Civil society has an immediate role to play in the response to COVID-19. In Senegal and in West Africa, humanitarian organisations and associations are in the front line to implement several response actions: support in medical equipment to health structures, sensitisation of populations, distribution of personal protective equipment to populations or support in food kits. In this interview, Daouda Diouf, Executive Director of ENDA Santé, explains the essential role of community organisations in the response to the epidemic and discusses the issue of vaccines.
The epidemiological situation of the coronavirus is constantly changing and the strategies implemented do not stop its progression. In view of the successes achieved in the fight against AIDS, what recommendations do you have?
What we have learned from the fight against AIDS is that strategies must always be adjusted, approaches diversified and, above all, the involvement of all actors must be strengthened according to their knowledge of the field and the importance of their contribution for an effective response. In fact, in order to deal with the AIDS epidemic, there was a phase during which efforts were almost exclusively concentrated on finding a treatment (drugs) for infected people, a vaccine and hospital care. Very quickly it was realised that this strategy was important but not sufficient.
This is where another global adjustment was made to involve community actors. Their proximity to communities through prevention, awareness-raising and social communication activities has been decisive for access to screening and treatment, psychosocial support, stigma reduction and the reduction of new infections. We have thus understood that, alongside a health system, it is essential to have a community-based health dynamic that offers services as close to the people as possible and that allows for more precise targeting of people in vulnerable situations.
In its communication, the Ministry of Health invited all civil society structures to get involved in the response. Is there a national platform for the response to COVID through which all stakeholders are represented?
There are many bodies fighting against COVID, but it must be recognised that the involvement of civil society is not as strong as one might expect in a country like Senegal. Inviting civil society is a very good thing, but it is already doing remarkable work in the fight against COVID at the community level. What is needed is to organise a clearer, more formal framework through which the contributions of all parties are valued. Civil society could play a more important role in what is being done at national level. The issue of community mobilisation has been much discussed.
We have seen government structures get involved in community mobilisation, which is very good, but I think we would have a stronger and more sustainable community commitment if it were already based on community structures. There are community structures in every neighbourhood and village in Senegal, and they work on a voluntary basis and do not need to be funded to do this. They have already had to do this on many occasions, whether it be for child immunisation, malaria, HIV/AIDS or tuberculosis. There is a potential and there are organisations that have a good knowledge of the field and relevant approaches to mobilise communities in the long term.
What lessons can be learned about health disaster management and community sovereignty?
It is important to build community resilience to emergencies. Because, let's not forget, before, during and after disasters or emergencies, communities are always there. We know that our states do not have the capacity to deal with all unexpected and difficult situations, so we need to invest more in preparing and supporting local communities. This could be a good policy to be able to cope with possible emergencies or disasters that might hit our countries.
Following the example of the international community, the health authorities are turning to the vaccine, but the population does not seem convinced. How do you read this?
We are in a democracy, and people must be given the right to say whether they agree or not. Our role as community actors is to give the right information, to be transparent and to communicate widely with the population. There are legitimate fears, but they must be dispelled with good communication. All the resistance to vaccines is mainly linked to the circulation of false information (Fake News) that is widely disseminated, to fear and to the many conspiracy theories, but this has always existed in the face of new facts.
However, conspiracy theories do not stand up for long to the force of scientific evidence and health benefits that each person will be able to appreciate for themselves over time. There will always be some people who will continue to be reluctant, but this does not mean that we should talk about disaffection or lack of support. I am convinced that when people are given the right and true information, they will make the best decisions.
Enda Santé, 26 February 2021