India’s last-mile Covid-19 responders are leading the way to a just recovery

From inclusive vaccine access to securing livelihoods, India-based non-profit organisations are reaching about 17.1 crore marginalised people.

A drive organised by Indus Action distributing oximeters to ASHA Workers in Sevapuri Block in Uttar Pradesh | Twitter/@IndusAction

• As trusted local actors, social entrepreneurs have demonstrated that swift action in four priority areas can enhance reach and scale in the difficult to reach ‘last mile’.
• Their efforts hold vital lessons for other regions battling new waves of the COVID-19 pandemic.
• A list of the Top 50 last-mile responders in India has been launched by the World Economic Forum’s COVID Response Alliance for Social Entrepreneurs.

For domestic worker Shayna, the COVID-19 crisis has brought her life to a standstill. Stranded in Bengaluru, she hasn’t seen her children in Kolkata since early in 2020 and there has been no work for months. Along with millions of vulnerable Indian citizens, she has relied on food support, provided by community organisations like Indus Action, to keep her and her family from going to bed hungry at night.

Indus Action is one of 50 social entrepreneurs and 12 ecosystem initiatives on the World Economic Forum’s listing of Top 50 COVID-19 Last Mile Responders. Collectively these 62 leaders reach 171 million people, most of whom are part of marginalised communities and detached from effective support systems. Nominated by the 86 members of the World Economic Forum’s COVID Response Alliance for Social Entrepreneurs, they are providing support in four priority areas on-the-ground: Prevention and protection; COVID-19 treatment and relief; inclusive vaccine access; and securing livelihoods.

Their work offers vital lessons on response mechanisms at a time when new COVID-19 surges threaten across the globe. We are showcasing them to keep the spotlight on the millions of people who will be left behind because of the pandemic as well as to forge necessary connections between the work of social entrepreneurs and mainstream response efforts.

Prevention and Protection: A critical first line of defence

“COVID-19 has sharply reinforced the importance of a robust primary health and referral system and the potential of technology-enabled interventions. We work hard to provide that support” says Dr Aparna Hegde, founder of Armman, an India-based non profit organization that leverages technology to create scalable solutions empowering mothers and enabling healthy children. A Top 50 first line responder, Armman was able to quickly adapt its focus to provide over 300,000 women and 800,000 health workers with critical information on COVID-19 via their mobile phones. They are one of many social entrepreneurs on our list that work to preempt, track, and respond to outbreaks early on, helping to slow down ‘reproduction numbers’ (R values) and hospital admissions.

As new surges threaten across the world, their work shows us that taking advantage of the agility of entrepreneurs by integrating their responses into mainstream, public and donor-led, response efforts increases the extent and speed by which the hard-to-reach last mile is brought along.

COVID-19 treatment & relief: Filling the gaps for those in dire need

While many organisations saw the new wave of the crisis coming, the magnitude and cross-cutting nature of the surge made it tough for them to fulfill their role on the frontlines. Almost all of our Top 50 first-line responders and ecosystem innovators however have stepped up where traditional services have been unable to care for the sick, and to bring relief. Without exception, these organizations have used their extensive and long-standing networks to rally stakeholders – including governments and corporates. For example, the Mann Deshi Foundation led a collaboration to build hospital facilities and deliver healthcare in record time and Healing Fields Foundation leveraged its existing network of women community health entrepreneurs (CHEs) to lead the COVID-19 response and training efforts in 5,000 villages across Northern India.

These responses show us that a shared ‘early warning system’ and infrastructure for moving quickly is fundamental to countries’ ability to be on time when the next health, environmental, or economic crisis hits.

Inclusive Vaccine Access: Ensuring that no one is left behind

Agility and strong networks have also proved to be invaluable as the focus of the pandemic response has shifted towards vaccine access – increasingly understood as a global good and critical to containing the virus. Several innovators on our list are using their existing expertise and networks to broaden access to vaccines. Their work includes efforts to overcome vaccine hesitancy and build trust with local communities. Top-50 Responder Haqdarshak, for example, is publishing vaccine information in 11 local languages to help drive vaccination registrations. Unfortunately such initiatives are often excluded from globally funded efforts. But with vaccines only estimated to reach the most remote areas by 2023, changing this could prove seminal in ending the pandemic. As one social entrepreneur told us ‘We struggle to gain access to such procurement and funding streams, which is understandable yet also not an option if we want to bring all Indian people along’.

Securing Livelihoods: Standing by those who have lost their jobs

While the COVID-19 crisis has predominantly been a health crisis, it has also delivered a hammer blow to livelihoods; nowhere is this more visible than in India where the IMF estimates more than 90% of the workforce is informal (defined as not having any social insurance). Within three weeks of the first lockdown, most of these people had lost their jobs. Not surprisingly, many of the leaders we are profiling have made this their focus. For example, ecosystem innovator, Creative Dignity, a collaboration of over 2,000 organisations, is providing relief and rejuvination to India’s rural artisans, and the Migrants Resilience Collaborative, the largest initiative of its kind in the whole of Asia, is supporting 10 million migrant workers and their families for the next five years. Sustained attention for these longer-term, yet vital support needs is fundamental to ‘build back better’ and get back to the 2030 sustainable development goals.

“Nothing in history has shown more clearly than the COVID-19 pandemic that society now must rejig its economic, social and governance structures to ‘expect the unexpected’. The goals of decision-making, whether local or global, must now add resilience to the environmental, equity, economic and empowerment criteria of sustainability,” comments Dr Ashok Khosla from the Society For Development Alternatives.

Carving the path to an inclusive, green COVID-19 recovery

Across India, the social entrepreneurs in our Top 50 list and the partnerships they have rolled out are demonstrating that they have an outsize impact. They have the experience and understanding of context as well as the trust of local communities, which allows them to trial new and local solutions, get to hard-to-reach people and places, build coalitions of local actors, and solve challenges at a local scale.

As the world battles to get past this pandemic, it is high time that their role in reimagining and shaping a new post-COVID 19 reality is recognized and supported. The members of the COVID Response Alliance have joined hands to stand by the social entrepreneurs in our networks. In India, the top responders are ready to break through the persistent income and opportunity barriers that stand in the way of such a recovery. We call on all sectors to join us in backing them and others on the frontlines of this crisis.

This article was originally published in the World Economic Forum. You can read it here.