While scientists and big pharma work on vaccines, innovations and solutions developed at the community level will be key to slowing the spread of the virus.\ ______________________________________________________________________________________________________________________

By Katusha de Villiers

As the US and the UK brace for an escalation of the COVID-19 pandemic, many South Africans remain hopeful that our government’s swift and ruthless response will save us from a worst case scenario outbreak.

Learning from outbreaks in other countries, South Africa implemented its lockdown early and with some of the strictest regulations in the world. The move was both a reflection of the fragility of our public healthcare system as well as the vulnerability of huge sections of our population. The picture is similar across Africa and in countries like India, which is attempting to lockdown a population of 1.3 billion people.

In countries like these, decisive government action is needed, but we also need creative solutions to do more with less and bring healthcare into underserved communities where the virus can spread fastest and to most devastating effect.

Innovation through collaboration

Developing countries are, of course, used to making do with less and, as a result, are no strangers to grassroots innovation. To deliver affordable and accessible healthcare with limited budgets, innovation is vital – and there is indeed an abundance of health care solutions that have successfully been implemented by passionate change-makers across Africa, Asia and Latin America. To scale up these innovations and to test and develop new ones, the Social Innovation in Health Initiative (SIHI), a project of the Special Programme for Research and Training in Tropical Diseases, at the World Health Organization, has been working to catalogue and connect social innovators in health across the global South since 2014.

There is much that their experience can teach us during this time of crisis. Firstly, SIHI shows us that building enduring relationships between those who are already innovating on the frontlines and connecting them with other players in the healthcare sector such as community healthcare workers (CHWs) and government, is key. This collaboration does not have to involve shared projects or budgets, it is instead a sharing of ideas and challenges, inspiration, successes and research. We saw this in countries like Liberia during the 2014 Ebola outbreak, where CHWs became a critical source of information for government on how the disease was spreading and in implementing controls to contain it.

Innovation does not happen in a vacuum and no matter how innovative, a single actor in isolation cannot hope to do this work alone. The COVID-19 crisis is bringing this home to us like never before. This crisis cannot be contained neatly within borders and there’s an urgent and obvious need for collaboration across governments, healthcare bodies and more broadly with NGOs, faith-based organisations, grassroots individuals and more.

Responding to needs in a novel way

SIHI’s experience also shows us that innovation is a state of mind. It does not need to be high-tech and expensive; what you really need is a big idea and a person or group of people responding to a need in a novel way. In fact, most social innovation comes from committed individuals and organisations working with very little resource on the frontline of community well-being. They often cut across traditional silos and sit outside of traditional boxes. For example, the Abalimi Bezekhaya community garden in Khayelitsha is responding to the COVID-19 crisis with yet another innovative pivot. The organisation is taking seeds, seedlings and manure and selling these at nominal cost, together with free adviceand mentorship, to home and community gardens across the Western Cape. This reduces the need for farmers to use public transport to collect resources for their gardens so that food production can continue uninterrupted without increasing the risk of contracting COVID-19.

Such innovative solutions often start small. Here in South Africa, the Vula health app is another example. The app, which allows primary healthcare workers to liaise directly with on-call specialists to improve and speed up the referral process, started when an ophthalmologist in Eswatini realised he could diagnose simple conditions like sties at the point of care by getting nurses to send pictures via their mobile phones. It has evolved to include on-call specialists in cardiology, orthopaedics and burns. It’s saving patients from unnecessary travel and making sure those who really need treatment get it quicker.

Each one of us has a role to play

During this time of crisis, recognising and connecting with innovators on the frontlines – no matter how small or insignificant they appear is going to be vital. While the pandemic runs its course, and citizens across the world are told to stay indoors, the battle may well be won or lost at the community level. This is especially true for under-resourced communities where public healthcare systems are ill-equipped to cope and cramped conditions are making social distancing difficult. While the South African government proposes to solve this partly by relocating whole communities, this is clearly not going to be possible for everyone.

It’s worth remembering that it’s not just nurses and CHWs who are at the coalface of containment efforts, but all of us as individuals too. Across the world, lockdowns and social distancing measures remain the chief strategy in efforts to slow the spread of the virus – we are each being asked to take responsibility like never before.

Every week, more stories surface of how communities are rising to the call. From the Bo-Kaap family who mobilised their whole community after a family member contracted the coronavirustoteachers in the UK using their free time to make protective visors for NHS staff, people are finding innovative ways to protect their fellow citizens and fight this pandemic. This is social innovation in action.

While the scientists and pharma companies continue to work on vaccines and treatments, we need to take the best of these local innovations and ideas and share them across our global community, as quickly as the virus itself is spreading.

Katusha de Villiers, Acting Senior Manager & Senior Project Manager at the Bertha Centre for Social Innovation at the UCT Graduate School of Business, one of the implementing partner of SIHI. SIHI's other partners include the London School of Hygiene and Tropical Medicine, the University of the Philippines, the University of Malawi, Makerere University, Uganda, and the Pan American Health Organization.