SYDNEY – Greater meaningful engagement with communities confronting disease threats should be prioritized in efforts to strengthen global health security moving forward, leaders said here on Thursday. Communities and their cultural practices and traditions should no longer be viewed as obstacles getting in the way of implementing activities related to preventing, detecting and responding to infectious disease threats, but should be placed at the core of responses, Amanda McClelland with Resolve to Save Lives, said. Putting communities at the center of the development of global health security interventions not only builds trust, it also results in stronger programs, panelists said.
“If you’re trying to engage with communities after the start of an outbreak, you’re too late,” Peter Sands, head of the Global Fund to Fight AIDS, TB and Malaria said. “You need to build engagement with communities in an everyday manner.”
This includes not only understanding cultures and traditions before going into communities, but “using the local community members to build programs,” Stella Chunong of the World Health Organization said. “Get their input, let them inform programs and tailor interventions to community needs,” she said. “Their contributions are more credible than that of international experts,” she said.
“We need to look to communities for solutions,” McClelland said, recalling that there are communities in Ebola-stricken areas that practice traditional forms of quarantine in which outsiders are required to stay outside the village limits for four days before being allowed in.
The current Ebola outbreak in the Democratic Republic of the Congo should have been controlled by now, as past outbreaks were swiftly controlled, McClelland said. Had health authorities and foreign assistance programs built more trust among affected communities, the Ebola response would have been more successful by now, panelists said.
“A lot of outbreaks are happening right now due to politics and social constructs,” McClelland said. “There’s a measles outbreak two miles from my home in New York City because of political issues,” she said.
Keeping affected communities at the center of global health security responses also means addressing their basic needs on top of building surveillance and lab capacities along with other outbreak detection and response efforts, panelists said. “When every day they are saying we need drinking water and they don’t get it, and then something happens, and you go in and say, we need you to do 1, 2, 3, and 4, why would they listen to you?” Chunong said.
Building community trust also includes mitigating viral misinformation along with actual viruses, McClelland said. Even in rural areas, misinformation on everything from vaccines to health centers contribute to distrust and complicates outbreak responses, she said. “We need to identify this as a new emerging threat and we need better countermeasures to contain viral misinformation,” McClelland said.
Rabita Aziz is senior global health policy specialist at the Infectious Diseases Society of America, which produces this blog.