Latest Equinet Updates

Call for applicants: East and Southern Africa Regional Peoples Health University, Online 29 July to 12 November 2021
EQUINET and PHM: Closing date 25 June 2021

The first East and Southern Africa Regional People’s Health University (ESA RPHU) jointly convened by PHM and EQUINET is being held virtually between 29 July and 12 November with the theme ‘Past, present and future struggles for Health equity’. The course aims to build and share evidence, experience, analysis and knowledge on the drivers of health equity to support efforts and activism within countries, as new and existing members of PHM and EQUINET, and in regional co-operation and joint engagement, from local to global level, on shared priorities. The course aims to link key areas of evidence and knowledge to practical experiences and action to share insights and build learning from action. We invite applicants based / working in the east and southern Africa region in state, non-state, community-based institutions involved in health-related work, from health and other sectors and disciplines that have an impact on health equity. See the website link for further details on the course, features for applicant eligibility, and for the online application form. Applicant forms must be received by 25 June 2021. Applicants will be informed by 12 July.

A People’s Vaccine or Apartheid Vaccine? Challenging WTO and Big Pharma
Daraja Press, January 2021

Access to health technologies (vaccines, medicines, diagnostics, PPE, ventilators etc) depends on distributed local production. Nationalism and protectionism on these technologies has implied a sustained struggle to get sufficient access to meet population needs, and global measures such as CTAP (for voluntary patent pooling) and COVAX (for vaccine and technology pooling) have not had the support that matches need. One of the barriers is the patent protection in the TRIPS agreement. In this interview, Firoze Manji speaks with Leslie London, Professor of Public Health in the School of Public Health and Family Medicine University at the Cape Town (and an EQUINET steering committee member), and Jens Pedersen from Medicins Sans Frontiers on the issues of access.

Brief: Ensuring access to COVID-19 related vaccines and health technologies in East and Southern Africa

The ability of African countries to mount effective and equitable responses to COVID-19 reflects in part the access that countries have to reliable, sustained, distributed supplies of diagnostics, medicines, vaccines and other health technologies. By 2021 significant inequality in access to vaccines has become clearly evident, a situation that the World Health Organisation director-general called a “catastrophic moral failure” in January 2021. While noting that vaccine roll out in East and Southern Africa (ESA) is a dynamic situation, this brief discusses the different vaccines and the distribution of vaccines in the region and issues involved in the development and production of vaccines and other health technologies in the region. It raises areas where regional co-operation is taking place and suggests where it could be strengthened.

EQUINET Information sheet 5 on COVID-19: Pandemic impacts on labour – experience and responses

This fifth information sheet in the COVID-19 series summarises information on how COVID-19 has affected working people in the ESA region, and the response by workers, unions, states and others, with recommendations for how to better address the impacts. Nearly a million African workers are estimated to have had COVID-19 in 2020, probably more given the low level of testing. Health workers (HWs), those in crowded or poorly protected workplaces or in crowded accommodation, those in common contact with the public and those in caring roles may be more at risk. Informal, migrant, young, disabled and female workers may be more vulnerable to COVID-related disease. Lockdowns and blocks in supply chains have disrupted key areas of employment, affecting working people’s livelihoods, jobs and mental health, and leading to stigma and social insecurity and falling remittances from African migrants and revenues for social protection. Possible responses include public health measures, including now equitable access and vaccines; workplace infection control; social protection to prevent impoverishment; protection of jobs and wage subsidies. Workers and unions have contributed to these responses, despite the pandemic undermining union operations. The brief outlines recommendations to protect workers and their rights at work, noting that not implementing such measures makes the whole of society vulnerable.

Putting the public back into public health: Communities organising solidarity responses to Covid-19
Whyle E; van Ryneveld M; Brady L; Loewenson R: Maverick Citizen, December 2020

This oped draws on EQUINETs 42 case studies of community action on Covid-19 that collectively show innovative and solidarity-based approaches to prevent and care for Covid-19, to address social needs and hold states accountable, and in more detail on the experience with the Community Action Networks in South Africa.

What do we know about COVID-19 spread in Africa?
Daraja Press, 5 February 2021

This interview between Firoze Manji Daraja press and Dr Rene Loewenson, Training and Research Support Centre explores evidence and knowledge gaps on COVID-19 in east and southern Africa, drawing on EQUINET information briefs and other sources. The interview identifies positive examples of state and public proactive responses to the pandemic in the region, the challenges faced and what learning that brings for equity in responding to pandemics.

'We are subjects, not objects in health’: Communities taking action on COVID-19
Loewenson R; Colvin C; Rome N; Nolan E; et al: Training and Research Support Centre in the Regional Network for Equity in Health in East and Southern Africa (EQUINET) and Shaping Health, September 2020

This document provides evidence of practical and affirmative options of people-centred, participatory forms of community organising and engagement in diverse areas of prevention, care and wider social protection in responding to COVID-19. The 42 case studies from different regions intend to inspire, inform and support. They report the creative development and use of social media platforms for action across all areas of response, connecting people within and across communities and countries, giving voice and visibility to community experiences and linking people to key resources and services. They demonstrate that a compassionate society enhances public health. Many build on histories, ideologies, structures, organisation and relationships that began long before the pandemic, enabling a relatively rapid response to new challenges posed by COVID-19 and with an intention to sustain relevant innovations after the pandemic. They reach to socio-economically disadvantaged groups within communities, strengthening collective organisation, investing in capacities and leadership and making links with more powerful groups to address local priorities and negotiate delivery on state obligations. They build new relationships between communities and producers and between communities and health workers, and solidarity interactions with international agencies and diaspora communities. The challenges presented by the pandemic are creating demand and space for innovation, and in many settings communities are rising to that demand. The mobilization of affirmative community effort and creativity needs to be recognised in the story of the 2020 pandemic.

Using evidence and analysis for an adaptive health system response to COVID-19 in Uganda in 2020
Kadowa I: EQUINET Case study paper, Ministry of Health Uganda, TARSC: EQUINET: Harare, 2020

Uganda reported its first confirmed case of COVID-19 on 21 March 2020. The country has since implemented a series of public health measures to limit the spread of the virus. The pandemic has progressed from imported cases through sporadic community cases to stage four, with widespread community transmission. This paper documents how evidence and analysis were used to support decision-making for an adaptive health system response to COVID-19 in Uganda in 2020. A desk review was thus implemented using published and grey literature covering the period from February to October 2020 to document the nature and organisation of different data and related evidence used to support projections, planning and decision-making on the surveillance, prevention, care and health system response to COVID-19. The desk review also looked at how evidence was used and communicated across different actors to support adaptive responses. While there have been challenges, Uganda’s response to COVID-19is reported to have been dynamic, responding to different sources of evidence, and through different institutional channels and actions, with the latter generating evidence and experience that feeds back to the response.

Brief: COVID-19 in East and Southern Africa: developments in the pandemic, July 2020
EQUINET and ECSA HC: Mimeo, 2020

This information sheet is the second presenting work summarising evidence as of July 17 2020 from official and scientific population data across countries in east and southern Africa (ESA) on the COVID-19 pandemic, the responses to it and the relationship with other indicators of population health, health systems and health determinants. The information sheet aims to address four questions: What is happening with COVID-19 testing and detection? How and where is the epidemic progressing over time? How has the health system responded? What are the implications for wider vulnerability? In terms of the epidemic profile, increased testing has improved case detection, although still at low levels for an effective public health response. The pandemic continued to take different forms in different ESA countries. In terms of the health system response, the evidence in July indicated continued constraints in accessing diagnostics, limiting case detection, despite reasonable surveillance capacities. In terms of wider vulnerability, the slower, sustained increase in cases in the ESA region were noted to raise concern on the effects of sustained implementation of measures such as school and workplace closures.

COVID-19 in East and Southern Africa: Rebuilding Differently and Better Must Start Now
Loewenson R: MEDICC Review 22(3), doi:, 2020

This paper outlines how for ESA countries, COVID-19 has exposed the weakness in being dependent on research and production outside the region of commodities that are needed in good time for communities and services across the region. This not only relates to current demand, like test kits. It forewarns that African countries will be last in the queue when COVID-19 treatments and vaccines are approved. Tariff reductions and reduced protections for domestic industry have suited a global strategy of ‘lowest-cost-production’ but leave ESA countries vulnerable in the global competition for products. The author also notes that COVID-19 has pointed to resources in the region that could play a more significant role in public health. The Ebola experience showed that an effective response demands collaborative work that involves communities and is supported by professionals, governments and accessible, capable public services. This is the same lesson learned from the gains made in health by applying primary health care strategies in the region, despite their being weakened by underfunding of public services. In contrast, the response to COVID-19 has often generated a self-protective response across countries in global trade and a command-and-control response within countries. Yet neither are effective strategies for a global pandemic that demands distributed local capacities and action. Noting the UN call to use COVID-19 as an opportunity “to rebuild differently and better, the author observes that this begins with how we respond to COVID-19 today, and raises what this implies.