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This country asks for justice.

In this unprecedented moment of COVID, health has been identified as one of our most valuable possessions and protecting it is a must.

By Viona AmindaPublished 3 years ago 5 min read
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This country asks for justice.
Photo by KirstenMarie on Unsplash

The right to the health was articulated by WHO in the Alma Declaration in 1978. The constitutional debate in Chile is an opportunity to reexamine this concept.

Chile's constitution provides for the right to "free and egalitarian access" to health care. At the same time, the constitution guarantees that "everyone has the right to choose the health system they want, whether public or private."

This provision has championed a prosperous private health sector, with corporate clinics and private insurance systems representing nearly half of total health spending.

However, this private sector serves less than 20 percent of the population. Nearly 80 percent of the population uses public sector insurance. Although the public sector has expanded its coverage of health services, and health indicators for those with public insurance have improved, the public sector has been chronically underfunded.

Public sector health care spending represents only 4% of GDP. Public health interventions and pharmaceutical innovations are essential in extending life expectancy and increasing well-being.

In particular, access to medicine is an important part of health care. But access to medicines is far from universal.

Nearly a third of pocket expenditure in Chile is on medicines. And out-of-pocket spending represents 33 percent of Chile's total health spending, which is one of the highest proportions of out-of-pocket spending for OECD countries. Many feel that they have to deal with the health risks they face themselves, with salaries not increasing to cover costs.

As a result,

social protection is severely undermined. Access to health care and medicine was among the main demands during last year's social protests - which were attended by nearly 1 million demonstrators on October 25.

One of the main targets for dissatisfaction is the pharmacy shop. Weak access to necessary medicines is supported by high price variations in pharmacies.

Patients are encouraged to buy things they don't need at times of greater vulnerability.

This situation is exacerbated by the reluctance of the state to intervene and regulate retail pharmacy and drug prices. As a result, citizens demand the right to health guaranteed in the constitution.

Including the right to health in the constitution has had mixed results in Latin America. In the late 1990s and early 2000s in Brazil, the right to health had a positive impact on access to HIV / AIDS treatment and filled the gap between what was established in public policy and what was implemented.

Since the mid-2000s, disputes over the coverage the state should provide have been resolved through court proceedings. Sometimes, court proceedings lead to ineffective provision of care in the public sector, which is something we should be aware of in the future.

The upcoming plebiscite presents a historic opportunity to open debate and incorporate principles of the right to universal health and health care into the country's constitution, which, in turn, will facilitate legislative reforms that can protect people, especially those who are most vulnerable.

WHO urges equitable COVID-19 vaccine access to widen reach in Africa.

Africa urgently needs more COVID-19 vaccine supplies as deliveries begin to slow down and initial batches are nearly exhausted in some countries. The continent has so far administered 7.7 million vaccine doses mainly to high-risk population groups.

Forty-four African countries have received vaccines through the COVAX Facility or through donations and bilateral agreements, and 32 of them have begun vaccinations. The COVAX Facility has supplied nearly 16 million doses to 28 countries since launching deliveries to the continent on 24 February. Countries have made significant progress in reaching high-risk populations targeted in the initial phase of the rollout, including health workers, elderly people and people with conditions such as diabetes, which make them particularly vulnerable. Ghana has administered over 470 000 doses, while Rwanda has delivered 345 000 doses. In Angola, health workers account for more than half of those vaccinated.

While the COVAX deliveries have enabled many African countries to roll out vaccinations, a critical proportion of the population targeted in the initial phase of the vaccination campaign may remain unvaccinated for months to come due to global supply chain constraints. In 10 African countries, vaccines have not yet arrived.

“A slowdown in vaccine supply could prolong the painful journey to end this pandemic for millions of people in Africa,” said Dr Matshidiso Moeti, the World Health Organization (WHO) Regional Director for Africa. “While some high-income countries are seeking to vaccinate their entire populations, many in Africa are struggling to sufficiently cover even their high-risk groups. Acquiring COVID-19 vaccines must not be a competition. Fair access will benefit all and not just some of us.”

Most African countries are participating actively in the COVAX Facility. The platform – co-led by the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance, and WHO in partnership with UNICEF – aims to deliver enough vaccine doses to immunize at least 20% of Africa’s population in 2021.

However, COVID-19 vaccine demand is placing an enormous strain on the global manufacturing system which has an annual capacity of 3–5 billion vaccine doses. Up to 14 billion COVID-19 vaccines may be needed globally. To support manufacturers, WHO is urging greater global collaboration on supply chain issues, ensuring that manufacturers with excess supply can be linked to companies that have fill-and-finish capacity.

The COVAX Facility is exploring ways of dose-sharing by high income countries that have surplus stocks to encourage the release of these vaccines even before countries finish vaccinating their own people. While it is encouraging that high-income countries have promised to do this these, commitments now need concrete action.

WHO is urging efforts to be made towards equitable vaccine distribution, including strengthening local production in Africa to meet demand, promoting technology transfer and reducing intellectual property barriers. The Organization also encourages collaboration with the private sector to help secure and deliver vaccines such as the initiative by South African telecom firm MTN that has delivered 723 000 vaccines to nine African countries.

The downward trend of the pandemic trajectory in Africa seen since early January has slowed down to a plateau for the past five weeks. While most countries in the continent have seen their epidemiologic curve flatten, 11 countries, including Benin, Botswana, Cameroon, Djibouti, Ethiopia and Kenya have recorded a rising infection trend in recent weeks. The rise in cases is likely linked to super-spreader events such as mass gatherings as well as a relaxation by the population in observing public health measures.

During the past four weeks deaths in Africa have dropped by 45% compared with the previous four weeks, but the case fatality rate for cumulative deaths for the continent is 2.7% which is still higher than the global cumulative case fatality rate of 2.2%.

The WHO Regional Office for Africa held a virtual press conference today facilitated by APO Group during which Dr Richard Mihigo, the Immunization and Vaccine Development Programme Coordinator at the Regional Office, briefed on vaccine rollout in Africa. He was joined by Dr Sabin Nsanzimana, Director General Rwanda Biomedical Centre, Professor Anthony Costello, Professor of Global Health and Sustainable Development, University College London, and Dr Georges Ki-Zerbo, WHO Representative in Guinea.

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According to APO Group on behalf of WHO Regional Office for Africa.

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Viona Aminda

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