By Dr. Matshidiso Moeti
ADDIA ABABA – The COVID-19 pandemic has shone a light on inequalities between countries. Amid shortages of essential supplies, African countries have been pushed to the back of the queue in accessing COVID-19 test kits, personal protective equipment and now vaccines. Of 548 million COVID-19 vaccine doses administered worldwide, only 11 million or 2%, have been in Africa, whereas the continent accounts for around 17% of the global population.
There are also inequities within countries. Discrimination based on gender, place of residence, income, educational level, age, ethnicity and disability intersect to disadvantage vulnerable populations. Recent data from 17 African countries show, for example, that a person with secondary school education is three times as likely to have access to contraception as someone who has not attended school. Those in the highest economic quintile are five times more likely to deliver their babies in health facilities and have their babies vaccinated with BCG compared to those in the lowest quintile.
To improve this situation, we need to act on the social and economic determinants of health, by working across sectors to improve living and working conditions, and access to education, particularly for the most marginalized groups. Communities need to be engaged as partners, through their networks and associations, to shape and drive health and development interventions.
A key challenge in overcoming inequities is that there is limited data showing who is being missed and why. To address this, national health information systems need to capture age, sex and equity stratified data. This information can then be used to inform decision- and policy-making.
At WHO, we are working with countries to strengthen capacities to collect, manage and use data, and to enhance monitoring and action to address avoidable inequities. In the past year we have disseminated technical guidance on gender, equity and COVID-19 and trained 30 country teams in gender and health equity integrated programming. The teams are using skills gained to support equitable health response, including to deal with gender-based violence in the context of COVID-19.
Investment is also needed to accelerate progress towards Universal Health Coverage, to protect individuals from financial hardship in accessing needed care and to improve service coverage. Most African countries have initiated reforms in these areas believing that these reforms will in turn contribute to building more resilient health systems and societies.
Moving forward, leaders need to work together to address inequities in their own countries and abroad in the spirit of international solidarity. Specifically, on COVID-19 vaccines, we encourage pharmaceutical companies to support wider manufacturing to overcome current supply shortages. We also encourage wealthy countries to share their doses, so that the most-at-risk populations in all countries can be protected, to save lives and speed-up the recovery from this global crisis.
This World Health Day I call on Member States, partners, civil society, communities, and other stakeholders to intensify work with WHO to achieve Universal Health Coverage, and to invest in addressing the social and economic determinants of health, to tackle inequities and build a fairer, healthier world.
As WHO we remain committed to ensuring that all people in Africa, and globally, can realize the right to good health.
The author, Dr Matshidiso Moeti*, is WHO Regional Director for Africa. She wrote the message in connection with the World Health Day, which will be marked across the world on April 7.
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