Health inequity during the COVID-19 pandemic: a cry for ethical global leadership

Chiriboga, David E.; Garay, Juan; Buss, Paulo Marchiori; Madrigal, Rocio Saenz; Rispel, Laetitia C.

doi:10.1016/s0140-6736(20)31145-4

Cited by 85 publications

(93 citation statements)

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“…The coronavirus disease 2019 (COVID-19) pandemic has led to the tragic loss of human life with deep social and economic consequences, including on food insecurity and nutrition. Disproportionate burdens of infections, hospitalisations, and deaths from COVID-19 among already vulnerable communities were observed (1) .…”

Section: Introductionmentioning

confidence: 99%

High prevalence of food insecurity, the adverse impact of COVID-19 in Brazilian favela

Manfrinato

Marino

Condé

et al. 2020

Preprint

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Objective: To investigate food insecurity prevalence in two favelas in Brazil in the early weeks from physical distancing policy, between March 27, 2020 to June 1, 2020. Design: A cross-sectional study using online questionnaire to elicit information on socioeconomic and demographic characteristics, the types of stores visited to buy food and food insecurity screening. Experience of food insecurity was collected according to the Brazilian Food Insecurity Scale. Factors associated with moderate or severe food insecurity were investigated using the logistic regression model. Setting: Sao Paulo city, Brazil. Participants: 909 householders. Results: 88% of the households included young women working as cleaners or kitchen assistants and in sales services. One-fifth of the participants were recieving federal cash transfer programme, called Bolsa Familia. There were 92% households with children. The most frequent experience reported was uncertainty about food acquisition or receiving more (89%), to eat less than one should (64%), not being able to eat healthy and nutritious food (46%), and skipping a meal (39%). 47% of the participants experienced moderate or severe food insecurity. Factors associated with moderate and severe food insecurity were low income, being Bolsa Familia recipient, a low level of education, and households without children. Conclusions: Half of the participants experienced moderate or severe food insecurity, and close to ten per cent was hungry. Our data suggest that families with children were at lower risk of moderate to severe food insecurity. It is possible that nationally established social programs like Bolsa Familia were protecting those families.

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Section: Introductionmentioning

confidence: 99%

High prevalence of food insecurity, the adverse impact of COVID-19 in Brazilian favela

Manfrinato

Marino

Condé

et al. 2020

Preprint

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“…What is emerging is a new inequity and the focus is on new political processes that deal with UHC under these extreme conditions. 16 Estimates of the impacts on employment in Australia and hence incomes suggest that at least 3.6 million people will be out of work, with those from hospitality, retail and entertainment industries most hard hit. These are the low paid workers on casual employment with few savings behind them to support them through the pandemic.…”

Section: Discussionmentioning

confidence: 99%

Universal Health Coverage and Primary Health Care: Their Place in People’s Health

Walker¹,

Peterson

2020

Preprint

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Sturmberg and Martin in 2020 argue that Universal Health Care (UHC) is mainly about financing and Primary Health Care (PHC) is about the right care at the right time to ensure health. They maintain the World Health Organisation (WHO) has recently sent the wrong message about the "pillars" of PHC in their relationship to UHC. An understanding of political economy is required in order to come to terms with the bases of PHC and the fundamentals of UHC, that dealing with inequities is not only an economic issue but fundamentally a political issue. Neoliberal decision making can enhance inequities in society. Two chronic health conditions, diabetes and multiple sclerosis are examples of conditions that lead to costly and debilitating consequences for patients but also lead to substantial economic costs in terms of lost workforce participation and lost productivity. These cases demonstrate the socio-political issues involved in the management of care for a number of illnesses. The upsurge of COVID-19 has placed an enormous strain on health and broader social and economic resources and challenged the pretext of UHC as health for all: substantial differences in equity and political commitment have emerged. Sturmberg and Martin argue that the joining of UHC and PHC needs leadership which involves local communities and resourcing. PHC is a changing system based on power relationships involving funders and the health community. In Australia as in several countries out of pocket costs have grown rapidly and have affected access for some groups to PHC and have challenged the pretext of equity in UHC. In the context of PHC and UHC we support the position that health for all goes beyond healthcare for all, to embrace healthy lives promoting wellbeing.

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“…The harm principle; The principle of the least restrictive or coercive means; The reciprocity principle; The transparency principle; The precautionary principle; The equity principle; The principle of robust scientific evidence Other principles include: the harm principle; the principle of the least restrictive or coercive means; the reciprocity principle; the transparency principle; and the precautionary principle. [6][7][8] In a recent publication, Chiriboga et al 10 add to these, the principle of ensuring the fair allocation of resources to mitigate the unfair additional health and socioeconomic burden imposed by the pandemic on disadvantaged populations and Singh et al 11 appeal that "no one should be left behind": we will call this the principle of "equity. "…”

Section: T a B L E 1 Seven Principles To Guide Public Health Best-pramentioning

confidence: 99%

Principalism in public health decision making in the context of the COVID‐19 pandemic

Ferrinho

Sidat

Leiras

et al. 2020

Health Planning & Management

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Summary Background The COVID‐19 pandemic lead scientists and governmental authorities to issue clinical and public health recommendations based on progressively emerging evidence and expert opinions and many of these fast‐tracked to peer‐reviewed publications. Concerns were raised on scientific quality and generalizability of this emerging evidence. Main argument However, this way acting is not entirely new and often public health decisions are based on flawed and ambiguous evidence. Thus, to better guide decisions in these circumstances, in this article we argue that there is a need to follow fundamental principles in order to guide best public health practices. We purpose the usefulness of the framework of principalism in public which has been proved useful in real life conditions as a guide in the absence of reliable evidence. Conclusions It is recommended the implementation of these principles in an integrated manner adopting an holistic system approach to health policies adapted to specificities of local contexts.

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Health inequity during the COVID-19 pandemic: a cry for ethical global leadership

Abstract: We declare no competing interests. We thank our colleagues throughout the Burns Network in England and Wales for their collaboration towards this Correspondence.

Cited by 85 publications

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High prevalence of food insecurity, the adverse impact of COVID-19 in Brazilian favela

High prevalence of food insecurity, the adverse impact of COVID-19 in Brazilian favela

Universal Health Coverage and Primary Health Care: Their Place in People’s Health

Principalism in public health decision making in the context of the COVID‐19 pandemic

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