The Independent Panel for Pandemic Preparedness and Response was set up by WHO to review the state of pandemic preparedness before COVID-19, the circumstances of the identification of SARS-CoV-2 and responses globally, regionally, and nationally, particularly in the early months of the pandemic, and its health system, social and economic consequences. This report of the panel indicates that preparedness was limited and disjointed, leaving health systems overwhelmed when actually confronted by a fast-moving and exponentially spreading virus. The panel concluded addressing this gap not requires sustained investment, and new approaches to peer review of country preparedness, and to the international alert system. The panel suggests that the legally binding International Health Regulations (IHR) (2005) did not facilitate rapid action, and that the consequence of delays in response impacted most on already disadvantaged people.
Values, Policies and Rights
In an open letter to the Ambassador Extraordinary and Plenipotentiary, Colombia, the Peoples' Health Movement urged the government to abide by the Constitution, stop the violence, and join hands with citizens in defeating COVID urgently, and enacting policies that promote people’s health, equality and social justice. The PHM wrote: "We note with deep concern the criminalisation of protest and high levels of violence perpetrated on legitimate and peaceful protestors by the Colombian government security forces and armed civilian groupings. Credible sources report the use of lethal weapons, including rifles and semi-automatic guns, against protesters around the country by police. At least 37 people have been killed; some reports give larger numbers. There are also reports of disappearances. As a result of extreme militarisation, some cities, including Cali and Palmira, are running out of food and medicine supplies; Internet signals and social networks essential for communication among citizens and communities have been blocked; and levels of fear and uncertainty are growing among the population. The protests occur against the background of the COVID-19 pandemic. COVID is exacerbating poverty and inequality. The number of Colombian people living in extreme poverty grew by 2.8 million last year. And more and more people face hunger.
The authors investigated how gender power relations within households affected women’s health outcomes in Simiyu region, Tanzania. Women who reported being able to make their own health decisions were 1.57 times more likely to use condoms. Women who reported that they decide how many children they had also reported high contraception use. Seeking care at the health facility was also associated with women’s autonomy for making major household purchases. The authors observe that the association between decision-making and other gender domains with women’s health outcomes highlights the need for heightened attention to gender dimensions of intervention coverage in maternal health. They suggest that future studies should integrate and analyze gender-sensitive questions within coverage surveys.
High level speakers at the December 2020 United Nations General Assembly pointed to the growing inequalities and stress to health, social, economic and democratic systems caused by COVID-19, calling for a range of collective interest driven responses and measures for a sustainable recovery. The pandemic, lockdown and other responses, along with underfunded, poorly prepared and overstretched public sector social and health systems in many countries worsened many dimensions of health and well-being that were already facing deficits, generating a rising health and social debt in communities, the scale and long-term consequences of which are as yet unknown, especially for the most marginalised in society. Rather than ‘getting back to normal’, the authors argue that recovery and ‘reset’ demands change to tackle the inequalities, conditions, services, socioeconomic and environmental policies that made people susceptible and vulnerable to COVID-19. Economic recovery should not replicate the features of the global economy that are generating pandemic and other crises. The authors suggest further that for global aspirations to translate into benefit for communities, an equitable recovery should include significant investment in: (1) universal, public sector, primary health care-oriented health services; (2) redistributive, universal rights-based and life course based social protection; and (3) people, especially in early childhood and in youth, as drivers of change.
Some countries have considered using immunity certification as a strategy to relax restrictive measures by issuing an immunity passport for people certified as having protective immunity against SARS-CoV-2, the virus that causes COVID-19. The World Health Organization has advised against the implementation of immunity certification because of uncertainty about the length of time of immunity and concerns over the reliability of methods for determining immunity. However, even if immunity certification became well supported by science, the authors note many ethical issues in terms of the implementation process, its uses, measures in place to reduce potential harms, prevention of disproportionate burdens on non-certified individuals and potential violation of individual liberties and rights.
The Tanzanian Ministry of Health has now urged citizens to take all the required precautions against Covid-19 including wearing face masks. The statement issued on Sunday, February 21, 2021 by the Head of the Public Relations Unit, Gerard Chami said the Ministry continues to monitor and stress the implementation of precautionary measures against various non-communicable and communicable diseases including outbreaks and Covid-19. Precautions included hand washing, use of sanitizer, exercising, and protection for all those at risk such as the elderly, obese people, and those with chronic illnesses. The statement also urged Tanzanians to get proper nutrition including fruits and vegetables, use natural remedies registered by the council of traditional healers and as advised by relevant professionals and to visit health facilities on witnessing symptoms of illness.
The geopolitics of pandemics and climate change intersect. Both are complex and urgent problems that demand collective action in the light of their global and trans-boundary scope. In this article a geopolitical framework is used to examine some of the tensions and contradictions in global governance and cooperation that are revealed by COVID-19. The authors argue that the pandemic provides an early warning of the dangers inherent in weakened international cooperation. The world’s states, with their distinct national territories, are reacting individually rather than collectively to the COVID-19 pandemic. Many countries have introduced extraordinary measures that have closed, rather than opened up, international partnership and cooperation, including in border closures, restrictions on social mixing, domestic purchase of public health supplies and subsidies for local industry and commerce. For the poorest countries of the world, pandemics join a list of other challenges that are exacerbated by pressures of scarce resources, population density and climate disruption, and have a disproportionate impact on those living with environmental stresses. The authors highlight the need for a coordinated global response to addressing challenges that cannot be approached unilaterally.
After a long nine years of waiting, the Centre for Human Rights and Development (CEHURD) finally received the judgment in the famous Petition 16 maternal health case on 19th August, 2020. The Constitutional Court agreed with CEHURD submissions and all judges accepted all the grounds of the petition. Through this judgment, the right to maternal health care (and the right to health broadly) has been granted a place in Uganda’s Constitution. This judgment recognizes provision of basic maternal health care services and emergency obstetric care as an obligation by the government. It’s through unremitting advocacy, litigation and activism that CEHURD achieved this landmark decision. It took a whole movement/coalition on maternal health to realize what a few thought would be possible. CEHURD now turn their efforts to the implementation. Investing in maternal health is a political and social imperative, as well as a cost effective investment in strong health systems overall. The #Petition16 judgment entails some very powerful declarations and orders on health financing. This case creates positive jurisprudence and makes it possible for people to sustain a cause of action in the right to health against the state for failing to provide the basic minimum health care package.
This paper addresses interventions to address intimate partner violence (IPV) against women and girls by engaging with faith communities and their leaders. Two community surveys were conducted, one before and one after the intervention, in three health areas in Ituri Province in the Democratic Republic of Congo. Questionnaires were interviewer-administered, with sensitive questions related to experience or perpetration of violence self-completed by participants. The study showed significantly more equitable gender attitudes and less tolerance for IPV after the interventions. Positive attitude change was not limited to those actively engaged within faith communities, with a positive shift across the entire community in terms of gender attitudes, rape myths and rape stigma scores, regardless of level of faith engagement. There was a significant decline in all aspects of IPV in the communities who experienced the intervention. This intervention was premised on the assumption that faith leaders and faith communities are a key entry point to influence an entire community. The research affirmed this assumption.
This study examines determinants of gender attitudes among some of the poorest and most vulnerable adolescents in Tanzania using an ecological model. Data come from baseline interviews with 2458 males and females aged 14–19 years conducted within a larger impact evaluation. Secondary school attendance was associated with more equitable gender attitudes. Females had less equitable gender attitudes than males in the sample. Having had sexual intercourse was associated with more gender equitable attitudes among females, but the reverse was true among males. Addressing gender inequity requires understanding gender socialisation at the level of social interactions. The finding that females had more inequitable gender attitudes than males in the study is argued by the authors to suggest that more emphasis be given to highlighting the rights of women with female adolescents.