Details

Autor(en) / Beteiligte

• Assefa, Yibeltal
• Gilks, Charles F
• van de Pas, Remco
• Reid, Simon
• Gete, Dereje Gedle
• Van Damme, Wim

Titel

Reimagining global health systems for the 21st century: lessons from the COVID-19 pandemic

Ist Teil von

• BMJ global health, 2021-04, Vol.6 (4), p.e004882

Ort / Verlag

England: BMJ Publishing Group LTD

Erscheinungsjahr

2021

Link zum Volltext

Quelle

EZB Free E-Journals

Beschreibungen/Notizen

• The COVID-19 pandemic: a reminder for a strong global health system The COVID-19 pandemic is a timely reminder of the nature and impact of global health threats that could become Public Health Emergency of International Concern (PHEIC).1 The virus has spread quickly to all countries (although with variable epidemiological patterns), and has overwhelmed even some of the most advanced health systems.2 As of 12 April 2021, the pandemic has caused more than 136 million cases and 2.93 million deaths.3 But beyond morbidity and mortality, it affects the whole of society and government, and causes serious socioeconomic loss.4–6 With the emergence and spread of new variants of the virus,7 it is highly likely that the virus will be circulating and staying with us for the foreseeable future. Pandemics not only cost lives but also pose some of the greatest risks to the global economy and security.17 As the world’s population becomes more mobile and interdependent, and with biodiversity reduction and ecological degradation, global health threats increase and traditional defences at national borders cannot protect people against the invasion of a disease or vector.18 We argue that countries have at least three foreign policy imperatives why they should cooperate more intensively on global health; namely for security, economic and moral reasons.19 Health security risks can easily be transmitted from one place to another.20 21 The benefits of investments for GHS in one country often extend to the wider region or the globe.22 The implication is that health security requires a regional and global level response, management and coordination.23 24 On the other hand, the impact of a pandemic extends much beyond mortality and causes serious socioeconomic losses. The aspiration towards a safer world will be realised only if all countries have not only strong essential capacities for implementing the International Health Regulations (IHRs), but also health systems for UHC and realise strong synergy between IHR (GHS) and UHC.11 Compliance with the IHR is a critical step towards an effective response to epidemics (and pandemics)29; on the other hand, UHC is crucial to establish a first line of defence against threats to health,30 31 and to enable all people to ‘obtain the health services they need without suffering financial hardship when paying for them’.32 COVID-19 demonstrates that health security is a local, regional and global common good,33 which requires not only an individual action but also a collective response14 that is possible if there is adequate technical capacity and political will not only at local and national but also at regional and global levels. The governments of HICs with a successful response to COVID-19 exhibit the key characteristics of justice and comprehensive public health: governing for the common good; shared and clear responsibilities between different actors; rational, compassionate and transparent communication; and legitimate leadership and trust.42 43 The response to the pandemic should be guided by governance, which is balancing both sound analysis and decision speed, centralised and decentralised decision-making, societal deliberation and participatory representation, innovation and bureaucracy, and science and politics.44 Certain population groups, including the elderly, suffer a disproportionate share of severe disease and death.45 46 Countries should apply the principles of precision public health by investing in data systems and people-centred delivery platforms.