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Training to perform COVID-19 antigen testing. Photo: Ingrid Anne/Fiocruz Amazônia

A total of 7.5 million US dollars (approximately 37.3 million Brazilian reais) was allocated by the United States Agency for International Development (USAID) to civil society organizations working in the Brazilian Amazon in urgent response to COVID-19.

The funding comes from the first and second phases of the initiative NPI EXPAND Brazil: COVID-19 Response in the Brazilian Amazon Region. Twenty-one organizations are implementing 23 projects in the nine Amazonian states: Acre, Amapá, Amazonas, Maranhão, Mato Grosso, Pará, Rondônia, Roraima and Tocantins.

The objective is to support organizations to promote vaccination in Amazonian communities against the SARS-CoV-2 virus, strengthen the public health system to prevent and control the transmission of COVID-19, disseminate information materials in order to address misinformation and fake news, provide medical and hospital equipment and supplies, and monitor acute cases and post-COVID-19 syndrome.

The Brazilian Amazon has been extremely vulnerable to the devastating effects of the COVID-19 pandemic, aggravated by its complexities, such as the variety of populations including Indigenous, Quilombola, extractivist, riverine, and urban populations from the larger city outskirts. A mosaic of ecosystems, seasonal dynamics of the river’s water cycles, great distances to travel between population centers, low population density, high population dispersion, difficult access areas, absence of road infrastructure, etc., also contribute to its complexities. Moreover, the Amazon region suffers from a lack of health services, infrastructure, medical equipment, and human resources and low health investments from the government.

“Unfortunately, the COVID-19 pandemic continues to put stress on health systems, especially on areas that were already under-serviced, like the Amazon. The second phase of NPI EXPAND Brazil will help support health services at this critical time and strengthen them for the future,” said Ted Gehr, USAID Brazil’s Mission director.

Riverside populations, extractivists, indigenous peoples, quilombolas, immigrants, women and vulnerable groups in urban areas are especially affected by the pandemic, which are exacerbated by the lack of medical supplies, equipment, and infrastructure necessary to treat the most serious cases of COVID-19.

“The pandemic has shed light on the medical deserts in the Amazon region, where in addition to profound socioeconomic inequalities, there is a general absence of public health facilities, investment and human resources. While there is a general perception that the pandemic is over, this initiative remains incredibly relevant for vulnerable populations in the Brazilian Amazon. By promoting cross-sector partnerships, we aim to build greater resilience to COVID-19 and other pandemic threats in the region,” said Nina Best, Country Team Lead for NPI EXPAND Brazil.

The Brazilian Amazon has recorded more than 4 million confirmed cases of COVID-19, in addition to more than 130,000 deaths since the beginning of the pandemic. The total number of cases may be higher as sub-notification and underreporting are very likely due to lack of testing. Brazil ranks second in the world in deaths due to the global spread of the COVID-19 virus, behind only the United States, according to the Johns Hopkins Coronavirus Resource Center.

Municipalities where NPI EXPAND Brazil’s second phase is implemented.

NPI EXPAND Brazil is led by USAID and implemented by Palladium with fiduciary support from Sitawi Finanças do Bem. Local, state and federal health authorities are partners in the initiative.

This second phase, initiated in May 2022, is promoting risk communication and community engagement campaigns to promote and increase vaccination demand and coverage to prevent COVID-19, and address misinformation and fake news directed against the COVID-19 vaccine. It is expected that more than 7,000 people will receive the complete vaccination series (single dose or first and second dose) and 9,000 people will receive at least one booster dose of the vaccine.

Another expected contribution is the provision of technical assistance in the management of COVID-19 cases to more than 240 health facilities in the Brazilian Amazon and the training of 3,800 health professionals to manage these cases.

Training of community agents, doctors, nurses, and volunteers is planned to strengthen local health systems. The targets include training of 3,400 people in surveillance and rapid response to cases of COVID-19 (case investigation, contact tracing, and case finding) and training 6,200 professionals and non-health professionals in risk communication and community engagement.

The first phase of NPI EXPAND Brazil was implemented in partnership with the Partnership Platform for the Amazon (PPA) between 2019 and the first half of 2022. Visit www.ppa.org.br/ppa-solidariedade to see the results and impacts, as well as this piece on the NPI EXPAND website.

Art&Com Saúde festival promotes vaccination in Novo Airão, Amazonas. Photo: Ícaro Matheus/FVA.

The efforts of the 21 organizations that execute the 23 projects supported by NPI EXPAND Brazil reinforce decades of US work and leadership in dealing with global health crises. The projects benefit communities in 205 municipalities in the Amazon region.