WASHINGTON — On an almost daily basis, FHI360, the North Carolina-based global development organization, has seen country offices close due to public health measures taken by governments in response to the spread of COVID-19.
“Today it was Nigeria ... Zambia and Zimbabwe. Two weeks ago it was the Philippines, Tunisia, Senegal, [and] Indonesia,” said FHI360 CEO Patrick Fine, speaking to Devex on Monday.
“It doesn’t do anyone any good if we cowboy into various settings and either bring the virus to settings that don’t have it or carry it back and expose others.”— Chip Lyons, president and CEO, Elizabeth Glaser Pediatric AIDS Foundation
“Progressively — like daily — we look and see, all right, what are the country offices [that are closing], and that means that the projects that are managed out of those offices move to remote status,” Fine said.
FHI360’s U.S. and regional offices in Africa and Asia are now all working remotely.
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As global health and development organizations transition more and more staff to work from home — with some international staff evacuating to their home countries — aid leaders are faced with striking a difficult balance between ensuring employee safety, and maintaining activities that support peoples’ health and livelihoods.
“The concern that I, and I think other leaders have, is that at some point activities that we're able to maintain through a remote status will either become no longer relevant to the conditions of the country, and there will need to be major pivots, or you'll just exhaust what you can do remotely,” Fine said.
“It may not result in the end of an activity, but it may result in a complete redesign of an activity,” he added.
For now, health and development organizations are working project by project, and country by country, to balance multiple — sometimes competing — priorities: protecting employees, preventing the spread of COVID-19, and continuing to deliver services where possible.
For organizations that provide critical care and services to underserved communities — like HIV prevention and treatment, for example — those tradeoffs can be extremely challenging to manage.
The question for these programs is — “what level of service, for people whose lives depend on that service, is going to be maintained,” said Chip Lyons, president and CEO at the Elizabeth Glaser Pediatric AIDS Foundation.
For global health organizations, preventing staff from contracting COVID-19 has to be the first priority, Lyons said, because doing so contributes to pandemic mitigation effort and allows organizations to continue functioning — even if they have to do so from a distance.
“It doesn’t do anyone any good if we cowboy into various settings and either bring the virus to settings that don’t have it or carry it back and expose others. Then inadvertently — and almost certainly unknowingly — we’re exacerbating the COVID problem,” Lyons said.
“My understanding is that at this time, no project has ceased operations.”— Susi Mudge, board of directors chair, Chemonics
“The key question for us is — what are the minimum requirements where we’re meeting both objectives — safety of staff, and continuity of services,” he added.
For many of EGPAF’s country directors, the minimum requirement for staff traveling to communities to provide HIV services is an N95 mask, hand sanitizer, and gloves. The country directors have told Lyons they are prepared to deploy essential staff to communities with those precautions in place, with the exception of people at higher risk due to COVID-19 — such as those over 60, those who are pregnant, or those with other underlying conditions.
“There is a tension between safety of health care workers and safety of staff and continuity of services and continuing trying to achieve targets that are set,” Lyons said.
“There wouldn’t have to be as much of a tension if there was adequate [personal protective equipment] available,” he added.
For development leaders, the past month has presented an unprecedented global test of whether the protocols they have developed to handle crisis situations can allow organizations to continue functioning under rapidly evolving conditions.
“Two weeks ago today, we did a trial run to see if we could operate our organization remotely, and it worked, and we have gone to remote work. That was literally two weeks ago,” Susi Mudge, former president and CEO at Chemonics, told Devex on March 25.
“My understanding is that at this time, no project has ceased operations,” said Mudge, who now chairs Chemonics’ board of directors.
At Chemonics, each project’s chief of party is responsible for reviewing their work plans and determining which activities can continue. Many have been postponed, particularly those that bring large groups of people together, such as training and conferences, Mudge said.
As the COVID-19 outbreak escalated, Chemonics elevated the situation from an “emergency” to a “crisis.”
“By treating it as a crisis, it allows us to really ensure that we're focusing, first and foremost, on our staff and their well-being. But also, how can we ensure that we can continue to deliver the work to the best of our ability, recognizing that this is a challenge that I think in many ways is testing us all,” Mudge said.
When it comes to deciding who should evacuate and who should remain in a particular country, Chemonics has followed the U.S. government’s lead.
“We authorized the departure of all international staff and dependents around March 19, following the global authorized departure that was announced by the Department of State for U.S. personnel. We just thought it was the right thing to do,” said Christina Johnson, Chemonics' global safety and security director.
Johnson added that some international staff have chosen to return to their “home of record,” while other international staff and their dependents have opted to remain in place.
“We recognize that this is a pandemic. There are health concerns associated with it. There is a lot of uncertainty. And so we're really leaving it to individual choice, while … providing hopefully a lot of useful information and guidance to help inform those decisions,” she said.
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