Biometrics for every stage of a more effective global COVID-19 response
A new white paper outlines the benefits and risks of integrating biometrics in response to COVID-19 in humanitarian and developing country contexts, and links the successful handling of the pandemic in more complex settings to a better overall global response to the virus. The paper discusses the cost savings, better health outcomes and benefits to clinical trials, while also addressing the many precautionary considerations necessary ahead of a biometric rollout.
‘Using Biometrics to Fight COVID-19’, was authored by UK-based Simprints, a non-profit for building and deploying biometric identification solutions in development settings, and development consultancy IMC Worldwide. A condensed version of the paper is also available.
While much of the COVID-19 response has been too recent for in-depth analysis of results, the paper draws together examples of the use of biometrics in other health scenarios such as HIV and tuberculosis.
Biometrics for clinical trials, emergency response and vaccination records
Every step of COVID-19 response can potentially work more efficiently with an element of biometric integration for uniquely identifying individuals, finds the report, which is aimed at program designers.
Biometrics are effective tools in handling the first stage of COVID-19 response, when society and the economy were curtailed by restrictions. Emergency responses such as aid and cash disbursement benefit from reduced fraud where recipients are uniquely identified. Existing money distribution networks can break down, making aid agency or governmental responses even more important.
Certain biometric modalities, although time-consuming to capture, can allow greater physical distancing for verification, compared to document-checking, fingerprints and signatures. The data generated also helps progress-tracking and response mapping.
Biometrics are once again advantageous when vaccines are in development and clinical trials are needed. By providing unique identifiers for those recruited to take part, biometrics eliminate “cross-contamination” between test and control groups, prevent duplicate enrollments, minimize Lost to Follow-up (LTFU) rates and can encourage sign-ups from those not wanting to use their real names.
The paper cites the example of researchers at an East African institution using Simprints to track TB/HIV care for 12,870 patients: “They found no ‘contamination’ between intervention and control groups, which ‘is unprecedented.’ In addition, individual-level data enabled by biometrics allowed researchers to correlate HIV and TB data to specific risk factors for the first time.”
Then when vaccines are ready for distribution, biometrics once again aid efficiency. They help patient tracking by tying an individual to his or her vaccination records. This allows for ensuring a person has doses of the same vaccine. It also reduces fraud in instances where a black market develops in fake COVID health passes.
Traditional record-keeping can be highly inaccurate. The paper gives the examples of Nicaragua and Nigeria:
“In Nicaragua, measles coverage calculated based on caregiver recall or child health cards indicated an 82 percent coverage rate (crude coverage) while dried blood spot samples revealed an effective coverage rate of just 50 percent while in Nigeria, the gap between administrative data and WHO estimates is almost 34 percent.”
Biometrics can help increase the number of people coming forward for vaccinations. The paper cites a study in India where caregivers’ biometrics were tied to infant immunization records. This plus the use of electronic records and direct data capture may have contributed to an 8 percent increase in immunization coverage.
Similar benefits to continuity of care were recorded in TB treatment in Uganda. An LTFU rate of zero was recorded when biometrics were used for patient registration, compared to 8.8 percent the previous year. This led to a 45 percent higher cured outcome.
Biometrics can also help navigate vaccine distribution in places where other ID is not available, where cultural issues exist around relying on names when high rates of common names can prove problematic, or where people may not know fields such as their dates of birth. In some places, however, biometrics use may be deemed culturally inappropriate and program designers must plan for this with alternatives.
Other technologies can also play a part, such as chatbots to help tackle misinformation, as well as an effective cold chain for distributing temperature-sensitive vaccines.
Closing the reported gap with biometrics, health passes
As in the Nicaragua and Nigeria examples above, biometrics have huge potential for reducing the gap in what a program or government believes to have been achieved versus what actually did happen, as discovered by household surveys or taking samples from a population.
Speaking at a webinar to launch the white paper, Simprints’ Toby Norman referred to the data gathered by Gavi, the global vaccines alliance. More than half of the country that Gavi supports do not have an adequate connection between the figures for a vaccine exercise’s management data compared to the true data. An acceptable adequate level would be 5 to 10 percent whereas they find a difference of 20 percent.
Norman believes that in the next 5 to 10 years, vaccine registration digitization and other technologies will help reduce the gap.
Also speaking at the launch was paper co-author Siobhan Green from IMC Worldwide. She believes that the rising demand for fraudulent COVID-19 health passes, which leads to rising demand for anti-fraud solutions, could mean vaccination certificates need to be linked biometrically to the holder. The complexity of differing international standards and requirements and the need for interoperability complicate the matter and it may take the impact of a new COVID variant for that to be developed.
A reminder of the importance of efficient COVID-19 responses in lower income and humanitarian settings
“In low- and middle-income countries (LMICs), COVID-19 has halted routine healthcare delivery, increased the loss of livelihoods and lives, and exacerbated existing inequities in the countries with the fewest resources to address them,” states the white paper.
“The nature of the virus — its lack of regard for borders and geography — means that tackling its effects in LMICs is of pressing concern for all countries worldwide.”
The paper cites World Bank estimates of COVID-19 pushing more than 18 million people in sub-Saharan Africa into poverty and 49 million people worldwide into extreme poverty.
The white paper was funded by UKaid as part of the Ideas to Impact Programme and Data Challenge, itself part of the Foreign and Commonwealth Development Office’s Frontier Technology Hub COVIDaction programme.