Opinion: Our collective vulnerability

Never in modern history has a disease so clearly demonstrated that health is essential for individual, national, and global security. As COVID-19 sweeps across the world, it leaves devastation in its path at each of these levels.

The response of the global community must reflect this profound reality. Global health challenges like COVID-19 will not be ameliorated by a vaccine alone; as the world mobilizes to fight the pandemic, we must come together to strengthen comprehensive health systems in order to maintain progress on global goals — both within the health domain and beyond.

Already, the World Health Organization and UNAIDS are reporting that disruptions of antiretroviral therapy due to the COVID-19 pandemic could lead to more than 500,000 additional deaths from HIV/AIDS in sub-Saharan Africa.

Another report from WHO showed that at least 30 measles vaccination campaigns were or are at risk of being canceled. And a recent pulse survey from Gavi, the Vaccine Alliance, UNICEF, and WHO reported that three-quarters of responding countries were experiencing disruptions in essential health services and immunization programs as a result of the pandemic.

While infant mortality has decreased substantially over the past two decades, this trend is being reversed as health systems are disrupted and access to food decreases. Similarly, a recent piece published by the World Economic Forum showed that COVID-19 has caused the biggest setback to gains in gender equality in a decade. The ultimate ramifications of COVID-19 will be far more severe — and wide-reaching — if we do not strategically protect all health services.

Despite these risks, the pandemic also presents a remarkable opportunity for the global community to refocus on the importance of health systems. COVID-19 can, and should, be used as a catalyst for change. If countries leverage this moment to build health systems capacity to not only respond to the pandemic but meet the future health needs of their populations, the health and economic benefits will be profound.

While governments and development partners work assiduously to implement COVID-19 response plans and the private sector accelerates vaccine research, all actors should consider how to structure pandemic responses as the foundations for more robust, resilient, and responsive health systems for the future.

As the global health community has learned from fighting pandemics over the past 50 years, focusing on one disease is never enough.

When HIV devastated the world in the 1980s and early 1990s, an unprecedented global response mobilized financing and infrastructure to help ensure access to care for those living with HIV/AIDS. However, this unprecedented global response did not address the primary health care needs of the population. Today, crumbling one-room clinics with a paucity of equipment hide in the shadows of glistening centers of HIV excellence.

By focusing too strongly on one disease, the world missed the opportunity to intervene in the growing burden of noncommunicable and preventable disease. As we look to mobilize and invest in a robust COVID-19 response, we must recognize the need to build out training, infrastructure, and primary care systems that can endure long past the pandemic’s end.

Any meaningful COVID-19 response will also rely on strong referral networks, facilitated by a well-distributed workforce that can address patient needs. As digital platforms are built to manage COVID-19 care and facilitate training, we must also remember that health care is fundamentally a human-centered art.

Managing COVID-19 today and providing for the ongoing health needs of populations will require trained health workers able to provide direct, dignified, and quality care or support to move patients to the facilities they need for higher-level care. Human resource investment and training is essential, as the backbone of any strong health care and referral networks and the fundamental building block for strengthening national health services going forward.

We don’t have to choose between strong health systems and a robust response to this pandemic. Prescient governments and agile NGOs are already finding ways to connect national COVID-19 responses to long-term strengthening of health systems.

In Sierra Leone, Seed Global Health is partnering with the government to transform health professional education and training to address the country’s high rates of infant and maternal mortality. In South Sudan and Syria, Plan International is working to strengthen health systems for vulnerable refugee populations.

Across East Africa, the Japanese Organization for International Cooperation in Family Planning is working to strengthen health promotion and front-line services for women and children to improve maternal and child health. And in India, World Vision is strengthening health systems through investment in community health services and front-line workers.

Across all of these organizations and countries, investments in the strengthening of health systems are being leveraged for COVID-19 response and to provide care in the face of myriad persistent pandemics affecting vulnerable populations around the world.

I am proud to join these organizations and Devex on Sept. 23 at the event “From the Frontlines: How to move from COVID-19 to health for all.” On the occasion of the United Nations’ 75th General Assembly session, we will discuss practical policy and program solutions to help governments integrate pandemic response to comprehensive health systems.

The time to act is now. In a world where we are only as safe as our neighbors, fragile health systems represent our collective vulnerability.

At a global level, failure to strengthen health systems, achieve universal health coverage, and invest in the necessary human resources for health may lead to dire consequences — both within the sphere of health and beyond. We are seeing this reality play out as the COVID-19 pandemic unfolds. It is time to act courageously and comprehensively; we can save lives today and protect health in the future.