The United States Agency for International Development (USAID), the New Partnerships Initiative, Expanding Health Partnerships (NPI EXPAND), SITAWI (Finance for Good) and the Leônidas & Maria Deane Institute (ILMD/Fiocruz Amazônia) partnered to support the Response to COVID-19 in the Brazilian Amazon Region. The Response to COVID-19 in the Brazilian Amazon - Phase 2 is an initiative that involves civil society organizations in strategic partnerships to boost innovative and scalable solutions to strengthen the fast response to COVID-19. The work will be developed within the riverside population, indigenous, immigrants and quilombos in the states of Amazonas, Acre, Roraima and Rondônia.
The head of Fiocruz Amazônia, Adele Schwartz Benzaken, explained that the planned interventions for the project make a full “pack” of intervention, considering the importance of each one of the activities to be developed during each front (photo: Fiocruz Amazônia)
The project, entitled Amazon: Science, Health and Solidarity in the Confrontation of the Covid-19 Pandemic, relies on the support of Fiocruz Rondônia and Foundation for Scientific and Technological Development in Health (Fiotec). The project shall operate on three fronts and shall happen simultaneously in the four states over the next eight months. The operate fronts shall be: Qualification and training of community health agents, indigenous community health agents and endemic control; Genomic surveillance to diagnoses and training teams of central and border labs, broad support to vaccination, and, finally, broad, effective and equity access to the information on the COVID-19 vaccine, strengthening the fight against fake news.
In August, a team of NPI EXPAND consultants met with Fiocruz Amazônia board to discuss the action strategies of the project, as well as the deadlines for the execution of the work schedules. The activities related to Front 1 of the project have already begun to be executed. The head of Fiocruz Amazônia, Adele Schwartz Benzaken, explained that the planned interventions for the project make a full “pack” of intervention, considering the importance of each one of the activities to be developed during each front. “The Fiocruz Amazônia has been acting in a decisive way in the health professionals qualification in the hinterland of Amazonas and now takes the challenge of working in other states, being consolidated as an agent of health professionals qualification in Amazon”, she stated.
Further, she reminded that the expertise acquired by Fiocruz Amazônia during the COVID-19 pandemic enabled the institution to be consolidated in generation of knowledge and innovation in different areas. Regarding the Genomic Surveillance (VG) of emerging, reemerging and neglected viruses in the Amazon region, the researchers team of ILMD has collaborative actions with other actors for more than 15 years, in the states of Amazonas (AM), Rondônia (RO) and Roraima (RR).
The Front 2 of the project, in partnership with USAID/NPI Expand, expects support actions to the local lab infrastructure, performance of genetic sequencing and training of different techniques and laboratory procedures, with the due transfer of protocols. “We are from here and here we will stay, it is important that we consolidate the qualification of the health professionals who work in the hinterland of the State as an important legacy to Amazon", Adele Benzaken observes.
The leader of the NPI Expand National Team, Nina Best, highlighted that the project is part of a global program of USAID in response to COVID-19, with actions in several countries that present similar characteristics to Brazil, with specific constructions for each reality. “Today we have a portfolio with 23 different initiatives, working with a wide range of organizations, and now we are privileged to have the partnership of Fiocruz Amazônia, along with socio-environmental, indigenous, art-education in health non-governmental organizations spread in the Amazon,” Nina explained.
“We intend to make this set of actions to affect the health agenda in these Amazon territories, with their riverside and indigenous populations, introducing interesting discussions on topics like deforestation, climate changes, endemics and pandemics. We are in a region of many emerging viruses, and the initiatives of the USAID/NPI Expand partnership create the opportunity for us to make these connections here. Health and environmental conservation walking together within a single concept, always highlighting the importance of access to public health policies within the Amazon context, where the populations face many challenges, being most of the time the ones responsible for keeping the forest standing and acting in several other sustainable productive chains", she clarified.
To Nina, the challenge is huge. “COVID-19 is the gateway of the project and, although we are at a different point in the pandemic, we know that we can learn from each phase. We launched the Notice last year with the objective of strengthening the promotion of vaccination against COVID-19, as a deliberate intervention strategy, and to strengthen the local health systems, including for the confrontation of new potential pandemic threats”, she observed, noting that there are cities where vaccination coverage is still low and it is necessary to intervene.
Fiocruz Amazônia and the Office of Fiocruz of Rondônia, through Fiotec, executed the QualificaSUS, a program focused on the qualification actions of the workforce of the Unified Health System in the hinterland of Amazonas. QualificaSUS qualified 5,026 ACS (Community Health Agents) and ACE (Endemic Control Agents) in the 62 cities of Amazonas, through the education actions within the courses: Organization of actions of surveillance, prevention and control of reportable diseases, and Organization of monitoring actions for immuno-preventable diseases.
The partnership with the cities was due to the signature of Technical Cooperation Agreements between the Municipal Health Departments and Fiocruz Amazônia, effective up to the year 2023. And it was through QualificaSUS that the Institute defined that one of the strategies in the fight against COVID-19 would be through educational actions focused on Community Health Agents (ACS), Indigenous Community Health Agents (ACSI) and Endemic Control Agents (ACE), considering that these professionals are almost always the first contact with the population belonging to groups in vulnerable situations, such as indigenous, riverside, African descendent and residents of remote areas.
About the partners
In Brazil, USAID, NPI EXPAND and SITAWI Finance For Good, got together to create a partnership to support the Response to COVID-19 in Amazon. Between 2020 and 2021, the first phase of NPI EXPAND Response to COVID-19 project in Amazon, distributed more than 23,000 food baskets and hygiene kits, trained more than 500 community health agents, donated more than 1.4 million masks made by local seamstresses and spread educational prevention messages to more than 875,000 people in the region. Phase 2 is promoting bigger resilience of the Amazon communities through broad support for vaccination against COVID-19, information and fighting fake news campaigns, and supporting local health systems in the region with equipment and supplies to detect, prevent and control Covid-19 transmission, as well follow-up of acute COVID-19 cases and treating post-COVID-19 sequelae syndrome.