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Improving Health Resilience through Pandemic Response: Lessons from COVID-19 in Eastern Caribbean Countries

Medical workers doing analysis in laboratory during corona virus outbreak.

Medical workers doing analysis in laboratory during coronavirus outbreak.

Alessandro Biascioli | Adobe stock

Eastern Caribbean countries were hit hard during the COVID-19 pandemic and the World Bank provided critical support by reallocating US$ 15 million using the Contingency Emergency Response Component (CERC) available through ongoing health projects. [1] These funds addressed emergency response needs, strengthened the capacity of the health system, and supported frontline health workers during the public health emergency.

The COVID-19 pandemic has disturbed the economic and social well-being of Eastern Caribbean countries. In addition to the health impact of COVID-19, the pandemic’s socio-economic impact has been severe. In 2020, Gross Domestic Product (GDP) contracted as much as 16-20 percent in some Caribbean countries. International travel was almost completely halted to contain the spread of infections, which impacted countries within the Organization of Eastern Caribbean States (OECS) earnings from tourism enormously, as tourism accounts for 35 percent of GDP on average in these countries and provides more than half of all jobs. Non-tourism-related economic activities also contracted due to disruptions in international logistics and supply chains, as well as the implementation of social distancing measures including curfews and business closures.

In addition to the pandemic, OECS countries have had to grapple simultaneously with the impact of natural disasters and outbreaks of other infectious diseases. In April 2021, the La Soufrière volcano in St Vincent and the Grenadines erupted, which further affected access to health services and the economy of the island. Outbreaks of Dengue Fever also affect Caribbean countries regularly, adding further pressure to their already constrained medical resources.

The response

To address the public health emergency, the World Bank activated the Contingent Emergency Response Component for Dominica, Grenada and St Vincent and the Grenadines. CERCs are a World Bank financing instrument that allows for the rapid reallocation of funds from ongoing operations, to cover immediate needs in case of a disaster or public health emergency. In these three countries, the CERC was activated through the ongoing OECS Regional Health Project as early as April 2020, which allowed for the reallocation of US$ 10 million to emergency response. [2] Additional funds were also provided for these countries from the Pandemic Emergency Financing Facility in November 2020.

The funding helped countries to strengthen their pandemic response: it allowed them to quickly procure essential pharmaceuticals, medical and laboratory supplies, and equipment. The financing also helped to expand laboratory testing capacity, strengthen health facilities’ isolation capacity, and purchase personal protective equipment and sanitizing products. Two containerized labs were established on Canouan Island and Union Island in St Vincent and the Grenadines, and a mobile unit was installed at the Roseau Health Centre in Dominica. In total, these investments benefited over three hundred thousand people in the three countries, at a critical time.

“We appreciate all members for their strong commitment to this project, despite the challenges encountered and the increased workload involved in our robust response to the ongoing pandemic and regional public health", said Dr. Lisa Indar, Director of the Surveillance, Disease, Prevention and Control at the Caribbean Public Health Agency Caribbean during OECS Regional Health Project Advisory and Mid-term Review meeting.

”Under the OECS Regional Health Project,  significant strides have been made towards the development of an inventory and Geographic Information System (GIS) mapping of emergency and critical care facilities and services, harmonized registration of health professionals; and has advanced efforts towards the creation of a multisectoral, multi-hazard emergency preparedness, mitigation, response and recovery mechanism within the Region,” says Mrs. Faith Harry – Jn Baptiste, Project Manager at the OECS Commission.

As the world is steadily returning to normal, the World Bank is capturing lessons learned from the COVID-19 pandemic in real time to further strengthen health systems. Major infectious outbreaks have the potential to exert a significant negative impact on health systems, as existent resources are diverted toward responding to the outbreak. The COVID-19 crisis, for instance, resulted in major shortages of medical products, and in an increase in their prices. Many people also delayed seeking care, particularly those with chronic conditions, and shortages in human resources and infrastructure meant the disruption of regular health services, delaying healthcare for many non-COVID-19 conditions. Improving health systems’ resilience to health emergencies has proven key to withstand shocks without major disruptions.

To replenish the financing gap left by the activation of the CERC, facilitate the transition to recovery and increase resilience, the World Bank approved additional financing later in 2020 for Dominica, Grenada and St Vincent and the Grenadines. This additional funding is playing a crucial role in helping OECS countries to improve their health security by strengthening resilience to climate change and extreme weather conditions, and by improving disease surveillance and laboratories’ capacities. Countries are also developing regional and country-specific preparedness and response action plans and strengthening their emergency management capabilities to be able to withstand future health crises.

[1] The CERC was activated for Dominica, Grenada, and Saint Vincent and the Grenadines under the OECS Regional Health Project, for a total of US$ 10 million (i.e., US$2.5 million for Grenada, US$3 million for Dominica, and US$4.5 million for Saint Vincent and the Grenadines). Saint Lucia, in turn, activated the CERC under the Health Systems Strengthening Project, for a total of US$ 5 million.  

[2] Saint Lucia requested activation of the CERC under the Health Systems Strengthening Project, which was approved for a total of US$ 5 million.


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