Challenges

COVID-19 has exposed glaring gaps in public health preparedness for infectious disease outbreaks in developing countries. The lack of a robust infectious disease surveillance and control system is particularly evident.  

In Bangladesh, a country of 165 million people, the fight against COVID-19 began with only one testing facility, highlighting the country’s lack of capacity to trace infections and prioritize interventions in terms of additional ventilators, doctors, ICU units, etc. As of September 2021, there were more than 1.4 million confirmed cases across the country, with over 24,000 deaths. Similar to what happened in other countries, lack of testing capabilities, limited health care capacity and absence of a system for data-driven monitoring and response to the epidemic hampered the response at the beginning of the crisis. The scarcity of urgent data, inaccessibility to data, absence of common data-sharing platforms, different data collection standards, formats and conventions for recording data plagued the decision-making process.  

Toward a Solution

In the face of all these crises, Bangladesh integrated the efforts of many epidemiologists, data scientists, economists and researchers, resulting in the “National COVID-19 Intelligence Platform.” The platform was created to equip policymakers with crucial data-driven information, allowing them to make data-driven decisions. The system was developed in collaboration with public and private partners, including the Ministry of Information & Technology, the ICT Division, and the Directorate of Health, as well as telco companies and hotline services. Big data is being collected in several streams, through citizen self-reporting from different telecom services, from websites and mobile apps, from community health workers, etc. Analysis and analytics generated from the system has allowed tracking of the disease’s progression 7-10 days ahead of any kind of lab testing and has introduced many new methods in terms of prioritization and intervention in health services for the most affected areas (e.g., mass testing, oxygen supply, etc.). In its later days, the COVID-19 Intelligence System integrated COVID-19 case data, test data, test positivity, death data, hospitalization capacity, equipment availability, etc. into the system.  

A number of fragmented technology solutions have been developed by Access to Information (a2i) of the Prime Minister’s Office in collaboration with the Directorate General of Health Services (DGHS) and the Institute of Epidemiology, Disease Control and Research?(IEDCR) to monitor the nationwide COVID-19 scenario and make timely policy responses and decisions. Specific initiatives include: 

• Syndromic surveillance 
• Mortality surveillance 
• Contact tracing 
• Epidemiological modelling 
• Health response planning and management 

All these solutions have been integrated into a single platform called the “National COVID-19 Intelligence Platform”, which has eased the accessibility for policymakers, resulting in timely decision making. The initiative helps to achieve SDGs 3 (Good Health and Well-being) and 17 (Partnerships for the Goals), as well as IPoA Priority Area number 5 (Human and Social Development). 

The platform not only visualizes the analytics, but also generates policy recommendations for field administrators. The Risk Matrix generated at the platform clearly shows which districts have a high infection rate, allowing policymakers to take quick action. This platform provides real-time disease progression monitoring, policy guidance for field administration and field health administration, and real-time policy advocacy on resource allocation. Therefore, the platform has become one of the priorities in national COVID-19 decision-making. It assists the Prime Minister’s Office, Cabinet Division, Health Ministry and field administration at the division and district levels, and the National Public Health Advisory Committee to take prompt, needs-based, high-impact interventions to help citizens and mitigate the effects of the COVID-19 pandemic.  

This platform has been developed in reference to the recommendations of DGHS with the support of donor funds, such as the Bill and Melinda Gates Foundation (BMGF), and technical support from a2i. Since this platform is being used by DGHS every week for policy decisions, and they have been using this platform for more than one year, the capacity of the relevant authorities has already been developed. In this context, the platform can now be run by the in-house capacities of DGHS, and the DGHS and IEDCR authorities are also highly interested in taking over this platform, since they are using it regularly to monitor the COVID scenario countrywide and initiate necessary intervention. This platform can also be used for dealing with any health crises in the future.  

This platform was developed based on open-source platforms, so that any country interested can replicate it through South-South knowledge exchange. The only concern will be the willingness of data providers to utilize it for reporting. Since this platform integrates data from different public and private platforms, the willingness of the concerned authorities would be important.