Tajikistan’s success against COVID-19 using hybrid top-down and bottom up approaches

Friday, March 12, 2021

Tajikistan’s President Rahmon declared the country free of COVID-19 on January 25, 2021. Multiple sources, including Johns Hopkins University, verify the claim by President Rahmon. This is truly exceptional, as Tajikistan totaled more than 10,000 cases throughout the pandemic. Tajikistan is reaching 3 months without any active cases or deaths due to COVID-19 just as the United States is beginning to recover from its devastating winter peak of infection. Tajikistan was able to recover from the pandemic without the use of vaccines thanks to their country’s hybrid response to the outbreak. These approaches may prove to be useful in the United States as COVID-19 vaccines will soon be available to the public.

Tajikistan can be an example for good practice in how to handle COVID-19 as a diverse low-income country. Tajikistan contributed its success to the use of hybrid bottom-up and top-down approaches. This hybrid method involves a balance between leadership developing and implementing good policy and the capacity of the public and local organizations to identify and act upon their specific community’s needs. Tajik leadership reunited their society, prioritized science, used resources in efficient ways, and built hope in their diverse society. Society followed the suggestions of professionals by wearing masks, socially distancing, accepting government decisions, and posting supportive messages and knowledge on their social media. Since December 31, 2020, Tajikistan’s Ministry of Health has reported no new diagnosed COVID-19 cases, while thousands of tests continue in 15 facilities nationwide. These approaches showed us that progress and failure were not entirely related to access to technology, income of countries or situations of individuals.

Tajikistan’s MoH reports the COVID-19 case mortality rate is 0.7% with only 0.99 deaths per 100,000 population. There is an argument that there may be more COVID-19 cases and the mortality rate may actually be higher. However, when looking at data collected about patients with signs or symptoms of COVID-19 and pneumonia, regardless of COVID-19 test results, the data shows that there is only one peak in late spring and summer. The number of pneumonia cases in January and February of 2021 are no higher than before the pandemic.

Unlike Tajikistan, the leadership in the United States failed to use the hybrid approach and continues to average thousands of deaths due to COVID-19 every day. Each political party had their own strategy for handling COVID-19, causing recovery efforts to become politicized. Some American leadership did not acknowledge scientific suggestions and used divisive rhetoric that split the nation. Additionally, organizations were formed by people who denied the existence of the pandemic and encouraged their members not to listen to scientists. Despite the state mandated mask requirements, many public places, like stores, gyms, and restaurants refused to follow prevention methods.

The government of Tajikistan, led by President Rahmon, established and led the national committee to control COVID-19, which included key decision makers from the government, scientists, and society. To prevent the coronavirus from entering the country, there was a quarantine for all travelers entering the country regardless of nationality, and soon after the borders were closed for months despite their major loss of income from tourism and remittances, which makes up close to one third of the nation’s GDP. However, society trusted leadership and accepted the major loss in income.

To respond to fear and anxiety about the outbreak, the president reunited all national, regional and district mass media and television channels and created a nonpartisan public awareness and education campaign to reduce fear, prevent the use of non-scientific messages, and increase hope and attention to COVID-19. International experts were invited to share their expertise to the public for the first time. Soon after, the spring peak of infection and the mortality rate started declining. Mobile phones and the internet were used successfully to build public awareness, conduct professional training, and connect international experts with local professionals and society.

The Ministry of Health implemented innovative home care services and conducted active surveillance to find cases in early stages. This allowed hospitals and specialists to provide services for complicated and critical cases without overloading hospitals. The home care approach supported clients by allowing them to receive mental and social support by their families and partners and daily medical care virtually and in-person by nurses and family physicians from the comforts of home, avoiding isolation in the challenging hospital environment. The Minister of Health provided ongoing monitoring and evaluation services to solve any local logistical and managerial issues and technical questions in collaboration with international experts.

To build trust and empathy, the president and key social and political decision makers modeled safe behaviors while engaging with society and during public speeches. This approach avoided miscommunications and divisions within the country.

Individual knowledge sharing on blogs and social media, campaigning by civil society organizations and community key stakeholders, and having an overall united attitude towards COVID-19 recovery were successful bottom-up approaches.

Overall, countries could benefit from hybrid approaches used in Tajikistan where the president’s effective and efficient leadership and society’s united attitudes and responses reduced the mortality rate and new cases of COVID-19. The United States, specifically, could benefit from uniting society since prevention and policy regarding COVID-19 are highly politicized. Evidence shows that Democrats in the United States are more likely to receive the COVID-19 vaccination. Vaccines will soon be available to all Americans who want it, and the United States leadership have a duty to protect all of their people, not just those who support the current President.

Category:COVID-19 Category:Tajikistan Category:Health

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