Rethinking the Central Role of Equity in the Global Governance of Pandemic Response

Background The shift in the global burden of disease from communicable to noncommunicable was a factor in mobilizing support for a broader post-Millennium Development Goals (MDGs) health agenda. To curb these and other global health problems, 193 Member States of the United Nations (UN) became signatories of the Sustainable Development Goals (SDGs) and committed to achieving universal health coverage (UHC) by 2030. In the context of the coronavirus disease 2019 (COVID-19) pandemic, the importance of health systems governance (HSG) is felt now more than ever for addressing the pandemic and continuing to provide essential health services. However, little is known about the successes and challenges of HSG with respect to UHC and health security. This study, therefore, aims to synthesize the evidence and identify successes and challenges of HSG towards UHC and health security. Methods We conducted a structured narrative review of studies published through 28 July 2021. We searched the existing literature using three databases: PubMed, Scopus and Web of Science. Search terms included three themes: HSG, UHC and health security. We synthesized the findings using the five core functions of HSG: policy formulation and strategic plans; intelligence; regulation; collaboration and coalition; and accountability. Results A total of 58 articles were included in the final review. We identified that context-specific health policy and health financing modalities helped to speed up the progress towards UHC and health security. Robust health intelligence, intersectoral collaboration and coalition were also essential to combat the pandemic and ensure the delivery of essential health services. On the contrary, execution of a one-size-fits-all HSG approach, lack of healthcare funding, corruption, inadequate health workforce, and weak regulatory and health government policies were major challenges to achieving UHC and health security. Conclusions Countries, individually and collectively, need strong HSG to speed up the progress towards UHC and health security. Decentralization of health services to grass root levels, support of stakeholders, fair contribution and distribution of resources are essential to support the implementation of programmes towards UHC and health security. It is also vital to ensure independent regulatory accreditation of organizations in the health system and to integrate quality- and equity-related health service indicators into the national social protection monitoring and evaluation system; these will speed up the progress towards UHC and health security.

show abstract

“…The global health governance of the COVID-19 response strengthens to combat the conditions of the pandemic [ 37 ]…”

Section: Resultsmentioning

confidence: 99%

Successes and challenges of health systems governance towards universal health coverage and global health security: a narrative review and synthesis of the literature

Debie

Khatri

Assefa

2022

Health Res Policy Sys

View full text Add to dashboard Cite

show abstract

“…The robust implementation of the restrictive measures that compose a lockdown strategy must consider both how we can impose and subsequently relax restrictive measures in a way that is feasible (i.e., easily or conveniently executed given contextual features), effective (i.e., successful in achieving the desired outcome), and ethical (i.e., seeks to limit the disproportionate burdens borne by the least advantaged). The key challenge for policy makers is achieving a lockdown strategy that can meet all three objectives, with the acknowledgement that successful pandemic response strategy requires more than a one-size-fits-all approach [ 19 ]. For instance, China’s authoritarian approach to COVID-19 response can be viewed as effective, but will not be feasible in other settings with different political and legal cultures.…”

Section: Lmic Lockdown Strategies: Entrance Exit and Preventionmentioning

confidence: 99%

Lockdowns and low- and middle-income countries: building a feasible, effective, and ethical COVID-19 response strategy

2021

Self Cite

View full text Add to dashboard Cite

Lockdowns can be an effective pandemic response strategy that can buy much needed time to slow disease transmission and adequately scale up preventative, diagnostic, and treatment capacities. However, the broad restrictive measures typically associated with lockdowns, though effective, also comes at a cost – imposing significant social and economic burdens on individuals and societies, especially for those in low- and middle-income countries (LMICs). Like most high-income countries (HICs), many LMICs initially adopted broad lockdown strategies for COVID-19 in the first wave of the pandemic. While many HICs experiencing subsequent waves have returned to employing lockdown strategies until they can receive the first shipments of COVID-19 vaccine, many LMICs will likely have to wait much longer to get comparable access for their own citizens. In leaving LMICs vulnerable to subsequent waves for a longer period of time without vaccines, there is a risk LMICs will be tempted to re-impose lockdown measures in the meantime. In response to the urgent need for more policy development around the contextual challenges involved in employing such measures, we propose some strategies LMICs could adopt for safe and responsible lockdown entrance/exit or to avoid re-imposing coercive restrictive lockdown measures altogether.

show abstract

“…Forth, a stewardship function [ 2 ]. Health equity is defined as “the absence of unfair, avoidable, or remediable differences among groups of people, whether those groups are defined socially, economically, demographically, geographically, or by other stratifiers (e.g., sex, gender, ethnicity, disability, or sexual orientation)” [ 3 ]. GHG has both a moral and a functional role in achieving health equity [ 4 ] so that every human being enjoys his right to health.…”

Section: Introductionmentioning

confidence: 99%

Global Health Governance and Health Equity in the Context of COVID-19: A Scoping Review

et al. 2022

View full text Add to dashboard Cite

Background: Health equity is an important aspect of responsible governance. COVID-19 exposed existing shortfalls of Global Health Governance (GHG). A considerable amount of related literature is produced. This scoping review aims at mapping the present knowledge and at identifying research gaps. Methods: This scoping review is based on the Joanna Briggs Institute’s guideline for standardized methods and PRISMA-ScR guidelines for reporting. Documents published from December 2019 to October 2021 were searched using PubMed, Scopus, Google Scholar, World cat, and WHO-Global Index Medicus. Two reviewers screened and reviewed eligible studies in three stages: duplicates identification and elimination, title and abstract screening, and full-text assessment. Data was charted and results were classified into conceptual categories. Analysis was done in three stages: open descriptive coding, focused thematic analysis, and frequency, commonality and significance analysis. Results: forty-nine studies met the inclusion criteria. Areas of research were grouped into seven themes: “human rights and inequities”, “solidarity, collaboration and partnership”, “GHG structure change”, “political and economic power and finance”, “approaches to address inequity”, “law and regulations”, and “private investment and public-private partnerships (PPPs) in GHG”. The highest number of papers were in the first theme, “human rights and inequities”. However, the themes are interrelated. Authors who contributed to research were mostly affiliated to developed countries indicating a gap in knowledge and expertise in developing countries. Conclusion: Through this scoping review we found that the seven themes are interconnected. Disciplinary collaboration in research relating GHG to health inequities is solicited. Collaboration in research, information sharing, and research capacity development are in needed in developing countries.

show abstract

Rethinking the Central Role of Equity in the Global Governance of Pandemic Response

Cited by 21 publications

References 7 publications

Successes and challenges of health systems governance towards universal health coverage and global health security: a narrative review and synthesis of the literature

Successes and challenges of health systems governance towards universal health coverage and global health security: a narrative review and synthesis of the literature

Lockdowns and low- and middle-income countries: building a feasible, effective, and ethical COVID-19 response strategy

Global Health Governance and Health Equity in the Context of COVID-19: A Scoping Review

Contact Info

Product

Resources

About