COVID-19 has stressed every health system around the globe. The lethal virus has left almost no part of the world untouched—confounding governments, health experts, and frontline health workers alike with its speed and complexity.

As world leaders and health officials face a multitude of obstacles, including the lack of a global framework and scarce resources, the results have been catastrophic. Nearly 18 months later and 4 million lives lost, the global pandemic still rages on in most of the world, including Central America.

Palladium immediately joined the global response by applying its expertise in health policy, clinical service delivery, systems strengthening, and rapid emergency response—having recently worked on the Ebola outbreaks in West Africa and having a long history of fighting HIV, tuberculosis, and other infectious diseases where health systems were disadvantaged in emergencies. Palladium’s depth of experience in Central America, after decades supporting health reform in Guatemala, also came into play.

In a new report, COVID-19 Response in Central America: A Race Against the Virus, Palladium’s Health Policy Plus (HP+) project team highlights its health systems strengthening efforts and pandemic control in Central America in partnership with the U.S. Agency for International Development (USAID).

With a focus in El Salvador, Guatemala, and Honduras, HP+ partnered with government officials and local and regional leaders on rapid response initially organized around three pillars: laboratory capacity, surveillance, and case management and infection prevention and control, followed by vaccine rollout support.

Team Lead, Sara Bowsky, recalls the early days of rapid response and the team’s immediate flexibility, “Bringing ventilators into a country overnight—importing, finding space, getting the right medication, the right tubing, training—how do you do an assessment so fast?”

“We think linearly often, but this isn’t linear, and we are fortunate to have a team that knows how to move in a way that matched the needs,” Bowsky notes.

At the beginning of the pandemic, training and equipping healthcare workers to use ventilators and deploying infection control and home-based care guides were essential. One example in Guatemala was an innovative clinical training program mounted by HP+, that reached more than 2,300 public and private sector health professionals who participated in five hours of live training on COVID-19 via YouTube. This program provided a solid foundation on the basics of COVID-19, enabling health professionals nationwide to improve service delivery to support pandemic response.

According to Mirwais Rahimzai, Senior Technical Advisor, Health, Palladium, shifting realities in each country meant constant change and resourcefulness was needed amidst a host of daily stressors. “The operational challenges were constant. You train 20 workers, and the next day five of them are infected. Or many of your lab workers are infected and must be quarantined. You lose your workforce,” adds Rahimzai.

As the shift to supporting vaccine rollout began, HP+ developed a COVID-19 vaccination strategy to be shared with USAID and country-level partners. HEP+ Guatemala played a key role in coordinating and planning vaccine rollout with multiple stakeholders. The project also supported the development of Guatemala’s national vaccine plan and is coordinating its implementation.

The implementation plan’s focus is on procurement options; from personal protective equipment (PPE) for vaccine staff, outreach to targeted populations, to communications and community distribution of information, equipment for facilities, recordkeeping of inoculations, consent forms and complaint processes, training on safe injection and adverse effects, the use of WHO guidance, and security for staff at vaccine sites.

The COVID-19 pandemic has revealed flaws in local, national, and global health systems—that every individual is not treated equally and there is inequitable access to care and medicines based on stark class divides. It has also revealed global supply chain issues—for PPE, ventilators, and vaccines. At the same time, activities led to learnings that persist as instruction for health systems strengthening and strategies for rapid response in the future that can save lives.

Read the full report and contact sara.bowsky@thepalladiumgroup.com for more information.