Health Systems Strengthening

Pandemics challenge the efficacy and resiliency of many systems, including the pharmaceutical system—how medicines and other medical products are managed in health systems. That’s particularly true in low- and middle-income countries, which already face significant challenges in securing sustainable access to and appropriate use of quality-assured affordable medical products.

As governments, researchers, and health care workers work to develop and deliver medical products to adequately prevent, test for, and treat COVID-19, countries will benefit from a response that strengthens the pharmaceutical system to ensure that any medical product deployed in the pandemic protects and promotes public health as opposed to causing harm. 

Key areas country governments and development partners should focus on include:

Nwando Mba is the Director of Public Health Laboratory Services at the Nigeria Centre for Disease Control (NCDC), a sub-recipient to the Resilient and Sustainable Systems for Health (RSSH) project, funded by the Global Fund and managed by MSH. A medical laboratory scientist by profession, Mba started her career over 30 years ago in Nigeria’s Vaccine Production Laboratory at Yaba, Lagos. Mba discusses Nigeria’s efforts to increase the country’s testing capacity for coronavirus.

Andre Zagorski of the MSH-led, USAID-funded MTaPS Program talks about the program's urgent work to help contain the virus in more than a dozen countries.

Andre ZagorskiHow did you and MTaPS rally to support USAID’s call for a rapid response to COVID-19 in a dozen countries? What were the challenges? 

MTaPS is the USAID Global Health Security Agenda (GHSA) go-to program for infection prevention and control (IPC), and we have been implementing activities to strengthen health systems for stronger IPC programs in 10 countries since the MTaPS award in 2018. We have offices and small but strong professional teams in these countries and have established productive working relations with national stakeholders and partners.

Story by Samy Rakotoniaina and Misa Rahantason

Malaria is one of the leading causes of mortality among children under five in Madagascar. Atsimo Andrefana is one of Madagascar’s regions most severely impacted by endemic malaria. More than half of the population in this region lives more than five kilometers from the nearest health facility, putting Community Health Volunteers (CHVs) on the front lines in the fight against malaria.

Retsilake is one of the 6,000 high-performing CHVs supported by the USAID-funded Accessible Continuum of Care and Essential Services Sustained (ACCESS) project. ACCESS is implemented by Management Sciences for Health (MSH), in partnership with a consortium of international and local organizations, and alongside Madagascar’s Ministry of Public Health. The project is partly funded by the U.S. President’s Malaria Initiative (PMI).

Retsilake diagnosed and treated nearly 2,000 children from his village and the surrounding area during a particularly severe malaria outbreak in 2015. He understands the impacts of malaria on children's health and this keeps him motivated to serve his community.

Raian Amzad, a technical advisor with the DFID-funded Better Health in Bangladesh (BHB) project, and her colleagues took time away from their regular work to help Bangladesh’s central response to COVID-19. Here’s how the project and the country are handling the pandemic threat. 

Can you tell me about your recent work assignment related to COVID-19? What did your typical day look like?

On March 17, the Directorate General of Health Services opened a temporary Integrated Control Room for COVID-19 response. Fifteen different groups are working there. I was in one with other developmental partners.

The control room guides, supervises, and monitors the entire country in responding to COVID-19; facilitating meetings with donors; disseminating awareness messages and myth busters for the public; developing guidelines for the health workforce; and coordinating logistics, commodities, and media outreach. I have been engaged in all sorts of tasks, and it was enlightening to work so closely with the government health system. 

COVID-19’s lethal invasion in late 2019 has turned the world inside out. Yet, another disease, tuberculosis, has been plaguing humans since the Upper Paleolithic era, some 20,000 years ago. In fact, many infection-prevention precautions promoted for the coronavirus—coughing etiquette, distancing, and hand washing—originated as TB-control measures in Victorian times. The COVID-19 response can draw on more challenges and lessons from TB programs that emphasize investments in research and rapid uptake of new diagnostic, prevention, and treatment tools for universal health coverage.

This article was originally published in NextBillion.

What does scalable innovation in global health look like?

It could be a piece of software that provides faster access to blood supplies in Cameroon, an m-health platform that links virtual health coaches to people facing chronic illness in Nigeria, or an app that lets people use points to buy and exchange health products in Senegal, helping them save for out-of-pocket expenses. Or it might be a primary care service that reaches underserved people in India via telemedicine, or a microscope app that can diagnose breast and cervical cancers in remote areas in sub-Saharan Africa, where some 400,000 women die each year because they cannot access screening services.