Opinion: COVID-19 requires 'business as unusual' in global health

Nearly 18 months after the World Health Organization declared COVID-19 a pandemic, the coronavirus continues its march around the globe, leaving medical, social, and economic trauma in its wake. With the delta variant driving new and deadly waves of the disease across the world, the pandemic appears far from over.

Despite the efforts made by global development institutions to mobilize human and financial resources to fight COVID-19, critical and immediate operational adjustments are needed to accelerate and facilitate implementing partners’ ability to execute programming that would protect and save lives.

The adjustments listed here are not designed to address the inadequacy of the multilateral pandemic response or any of the broader procurement challenges within the global development sector. Rather, they relate to the modus operandi of institutions in the sector and how they should adapt to address the unique challenges of this public health emergency.

More delivery flexibility for implementers

Implementing organizations worldwide have had to shift operations to work safely during the pandemic. To complement these efforts, however, we need partners — particularly funders and donors — to issue umbrella policy directives allowing for delivery flexibility under existing grants and contracts.

Implementers typically work according to donor-approved work plans that specify activities and deliverables to be completed on a specific timeline. Once these performance metrics are met, implementers invoice donors and get paid for their efforts.

This process generally works in nonemergency settings. However, the requirement to deliver — and be paid — against pre-pandemic expectations and work plans severely constrains implementers’ ability to introduce programmatic modifications in response to a new, fast-changing, and highly contagious infectious disease.

Assumptions that were made earlier in the pandemic are now being challenged and refuted. Funders should support timely reevaluation of program priorities, deliverables, and deadlines to responsibly sustain and direct work.

The U.S. Agency for International Development’s recent guidelines offer examples of delivery flexibility that help implementers to some extent.

At Zenysis Technologies, we have been able to renegotiate deadlines with select partners. The process, when successful, typically involves a discussion with the donor concerning activities that could not be implemented remotely, such as training that requires participants to be physically present in one place. In some cases — most often with grant funding, as opposed to contracts — we were also able to negotiate a change in scope allowing us to continue implementing activities with funds already received.

However, all of this takes time — during which COVID-19 rapidly spreads.

The development of blanket flexibility policies would enable funders to proactively initiate project modifications. They would also empower implementers to request or notify funders of allowable changes in project implementation without fear of negative performance consequences or disruption of funding. And critically, these policies would save all parties precious time and energy and afford them the flexibility that this public health emergency demands.

Timely access to COVID-19 funding for implementers

Whether it’s WHO’s Access to COVID-19 Tools Accelerator, the Global Fund to Fight AIDS, Tuberculosis and Malaria’s COVID-19 Response Mechanism, or USAID’s new funding for COVID-19 response and recovery worldwide, forms of supplemental donor support amid the pandemic are mainly being disbursed through existing funding mechanisms. These are typically held by large and well-established contractors based in high-income countries.

Consequently, COVID-19 response funding is disproportionately allocated to implementing partners with extant grants and contracts. Small businesses, innovators, and new and local partners face barriers in accessing these resources even when partnering with governments to mobilize funding in response to their specific requests.

This challenge could be mitigated if donors reserved funds outside of existing, large-scale contracting mechanisms and issued grants to local organizations and government partners for rapid COVID-19 response and recovery initiatives.

One example of such funding is USAID’s unsolicited proposals and grant applications mechanism, which gives central offices and country missions a degree of latitude, flexibility, and authority to respond to urgent and critical needs. While the funding may be limited, missions can typically deploy it relatively quickly. This type of instrument would greatly expedite responsive grant-making if it were more widely available.

What the private sector can do

For us, the pandemic is personal, as we endeavor to do our work, adapt our operations, and support our teams through this crisis. At Zenysis, we continue to update policies related to bereavement and sick leave, paid time off, and more to accommodate staffers and support them in caring for themselves and their families. We encourage other organizations to reassess their internal policies as well, aligning with the pandemic’s evolving epidemiology.

As a mission-driven tech company, we are also committed to co-investing where we believe we can make an impact, as we have done in partnership with the Global Fund, Vital Strategies, and Gavi, the Vaccine Alliance.

However, we are only one company with limited resources, and our philanthropic initiatives pale in comparison to what larger businesses, foundations, and donors can do. We are hardly alone in this challenge. These recommendations for global development institutions would have broad application, accelerating the impact we are all committed to achieving — namely, saving lives.

Visit the Building Back Health series for more coverage on how we can build back health systems that are more effective, equitable, and preventive. You can join the conversation using the hashtag #BuildingBackBetter.