Protecting essential health services in low-income and middle-income countries and humanitarian settings while responding to the COVID-19 pandemic

Abstract

In health outcomes terms, the poorest countries stand to lose the most from these disruptions. In this paper, we make the case for a rational approach to public sector health spending and decision making during and in the early recovery phase of the COVID-19 pandemic. Based on ethics and equity principles, it is crucial to ensure that patients not infected by COVID-19 continue to get access to healthcare and that the services they need continue to be resourced. We present a list of 120 essential non-COVID-19 health interventions that were adapted from the model health benefit packages developed by the Disease Control Priorities project.

Working short and working long: can primary healthcare be protected as a public good in Lebanon today?

“…In resource -constrained contexts where the burden of disease and risk factors are often distributed unevenly in the population, factors such as siloed nancing and fragmented governance of the health system may well have contributed to an increased burden on the poor [15]. Today, service providers and policy-makers worldwide are pressured to decide which essential services must be protected as precious resources are reallocated [16]. Making sound decisions is even more di cult in a context where political, economic or nancial interests might well result in fragmented directives that privilege the powerful and thus serve to increase inequities [15].…”

“…It has been recognized that around the world the poor are experiencing more severe direct and indirect consequences of Covid-19. To disregard the short-and long-term effects of the pandemic may have costly impacts on the society overall, as Covid-19 is affecting both the demand for and the provision of essential services [15][16][17]. A one size ts all response is likely to cause great hardship for those most in need.…”

“…In contexts where constrained resources are now further dwindling, it is crucial to understand the context of the pandemic, the capacities of the health systems, and the needs of the community. In such settings, the decisions made to control the Covid-19 pandemic could impose even more drastic and inequitable short-and long-term consequences on health systems and on populations affected [15][16][17].…”

Cardiovascular health and COVID-19: time to reinvent our systems and rethink our research priorities

“…On value-for-money grounds, basic cardiovascular disease prevention and care are just as 'essential' as immunisation programmes, maternal healthcare and screening and treatment of HIV infection. 6 At the same time, locations with advanced cardiovascular care systems need guidance on how to balance the need to treat severe cardiovascular disease against the need to adapt quickly to increased COVID-19 caseloads. Ball et al found that emergency department visits and percutaneous coronary intervention procedure rates in UK hospitals had partially rebounded by the end of May 2020.…”

The Indirect Consequences of the Response to the COVID-19 Pandemic

“…In recognition of this vulnerability, Blanchet et al. ( 7 ) identified the prevention of cardiovascular disease as a health system priority that should be unconditionally preserved despite the pandemic, based on their assessment of the magnitude of harm that would arise from its interruption. Even in the midst of the pandemic, clinicians can evaluate patient risk by telephone or video.…”