Petra Klepac Climate change, malaria and neglected tropical diseases-a scoping review

Klepac and colleagues‘ scoping review of climate change, malaria and neglected tropical diseases: what about the epistemic significance of health worker knowledge?

Reda SadkiGlobal health

By Luchuo E. Bain and Reda Sadki

The scoping review by Klepac et al. provides a comprehensive overview of codified academic knowledge about the complex interplay between climate change and a wide range of infectious diseases, including malaria and 20 neglected tropical diseases (NTDs).

The review synthesized findings from 511 papers published between 2010 and 2023, revealing that the vast majority of studies focused on malaria, dengue, chikungunya, and leishmaniasis, while other NTDs were relatively understudied.

The geographical distribution of studies also varied, with malaria studies concentrated in Africa, Brazil, China, and India, and dengue and chikungunya studies more prevalent in Australia, China, India, Europe, and the USA.

One of the most striking findings of the review is the potential for climate change to have profound and varied effects on the distribution and transmission of malaria and NTDs, with impacts likely to vary by disease, location, and time.

However, the authors also highlight the uncertainty surrounding the overall global impact due to the complexity of the interactions and the limitations of current predictive models.

This underscores the need for more comprehensive, collaborative, and standardized modeling efforts to better understand the direct and indirect effects of climate change on these diseases.

Another significant insight from the review is the relative lack of attention given to climate change mitigation and adaptation strategies in the existing literature.

Only 34% of the included papers considered mitigation strategies, and a mere 5% addressed adaptation strategies.

Could we imagine future mapping to recognize the value of new mechanisms for and actors of knowledge production that do not meet the conventional criteria for what currently counts as valid knowledge?

What might be the return on going at least one step further beyond questioning our own underlying assumptions about ‘how science is done’ to actually supporting and investing in innovative indigenous- and community-led, co-created initiatives?

This gap highlights the urgent need for more research on how to effectively reduce the impact of climate change on malaria and NTDs, particularly in areas with the highest disease burdens and the populations most vulnerable to the impacts of climate change.

While the review emphasizes the need for more research to fill these evidence gaps, this begs the question of the resources and time required to fill them.

This is where there is likely to be value in the experiential data from health workers on the frontlines to provide insights into the mechanisms of climate change impacts on health and effective response strategies.

The upcoming Teach to Reach 10 event (background | registration) , a massive open peer learning platform that brings together health professionals from around the world to network and learn from each other’s experiences, offers a unique opportunity to engage thousands of health workers in a dialogue that can deepen our understanding of how climate change is affecting the health of local communities.

Experiential data has been, historically, dismissed as ‘anecdotal’ evidence at best.

The value and significance of what you know because you are there every day, serving the health of your community, has been ignored.

The expertise and knowledge of frontline health workers are often overlooked or undervalued in global health decision-making processes, despite their critical role in delivering health services and their deep understanding of local contexts and challenges.

Yes, the importance of incorporating the insights and experiences of health workers in the global health discourse cannot be overstated.

As Abimbola and Pai (2020) argue, the decolonization of global health requires a shift towards valuing and amplifying the voices of those who have been historically marginalized and excluded from the dominant narratives.

This concept, known as epistemic justice, recognizes that knowledge is not solely the domain of academic experts but is also held by those with lived experiences and practical expertise (Fricker, 2007).

Epistemic injustice, as defined by Fricker (2007), occurs when an individual is wronged in their capacity as a knower, either through testimonial injustice (when a speaker’s credibility is undervalued due to prejudice) or hermeneutical injustice (when there is a gap in collective understanding that disadvantages certain groups).

In the context of global health, epistemic injustice often manifests in the marginalization of knowledge held by communities and health workers in low- and middle-income countries, as well as the dominance of Western biomedical paradigms over local ways of knowing (Bhakuni & Abimbola, 2021).

By engaging health workers from around the world in peer learning and knowledge sharing, Teach to Reach can help to challenge the epistemic injustice that has long plagued global health research and practice.

By providing a platform for health workers to share their experiences and insights, Teach to Reach – alongside many other initiatives focused on listening to and learning from communities – can contribute to ensuring that the fight against malaria and NTDs in the face of climate change is informed not only by rigorous scientific evidence but also by the practical wisdom of those on the ground.

That is only if global partners are willing to challenge their own assumptions, and take the time to listen and learn.

Moreover, the decolonization of global health requires a shift towards more equitable and inclusive forms of knowledge production and dissemination.

This involves challenging the historical legacies of colonialism and racism that have shaped the global health field, as well as the power imbalances that continue to privilege certain forms of knowledge over others (Büyüm et al., 2020).

By fostering a dialogue between health workers and global partners, Teach to Reach can help to bridge the gap between research and practice, ensuring that the latest scientific findings are effectively translated into actionable strategies that are grounded in local realities and responsive to the needs of those most affected by climate change and infectious diseases.

The value of experiential data from health workers in filling evidence gaps and informing effective response strategies cannot be understated.

As the Klepac review highlights, there is a paucity of research on the impacts of climate change on many NTDs and the effectiveness of mitigation and adaptation strategies.

While more rigorous scientific studies are undoubtedly needed, waiting years or decades for this evidence to accumulate before taking action is not a viable option given the urgency of the climate crisis and its devastating impacts on health.

Health workers’ firsthand observations and experiences can provide valuable insights into the complex mechanisms through which climate change is affecting the distribution and transmission of malaria and NTDs, as well as the effectiveness of different intervention strategies in real-world settings.

This type of contextual knowledge is essential for developing locally tailored solutions that account for the unique social, cultural, and environmental factors that shape disease dynamics in different communities.

Furthermore, engaging health workers as active partners in research and decision-making processes can help to ensure that the solutions developed are not only scientifically sound but also feasible, acceptable, and sustainable in practice.

The involvement of frontline health workers in the co-creation of knowledge and interventions can lead to more effective, equitable, and context-specific solutions that are responsive to the needs and priorities of local communities.

References

Abimbola, S., & Pai, M. (2020). Will global health survive its decolonisation? The Lancet, 396(10263), 1627-1628.

Bhakuni, H., & Abimbola, S. (2021). Epistemic injustice in academic global health. The Lancet Global Health, 9(10), e1465-e1470.

Büyüm, A. M., Kenney, C., Koris, A., Mkumba, L., & Raveendran, Y. (2020). Decolonising global health: If not now, when? BMJ Global Health, 5(8), e003394.

Fricker, M. (2007). Epistemic injustice: Power and the ethics of knowing. Oxford University Press.

Klepac, P., et al., 2024. Climate change, malaria and neglected tropical diseases: a scoping review. Transactions of The Royal Society of Tropical Medicine and Hygiene. https://doi.org/10.1093/trstmh/trae026

77th World Health Assembly Climate and Health Resolution

How will we turn a climate change and health resolution at the World Health Assembly into local action?

Reda SadkiGlobal health

The Geneva Learning Foundation (TGLF) has developed a new model that could help address the urgent challenge of climate change impacts on health by empowering and connecting health workers who serve communities on the receiving end of those impacts.

This model leverages TGLF’s track record of facilitating large-scale peer learning networks to generate locally-grounded evidence, elevate community voices, and drive policy change.

A key strength of TGLF’s approach is its ability to rapidly connect diverse networks of health workers across geographic and health system boundaries.

For example, in March 2020, with support from the Bill and Melinda Gates Foundation, TGLF worked with a group of 600 of its alumni – primarily government staff working in local communities of Africa, Asia, and Latin America – to develop the Ideas Engine.

Within two weeks, the Ideas Engine had connected over 6,000 immunization staff from 90 countries to share strategies for maintaining essential services during the COVID-19 pandemic.

Within just 10 days, participants contributed 1,235 ideas and practices.

They then developed and implemented recovery plans, learning from and supporting each other. 

Within three months, over a third of participants reported successfully implementing their plans, informed by these crowdsourced insights.

This illustrates how peer learning – a tenet of TGLF’s model – can facilitate and accelerate problem-solving.

The Ideas Engine became a core component of TGLF’s model for turning knowledge into action, results, and impact.

TGLF has also demonstrated the model’s effectiveness in informing global health policy initiatives.

Working with the Wellcome Trust, TGLF mobilized – in the first year – over 8,000 health professionals from 99 low- and middle-income countries to take ownership of the goals of the Immunization Agenda 2030 (IA2030) strategy.

This participatory approach generated over 500,000 data points in just four months, providing IA2030 stakeholders with valuable, contextually-grounded evidence to inform decision-making.

Fostering a culture of continuous learning and adaptation among health workers lays the groundwork for a more resilient, equitable, and sustainable approach to global health in the face of accelerating climate change.

Applying this model to the climate and health nexus, TGLF supported 4,700 health workers from 68 countries in 2023 to share observations of changes in climate and health in the communities they serve.

Over 1,200 observations highlighted the diverse and severe consequences already being experienced.

See what we learned: Investing in the health workforce is vital to tackle climate change: A new report shares insights from over 1,200 on the frontline

This demonstrates the feasibility of rapidly generating a new kind of evidence base on local climate-health realities.

Furthermore, if we assume that each health worker could reduce the climate-related health burden for those they serve by a modest five percent, a million health workers connected to and learning from each other could make a significant dent in climate-attributable disease and death. 

This illustrates the model’s potential to achieve population-level impact, beyond sharing knowledge and strengthening capacity.

At Teach to Reach 10 on 20-21 June 2024, over 20,000 health workers will be sharing experience of their responses to the impacts of climate change on health. Learn more

It is important to note that TGLF’s approach differs from models that work through health professional associations in several key ways.

First, it directly engages health workers across all levels of the health system, not just those in leadership positions.

Second, it focuses on peer learning and locally-led action, rather than top-down dissemination of information.

Third, it leverages digital technologies to connect health workers across geographies and hierarchies, enabling rapid exchange of insights and innovations at the point of need.

Finally, it embeds participatory and citizen science methods to ensure solutions are grounded in community needs and that everyone can contribute to climate and health science.

TGLF’s model offers a complementary pathway to address current global priorities of generating novel evidence on climate-health impacts in ways that are directly relevant and useful to communities facing them.

This model can help fill critical evidence gaps, identify locally-adapted solutions, and build momentum for transformative change.

TGLF’s track record in mobilizing collective intelligence to drive impact in global health crises suggest transferability to the climate and health agenda.

As the world grapples with the accelerating health threats posed by climate change, investing in health workers as agents of resilience has never been more urgent or important.

50 years of the Expanded Programme on Immunization

50 years of the Expanded Programme on Immunization

Reda SadkiGlobal health

In two articles published during the fiftieth year of the World Health Organization’s Expanded Programme on Immunization (EPI), Samarasekera and Shattock provide valuable insights into EPI’s remarkable impact on reducing childhood mortality and morbidity since its launch in 1974.

Shattock et al. present a detailed quantitative analysis of the lives saved and health gains attributed to vaccination.

They estimate that “since 1974, vaccination has averted 154 million deaths, including 146 million among children younger than 5 years of whom 101 million were infants younger than 1 year.” 

The authors further emphasize the long-term benefits of vaccination, noting that “for every death averted, 66 years of full health were gained on average, translating to 10.2 billion years of full health gained.”

These findings underscore the transformative impact of EPI on global health outcomes.

Bill Moss of the International Vaccines Access Center (IVAC) calls this “one of humankind’s greatest achievements”.

Inherent uncertainties based on the modeling approaches, data limitations and gaps, and challenges in attributing causality over a 50-year time horizon do not diminish their significance.

Fresh challenges

Samarasekera highlights several fresh challenges as EPI moves into its next 50 years:

  1. COVID-19 pandemic disruptions: The pandemic has led to 67 million children globally missing out on one or more vaccines. This has resulted in outbreaks of vaccine-preventable diseases, with measles outbreaks being reported in twice as many countries in 2023 compared to 2022. Due to pandemic disruption, many unimmunized children are now older than 2 years, requiring new approaches to reach them and prevent further outbreaks.
  2. Sustainable funding: Countries are facing challenges in sustaining funding for immunization programs due to debt crises, conflicts, and climate change.
  3. Improving collaboration during emergencies: There is a need for quicker access to vaccines and better coordination among stakeholders during humanitarian crises and outbreaks.
  4. Reaching the “last child”: Challenges persist in reaching children in conflict areas, active war zones, and those facing humanitarian crises, with immunization coverage in these settings being as low as 50-60%.

While both articles recognize the urgent need to address these setbacks and reach underserved populations, they tend to emphasize the role of global agencies and donors in driving progress.

For example, Samarasekera highlights the importance of initiatives like Gavi, the Vaccine Alliance, which was established in 2000 “to close the equity gap in access to vaccines,” and the Accelerated Development and Introduction Plans, which “expedited vaccine introduction in Gavi-supported countries.”

While global plans and funding have been – and remain – undoubtedly crucial, this begs three questions:

How to carry out such coordinated action and advocacy?

Who will do it?

What, if anything, should be different, compared to what was done in the past?

Can we assume deployment?

Both articles acknowledge that today’s challenges are different, and that immunization strategies should be grounded in local realities.

Samarasekera’s report suggests exploring ideas such as involving community health workers more effectively, introducing newly approved vaccines (e.g., for malaria), and innovating vaccine delivery methods (e.g., microarray patches, single-dose vaccines).

Ephrem T. Lemango, for example, emphasizes the role of health workers : “They are the most trusted source of information” for communities. “If we can skill these community health workers to vaccinate, provide them the required vaccines, then the likelihood of reaching the last child could be much more imminent”.

Samarasekera also quotes O’Brien, who stresses that “every government that has had backsliding needs a plan, and most governments have made a plan and are starting to deploy. We have a very narrow window to get this completed.” 

Neither article delves deeply into the specific strategies or mechanisms that connect global policy and funding to local action.

Can “deployment” be assumed?

There is wide recognition that local adaptation is a key challenge.

This is most obvious in zones of armed conflict or when faced with the breakdown of trust in vaccines or government

At the end of the day, it is health workers at the local levels that get the job of vaccination done.

They are also the first to see epidemic outbreaks and to recognize changes in community trust.

Does the future of vaccination require new ways of thinking and doing to adapt or invent strategies to lead to improved, sustained health outcomes?

Global advocacy for community health workers to be paid is undeniably important.

But paid to do what, how, and with what degree of recognition and support of their capacities, leadership, and expertise?

This is where learning from the Movement for Immunization Agenda 2030 (IA2030) may offer useful insights that complement the top-down, global-level efforts emphasized in the articles.

What is the Movement for Immunization Agenda 2030 (IA2030)?

Launched by the Geneva Learning Foundation in March 2022, the Movement is a global network of over 10,000 health workers from 99 countries who have pledged to work together to achieve the goals of the Immunization Agenda 2030, the global strategy adopted by the World Health Assembly in 2020.

Through peer learning and locally-led action, IA2030 members are sharing experiences, identifying root causes of immunization challenges, and implementing corrective actions tailored to their specific contexts.

What does that actually mean?

Wasnam Faye, a Senegalese midwife, moved the needle of vaccination coverage in a poor-performing remote health outpost from 8% to over 80%.

How did she do it?

At Teach to Reach, she met a doctor from the Democratic Republic of Congo who shared his EPI know-how with her, over WhatsApp.

She then invited and trained caregivers to become peer educators, also building on what she heard at Teach to Reach.

She then realized that she could speak about HPV vaccination for their daughters to mothers who came for cervical cancer screening.

In global health, individual case studies and lived experience are often dismissed as anecdotal evidence.

Each edition of Teach to Reach connects over 15,000 health workers, who share experience around their local challenges.

At that scale, the cumulative insights gained take us beyond anecdotes and enable us to document how change happens at the local levels.

Watch: Teach to Reach Insights Live with Orin Levine

Rethinking immunization’s learning culture: Capacity for change, innovation, and risk

To catch up and achieve the goals set for 2030, these articles suggest that a combination of increased funding, political commitment, and innovative strategies will be needed.

It is important to recognize that top-down control and directive management appear to have been key to how immunization programmes achieved impressive results in previous decades.

This explains why some EPI stakeholders may have an innovation challenge: why risk making changes or consider new models? 

Addressing these underlying issues may require strengthening learning culture.

Learning culture” is a new concept in global health that provides the missing link between learning and performance.

It measures the capacity for change and the leadership to recognize and support that capacity over time.

That requires sustained financing, including specific funding required to test and scale new models and approaches. 

But who will risk funding new ways to tackle the challenges facing immunization programs, such as weak health systems, inadequate infrastructure, and community trust?

References

Faye, W., Jones, I., Mbuh, C., & Sadki, R. (2023). Wasnam Faye. Vaccine angels – Give us the opportunity and we can perform miracles. (IA2030 Case study 18) (1.0). The Geneva Learning Foundation. https://doi.org/10.5281/zenodo.7785244

Jones, I., Eller, K., Mbuh, C., Steed, I., & Sadki, R. (2024). Making connections at Teach to Reach 8 (IA2030 Listening and Learning Report 6) (1.0). Teach to Reach: Connect 8, Geneva, Switzerland. The Geneva Learning Foundation. https://doi.org/10.5281/zenodo.8398550

Jones, I., Sadki, R., Brooks, A., Gasse, F., Mbuh, C., Zha, M., Steed, I., Sequeira, J., Churchill, S., & Kovanovic, V. (2022). IA2030 Movement Year 1 report. Consultative engagement through a digitally enabled peer learning platform (1.0). The Geneva Learning Foundation. https://doi.org/10.5281/zenodo.7119648

Samarasekera, U., 2024. 50 years of the Expanded Programme on Immunization. The Lancet 403, 1971–1972. https://doi.org/10.1016/S0140-6736(24)01016-X

Shattock, A.J., et al. Contribution of vaccination to improved survival and health: modelling 50 years of the Expanded Programme on Immunization. The Lancet S014067362400850X. https://doi.org/10.1016/S0140-6736(24)00850-X

Climate change and health-Health workers on climate, community, and the urgent need for action

Climate change and health: Health workers on climate, community, and the urgent need for action

Reda SadkiGlobal health

As world leaders gathered for the COP28 climate conference, the Geneva Learning Foundation called for the insights of health workers on the frontlines of climate and health to be heard amidst the global dialogue.

Ahead of Teach to Reach 10, a new eyewitness report analyses 219 new insights shared by 122 health professionals – primarily those working in local communities across Africa, Asia and Latin America – to two critical questions: How is climate change affecting the health of the communities you serve right now? And what actions must world leaders take to help you protect the people in your care?

(Teach to Reach is a regular peer learning event. The tenth edition on 20-21 June 2024 is expected to gather over 20,000 community-based health workers to share experience of climate change impacts on health. Request your invitation here.)

Their answers paint a picture of the accelerating health crisis unfolding in the world’s most climate-vulnerable regions. Community nurses, doctors, midwives and public health officers detail how volatile weather patterns are driving up malnutrition, infectious disease, mental illness, and more – while simultaneously battering health systems and blocking patient access to care.

Yet woven throughout are also threads of resilience, ingenuity and hope. Health advocates are not just passively observing the impacts of climate change, but actively responding – often with scarce resources. From spearheading tree-planting initiatives to strengthening infectious disease surveillance to promoting climate literacy, they are innovating locally-tailored solutions.

Importantly, respondents emphasize that climate impacts cannot be viewed in isolation, but rather as one facet of the interlocking crises of environmental destruction, poverty, and health inequity. Their insights make clear that climate action and community health are two sides of the same coin – and that neither will be achieved without deep investment in local health workforces and systems.

Rooted in direct lived experience and charged with moral urgency, these frontline voices offer a stirring reminder that climate change is not some distant specter, but a life-and-death challenge already at the doorsteps of the global poor. As this new collection of insights implores, it’s high time their perspectives moved from the margins to the center of the climate debate.

As Charlotte Mbuh of The Geneva Learning Foundation explains: “We hope that the chorus of voices will grow to strengthen the case for  why and how investment in human resources for health is likely to be a ‘best buy’ for community-focused efforts to build the climate resilience of public health systems.”

Jones, I., Mbuh, C., Sadki, R., & Steed, I. (2024). Climate change and health: Health workers on climate, community, and the urgent need for action (1.0). The Geneva Learning Foundation. https://doi.org/10.5281/zenodo.11194918

International Nurses Day 2024 Teach to Reach

International Nurses Day 2024: Climate change and health

Reda SadkiGlobal health

English version | Version française

On International Nurses Day 2024, The Geneva Learning Foundation stands in solidarity with the over 28 million nurses worldwide who form the backbone of health systems globally.

As an organization dedicated to researching, developing, and implementing new approaches to learning and leadership for health, we recognize the vital role of nurses in driving progress towards global health goals, including the health-related Sustainable Development Goals and Universal Health Coverage.

Nurses represent a significant proportion of participants in our Teach to Reach peer learning programme, which exemplifies commitment to lifelong learning and desire to connect with and learn from colleagues around the world to improve practice.

Teach to Reach is the world’s largest health peer learning event, bringing together tens of thousands of health professionals, primarily from low- and middle-income countries, in dynamic digital convenings. Request your invitation

It exemplifies our vision of empowering health workers as agents of change through digitally-enabled collaborative learning and knowledge sharing.

For its tenth edition on 20-21 June 2024, Teach to Reach will focus on the critical issue of climate change and health.

Nurses are already finding themselves on the frontlines in supporting communities to navigate the increasing health risks posed by a changing climate.

As trusted members of the communities they serve, nurses are uniquely positioned to strengthen resilience and lead adaptations to protect health.

Through platforms like Teach to Reach, The Geneva Learning Foundation aims to elevate nurses’ voices and insights, facilitating the rapid exchange of locally-tailored solutions to shared challenges.

We call on global health leaders to recognize the expertise that nurses hold as a result of their proximity to communities, and to systematically include nurses in policy dialogues and decision-making on the health impacts of climate change.

On this International Nurses Day, we reaffirm our commitment to leveraging the power of digital networks and innovative learning approaches to support nurses in their vital work to protect and promote health.

Through strong partnerships and by empowering nurses as leaders, we believe it is possible to build resilient, equitable and sustainable health systems in a changing climate.

Journée internationale des infirmières 2024: Changement climatique

Journée internationale des infirmières 2024 : Changement climatique et santé

Reda SadkiGlobal health

English version | Version française

À l’occasion de la Journée internationale des infirmières 2024, La Fondation Apprendre Genève est solidaire des plus de 28 millions d’infirmières et d’infirmiers dans le monde qui constituent l’épine dorsale des systèmes de santé à l’échelle internationale.

En tant qu’organisation dédiée à la recherche, au développement et à la mise en œuvre de nouvelles approches de l’apprentissage et du leadership pour la santé, nous reconnaissons le rôle vital des infirmières et infirmiers dans la réalisation de progrès vers les objectifs de santé globale, y compris les Objectifs de développement durable liés à la santé et la Couverture santé universelle.

Les infirmiers représentent une proportion importante des participants à notre programme d’apprentissage par les pairs Teach to Reach, qui illustre l’engagement en faveur de l’apprentissage tout au long de la vie et le désir de tisser des liens avec des collègues du monde entier et de partager l’expérience afin d’améliorer les pratiques.

Teach to Reach est le plus grand événement que nous connaissons de partage d’expérience dans le domaine de la santé au monde, réunissant des dizaines de milliers de professionnels de la santé, principalement issus de pays à revenu faible ou intermédiaire, dans le cadre de rassemblements digitaux dynamiques. Demandez votre invitation

Il illustre notre vision de l’autonomisation des travailleurs de la santé en tant qu’agents de changement grâce à l’apprentissage collaboratif et au partage des connaissances par voie numérique.

Pour sa dixième édition, les 20 et 21 juin 2024, Teach to Reach se concentrera sur la question cruciale du changement climatique et de la santé.

Les infirmières se retrouvent déjà en première ligne pour aider les communautés à faire face aux risques sanitaires croissants posés par le changement climatique.

En tant que membres de confiance des communautés qu’elles servent, les infirmières sont particulièrement bien placées pour renforcer la résilience et mener les adaptations nécessaires à la protection de la santé.

Grâce à des plateformes telles que Teach to Reach, La Fondation Apprendre Genève vise à élever les voix et les points de vue des infirmières et infirmiers, facilitant l’échange rapide de solutions adaptées localement à des défis partagés.

Nous appelons les leaders de la santé globale à reconnaître l’expertise que les infirmières détiennent du fait de leur proximité avec les communautés, et à inclure systématiquement les infirmières dans les dialogues politiques et les prises de décision sur les impacts sanitaires du changement climatique.

En cette Journée internationale des infirmières, nous réaffirmons notre engagement à tirer parti de la puissance des réseaux digitaux et des approches d’apprentissage innovantes pour soutenir les infirmières dans leur travail vital de protection et de promotion de la santé.

Grâce à des partenariats solides et à l’autonomisation des infirmières en tant que leaders, nous pensons qu’il est possible de mettre en place des systèmes de santé résilients, équitables et pérennisés dans un contexte de changement climatique.

Les visage de la vaccination 2023

Semaine mondiale de la vaccination: Que voyez-vous?

Reda SadkiGlobal health, Writing

English version | Version française

Ceci est la préface de la nouvelle publication Les visages de la vaccination. En savoir plusTélécharger la collection

Chaque jour, des milliers d’agents de santé, de l’Afghanistan au Zimbabwe, se lèvent et se rendent au travail avec un seul objectif en tête : faire en sorte que les vaccins parviennent à ceux qui en ont besoin.

À l’occasion de la Semaine mondiale de la vaccination du 24 au 30 avril 2023 et du lancement de la campagne « Big Catch Up », la Fondation Apprendre Genève (TGLF) a invité les membres du Mouvement pour la vaccination à l’horizon 2030 (IA2030) à partager des photographies d’eux-mêmes et de leur travail quotidien.

Plus de 1 000 témoignages visuels ont été partagés.

Il ne s’agit pas de clichés soigneusement composés et techniquement élaborés par des photographes professionnels, mais plutôt d’une vue authentique sur ce que signifie la vaccination dans la pratique. Les difficultés de transport. Les mères concernées et aimantes. Les curieux. Le dialogue entre les praticiens et les membres de la communauté. Les écoliers brandissant leur carte de vaccination. Les cahiers contenant les données.

Voici donc notre deuxième galerie annuelle de photographies partagées par les membres du Mouvement. Une fois encore, elle célèbre la diversité de leurs rôles et des défis auxquels ils sont confrontés dans leur vie quotidienne, ainsi que leur engagement en faveur du Programme pour la vaccination à l’horizon 2030 (IA2030), qui vise à ce que chaque enfant, chaque famille, soit protégés contre les maladies évitables par la vaccination.

Si nous avons réitéré cette opération, c’est parce que nous avons observé que la narration visuelle avait un effet profond sur l’ensemble du Mouvement. Cet effet peut être difficile à quantifier. En soi, il n’améliore certainement pas la couverture vaccinale. Il a tout à voir avec la façon dont les agents de santé se perçoivent eux-mêmes, perçoivent la valeur de leur propre travail. En effet, le fait non seulement de savoir, mais aussi de voir qu’il y a des collègues dans le monde entier qui font le même travail, quel que soit le contexte, est réconfortant et inspirant. Cela peut contribuer à renforcer ou à renouveler la détermination et l’engagement. Cela peut aider à faire la différence – et à la maintenir dans le temps.

Certains professionnels de la santé travaillent dans des centres de santé offrant des services de vaccination et d’autres formes de soins de santé primaires. D’autres prennent part à des stratégies avancées, allant à la rencontre de la population. Ils peuvent également être basés dans des bureaux de district ou régionaux, où ils assurent la supervision et des conseils pour permettre aux praticiens de mieux faire leur travail.

Pour ceux qui contribuent aux activités de sensibilisation, ils peuvent être confrontés à de multiples défis. Ils peuvent avoir à surmonter des obstacles géographiques : rivières, inondations, routes en mauvais état, ou simplement de longues distances. Ils peuvent être amenés à s’aventurer dans des zones d’instabilité politique ou de conflit. Ils peuvent être amenés à entrer en contact avec des populations mobiles dont la localisation précise peut être incertaine. Enfin, ils peuvent être amenés à pénétrer dans des zones urbaines informelles en perpétuel changement.

Une fois arrivés à destination, ils constatent parfois que les personnes qu’ils contactent ne sont pas forcément réceptives à la vaccination. Ils devront alors passer du temps avec les gens pour les aider à comprendre les bénéfices et la sécurité de la vaccination.

Bien entendu, la vaccination proprement dite n’est pas la seule tâche à accomplir. Les programmes de vaccination s’appuient sur un réseaux de personnes ayant des rôles divers, tels que l’entretien des équipements essentiels de la chaîne du froid, la gestion des données et la collaboration avec les communautés pour obtenir leur soutien en faveur de la vaccination. Les volontaires issus de la communauté constituent un lien vital entre les programmes de vaccination et les communautés locales. Un travail d’équipe efficace est essentiel.

À la fin d’une longue journée, chaque praticien de la vaccination peut rentrer chez lui en sachant qu’il a contribué à rendre le monde plus sain et qu’il a peut-être sauvé une vie. Ce sont les véritables héros de la vaccination, et nous les saluons. 

Charlotte Mbuh et Reda Sadki
La Fondation Apprendre Genève (TGLF)

Journée mondiale de lutte contre le paludisme La Fondation Apprendre Genève

Journée mondiale contre le paludisme: nous avons besoin de nouvelles façons de mener le changement

Reda SadkiGlobal health

English version | Version française

Aujourd’hui, à l’occasion de la Journée mondiale contre le paludisme, la Fondation Apprendre Genève est fière de se tenir aux côtés des travailleurs de la santé en première ligne dans la lutte contre cette maladie.

Le paludisme reste un problème de santé majeure, affectant de manière disproportionnée les communautés d’Afrique et d’Asie.

C’est pourquoi la lutte contre le paludisme sera au cœur de Teach to Reach 10, un événement phare qui permet à des milliers de professionnels de santé du monde entier de partager leurs expériences, leurs réussites et leurs défis.

Teach to Reach est une plateforme qui facilite l’apprentissage par les pairs afin de mener des actions locales sur des questions de santé urgentes.

Lors de Teach to Reach 10 le 21 juin 2024, nous nous concentrerons sur la menace urgente que représente le changement climatique pour la santé, en mettant particulièrement l’accent sur la façon dont l’évolution des conditions environnementales modifie le paysage du risque de paludisme et de la riposte à ce fléau.

Le leadership des professionnels de la santé est essentiel pour une vision intégrée de la lutte contre le paludisme par et pour les communautés locales

Comme le montre notre récent rapport « De la communauté à la planète: Professionnels de la santé sur le front du climat», les agents de santé du niveau périphérique sont déjà les témoins directs de la manière dont les changements climatiques affectent les schémas pathologiques et pèsent sur les systèmes de santé.

La hausse des températures, les phénomènes météorologiques extrêmes et l’évolution des précipitations créent des conditions idéales pour la prolifération des moustiques vecteurs du paludisme, exposant ainsi les communautés à des risques accrus.

Des acteurs comme Yapoulouce Bamba, de Guinée, ont observé cette tendance inquiétante : «La dégradation de l’environnement a créé davantage de lieux de reproduction pour les moustiques. Pendant la saison des pluies, on observe une augmentation exponentielle des populations de moustiques, ce qui accroît le nombre de cas de paludisme.»

De la gouvernance internationale à l’action locale : comment Teach to Reach peut contribuer à transformer la déclaration de Yaoundé en action locale

Lors de la conférence Teach to Reach 10, nous discuterons de la manière de transformer l’engagement des dirigeants africains dans la déclaration de Yaoundé en actions concrètes, menées localement pour accélérer la lutte contre le paludisme.

En rassemblant les acteurs de la santé pour partager des solutions locales et renforcer la résilience, nous soutenons l’appel de la déclaration en faveur de l’investissement dans la recherche et l’innovation, de la collaboration transfrontalière et de l’engagement des communautés en tant que partenaires dans la lutte contre le paludisme.

Teach to Reach incarne ainsi la vision de cette Déclaration, qui consiste à soutenir ceux qui sont en première ligne de la lutte contre le paludisme en leur apportant les connaissances, les outils et la solidarité dont ils ont besoin pour avoir un impact transformateur dans leurs communautés.

Nous avons besoin d’inventer de nouvelles façons de mener le changement

En cette Journée mondiale contre le paludisme, nous invitons tous ceux qui se sont engagés à mettre fin à cette maladie à se joindre à nous pour apprendre et écouter auprès des agents de santé de première ligne.

Leurs voix, leurs expériences et leur leadership sont essentiels pour stimuler l’action locale et la collaboration internationale nécessaires pour vaincre cette menace persistante dans un climat changeant.

Ensemble, nous pouvons trouver de nouvelles façons de mener le changement pour construire un avenir sans paludisme, pour tous.

Image: Collection de la Fondation Apprendre Genève © 2024

World Malaria Day 2024 The Geneva Learning Foundation

World Malaria Day 2024: We need new ways to support health workers leading change with local communities

Reda SadkiGlobal health

English version | Version française

Today, on World Malaria Day, the Geneva Learning Foundation is proud to stand with health workers on the frontlines of the fight against this deadly disease.

Malaria remains a critical global health challenge, disproportionately affecting communities in Africa and Asia.

That’s why we’re putting malaria at the heart of the agenda for Teach to Reach 10, our landmark event connecting tens of thousands of health workers worldwide to share their experiences, successes, and challenges.

Teach to Reach is a unique platform that enables health workers to learn from each other, contribute to global knowledge, and drive local action on pressing health issues.

At Teach to Reach 10 this June, we will be focusing on the urgent threat of climate change to health, with a special emphasis on how changing environmental conditions are altering the landscape of malaria risk and response.

Read Gavi’s article about our work: Global problems, local solutions: the health workers helping communities brace for climate change

Health worker leadership is critical to an integrated view of malaria response by and for local communities

As our recent report “On the frontline of climate change and health: A health worker eyewitness report” highlighted, health workers are already witnessing firsthand how climate shifts are affecting disease patterns and burdening health systems.

Rising temperatures, extreme weather events, and changing rainfall patterns are creating ideal conditions for malaria-carrying mosquitoes to thrive, putting communities at greater risk.

Health workers like Yapoulouce Bamba from Guinea have observed this worrying trend: “The degradation of the environment has created more breeding grounds for mosquitoes. During the rainy season, there is a noticeable exponential increase in mosquito populations, which in turn raises the number of malaria cases.”

From global governance to local action: how Teach to Reach can contribute to turning the Yaoundé Declaration into local action

At Teach to Reach 10, we’ll be discussing how to turn the commitment of African leaders in the Yaoundé Declaration into locally-led action to accelerate action against malaria.

By bringing together health workers to share local solutions and build resilience, we are supporting the Declaration’s call for investment in research and innovation, cross-border collaboration, and engagement of communities as partners in the malaria fight.

Teach to Reach embodies the Declaration’s vision of supporting those at the forefront of the malaria fight with the knowledge, tools, and solidarity they need to drive transformative impact in their communities.

We need new ways to learn and lead

On this World Malaria Day, we invite all those committed to ending malaria to join us in listening to and learning from frontline health workers.

Their voices, experiences, and leadership are key to driving the local action and global collaboration needed to overcome this persistent threat in a changing climate.

New ways to learn and lead are vital so that we can build a healthier, malaria-free future for all.

Image: The Geneva Learning Foundation Collection © 2024

The many faces of immunization.10.5281/zenodo.8166653

World Immunization Week: What do you see?

Reda SadkiGlobal health

English version | Version française

This is the preface of the new publication The many faces of immunization. Learn more… Download the collection

Every day, thousands of health workers, from Afghanistan to Zimbabwe, get up and go to work with a single goal in mind ­ to ensure that vaccines reach those who need them.

To mark World Immunization Week 2023 (24­–30 April 2023) and the launch of the “Big Catch Up” campaign, the Geneva Learning Foundation (TGLF) invited members of the Movement for Immunization Agenda 2030 (IA2030) to share photographs of themselves and their daily work.

More than 1,000 visual stories were shared.

These are not the carefully composed and technically accomplished shots of the professional photographer: rather, they capture a raw and authentic view of what immunization means in practice.

The transport challenges.

The concerned and loving mothers.

The curious onlookers.

The dialogue between practitioners and community members.

The schoolchildren waving their vaccination cards.

The reams of paper-based data.

This is our second annual gallery of photographs shared by members of the Movement. Get the 2022 World Immunization Week photo book It takes people to make #vaccineswork

Once again, it celebrates their diversity of roles and challenges faced in their daily lives, and their commitment to the IA2030 goal of ensuring that every child, every family, is protected from vaccine-preventable diseases.

If we did it again, it is because we observed that visual storytelling had a profound effect across the Movement.

This effect may be hard to quantify.

On its own, it certainly does not improve vaccination coverage.

And yet, it has everything to do with how health workers perceive themselves, perceive the value of their own work.

Not just knowing but seeing that there are colleagues across the world who are doing the same work, whatever the contexts, is heartening and inspiring.

It can help strengthen or renew resolve and commitment.

It can help make a difference – and sustain it over time.

To achieve their goals, they may be working in health facilities offering immunization services and other forms of primary health care.

Or they may be taking part in outreach or stratégies avancées, delivering vaccines out in the communities where people live.

Alternatively, they may be based in district or regional offices, providing oversight and offering “supportive supervision” ­ constructive feedback and advice to ensure practitioners can do their jobs better.

If they are among the many practitioners engaged in outreach activities, they may face multiple challenges.

They may have to overcome geographical obstacles ­ rivers, flooding, poor roads, or just long distances.

They may have to venture into areas of political instability or conflict.

They may have to make contact with mobile populations whose precise location may be uncertain.

And they may have to enter informal urban settings in a state of permanent flux.

Then, when they reach their destination, they may find that those they engage are not receptive to vaccination.

They may have to spend time with people to help them understand the benefits and safety of vaccines.

Of course, actually vaccinating people is not the only task that needs to be undertaken.

Vaccination programmes rely on a collective of people with a diverse range of roles, such as maintaining essential cold chain equipment, managing data, and working with communities to build support for vaccination.

Community-based volunteers provide a vital link between immunization programmes and local communities.

Effective teamwork is essential.

At the end of a long day, every vaccination practitioner can return home knowing that they have done their bit to make the world a healthier place, and just might have saved a life.

Charlotte Mbuh and Reda Sadki
The Geneva Learning Foundation (TGLF)

Jones, I., Sadki, R., & Mbuh, C. (2024). The many faces of immunization (IA2030 Listening and Learning Report 5) (1.0). Special Event: World Immunization Week. The Geneva Learning Foundation. https://doi.org/10.5281/zenodo.8166653