Improving access to quality of care for COVID-19 in 11 States of Sudan. On 30 January, the World Health Organization (WHO) declared the 2019 coronavirus disease (COVID-19) outbreak a Public Health Emergency of International Concern (PHEIC) for countries to prepare and respond to it in time. Afterwards, on 11 March 2020, WHO declared COVID-19 a global pandemic as it spreads to many countries. Globally, as of 10:00am CEST, 01 May 2020, a total of 3,175, 207 confirmed cases of COVID-19, including 224, 172 deaths (CFR% 7.06%) have been reported to WHO from 215 countries, areas or territories. In the Sudan, according to the Federal Ministry of Health (FMOH), 91 new confirmed cases and associated 5 deaths of COVID-19 were reported on 01 May 2020 increasing the total number of confirmed cases to 533 with 36 associated deaths (CFR: 6.7 %) and 42 recovered cases. Majority of the confirmed cases (474 89%) are from Khartoum State  followed by Gezira (24 cases), Sinnar (8 case), North Kordofan (8 cases), River Nile (5 case), Gedaref (5 cases) and West Kordofan (2 cases). The government of Sudan has been implementing various “lock downs” to slow COVID-19 transmission by limiting contact between people. 

The WHO has defined four transmission scenarios for COVID-19 and advised each country to assess its risk and rapidly implement the necessary measures at the appropriate scale at national and sub-national level as there is no one-size-fits-all. Accordingly, WHO classified the current transmission scenario in Sudan as “sporadic” as cases are either imported or locally detected. The WHO recommended that countries must do everything they can to stop cases from becoming clusters and clusters from becoming explosive outbreaks. As hitherto experiences attested, majority (80%) of COVID-19 patients developed into mild and moderate disease. Only 15% develops sever diseases while only 5% develops critical diseases requiring in patient care or Intensive Care Units (ICU) at designated isolation centres. Confirmed COVID-19 cases should be isolated in dedicated facilities to prevent transmission and optimize clinical care.  Rapid expansion of clinical care capacity to manage COVID-19 cases requires substantial reconfiguring of existing health facilities and repurposing existing health facilities to provide essential life-saving services. In Sudan, only 14 out of 46 (30%) designated COVID-19 isolation facilities in 14 States are functioning with a total capacity of 641 normal beds, 69 ICU beds and 53 ventilators as at 30 April 2020. Recent assessments by WHO revealed that there are huge gaps in the designated isolation centres prepared for management of COVID-19 cases in Sudan. Among other things, isolation centres and treatment facilities lack appropriate equipment, medicines, medical supplies and WASH facilities in most instances. The need for operational support to functional isolation centres was reported in many occasions. 

Although there were no suspected or confirmed COVID-19 cases reported from the two-areas, it is a matter of time, since all the three countries neighboring them (South Sudan, Ethiopia and Sudan) already reported confirmed  COVID-19 cases and their transmission scenarios are fast progressing. Preventing importation of cases in underserved and marginalized communities such as the newly accessed two areas in South Kordofan and Blue Nile state is both critical and human-right issue. Such areas could serve as amplifiers of the pandemic becoming clusters of cases without timely intervention. Therefore, the two-areas are at greater risk of importation and local spread of COVID-19 without timely interventions. 

This project is going to complement ongoing government, UN agencies and NGOs response effort under the auspices of the Country Preparedness and Response Plan (CPRP) to COVID-19. As WHO, this proposal will focus on addressing the three pillars of interventions (i.e. risk communication, IPC and case management) identified as critical gaps by the allocation paper in 11 prioritized States of Suda