Interview
Working with governments to rapidly deliver masks to millions of people | Maha Rehman (2021)
- The pandemic control journey in developing countries is expected to be prolonged, yet the NORM model plans to scale from a successful mask initiative to increasing vaccine uptake in Lahore using a 1,000-person volunteer force from 25 universities to synchronize data and vaccinate neighborhoods systematically.
- Vaccine availability is projected to remain stable with seven types in stock to eliminate access excuses, while the goal is to fully vaccinate one union council after another by analyzing volunteer-collected data on barriers like mobility, time, and fertility concerns to deliver customized messaging.
- Bangladesh RCT data showing a 30% increase in mask-wearing and a 10% infection reduction is expected to validate a 100% mask-wearing scenario, predicting significantly higher declines in symptomatic infections, particularly a 35% reduction for those over 60 and a roughly 50% effectiveness boost for surgical masks over cloth.
- The intervention aims to distribute 24 million surgical masks to every household in Lahore via the postal system using verified addresses from Lahore Electric Supply Company, with costs covered by corporate and philanthropic donations rather than government expenditure.
- A launch is planned for late June inaugurated by the health minister, utilizing flag marches by the police commissioner, reinforcement teams at markets and mosques, and mobile announcements to overcome complacency and high mobility in the urban setting.
- Data collection methods include a mobile app with random audio and time checks, weekly data sharing with the commissioner's office, and unannounced visits by the LUMS team to verify quality, while blind enumeration ensures high observational standards.
- The campaign strategy anticipates challenges such as anti-government sentiment from some imams, relying on organic media coverage and public commitments by bureaucrats to maintain accountability without the high costs of paid advertising.
- Future plans include adapting the rural NORM model to other South Asian cities like Ahmedabad and Nepal, formalizing university volunteer credits, and leveraging the government's existing monitoring cell and WhatsApp feedback loops for real-time operational adjustments.
- The procurement experiment results are expected to drive legislative changes, such as automating processes to reduce face-to-face interaction, training officials on budget creation, and shifting from risk-averse rules to incentive-aligned monitoring to reduce both active corruption and passive waste.
- Long-term expectations involve scaling the NORM model to 30 million people, sustaining data collection for 10 weeks post-intervention to confirm habit retention, and preparing health systems for future pandemics while investigating energy sector losses as a new area of research.
- Risks identified include the potential resistance of specific community leaders, the inefficiencies of current procurement rules that inflate costs due to fear of complex regulations, and the possibility that simple data-driven fixes may not resolve complex government coordination failures.
- Personal and operational strategies focus on avoiding perfectionism by accepting that only some elements of a campaign can be perfect, managing work-related stress through mindfulness and running, and prioritizing receptive stakeholders over those initially unwilling to engage.