Monitoring equity and research policy

The authors explored how health research knowledge is translated into policy in Zambia, and what facilitates or hinders this, from document review and key informant interview. While the document review suggested policy efforts to promote knowledge translation, the interviews raised challenges in coordination and linkages between knowledge and policy-making processes, attributed to lack of research knowledge translation capacity, limited resources and lack of knowledge hubs. However, the authors suggest that emerging local research leadership and a stock of underused local health are an opportunity to enhance knowledge to policy links, if supported.

To ask why COVID-19 hasn’t been deadlier in Africa is to suggest that more Africans should be dying. We need better questions. Almost every major international news outlet has asked a variation of the question. Some speculate that something structural or physiological has dampened the impact of COVID-19 on Africa’s population; otherwise, Africa would be faring worse. Others argue that African governments are simply doing a better job of managing the disease than other regions, despite evidence to the contrary. Neither analysis reflects the complex realities of COVID-19 in Africa. The question itself, in its crudest form, has provoked considerable, justifiable anger on social media in various African countries. Yet as the deaths mount in Brazil, India, the United States, and the UK, and as Europe prepares for its second wave, the official death toll in African countries remains low. Even in South Africa, the most severely affected African country, confirmed deaths are far fewer than predicted. Experts are left wondering why their predictions were wrong. To ask why more Africans aren’t dying of COVID-19 exposes the expectation that when the world suffers, Africa must suffer more. We can learn collectively from the questions we ask. Knowledge-making is about grappling with useful questions—those that move humanity toward a greater understanding of shared circumstances. But questions that distract from meaningful comparisons dominate the current moment. “Why aren’t more Africans dying of COVID-19,” like so many questions about Africa, fails to illuminate.

In this article the authors argue that many African governments have so far responded more proactively and effectively to Covid-19 than some governments in high income countries (HICs). Much of this capacity to respond effectively can be explained by an existing culture of using evidence to inform policy decision-making. African researchers are producing evidence on how to protect and prioritise already existing health interventions which can increase health system resilience and preparedness for Covid-19. The authors argue that African nations have generated and used evidence for decision- making on solutions to tackle the pandemic. Data-poverty and technology deficits are a challenge. The authors note that partnerships to assist with production, collation, and use of evidence are appearing nationally, regionally, and globally to support quick but measured evidence-informed decisions.

To understand better both impact of and responses to COVID-19, UN Women is recommending stand-alone surveys or integration of questions on violence against women in socio-economic and gender surveys to assess the prevalence and responses to gender based violence during COVID-19. This data is argued to be critical to support evidence-based interventions and to make available lifesaving services. UN Women in East and Southern Africa is working closely with the partner agencies and providing technical support to develop model surveys and guidelines to support quality assessments. This briefing also provides case study analyses of gendered effects of COVID-19 in Uganda, Kenya, South Africa, Ethiopia, Burundi, Zimbabwe, Mozambique and Malawi.