultural sector and create a better future for millions of families. In addition to infrastructure investments, a migration pact could be considered to promote the return of skilled workers to Africa.
Setting sound priorities
Africa is a diverse continent with tremendous natural and human capital and endless possibilities. A flourishing agricultural sector (primarily geared to local and regional markets) can reduce the root causes of migration between rural areas, cities and Europe. Africa should not be further patronized by the North, for it can take matters into its own hands – with external technical and / or financial support, where and when demanded by the local experts. Let us stop pretending that westerners have all the expertise for African agriculture.
Equal trade and tax relations between the EU and AU are essential preconditions for no longer misusing Africa just as a resource. Stable and fair world market prices for products such as coffee and cocoa can contribute to rural development and lift living standards of the rural poor. The role and responsibility of the African political class is central to this. In that context, it is also essential to take the recently launched “African Continental Free Trade Area (ACFTA)” as a serious starting point.
The UN Food Systems Summit 2021 can provide the right momentum for a new global agricultural policy based on regional self-reliance, equality and a preservation of Planetary Health. In Africa and across the globe, agriculture can and should become a regenerative force, with smallholder farmers as stewards of biodiversity and guardians of human health. The immense potential and socio-economic reach of Africa’s agricultural and food system should not be overlooked, and the aforementioned transition must be tackled as a matter of priority.
Thanks to Orlando de Ponti and Martin Smith
This article is a reflection by Ad Spijkers following the COVID-19 Open Online Briefings of Dr David Nabarro.
Ad worked as Representative of the Food and Agriculture Organization (FAO) of the United Nations. He is part of a group of Wageningen development veterans with extensive experience in Africa and Asia.
Participants of the COVID-19 Open Online Briefings are invited to share their reflections on how they are navigating complexities from their own perspectives. The views and opinions expressed in these reflections are intended to inspire greater systems leadership during the COVID-19 pandemic. They do not necessarily reflect the official policy or position of 4SD as an organisation or it’s associated personnel. Any content provided by authors are of their opinion and are not intended to malign any religion, ethnic group, club, organization, company, individual or anyone or anything.
By Miles Bredin.
David is an old friend and colleague of my wife, Jo Nickolls. They worked together on ebola. When I practised for COVID-19 by very nearly dying of H1N1 in 2019, David used systems leadership to harvest a huge honeycomb of knowledge and contacts to help save save my life; Katherine, another member of the 4SD team, once lent us her house for Christmas…
I joined the online briefings in the context that these were good, inspiring, clever people but also wanting to know as much as possible about covid-19. Little did I know that 4SD would guide my thinking on so many broader issues.
Inspired by David, John, Katherine, Thuy, Julien and Florence we have been able to refine our strategy at my company, Well Made Strategy , so that we are now acting with purpose in all that we do. We are a social enterprise and have only ever worked with partners doing great work, turning down jobs with people with whom we disagree. The need for social justice and equity guides all our work. But, ours is a weird case: we provide strategic communications advice in many disparate fields. Indeed we market ourselves on the basis that we are not specialists in anything save communications.
We don’t act for people – like a PR company – we help our clients to act for themselves. As well as private business, we work on learning, health, SGBV, the environment, human rights; the list is endless. Basically, if someone’s doing something good, we help them to do it better. How therefore could we define our purpose?
The blog below tells the story of how our team decided the climate crisis was something we could address with all our partners, setting the example ourselves and helping them to join us. We hope it inspires you to define your purpose and act upon it.
Please have a look and share far and wide.
Free books! Competition!
By TEAM WMS (originally published on LinkedIn)
Well, we made it to February! And if the last year has taught us anything, it is that we must all play our part. The covid-19 response is all about our own personal contributions to the bigger system, our responsibility each to act for the good of others. We must work together to thrive and if we all do our part, things will get better!
That applies to individual people wearing masks to protect their fellows and it applies to governments supporting Covax to protect their fellows.
Somewhere between washing our hands, physical distancing and wearing masks, we were hit by an insight! The exact same thing applies to the climate crisis. Only thirty years late…
As the US once more accepts its climate crisis responsibilities, so must we.
While WMS has a great record of working with organisations on the environment, covid-19 has helped us to rethink our approach and make it more intentional. Last year WMS partnered with many diverse organisations working on their covid-19 response and we saw that while, like the pandemic, the climate crisis affects all aspects of human life, our environmental work at WMS was siloed when it should be infiltrating all that we do. We did great work on climate with Future Earth but how did our work with the Regional Education Learning Initiative tackle the climate crisis?
The world now understands that health care is a security issue. So is the climate crisis. And the climate crisis is a human rights issue, an education issue and an equity issue too.
We know that covid-19 is worse in the rest of the world than it is in Africa – but I’m afraid we are catching up – and yes, we know that the rest of the world is a greater greenhouse gas contributor than we are. Neither fact should stop us from trying to address the crisis for ourselves. And in March last year we were lucky enough to find a guide – Dr. Myriam Sidibe. It has been an eye-opening partnership!
Working with Unilever and UNICEF, Myriam Sidibe has spent decades designing handwashing behaviour change programmes that have reached over a billion people across the globe. And as the world began to plan the covid-19 response all eyes turned to the world’s first doctor of handwashing.
Myriam approached WMS for help with the launch of her book at the start of the pandemic, just as she co-founded the Nairobi Business Compact to address covid-19 in Kenya. She has written a how-to guide that rivals in practicality our own Communications for Social Change Handbook.
Myriam’s book Brands on a Mission encourages organisations in both the public and private sector to go beyond having a purpose to living that purpose and what’s more: it shows us how. Working with Myriam helped us figure out how to use the Sustainable Development Goals to reorient our work on climate.
We feel strongly about positive social change, so we choose our partners as much as they choose us and we have had great success helping all sorts of organisations – business, human rights, child protection, learning – to reach their goals. For years – as many of our partners will remember – we have been teaching how clever the United Nations Environment Programme was at getting the environment into so many of the Sustainable Development Goals. Now we will do it too.
This year at Well Made Strategy we will be expanding our Environmental Social and Governance communications practise and urging all our partners to put the climate crisis at the forefront of their planning. We’ll be reducing our carbon emissions and addressing the climate crisis in all our work.
To embed the climate crisis in all that we do we will be using advice on systems thinking and leadership from the WHO Covid-19 Envoy Dr. David Nabarro and his team at 4SD. As they teach at 4SD, you need to identify all the players in a system, then work out how they relate to each other. To start on that we are launching a competition. In time this will help us to “understand and quantify the impact of those relationships on each other and on those outside the system”.
We commit to going beyond caring about the climate crisis to embedding climate work in all we do.
This will allow us to address equity, justice, nutrition, disability, learning, even female genital mutilation and all of the other issues that drive our work.
Of all the issues that we address daily at WMS, we have found one we are passionate about that can further all our other concerns. And Myriam Sidibe has taught us how to incorporate this into our work.
As we set out, we think you should all know Myriam! So, we’re giving away ten signed copies of her book to people who can best describe what they feel passionately about and what they’re going to do about it.
Dare you tell us?
Follow us @WMSComms and tell us in a tweet what you are passionate about. Tag it #vision21.
And if you’re outside Kenya, we’ll send you an e-book.
This article is a reflection by Miles Bredin following the COVID-19 Open Online Briefings of Dr David Nabarro.
Miles is a bestselling author and former foreign correspondent. He was United Press International’s last East Africa Bureau Chief and private sector strengthening advisor to the Afghan Minister of Finance. He was a Paul Mellon Fellow at Yale’s British Art Center and has written a number of books. Miles set up Well Made Strategy with Rob Burnet, founder of network of social ventures Shujaaz Inc in 2009. Well Made Strategy has devised and implemented communications strategies across Africa and beyond.
The feature image is a COVID-19 campaign in Kimaa (Maasai language) by Well Made Strategy and friends at Shujaaz and the Africa Educational Trust which were distributed in Tanzania and Kenya.
Participants of the COVID-19 Open Online Briefings are invited to share their reflections on how they are navigating complexities from their own perspectives. The views and opinions expressed in these reflections are intended to inspire greater systems leadership during the COVID-19 pandemic. They do not necessarily reflect the official policy or position of 4SD as an organisation or it’s associated personnel. Any content provided by authors are of their opinion and are not intended to malign any religion, ethnic group, club, organization, company, individual or anyone or anything.
By Jane Aslanidis.
On the first of January 2020, I was choking on the smoke created by the horrific bushfires in New South Wales, Australia. One year later, on the first of January 2021, I was indoors under London’s third lockdown to save lives and protect the NHS. In the face of these disasters, our own life plans suddenly seem insignificant.
My experience of moving to the UK and learning about a new culture has reaffirmed the value of relationships to me. I am fascinated by the human experience. When I arrived in the metropolis of London I quickly learnt people here generally value their anonymity, ‘cold and stiff’ is a generalisation for the weather and the attitudes. At 8pm on 26 March 2020, the instigation of Clap For Our Carers gave me goosebumps and transformed my neighbourhood. Today, local business owners smile, wave and we not only know each other’s names, we look out for each other.
My community is not limited to outside my doorstep. Technology solutions and online forums have allowed us to feel more interconnected than ever before. As a professional changemaker, I convene with organisations to explore issues that have meaning and impact on many people and cultures. Much of the work I do sits at economic, technology, political, climate and humanitarian crossroads. I’ve designed and facilitated over 1,000 workshops, conferences and convenings and over the past few months, I’ve noticed the accessibility improvements in video conferencing are empowering those traditionally left out of the conversation.
For example, I mentor entrepreneurs and grassroots activists in places like Mysore, Athens, Freetown – in villages, on farmland, in co-working spaces. No longer do we feel we have to wait to travel to each other to talk about challenges, we’ve adapted our discussions to video conferencing. We speak candidly about our personal experiences – with a shared realisation of the stress the virus creates for systems – from local food systems to the international system. Just when we need collective action more than ever, support for the international system has been deteriorating as countries look inwards. An unequal distribution of vaccines in vaccine nationalism paired with closing cooperation, borders and supply chains is shaping a concerning start to the year.
Despite this, and through my experiences and those of my community, I have noticed three themes emerging:
I define systems leadership in the international system as individuals and countries who are able to step up and bring collective leadership. Whether large or small, this includes interventions and convenings that aim to bring together those divided to face common challenges collectively and build a new system.
4SD explores what comfort in complexity means, engaging with living systems and seeing into multiple systems. Amanda Gorman’s stunning poem at Biden’s inauguration in the United States, one of the most severely affected countries by the virus and political turmoil, demonstrates what the next generation of system leaders can look like.
Dr David Nabarro shared in the latest COVID-19 Open Online Briefing the difficulty of rebuilding trust in the international system. Fact-based communication is needed to communicate our messages given the large amount of misinformation.
Trust in governments and international institutions is suffering, with unsustainable or misleading information provided, and false promises of hope or freedom in sight. The legitimacy crisis institutions are facing has been exasperated in the past decade. The UK government in particular is suffering a trust crisis. Last week, the 2021 Edelman Trust Barometer revealed a trust bubble in May 2020, with a sudden rush of trust towards government, to a particularly acute loss of confidence in the UK government by year-end.
I’ve learnt that advocating for people and communicating clearly with them, listening carefully to the needs of marginalised communities is a top priority in the face of a crisis. Clear communication and inclusion of low-income communities and non-English speaking audiences, including immigrants, is particularly important in public health campaigns.
Fundamentally, intertwining economic policy and climate policy will not only strengthen government’s adaptability and resilience to the impacts of climate change, it will also demonstrate leadership and the ability to listen to their citizen’s needs:
The year ahead is offering each and every one of us the opportunity to shape and change how we live our lives like never before. Many of us have resolved to purge ourselves of the “old ways” – of living, connecting, working and convening. My recent experiences have led me to a final reflection – how you lead your community in a pandemic says a lot about your character.
This article is a reflection by Jane Aslanidis following the COVID-19 Open Online Briefings of Dr David Nabarro. Jane is an international relations expert. Currently a senior manager at the Boston Consulting Group’s Centre for Public Impact and a former consultant at the United Nations World Food Programme.
A business owner, non-executive director and youth advocate, she has built and led community initiatives from the grassroots-up, and is now overseeing and designing global initiatives from the top-down. Jane welcomes any conversation to navigate, innovate, influence and advocate with others, bringing boldness, pragmatism and a strong set of values to all that she does.
Participants of the COVID-19 Open Online Briefings are invited to share their reflections on how they are navigating complexities from their own perspectives. The views and opinions expressed in these reflections are intended to inspire greater systems leadership during the COVID-19 pandemic. They do not necessarily reflect the official policy or position of 4SD as an organisation or it’s associated personnel. Any content provided by authors are of their opinion and are not intended to malign any religion, ethnic group, club, organization, company, individual or anyone or anything.
By Dr Carlos Madrigal- Iberri
During this Open Online Briefing with Dr. Nabarro, I realized that local efforts are crucial in order to stop and overcome this pandemic. My opinions of this session will address one main topic: What can we learn from governments that are successfully controlling the virus and how to implement those learnings in developing countries?
According to WHO statistics, COVID-19 is affecting 213 countries and territories around the world, and the number of new cases are rising at an astonishing rate. So far, we have learned many lessons but probably, one of the most important is that we are just at the beginning of this sanitary crisis.
Different strategies had been taken from some countries where they really took on board many communities’ members, such as heads of states and business, civil societies, universities, local entrepreneurs, etcetera and this is how they could put themselves ahead of the virus.
New Zealand for example, has declared itself as a COVID-19 free country. Aware that they cannot close the borders and live forever in the lock down, they teach every citizen in the country about the threat that this virus represents to their lives. The Public Health Department focused on preparing the entire population to know what to do in case someone gets sick and explained the importance of how these measures can get them ahead of the virus.
Germany and Ireland are other good examples of how the adequate organization and straightforward communication between government and society truly works. The measures taken by these countries are focused on assure to their citizens that if there is a new outbreak they are prepared to stop it as soon as possible and they can offer protection to the most vulnerable people, the older and the factory workers.
So far, we have learned that strong leaderships and deep commitment to face this crisis is the more solid strategy to overcome the pandemic that is going to live with us from now on. Unfortunately some other countries, are not dealing with the situation by these learnings. USA, Mexico and Brazil are three particular cases where their leaders had diminished the danger of this virus to their population and by not setting a clear direction, the amount of cases continues peaking every week. Because of not having a nationwide effort to make citizens conscious of what this threat means to their lives, these three countries are some of the most deadly places where you can get sick of Coronavirus. It still does not seems like they can stop the transmission soon.
Despite the beliefs and non-logical declarations that had been made for these three leaders of state, the COVID crisis will not disappear from one day to another a huge effort is needed between governments, academia, healthcare systems and citizenship in order to reduce the risk of infection. The message must be sent loud and clear: The virus will not magically evaporate; we need to increase the physical distancing and adequate hygiene measures. Continuous education and disease awareness are imperative to isolate contagious persons, particularly in very dense populated areas if we want to stop deaths due to coronavirus.
The virus is becoming almost endemic in many places and also the economic crisis is arising, by being certain that the population really understands the nature of the disease, we are closer to reduce the transmission and adapting ourselves to a new reality. We must recognize that this condition affects specially people living in poverty and we need to keep a constant and intensive effort to clear away the barriers that endangers these minorities.
Against presidential obstruction, local communities can and empowering themselves to defeat this condition, we do not need government permission to change our behavior, to getting organized, to keep physical distance and frequently wash our hands. Being part of the change is a personal decision and spreading the adequate information should be our responsibility. If we want to make a sustainable change, we must start by ourselves and to involve our communities.
Follow Salvando Latidos on Social Media @salvandolatidos
Follow One Young World on Social Media @OneYoungWorld
This article is a reflection by Dr. Carlos Madrigal- Iberri following the COVID-19 Open Online Briefing of Dr David Nabarro on 9 June 2020. It forms part of a collaboration between 4SD and One Young World to inspire greater systems leadership amongst youth during the COVID-19 pandemic.
Carlos is a Medical Doctor & One Young World ambassador who is deeply committed to Global Health. He serves on the Board of Salvando Latidos a non-profit organization, which provides free medical care to low income populations; during this pandemic, they are fundraising to provide protective personnel equipment for hospitals facing COVID-19 in Mexico. He has also been actively working for Novartis Mexico to bring to public agenda Chagas Disease, which is one of the 17 Neglected Tropical Diseases determined by World Health Organization and the second cause of heart failure in Latin America.
Carlos states, “In order to make a difference in public health, the world needs people that are willing to join forces to make this problem a part of our past, and not a new threat to our future”.
COVID-19 Open Online Briefing #23
Tuesday, 9 June 2020
17:00 – 18:00 CEST
The views and opinions expressed in these reflections form part of the collaboration between 4SD and One Young World to inspire greater systems leadership amongst youth during the COVID-19 pandemic. They do not necessarily reflect the official policy or position of 4SD as an organisation or it’s associated personnel. Any content provided by authors are of their opinion and are not intended to malign any religion, ethnic group, club, organization, company, individual or anyone or anything.
One Young World (OYW) is the global forum for young leaders. OYW identifies, promotes and connects the world’s most impactful young leaders to create a better world, with more responsible, more effective leadership. The annual OYW Summit convenes the brightest young talent from every country and sector, working to accelerate social impact. Learn more about OYW at https://www.oneyoungworld.com/
By Dr Carlos Madrigal- Iberri
En esta sesión con el Dr. Nabarro, terminé de comprender que los esfuerzos locales son de vital importancia para detener y superar esta pandemia. Mis opiniones de esta sesión se centrarán alrededor de una pregunta medular: ¿Qué podemos aprender de los gobiernos que están controlando el virus de manera exitosa y cómo implementar estos aprendizajes en los países en vías de desarrollo?
Acorde a las cifras de la OMS, el COVID-19 afecta a 213 países y territorios alrededor del mundo y el número de casos nuevos siguen aumentando a una tasa alarmante. Hasta ahora hemos aprendido muchas lecciones, pero probablemente una de las más importantes es que estamos apenas empezando esta crisis sanitaria. Múltiples estrategias se han tomado por diversos países en los que se comprometieron con miembros de sus comunidades como jefes de estado y negocios, sociedades civiles, universidades, emprendedores locales, etcétera y así fue como estos lugares pudieron ponerse por delante del virus.
Tomemos a Nueva Zelanda como un ejemplo, ellos se han declarado ya como un país libre de COVID-19. Conscientes de que no pueden cerrar sus fronteras y vivir permanentemente en encierro, para evitar de esta manera que el virus ingrese nuevamente a su comunidad, ellos se han enfocado en enseñar a cada ciudadano en el país el riesgo que este virus representa para su salud. El Departamento de Salud Pública concentró los esfuerzos en que la población sea consciente de las acciones que deberá tomar en caso de que alguien se enferme y explicó detalladamente la importancia de porqué estas medidas les ayudarán a salir adelante de la crisis.
Alemania e Irlanda son otros dos ejemplos de cómo la organización adecuada y la comunicación consistente entre el gobierno y la sociedad verdaderamente rinde frutos. Las medidas tomadas por estos países se centraron en asegurarle a los ciudadanos que, si existe un nuevo brote, ellos están preparados para intentar contenerlo tan pronto como sea posible y que ofrecerán protección a la población más vulnerable como los adultos mayores y los trabajadores de fábricas.
Hasta ahora, hemos aprendido que los liderazgos fuertes y el compromiso real para enfrentar esta crisis la estrategia más sólida para superar esta pandemia que existirá entre nosotros por un tiempo indeterminado. Desafortunadamente algunos otros países, no están lidiando con esta situación basados en estos aprendizajes. EUA, México y Brasil son tres casos particulares en los que sus líderes han menospreciado el peligro que este virus representa y ya que no han marcado una directriz estricta para sus ciudadanos, los casos continúan alcanzando cifras históricas cada semana. Por no hacer un esfuerzo nacional para que la ciudadanía sea consciente de lo que esta amenaza representa para sus vidas, estos tres países son los que tienen el mayor número de muertes por coronavirus y no parece que vayan a poder detener la transmisión pronto.
A pesar de las creencias y las declaraciones poco lógicas que han hecho en algún punto estos tres líderes de estado, la crisis ocasionada por COVID no desaparecerá de un día para otro, se necesitan grandes esfuerzos entre gobiernos, academia, sistemas de salud y la ciudadanía para poder reducir el riesgo de infección. El mensaje debe ser enviado fuerte y claro: El virus no se va a evaporar mágicamente, es por ello que necesitamos incrementar la distancia física y las medidas adecuadas de higiene. Educación continua sobre el tema y concientización de la enfermedad son imperativos para aislar de manera temprana a personas contagiosas, particularmente en áreas muy densamente pobladas si de verdad queremos detener las muertes por coronavirus.
El virus se está volviendo casi endémico en muchos lugares y también la crisis económica se está agravando. Si logramos hacer que la población verdaderamente entienda la naturaleza de esta enfermedad, estaremos más cerca de reducir la transmisión del virus y de adaptarnos a una nueva realidad. Debemos reconocer que esta condición afecta especialmente a las personas viviendo en pobreza y por esta razón debemos mantener un esfuerzo constante e intensivo para eliminar las barreras que ponen más en riesgo a estas minorías.
Sin importar la obstrucción presidencial, las comunidades locales pueden empoderarse a sí mismas para derrotar esta situación. No necesitamos un permiso presidencial para cambiar nuestros comportamientos, o para organizarnos y mantener una sana distancia y lavarnos frecuentemente las manos. Ser parte del cambio es una decisión personal y compartir la información adecuada deberá ser responsabilidad de todos nosotros. Si realmente queremos hacer un cambio sustancial, debemos empezar por cambiar nosotros mismos y envolver a nuestra comunidad.
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Este artículo es una reflexión del Dr. Carlos Madrigal- Iberri tras la sesión informativa abierta en línea de COVID-19 del Dr. David Nabarro el 9 de junio de 2020. Forma parte de una colaboración entre 4SD y Un Mundo Joven para inspirar un mayor liderazgo de los sistemas entre los jóvenes durante la pandemia de COVID-19.
Dr Carlos Madrigal- Iberri: Consejo Directivo de Salvando Latidos, una Asociación Civil sin fines de lucro que brinda atención médica para pacientes de bajos recursos. Durante esta pandemia se han dedicado a recaudar fondos para brindar equipo de protección personal a los hospitales que están haciendo frente al COVID-19 en México.
Además, trabaja de manera activa para Novartis México para traer a la Agenda Pública la enfermedad de Chagas, una de las 17 Enfermedades Tropicales Olvidadas declarada por la OMS, que es además la segunda causa de Insuficiencia Cardíaca en America Latina.
“Si queremos hacer una diferencia en salud pública, el mundo necesita gente dispuesta a sumar esfuerzos para hacer de estos padecimientos un problema del pasado y no una nueva amenaza para nuestro futuro”.
COVID-19 Open Online Briefing #23
Tuesday, 9 June 2020
17:00 – 18:00 CEST
Los puntos de vista y opiniones expresados en estas reflexiones forman parte de la colaboración entre 4SD y Un Mundo Joven para inspirar un mayor liderazgo de los sistemas entre los jóvenes durante la pandemia de COVID-19. No reflejan necesariamente la política oficial o la posición de 4SD como organización o su personal asociado. Cualquier contenido proporcionado por los autores son de su opinión y no pretenden difamar ninguna religión, grupo étnico, club, organización, compañía, individuo o cualquier cosa.
One Young World (OYW) es el foro mundial de jóvenes líderes. OYW identifica, promueve y conecta a los líderes jóvenes más impactantes del mundo para crear un mundo mejor, con un liderazgo más responsable y efectivo. La Cumbre anual de OYW convoca a los jóvenes talentos más brillantes de cada país y sector, trabajando para acelerar el impacto social. Más información sobre OYW en https://www.oneyoungworld.com/
I attended Dr David Nabarro’s debrief session of 18 June from Bangalore, India. As an admirer of strong leaders in public health through my work at GE Healthcare, trying to conceal my ‘fan-boy’ face was quite a challenge.
Dr Nabarro opened with discussing different facets of the pandemic and the manner in which the world should navigate a gradual opening of its social and economic systems. He mentioned of the cases steadily declining in Europe, on the contrary cases are increasing towards the East and in the USA. This strengthens the correlation between higher population and higher population densities to the number of infections. This correlation also poses a question, what would be the extent of damage caused to human life before countries with a higher population can flatten the curve, since there is never a shortage of people who could be infected.
Behaviour change is needed
While governments over the world over are doing their best (lockdowns, contact tracing, etc.) to manage the pandemic, there are a set of behavioural changes every individual has to exercise to manage the pandemic. These behavioural changes could be summarized as physical distancing of at least one meter and face protection when in public. These behavioural changes not only reduce the likelihood of exposure to the virus, they also reduce the amount of virus (viral load) one could be exposed to.
Emerging epidemiological and clinical aspects
There is also research towards patients suffering from lingering COVID and their identifying features. This research would help improve treatment protocols and improve patient outcomes. Amidst the various research efforts towards improving chances of recovery, dexamethasone’s efficacy towards helping patients recover from extreme inflammatory immune response due to COVID is being looked at as a wonder drug. The drug’s efficacy in reducing mortality was especially noted in patients in the late stages of disease progression. Another plus point of dexamethasone is its affordability.
Clinicians mention, an important feature worth tracking in COVID patients is blood oxygen saturation via SpO2 meters. Monitoring SpO2 early on can help clinicians undertake remedial actions timely (ex: Oxygen therapy), thus improving patient outcomes. To facilitate this effort, WHO has taken up in provisioning oxygen to several hospitals, particularly in developing countries. Such findings are important not only in reducing COVID mortalities, but also to uplift the general public sentiment.
It has been found that the virus spread is not uniform across regions. The avenues of high transmissibility often lie at the intersection of ability to physically distance in a region, ventilation of the region, and most importantly, prosperity of the region. Inequity of various forms, such as prosperity, gender, ethnicity, or age determine access to quality healthcare and consequently recovery. Governments must focus localized efforts towards identifying such areas of high incidence of patients and address the root cause for the virus spread.
A community-led public health response
The most recent demand in reaction to the pandemic is to increase public health spending. This is where I found Dr Nabarro’s suggestion very interesting. He suggests that models of public healthcare must be formulated that go outside the hospitals and to the communities. In my personal opinion, the advantage of such a system is that it would be agnostic to socio-economic inequalities and meet its intended purpose. I believe governments and corporations would be willing to implement such out-of-hospital public healthcare models for several reasons such as:
Question and answers from participants
One of the attendees, Katherine, raised a question on the accessibility of the drug dexamethasone. It sparked an interesting discussion. While the drug is certainly very cheap, it should only be administered in qualified healthcare settings, which may not be available to socio-economic disadvantaged groups. This comment underscored the importance of equal healthcare access.
Another attendee, Anthony Zwi raised an interesting point of view that individuals are only as empowered as the local community organizations that lend to them that power. Horizontal empowerment and facilitation by the local organizations to the citizen is very important to ensure success of community initiatives.
Karin Wiedenmayer brought an interesting situation to notice. She mentions the ignorance of some governments towards remedying the pandemic situation and feeding misinformation to their people. WHO intends find any measure possible to rectify the situation, even if it means bypassing those governments.
I had my fan-boy moment soon after where I asked Dr Nabarro’s take on the following situation. Currently, some cities (ex: New Delhi) are admitting only symptomatic cases and not pre-symptomatic and asymptomatic COVID cases. I asked, “Is the WHO looking at issuing homecare guidelines to pre-symptomatic and asymptomatic patients so that their disease progression is slowed and it gives hospitals the required bandwidth to cater to critical cases?”. The good news was that issuing such guidelines is in active discussion within the WHO. Given my line of work (healthcare technology, software development, and AI), Dr Nabarro discussed with me the role of AI in COVID, which is promising, especially towards screening COVID patients.
Annie and Jonathan raised an interesting point where the correct use of language and managing mental health by the leadership helps to handle the public during the pandemic. A simple example of this would be using the phrase ‘physical distancing’ over ‘social-distancing’. Nendirmwa’s story brought us back to ground reality. She lost her job amidst this pandemic since her employer couldn’t empathize with her challenges of working from home. Sadly, this is an issue faced by many.
Such a discussion brought to light the fact that while the pandemic is a grave situation, we must use this as an opportunity to identify and improve our areas of socio-economic inequalities as we remedy the pandemic.
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This article is a reflection by Sehaj Sharma following the COVID-19 Open Online Briefing of Dr David Nabarro on 18 June 2020. It forms part of a collaboration between 4SD and One Young World to inspire greater systems leadership amongst youth during the COVID-19 pandemic.
Sehaj is a One Young World Ambassador active in the space of healthcare technology and Artificial Intelligence. He is passionate about the Sustainable Development Goals of Quality Education, Good Health and Wellbeing, and Reduced Inequality. He represented these causes at the One Young World Summit 2019 in London.
COVID-19 Open Online Briefing #25
Thursday, 18 June 2020
08:30 – 09:30 CEST
The views and opinions expressed in these reflections form part of the collaboration between 4SD and One Young World to inspire greater systems leadership amongst youth during the COVID-19 pandemic. They do not necessarily reflect the official policy or position of 4SD as an organisation or it’s associated personnel. Any content provided by authors are of their opinion and are not intended to malign any religion, ethnic group, club, organization, company, individual or anyone or anything.
One Young World (OYW) is the global forum for young leaders. OYW identifies, promotes and connects the world’s most impactful young leaders to create a better world, with more responsible, more effective leadership. The annual OYW Summit convenes the brightest young talent from every country and sector, working to accelerate social impact. Learn more about OYW at https://www.oneyoungworld.com/
I attended Dr David Nabarro’s debrief session on the ‘State of the Pandemic’ from Mumbai, India. As I reflect on the session, I am reminded of his comprehensive picture of the global pandemic today and how it relates to my home country. I take this opportunity to share the images that stayed with me.
Not without my data
The session began with what my professors of Health Policy would lose no chance of drilling in us – what does the evidence say? As Dr Nabarro explained, the latest WHO evidence of cautiously conservative figures on COVID-19 tells us that the infection in various nations is picking up faster today than it was at the start of the pandemic. Though earlier the global North dominated news cycles with its high number of cases, countries like India and Brazil have come up now, indicating that lockdown measures were successful merely in buying time. Similar inferences from the data on deaths cannot be drawn due to its poor reporting and the varying definitions of deaths attributable to COVID-19 across nations.
Despite these ambiguities, the resounding message of the data from countries in various stages of the pandemic has been to test, trace, treat, and isolate. As has become increasingly clear, this feat is all but impossible without able leadership and robust community participation. I need not look further than my own country where the state of Kerala has shown grit in early intervention, allowing it to come ahead of this pandemic, while the big cities of Mumbai and New Delhi continue to struggle with rising cases. Governments across the world are refraining from extending lockdown measures in light of the massive aftermath on vulnerable populations (ex. migrant workers, pregnant women, transplant patients, survivors of violence) which means that learning to prepare and fight the virus is the only plausible solution.
Social movements meet health priorities
In the spirit of fighting health problems plaguing the world, an important question related to systemic issues which affect health outcomes was raised by a member of the session. In my experience of attending dozens of webinars in this period, Dr Nabarro was one of the few hosts who passionately answered a question about the role of social movements (such as #BlackLivesMatter) in advancing achievements in public health.
Of the three key points he made, first was that all movements against any form of inequity or inequality are interconnected. Echoing that, I believe the inclusion of intersectionality of the oppressions faced by marginalised populations (Blacks in America, Dalits in India, LGBTQI persons everywhere) is necessary for any health initiative to make lasting change. Second, he drew attention to the power of networks in bringing movements together. The importance of this is reflected in the understanding of racism as an issue of lives, livelihoods and public health, all together. Third, he brought focus to the people who will live with the legacy of this planet and this pandemic, the youth of the world. Taking the streets and social media by storm, evidently, the youth want to speak about the issues that affect them. Health policies and programmes must listen.
The way forward, for good
If one goes back in time to 2012, to the birth of the Sustainable Development Goals (SDGs), they will find a resolution adopted by the United Nations General Assembly called ‘The Future We Want’, where nations committed to eradicating various levels of inequality. Eight years on now, as the COVID-19 crisis is carried on the backs of the same inequalities of the past, the glaring call for social justice cannot possibly be ignored. Another eight years in the future, global health policy and systems must be compelled to eradicate all forms of inequity and inequality, while also being prepared for ‘The Future We Didn’t Anticipate’.
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This article is a reflection by Dr Surbhi Shrivastava following the COVID-19 Open Online Briefing of Dr David Nabarro on 16 June 2020. It forms part of a collaboration between 4SD and One Young World to inspire greater systems leadership amongst youth during the COVID-19 pandemic.
Surbhi is a Senior Research Associate at the Centre for Enquiry into Health and Allied Themes (CEHAT), a non-profit organisation in Mumbai, India.
A dental surgeon and public health researcher by qualification, she works on issues of gender equity and women’s health. During the COVID-19 pandemic, she has been managing a rapid-assessment of essential health services in 11 municipal hospitals of Mumbai for dissemination among various communities.
She is a scholar of AstraZeneca’s Young Health Programme and a One Young World Ambassador.
COVID-19 Open Online Briefing #25
Tuesday, 16 June 2020
17:00 – 18:00 CEST
The views and opinions expressed in these reflections form part of the collaboration between 4SD and One Young World to inspire greater systems leadership amongst youth during the COVID-19 pandemic. They do not necessarily reflect the official policy or position of 4SD as an organisation or it’s associated personnel. Any content provided by authors are of their opinion and are not intended to malign any religion, ethnic group, club, organization, company, individual or anyone or anything.
One Young World (OYW) is the global forum for young leaders. OYW identifies, promotes and connects the world’s most impactful young leaders to create a better world, with more responsible, more effective leadership. The annual OYW Summit convenes the brightest young talent from every country and sector, working to accelerate social impact. Learn more about OYW at https://www.oneyoungworld.com/
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