In 2020, the Brazilian non-governmental organisation Redes da Maré, based in one of the biggest favelas (slums) in Rio de Janeiro, came together with a team of scientists from Fiocruz and the community of Favela da Maré to form a new collective to respond to the emergent COVID-19 crisis. The diverse team, who came to be known as Conexão Saúde, developed nimble and accessible tools to control the rise of the pandemic in a territory of more than 160,000 people.
To kick-start the project, they brought together public and private organisations, mobilising financial and human resources in record time. The project combined home isolation, free COVID-19 tests, telemedicine and a strong web-based and interpersonal communication strategy to disseminate information and prevent fake news. Through a deeply community-based approach to research and intervention, the project help reduce the COVID death toll by more than 40% from March 2020 to April 2021 and managed to achieve 94.4% COVID vaccination rates.
The collective also created Vacina Maré, a research project that aimed to estimate the effectiveness of the vaccine against COVID-19 and the impact of the pandemic on the territory of Maré over time. The team is now building on the infrastructures, ways of working, and collaborations developed through these COVID-focused projects to tackle other pressing health and social concerns in Maré and other territories.
The Conexão Saúde project was designed through a joint effort between community organisations and scientific institutions. The success of their pandemic response programme was made possible by the collaborative team members’ ongoing engagementsin favela da Maré, which helped to foster deep trust between the project team and diverse communities living in the territory. As one Fiocruz project staff member explained:
"One of the insights of this project was the union among different groups: the organised favela movement, a data team, and epidemiologist scientists. This created robustness in the process, regarding how to address the issue, listen, and communicate with the community in various ways, with qualified information."
The community’s own systems for networking were also instrumental in organising a rapid response to the emergence of COVID-19. The application of the concept of ”symmetrical power “was key to the project's success, with Fiocruz scientists, Favela da Maré, and private donors committed to working hand in hand, as equal partners, to control the pandemic.
The project's first major direct success was the 40% reduction in COVID-19 deaths from March 2020 to April 2021, which was achieved before the vaccine Covid-19 arrived and achieved population coverage. In addition, the project was successful in building a collaborative network for knowledge exchange within Favela da Maré, mobilising the population through the situated practices, knowledge and different actors and dialoguing productively with the powerful social movements that emerged in the same geo-social-political area. Another successful aspect of the initiative was the project’s communication and community engagement efforts through the production of informative and engaging content on social media, bulletins, and press releases that helped to combat misinformation and fake news.
The greatest challenge the project team faced was the set-up of the entire infrastructure – from testing sites, health assistance, and telemedicine to supporting social protection, especially among the more vulnerable ones. Coordinating amongst a diverse group of stakeholders within such a short timeframe to respond to the unprecedented health emergency was a major challenge, but also a project success. The collaborative Management Committee was essential to building a horizontal, democratic and dialogical decision-making process. It was based on the weekly meetings, counting on institutional and societal representatives to participate openly and share their experiences, needs, communication strategies, and budget received from many sources transparently. Through this governance structure, the project’s financial decisions were also based on a participatory process, ensuring genuine co-ownership and collaboration.
The most exciting aspect of this project is the development of the “Collab” model, a new framework for engaged, collaborative health research that emerged from the project’s embedded experiences. To gain budgetary support from both the state and civil society, the team devised the model relying on three pillars: the Public Pillar, the Private Pillar, and the Society Pillar. The model has already been replicated in other areas, including Favela de Manguinhos, demonstrating the importance of collaboration across different social spheres.