The COVID-19 pandemic has been especially difficult for people living with noncommunicable diseases (NCDs) and other chronic conditions for various reasons: health systems buckling, heightened risk of severe COVID-19 or death, increased economic challenges and the extreme combined stress of these factors. To make matters worse for people living with NCDs during the pandemic, NCD civil society organisations have also been impacted and seen their sustainability at risk.

The role of NCD civil society in raising awareness of NCDs, promoting access to care, advocating for change and ensuring accountability has become more necessary than ever before. If we are to ensure that no one is left behind, particularly in health emergencies and pandemics, community engagement and a strong civil society are crucial. Unfortunately, the COVID-19 pandemic has not only affected governments and health systems, but also civil society. In a survey conducted with NCDA member organisations and alliances in early 2020, we identified that the top three challenges for NCD civil society due to COVID-19 in 2020 were: (1) delaying operations and services; (2) difficulty securing future funding; and (3) difficulty retaining funding.

With this awareness, the NCDA team and partners recognised our unique position to support regional and national NCD alliances to shape the legacy of COVID-19. Therefore, following discussions with our group of partners, a mechanism to support NCD alliances at the national and regional level during the COVID-19 pandemic was identified as a priority for the NCD Alliance’s response to COVID-19.

Thanks to the generous financial contributions of Access Accelerated, AstraZeneca, The Leona M. and Harry B. Helmsley Charitable Trust, Takeda and Upjohn Pfizer (now Viatris), the NCD Alliance was able to react to this need by launching the first-of-its-kind Civil Society Solidarity Fund on NCDs and COVID-19 to help accelerate civil society’s response to the pandemic.

Strengthening civil society to survive the pandemic

Launched in July 2020, the Solidarity Fund, totalling US$300,000, supported 20 national and regional NCD alliances from all regions of the world, with half of them being from low-income and lower-middle-income countries. With the support of the Fund, alliances in Africa, Asia, Europe, Eastern Mediterranean, Latin America and the Caribbean, were able to step up their advocacy and communications efforts to promote the needs of people living with NCDs in national pandemic response plans, ensuring that governments follow through on promises to build back better and fairer.

The South-East Asia Regional NCD Alliance, for example, noted the linkages between COVID-19 and NCDs in a statement delivered at the WHO SEARO Regional Committee Meeting in September 2020. NCD alliances were invited/engaged in their national COVID-19 response plans, particularly those in Bangladesh, Brazil, Cameroon, Philippines and South Africa, as well as the regional alliances in the Caribbean and East Africa. The Healthy Caribbean Coalition also launched a new regional long-term strategy for integrating NCDs into broader health agendas, including health security and pandemic preparedness.

Importantly, the Solidarity Fund supported alliances to meaningfully involve and support people living with NCDs, to help their voices be heard at a critical moment and their specific needs addressed as part of the pandemic response. More than 700 people living with NCDs were engaged through consultations, trainings and project development efforts. Moreover, communication campaigns resulted in more than 100 media stories being published and two mini-documentaries being produced by alliances in Cambodia and Benin. Also, with support from the Solidarity Fund, the East Africa NCD Alliance trained 140 journalists to ensure media coverage about the role of the NCD burden in the pandemic and to raise public awareness.

As the COVID-19 pandemic continues, there is an imperative to recover and build resilience, with stronger and more equitable health systems and healthier populations that are better equipped to face future crises. There is a need for continued support of NCD civil society and support to ensure its sustainability, as it will be essential to accelerate the much needed and long overdue action on NCD prevention and control.

Keeping the momentum: NCD civil society during and after the pandemic

The Solidarity Fund successfully supported alliances to involve and advocate for people living with NCDs during the peak of the COVID-19 pandemic. But the efforts needed to support NCD civil society are far from over. As the pandemic prolongs, it is imperative to continue strengthening NCD civil society to ensure its stability and resilience. To this aim, and with the support of different partners, NCDA aims to launch a second phase of the Solidarity Fund in 2021 focused on recovery and resilience, promoting NCDs and the needs of people living with NCDs in health systems strengthening and advancement towards Universal Health Coverage (UHC).

There are three key lessons learnt from the first phase of the Solidarity Fund in 2020, which will need to be considered in future support to NCD civil society, particularly to alliances. Firstly, half of alliances engaged directly with their governments’ COVID-19 response plans. However, many of them highlighted the difficulties the pandemic posed to traditional direct advocacy. This indicates a need for future initiatives to develop alternative advocacy strategies, such as digital ones, tailored to the context of the “new normal”. Secondly, whilst the Solidarity Fund helped strengthen alliance’s structures and efforts, many alliances still rely very much on external financial support for a smooth rollout of their activities. Thus, developing alliances’ own technical capacity, including resource mobilisation, is another important step towards a more sustainable and resilient NCD civil society. Finally, to achieve the most sustainable impact, initiatives should leverage resources and partnerships across multiple sectors, engaging all relevant stakeholders in the NCD response and beyond, in order to involve the greatest diversity possible for an effective response.

The Solidarity Fund has demonstrated once again the value of partnering with different actors to generate resources for the support of communities in times of crises. In order to avoid people being left behind, including the most vulnerable, it is essential to continue supporting the growth, resilience and sustainability of the global NCD civil society movement, so that civil society can continue their essential work advocating for the needs of people living with NCDs and promoting health systems strengthening, recovery and resilience.

About the authors:

Dr Cristina Parsons Perez (@cparsonsperez) is the Capacity Development Director for NCD Alliance where she is responsible for initiatives supporting national and regional civil society to drive improvements in NCD prevention and control. She oversees the Global NCD Alliance Forum and efforts to meaningfully involve people living with noncommunicable diseases in the NCD response. 

Luis Manuel Encarnación (@luismencruz) is Capacity Development Manager for NCD Alliance. Based in Mexico City, he works with national and regional NCD alliances worldwide, identifying relevant advocacy windows of opportunity for national action and for tailored technical support in topics including capacity development, coalition strengthening and advocacy.