Table 1

What’s needed now and next by epidemic phases

Anticipation/early detection/containmentControl/elimination
PROTECT health workers.
  • Coordinate with partners and invest to rapidly produce, deploy and restock PPE, including masks, gloves, goggles, gowns, hand sanitiser, soap and water, and cleaning supplies.

  • Ensure community health workers are included in PPE projections.

  • Work with governments to pay CHWs for supplemental hours.

INTERRUPT the virus.
  • Standardise and endorse a staffing and readiness protocol for CHWs responding to COVID-19.

  • Engage with governments to quantify training needs and invest to rapidly train existing CHWs to prevent, detect and respond.

  • Estimate need for RDTs as a basis for near-simultaneous investment to produce sufficient RDTs and supplies (including reagents and swabs) and deploy them in the countries on the brink of their own epidemic.

  • Continue to invest in ongoing training for community health teams.

MAINTAIN health services while surging their capacity.
  • Work with governments to ensure CHWs are designated as part of the essential workforce.

  • Invest in the national supply chain to quantify demand and coordinate distribution of essential commodities and surge supplies (eg, oxygen, fuel ventilators and outdoor fever tents).

  • Invest in quantification of the need for expanded or backup coverage and undertake necessary CHW and CHW supervisor recruitment.

SHIELD the vulnerable.
  • Support immediate cash injections at the household level and the creation of neighbourhood plans to protect the most vulnerable.

  • Work with governments and funding partners to ensure that budgets for CHWs incorporate holistic support.

  • Issue a call for multilaterals, regional development banks and national governments to establish economic recovery initiatives.

  • Invest in surveillance of emerging disease hotspots, typically in LMICs.

  • CHW, community health workers; LMICs, low-income and middle-income countries; PPE, personal protective equipment; RDT, rapid diagnostic test.