COVID-19 reveals weak health systems by design: Why we must re-make global health in this historic moment

Abstract

The COVID-19 pandemic demonstrates the critical need to reimagine and repair the broken systems of global health. Specifically, the pandemic demonstrates the hollowness of the global health rhetoric of equity, the weaknesses of a health security-driven global health agenda, and the negative health impacts of power differentials not only globally, but also regionally and locally. This article analyses the effects of these inequities and calls on governments, multilateral agencies, universities, and NGOs to engage in true collaboration and partnership in this historic moment. Before this pandemic spreads furtherincluding in the Global Southwith potentially extreme impact, we must work together to rectify the field and practice of global health. ARTICLE HISTORY

National Public Health Institutes: A Scoping Review

“…Similarly, a World Bank report stated that, "[o]ne critical investment countries can make to assist MoHs in their new role is the development and strengthening of national public health institutes" (57). More recently, Shamasunder and colleagues assert that this pandemic provides the opportunity and obligation to redesign stronger public health infrastructure and capacity (58). In sum, lessons accumulated from past outbreaks have repeatedly acknowledged the importance of national entities with designated authority and responsibility to respond (27).…”

Health systems trust in the time of Covid-19 pandemic in Bangladesh: A qualitative exploration

“…People's trust in health systems improves access, utilization, adherence, and continuity of care, leading to improved health and satisfaction 12,17,19 . Not only among the general people, but also among the service providers, trust is important, as it improves motivation and service provision; and lack of it can escalate to strike, e.g., against the lack of personal protective equipment (PPE) and medical equipment 20 Finally, Covid-19 response requires adaptive leadership, i.e., making bold decisions and passing newer regulations with the emergence of newer evidences, which is impossible without trust between decisionmakers and the range of stakeholders and the people 21 . However, while these examples suggest that trust is important in Covid-19 response and developing a resilient health system in the long run, understanding on trust in health systems context is ambiguous.…”

“…To curb corruption and discrimination, it is important to take punitive actions, dissolve the unholy syndicates, ensure accountability, regulate private sector for cost and quality of services, and make sure no service provider can ever deny giving healthcare to any patient irrespective their social, economic, political, religious, gender, or any other kind of identity. Politicians in power should engage with other social, cultural and religious forces and formally engage with other political parties in facing the Covid-19 crisis, with a view to fostering multisectoral collaboration and community engagement 20,27,39 . Finally, we recommend to ensure a free flow of correct information following evidence based, scientifically oriented social and behavior change communication (SBCC) strategies; restrict spreading misinformation; establish an effective communication channel up to the rural level; engage religious, cultural, political, and community based forces in message delivery; and formulate and implement an explicit policy and guideline to promote a culture of respect to counteract social stigma against Covid-19.…”

US elections and a foreign policy for pandemics

“…Yet, the security frame can, at times, lead to racialised models of global health that neglect the health needs of people in LMICs (eg, tuberculosis) if a security threat to the USA is not present. 5 Oversecuritisation can also encourage putting military staff in charge when public health officials are needed and trigger mistrust of public health efforts. 6 A new initiative could drive a more holistic approach, particularly since recent pandemics (from Ebola to severe acute respiratory syndrome to COVID-19) have shown the importance of a similar set of inputs across diseases and geography such as boosting laboratory capacity, increasing the health workforce, and sharing access to countermeasures or treatment.…”