How can international development organizations prepare their projects for the impacts of Coronavirus?

By Morgan Johnson | 11 March 2020
Maureen Miller
New York, New York

An expert in infectious disease, epidemiology, and medical anthropology

Maureen Miller, PhD, is an infectious disease epidemiologist and medical anthropologist. Her career straddles academic and public spheres. Dr. Miller ...

OnFrontiers spoke with Dr. Maureen Miller from our expert community – an epidemiologist and medical anthropologist – about how International Development organizations can prepare and protect their projects and beneficiaries around the world from the impacts of coronavirus. 

As coronavirus spreads around the world businesses, governments, and media continue to evaluate how we should react, both as individuals and as organizations. But despite the prevalence of coronavirus in public addresses and mainstream media conversations, the global impacts of the virus – especially on the developing countries around the world – are often left out of the conversations.

For international development companies with projects across Africa, Latin America, and Asia – it is critical to understand how the coronavirus will impact their work around the world, and the beneficiaries they are serving.

In order to better understand these impacts, and what International Development organizations and Project teams can do to prepare and protect the communities where they work, OnFrontiers spoke with Dr. Maureen Miller from our expert community.

Dr. Maureen Miller PhD, is an infectious disease epidemiologist and medical anthropologist who has been involved in applied infectious disease prevention research, programming and policy since the 1990s. She has published 50 theoretical and research articles in peer reviewed scientific journals, and consults regularly with governments and non-governmental organizations around the world. 

Where we are today:

“In the 20th century, we’ve recognized 4 different coronaviruses that have been transmitted from animals to humans. These 4 coronaviruses continue to be the cause of 25% of winter colds,” Dr. Miller says. “The current coronavirus which causes Covid-19 (similar to how the HIV virus causes AIDS) is a novel strain, and one which is particularly insidious because of how easily it spreads from human to human and how long it can linger on surfaces like doorknobs, tables, phones or any other hard surfaces.”

One of the key challenges, she explained, is that people can begin spreading the virus 2-3 days before they become symptomatic. With the limited tests that have been available around the world, and with how common and seemingly innocuous the symptoms can be in many people, the virus has likely already spread far beyond the locations where there have been identified and confirmed cases.

Another challenge, as Dr. Miller explains, is that we still don’t know how to treat the virus. “Currently, we’re just treating symptoms, but we have no way of effectively treating the virus itself,” she says. And while the official mortality rate is likely higher than the true mortality rate, because of the number of un-identified and unconfirmed cases, the lack of any identified treatment options for the virus itself leaves many at-risk populations particularly vulnerable for severe Covid-19 disease. 

Again, because of the lack of hard data and official research, it’s hard to say anything definitively, but the most vulnerable populations are typically the elderly and populations with pre-existing health conditions and compromised immune systems. Among these populations, the mortality rate will be higher. 

What that means for developing countries:

There have already been confirmed cases of coronavirus in every continent except Antarctica. Developing countries will likely be hit harder by the coronavirus as it continues to spread because of challenges with medical infrastructure as well as other public health and communicable disease issues prevalent in these countries.

“In the US, vulnerable populations likely include the elderly, people with pre-existing heart or lung issues, diabetes – anyone who may have a compromised immune system due to chronic health conditions. But in places like Africa, much larger proportions of the population may be considered at risk,” Dr. Miller explained.

“Obviously anyone who is HIV infected would be considered at risk, but also anyone who has TB, anyone who is malnourished, or anyone who even has malaria. All of those populations may be more vulnerable to the virus, and across Africa and other developing countries around the world, those populations include people of all ages.”

How can international development organizations prepare and protect their beneficiaries?

International development organizations, with their projects and field offices embedded in communities all around the world, are arguably better placed than many country governments to prepare and protect the communities they work with from the impacts of coronavirus. The power to implement coronavirus containment and mitigation strategies has just been vastly increased by the WHO with their declaration that the coronavirus is pandemic. So what can organizations, and individual projects, begin doing to protect the communities where they work?

  1. Educate the communities you work with
  2. Utilize existing infrastructure to reach at-risk populations
  3. Start developing infrastructure
  4. Explore procurement options for coronavirus test kits

1. Educate the communities you work with:

This is one of the most effective things that international development organizations and projects can begin doing with their communities immediately. Raising awareness and educating project beneficiaries about coronavirus and behavior change approaches to reduce the risk of contracting and spreading the virus doesn’t take any particular technical expertise. Of course, the information has to be accurate, but most organizations and projects already have the basic infrastructure in place to quickly spread the word and educate the communities where they work.

2. Utilize existing infrastructure to reach at-risk populations:

HIV/AIDs populations, TB patients, malnourished populations – most of these groups have already been actively identified and have programs in place to support and treat their conditions. Many of the most vulnerable and at-risk populations have existing infrastructure which can be utilized to educate, monitor, and eventually test for coronavirus. However, since the coronavirus is anticipated to infect 40% to 70% of the global population, it is important not to increase the stigma of at-risk populations.

3. Start developing infrastructure:

Apart from educating populations on the virus and specific mitigation strategies and techniques like hand washing, there are some basic infrastructure changes that can help reinforce those messages.

“Ebola can be an excellent model for this,” says Dr. Miller. “During the outbreak, and even afterwards, there were hand-washing stations placed at the entrance of every building. Little infrastructure changes like that can make a big impact on people’s behaviors and the effectiveness of the education and messaging.”

4. Explore procurement options for coronavirus test kits:

“One of the main failures with the US response to coronavirus has been the approach to testing, which has made it even more difficult to identify and track people who have contracted the virus,” Dr. Miller claims. “This was part a policy failure, trying to keep the testing centralized with the CDC. But another challenge has been the procurement and supply of test kits themselves.”

“Viral test kits are fairly easy to develop for countries that have the labs and resources available. Egypt, South Africa, India, Thailand – all of these countries should have the capacity to develop viral test kits for coronavirus.”

In Africa, Asia, and Latin America organizations and development projects should begin exploring procurement options for these test kits from countries and labs which are close by in order to build stable supply chains and have them on hand for if and when the virus hits their communities.

If you would like to speak with Dr. Miller, or have any other expert need related to coronavirus contact mjohnson@onfrontiers.com for more information. 
An expert in infectious disease, epidemiology, and medical anthropology
New York, New York
Executive Director, MMEpidemiology

Maureen Miller, PhD, is an infectious disease epidemiologist and medical anthropologist. Her career straddles academic and public spheres. Dr. Miller has been involved in applied infectious disease prevention research, programming and policy since the 1990s, has published 50 theoretical and research articles in peer reviewed scientific journals, and has a proven track record in attracting funding for the conduct of innovative research in resource poor settings. In addition to conducting research, Dr. Miller consults regularly with governments and non-governmental organizations around the world. Her completed projects range from the evaluation of an urban syringe exchange program that resulted in national program expansion; to the development of an analytic framework to evaluate international health programs in terms of gender health equity and human rights; to the creation of a simple, targeted and flexible biological behavioral surveillance system to identify emerging infectious diseases at their point of origin