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Coronavirus (COVID-19) and continuity of AMF operations - Update 22 Apr 2020

www.medicalgraphics.de (CC BY-ND 4.0)

Since our previous update, the eight countries where AMF is working have all implemented COVID-19 measures. These are affecting our programmes in different ways and more detail is provided below.

We are in regular contact with our partners to receive updates and discuss adjustments to plans. This is particularly important for the four countries in which we have 2020 net distributions planned – DRC , Uganda, Togo and PNG. We continue to support the strong guidance from WHO to maintain malaria prevention activities. Halting or delaying net distributions could well result in a spike in malaria cases and deaths that exceeds the potential harm caused by COVID-19. It is of course vital that all measures are taken to ensure the safety of the health workers that carry out distributions and we are discussing with our in-country partners the changes needed to our normal procedures.

The Alliance for Malaria Prevention (AMP) has recently published guidelines for carrying out distributions in COVID-19 affected countries. To reduce the chance of transmission, training will be carried out remotely and distribution sites that attract crowds will be avoided. The registration process – the door to door visits where each household is surveyed to understand the net need – is likely to be simplified. These changes will mean that net need is not known as accurately as in a normal distribution and it is therefore likely that an increased number of nets will be required to reach similar and acceptable levels of coverage. Other factors that are likely to increase net need include: the recommendation that those suffering from COVID-19 self-isolate and sleep separately; nets that have been used for COVID-19 sufferers may be rejected afterwards for fear of infection.

Many tools are available for tracking COVID-19, but we have been using this one to follow the cases in the countries in which we’re working. This graphic also shows a visualisation of the propagation of COVID-19 through the continent of Africa.

Impact on AMF’s programmes

Distributions

DRC – Going ahead as planned (with COVID-19 related operational adjustments)
The distribution in Sud Ubangi province is going ahead and is due to begin on May 5th. It will be a door to door distribution (as always planned) and not a ‘fixed site distribution’ where people would gather to receive nets. The PNLP has confirmed to us that PPE equipment will be available to all health workers and we will be monitoring closely the delivery and availability of this protective equipment. As current measures prohibit travel from Kinshasa to the provinces, the normal national staff from the NMCP and our distribution partner will not be present in the province. Risk mitigation measures have been taken and AMF has increased its independent monitoring presence in Sud Ubangi with our independent monitor RHA. Distribution in Haut Katanga is still due to go ahead, and discussions are ongoing as to how to reorganise the distribution which was originally planned as a fixed site distribution.

Uganda – Temporary delay
2020 distribution campaign on hold until current lockdown ends. Last week the 14 day lockdown was extended until May 5th. Currently, this is a 6 weeks delay to the net distribution.

Togo – Currently going ahead as planned
Discussions are continuing to establish what operational changes may be needed for the 2020 distribution. Currently the country is not in full lockdown, but a curfew and social distancing measures are in place.

PNG – Going ahead as planned (with COVID-19 related operational adjustments)
Social distancing measures are in place but distributions are continuing as they have been deemed an essential activity by the government.

Post-distribution monitoring

Guinea – Going ahead as planned (with COVID-19 related operational adjustments)
The final PDM at 9 months is going ahead this week with the following measures taken in line with government advice: 4 people per vehicle, 2 masks per day for all workers, alcohol solution, regular hand washing, social distancing, hygiene measures and temperature checks on leaving Conakry. We will continue to monitor closely the situation.

AMF’s PDM activities have been delayed in some countries as follows:

Ghana – Temporary delay
There is a 2-month delay to PDMs due to lockdown. The situation will be reviewed in 10 days when the current lockdown period ends, although high COVID-19 cases may mean that there is an extension.

Malawi – Temporary delay
There is a 2 month delay to PDMs due to COVID-19 measures. A three-week lockdown began last Saturday but has since been overruled by the high court.

Zambia – Temporary delay
PDMs have been suspended due to measures taken by the government. The country is not a full lockdown and options for continuing monitoring work are being explored.