Here are 8 cases Bill Gates makes for global health recovery
The health sector is no doubt the hardest hit by the coronavirus crisis. It has shaken weak foundations of health systems across the world and exposed the weaknesses of even the best hospitals at weathering a storm.
As Bill and Melinda Gates Foundation puts it, the damage done is clear but health structures across the world must take actions that matter in the next few months.
According to the 2020 Goalkeepers report, “Progress is possible but not inevitable.” Consequently, the Foundation has made a case for actions to be taken in the following key areas of health indicators.
Indirectly, Covid-19 will cause more women than men to suffer and die, largely because the pandemic has disrupted health care before, during, and immediately after childbirth.
Preventable, treatable complications such as severe bleeding, infection, and high blood pressure cause the vast majority of maternal deaths. Many health care workers, who used to manage these emergencies, including experienced nurse-midwives, are being diverted to Covid-19 wards.
Meanwhile, pregnant women and new mothers must weigh the benefits of visiting a clinic—where they may not have received high-quality care in the past, against the risk of exposure to Covid-19. Some are deciding to deliver at home or skip new born care visits as a result. Expert maternal care is the definition of an essential service. Unlike some other services, it cannot be safely postponed and caught up later. A pregnant woman is pregnant now and delivers her baby when she delivers. It is imperative that health systems have all the resources they need to ensure that she can do so safely and with dignity.
Current data suggest that children are less likely to have severe disease from coronavirus infection than older adults. However, as coverage for routine immunisations decreases and case management for pneumonia and diarrhoea have been interrupted due to the pandemic, children are increasingly vulnerable.
Models predict that acute malnutrition will increase dramatically, which will make it harder for children to fight off infectious diseases.
These consequences of the pandemic emphasise the need to figure out how to prevent secondary and tertiary crises. Yet even now, lifesaving innovation continues. Vaccines exist to protect against many causes of pneumonia, the leading infectious killer of young children. But they can be expensive—they account for about half the budget of Gavi, the Vaccine Alliance. Several months ago, however, the World Health Organisation prequalified a new pneumo
struggling to maintain services. nia vaccine that costs only One innovation that seems $6 for a three-dose regimen to be helping is multi-month instead of $9. And thanks to dispensing—a simple approach increased investment due to that helps people fit treatment Covid-19, more health care into their lives and keeps them facilities are providing access out of overburdened clinics. to oxygen to treat respiratory Even after Covid-19 is under conditions; this will help save control, this will be a more effecthe lives of many children intive, efficient way to dispense fected Art.withpneumonia.
Current evidence shows that people living with HIV are at increased risk of death due to Covid-19. But the indirect effects of the pandemic are also worrying.
Disruptions to health services could mean people do not get antiretroviral therapy (ART), which would result in more deaths and more infections (because viral loads are higher in untreated patients, they are more likely to transmit to others). So far, this worst-case scenario has not happened, although some countries are
Before Covid-19, there were already 3 million “missing cases” of TB: people with active TB who did not know it and were passing the disease to others while going untreated themselves. Now, that number will grow even larger as people either cannot go to health facilities for diagnosis or choose not to go to avoid the possibility of exposure to Covid-19.
For similar reasons, people who know they have TB may not go in for treatment. Our fear is that this expanded pool of undiagnosed infections will
lead to a long-term increase in the number of TB cases around the world. As they come out of Covid-19, countries are going to have to make case-finding and funding for TB a major priority.
Malaria is unforgiving: As long as it exists, it will kill the most vulnerable and take advantage of emergencies. That is why the Gates Foundation’s malaria strategy is geared toward eradicating the disease. Even under ordinary circumstances, both the malaria parasite and the mosquitoes that transmit it develop resistance to the drugs and insecticides used to fight them.
“We invest in modelling and surveillance technologies designed to help countries tailor strategies for deploying malaria tools so that they drive down ongoing, high-level transmission as much as possible,” the Foundation stated, noting that these same tools are also critical for epidemic preparedness and response.
Before Covid-19, there was good news about this indicator. In West Africa, for instance, where progress had been slow, the number of women using contraceptives more than doubled between 2011 and 2020.
One solution is to shift toward a model of self-care that equips women and families with the expertise, tools, and confidence to plan without having to rely on the health care system. This can include specific interventions like selfinjectable contraceptives or platforms like telemedicine, but it is broader than that. Selfcare is deeply rooted in women’s needs and can promote access to family planning and other essential health services. Universal health coverage
The Universal Health Coverage (UHC) Effective Coverage Index produced by IHME includes 23 indicators that, together, are a shortcut for thinking about whether people in a country have access to essential health services.
A breach of protocol for public gatherings at the burial ceremony of late Emir of Zazzau, Shehu Idris.