We’ve been through a year of Covid-19. Here’s how we emerge stronger.
By Mandeep Dhaliwal, Director of HIV, Health and Development, UNDP
On January 30, 2020, experts and officials around the world raised the alarm about a looming global health crisis.
One year after the World Health Organization declared COVID-19 a Public Health Emergency of International Concern (PHEIC), we are in the midst of an unprecedented global crisis affecting the health and livelihoods of billions. It is now clear just how ill-prepared countries’ health systems were for an emergency of this scope and scale.
Health systems continue to be overwhelmed and unable to adequately respond, and while COVID-19 vaccines were developed in record speed, they will not be distributed equitably and quickly enough to mitigate some of the worst impacts of the virus. Billions of people across the world in low- and middle-income countries (LMICs) will have to wait at least another year for widespread access. To end the pandemic and lay the groundwork for an equitable and sustainable global recovery, we must urgently strengthen the systems needed for equitable access to all the tools needed to address COVID-19, including diagnostics, therapeutics and vaccines.
It is critical to strengthen health systems because, first and foremost, the most vulnerable populations are bearing the brunt of the impact with deadly consequences. In Brazil, Afro-descendants are 40 per cent more likely to die from COVID-19 than their white peers. Workers in the informal sector — a disproportionate percentage of whom are women — have often been the first to lose their jobs, such as those in Southeast Asia. LGBTIQ+ people around the globe are at increased risk of discrimination and face impaired access to quality health services.
COVID-19 is exposing and exacerbating pre-existing inequalities, an effect that will further hinder sustainable development with long-lasting consequences. The World Economic Forum’s new Global Risks Report highlights that by worsening deep-rooted disparities and intensifying social unrest, political fragmentation and geopolitical tensions, COVID-19 has made it more difficult to tackle the existential risk posed by the climate crisis. Meanwhile, multiple UN agencies have recently warned that the interplay of COVID-19 and entrenched inequalities threatens malnutrition for billions in Asia and the Pacific alone. Combined with the fact that the pandemic continues to disrupt essential health services for millions, with UNAIDS projecting that there could be well over 100,000 additional AIDS-related deaths globally over the next few years, the long-term results could be truly devastating.
Countries facing the gravest consequences from disruptions in health services and other knock on effects are also getting the short end of the vaccine stick. While higher income countries begin large-scale vaccination campaigns, with over 39 million doses administered already, the projections for others are bleak: poorer countries might not be able to achieve widespread vaccination until sometime between 2022 and 2024, with only one poor country administering just 25 doses thus far. In the words of the WHO, this substantial equity gap puts the world at the brink of “catastrophic moral failure”.
Fortunately, there are a range of tools which, through the help of strong systems, can help LMICs tackle this crisis and mitigate the worst impacts as we work to close the vaccine equity gap. Nations must be supported to immediately scale up the diagnostics needed to adequately test, trace, and isolate. To do this, higher-income countries must make a stronger commitment to international cooperation through initiatives like the Access to COVID-19 Tools (ACT) Accelerator. COVAX, the vaccines pillar of the ACT-Accelerator, is also in urgent need of funding to ensure those countries receive life-saving vaccines quickly and equitably.
In the longer-term, significant investments to strengthen systems are needed to recover and minimize the pandemic’s broader impact and prepare for future emergencies. The most recent spike in cases in South Korea illustrates that while well-prepared countries are not immune to second or third waves, strong health systems lay the groundwork for quick, effective responses to future resurgences and shocks. Investing in health systems will not only help us recover sustainably from the current crisis, but also serve as a down payment on pandemic preparedness so that we can tackle inevitable future crises in a more efficient and effective manner.
Relying on advances in science and vaccine development alone will not prevent future pandemics from wreaking havoc on systems and people. Even with the record pace of COVID-19 vaccine development and deployment, it could take more than a decade for the world’s poorest to recover. Vaccines are an important tool in an arsenal for a successful recovery, but delivering vaccines equitably relies on strong systems to reach the people in need, and strong systems are critical for resilience as we face a future of multiple, inter-connected crises. We must double down on the efforts to strengthen health systems and preparedness, so that all countries are able to end the pandemic and emerge stronger in the face of challenges still to come.
