Uganda's swift response to yellow fever outbreaks pays off despite challenges

India has been able to eradicate polio through large-scale logistics, highly organized vaccine teams, proper funding, and accountability of health officials and front-line workers.

The Network of TB Champions in Kenya works with volunteer TB survivors to go door-to-door, screen people in public spaces, provide treatment support, trace contacts and link patients to nutritional assistance. Volunteers complete a two-day "Tuberculosis 101" course and then work under the supervision of local health facilities, using their lived experience with TB to build trust and overcome stigma in hard-to-reach populations.

Boda boda motorcycle taxi riders have become frontline HIV health advocates through the LISTEN (Local Innovation Scaled Through Enterprise Network) Community of Practice. Trained in HIV self-testing, prevention methods and counseling, the riders hold monthly awareness days, operate two community testing stations, and distribute preventive items to the public. Since the initiative began in 2019, the association has reached approximately 10,000 people, referred 2,000 for antiretroviral treatment and tested around 400 people per month.

The COVID Ambassador program trains people to listen, be empathetic, and acknowledge people’s COVID-19 vaccine concerns. Ambassadors’ training includes substantial practice talking to people who are resistant to getting vaccinated and they receive ongoing support at bi-monthly meetings, which has increased their confidence and led to more conversations with community members hesitant to get vaccinated. Like other community health worker programs, the ambassador program’s ability to be successful relies on the idea that people trust information from their peers more than from the government.

Community health workers from One World have gained community trust over the years and now go door-to-door to talk with residents about the COVID-19 vaccine and dispel misinformation. They provide resources in Spanish and carry vaccines in a refrigerated bag so residents can get vaccinated on the spot. The group has invested a lot of money, time, and personnel having intensely personal conversations with people. They also host pop-up clinics in the community and allow at-home vaccination appointments. The areas served by One World has seen more vaccinations than almost anywhere else in Nebraska.

Volunteers with India’s Meds For More initiative (MFM) collect leftover unused medications from recovered Covid-19 patients by canvassing their apartment buildings, offices, student clubs, schools, and other locations. Once collected, MFM distributes them to NGOs licensed to work in the health sector, who transport the medicines to marginalized communities in urban and rural areas. Medical professionals sort and pack the medicines and give them to local hospitals and health care centers, who distribute them to patients. The success of the program has inspired similar initiatives in several other cities.

Senegal limited COVID-19 cases in the pandemic’s first year using an existing infrastructure built from dealing with Ebola outbreaks. Coordinated emergency response teams quickly expanded testing capacity across the country and positive cases were required to quarantine in hotels or health centers, where Red Cross volunteers staffed the beds, rather than at home. Village health workers, who were trusted community members, educated people on how to respond to the virus, helped reduce the stigma of the virus, and urged people to follow the strict social distancing, masking, and quarantining rules.

Community health workers are a key part of Connecticut's public health response to COVID-19, particularly in marginalized communities. CHWs connect people to health care and other services, like rental assistance, help with contact tracing, and effectively increased vaccinations by taking the time to answer questions and dispel misinformation. Living in the communities they serve is a critical part of the model’s success and helps clients trust them more readily. The state now offers a CHW certification program, but the largely grant-funded model would be more sustainable with steady funding.

In Namibia, a combination of data analysis and a community-centered approach are helping to reduce the rate of HIV infections and increase awareness around prevention methodologies. The approach has been so successful, that cities in the U.S., such as Atlanta, are considering how to implement similar strategies.

Lane County, Oregon is one of many of the state’s counties working to create a survivor-focused network of responses to sex trafficking. The Lane County Commercial Sexual Exploitation of Children Multidisciplinary Team is seeking to strengthen existing organizations, like the Department of Human Services, Planned Parenthood, and mental health providers, by connecting them – creating a more efficient, effective response to a uniquely challenging issue.