. But how can institutions with different mandates, organizational cultures, risk profiles, and internal processes join forces in a public health crisis?
A pilot project supported by the State and Peacebuilding Fund (SPF) can now provide some helpful answers to this urgent question. The pilot, which helped launch an emergency cash-for-work program during the 2018-19 Ebola outbreak in the Democratic Republic of Congo (DRC), applied two basic operating principles: (i) deploy the World Bank’s convening power to forge HDP partnerships that boost project effectiveness and help the government gain credibility; and (ii) build on these partnerships to scale up IDA-financed investments in country systems. This approach thus echoes the tenets of World Bank Group’s new Strategy for Fragility, Conflict, and Violence (FCV): remain engaged in active crises and lay the foundations for long-term recovery.
DRC’s most recent Ebola outbreak took place in a context of forced displacement and persistent conflict between armed rebels, self-defense groups, and security forces. MONUSCO, the United Nations’ peacekeeping mission, had been deployed to stabilize DRC’s eastern provinces for almost two decades. By July 2019, the World Health Organization (WHO) reported more than 2,500 Ebola cases with a fatality rate of 70 percent. No fewer than 72 organizations including WFP, OCHA, UNICEF, and Médecins Sans Frontières mobilized to provide relief. But these efforts were all hampered by violent community resistance and deadly attacks against first responders. After decades of conflict, communities had developed an entrenched distrust of state institutions and external actors. The absence of redistributive impacts for the poor despite the unprecedent mobilization of resources also fed conspiracy theories about hidden interests behind the so-called “Ebola business.”
Against this backdrop, the emergency cash-for-work program aimed to fulfill three goals. First, to strengthen community resilience by providing temporary jobs to beneficiaries in Ebola hotspots. Second, to use public works to address long-standing gaps in community infrastructure that were hampering surges in medical and humanitarian responses. Third, to improve the acceptance of medical teams by delivering quick results.
Between April and December 2019, the cash-for-work pilot rehabilitated rural roads, providing temporary employment to over 12,000 women and men in hard-hit communities.
In such a high-risk operational environment, strong HDP partnerships can make or break a project. The government’s implementing agency, the Social Fund of DRC, had accumulated years of expertise on public works interventions and was accepted by local communities. But to maximize these assets in the Ebola context, new alliances and protocols had to be set up with public health agencies, humanitarian actors, and peacekeeping forces. This is where the World Bank’s convening power made a difference. Opening and maintaining communication channels was mutually beneficial for all HDP partners:
- Working with WFP, the cash-for-work program rehabilitated or maintained strategic humanitarian road corridors, thus facilitating the access of aid personnel and medical teams to local communities;
- As activities started on work sites, UNICEF donated hand-washing kits and thermometers to monitor project beneficiaries. This ensured that public health measures to prevent Ebola transmission were maintained throughout the different phases of the intervention;
- To manage security risks that could escalate at any moment, the Bank team worked with MONUSCO peacekeepers to share data and intelligence on violence trends. This helped adjust project supervision and implementation strategies to unforeseen crises;
- To access areas that were impossible to reach by road, the UN’s Humanitarian Air Service (UNHAS) facilitated flights for joint World Bank-Social Fund missions to remote communities.
These early attempts to work across the “triple nexus” paid off: one year after activities began, the cash-for-work program is integrated into the community engagement pillar of the Ebola Integrated Strategic Response Plan prepared by the government with international partners.
This “HDP delivery model” is now paving the way for longer-term investments in DRC’s social protection system. Building on the insights of the pilot stage, the Ebola cash for-work program will be expanded to all affected health zones through a US$50 million contingency fund. HDP partnerships will also inform the design of an IDA additional financing to the Eastern Recovery Project – known locally as Projet pour la Stabilisation de l’Est de la RDC pour la Paix (STEP). This much larger investment, currently under preparation, will continue public works, but also fund unconditional cash transfers and technical assistance to establish a unified social registry that could be used to reach the poor and vulnerable in any emergency.
But to succeed, it requires an up-front investment to create a shared operational understanding across organizations with different mandates, priorities, and cultures. The DRC Ebola experience shows how this approach can lead to tangible operational win-wins for all partners working to contain public health crises. As COVID-19 is now threatening fragile states, HDP partnerships could prove an invaluable ingredient to make sure none one is left behind.