IntroductionThe coronavirus disease 2019 (COVID-19) pandemic has intensified the urgency in addressing pressing global health access challenges and has also laid bare the pervasive structural and systemic inequities that make certain segments of society more vulnerable to the tragic consequences of the disease. This rapid systematic review analyses the barriers to COVID-19 health products in low-and middle-income countries (LMICs). It does so from the canon of global health equity and access to medicines by proposing an access to health products in low-and middle-income countries framework and typology adapted to underscore the complex interactive and multiplicative nature and effects of barriers to health products and their root cause as they coexist across different levels of society in LMICs.MethodsModified versions of the Joanna Briggs Institute (JBI) reviewers' manual for evidence synthesis of systematic reviews and the PRISMA-ScR framework were used to guide the search strategy, identification, and screening of biomedical, social science, and gray literature published in English between 1 January 2020 and 30 April 2021.ResultsThe initial search resulted in 5,956 articles, with 72 articles included in this review after screening protocol and inclusion criteria were applied. Thirty one percent of the articles focused on Africa. The review revealed that barriers to COVID-19 health products were commonly caused by market forces (64%), the unavailability (53%), inaccessibility (42%), and unaffordability (35%), of the products, incongruent donors' agenda and funding (33%) and unreliable health and supply systems (28%). They commonly existed at the international and regional (79%), health sectoral (46%), and national cross-sectoral [public policy] (19%) levels. The historical heritage of colonialism in LMICs was a commonly attributed root cause of the barriers to COVID-19 health products in developing countries.ConclusionThis review has outlined and elaborated on the various barriers to health products that must be comprehensively addressed to mount a successful global, regional, national and subnational response to present and future epidemics and pandemics in LMICs.

The COVID-19 crisis is affecting millions of lives and has wreaked some of its greatest havoc and suffering among the vulnerable and marginalised populations of the world, many of whom belong to religious and faith-based communities. In times of crisis and difficulty, religion and faith are a source of hope and strength for many. In this paper, we underscore the critical role and impact that some faith-based organisations have had in the pandemic crisis response and management of three countries: Brazil, Indonesia and Sri Lanka. In Brazil, Pastoral da Criança is leveraging their mobile phone application to fight mis-information about COVID-19. In Indonesia, Muhammadiyah launched a COVID-19 command centre to support treatment in hospitals, to disseminate guidelines for religious activities backed by science, and to provide water, sanitation and hygiene packages, food and financial support to the most vulnerable and neglected. In Sri Lanka, Sarvodaya is working closely with religious and community leaders on risk communication and community engagement messages and is also providing hygiene care and economic relief packages to the marginalised. We further discuss some of the challenges these organisations have faced and propose recommendations for greater engagement with this group of global public health actors to maximise their contributions and impact in the crisis management of and response to future infectious disease outbreaks, epidemics or pandemics in low-resource settings.

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IntroductionTwo years since the murder of George Floyd, there has been unprecedented attention to racial justice by global public health organisations. Still, there is scepticism that attention alone will lead to real change.MethodsWe identified the highest-ranked 15 public health universities, academic journals and funding agencies, and used a standardised data extraction template to analyse the organisation’s governance structures, leadership dynamics and public statements on antiracism since 1 May 2020.ResultsWe found that the majority of organisations (26/45) have not made any public statements in response to calls for antiracism actions, and that decision-making bodies are still lacking diversity and representation from the majority of the world’s population. Of those organisations that have made public statements (19/45), we identified seven types of commitments including policy change, financial resources, education and training. Most commitments were not accompanied by accountability measures, such as setting goals or developing metrics of progress, which raises concerns about how antiracism commitments are being tracked, as well as how they can be translated into tangible action.ConclusionThe absence of any kind of public statement paired with the greater lack of commitments and accountability measures calls into question whether leading public health organisations are concretely committed to racial justice and antiracism reform.