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1.
SSRN; 2022.
Preprint in English | SSRN | ID: ppcovidwho-333466

ABSTRACT

The coronavirus pandemic (COVID-19) has triggered a public health and economic crisis in both high and low resource settings since the beginning of 2020. With the first case being discovered on 12th March 2020, Kenya has responded using both health and non-health strategies to mitigate the direct and indirect impact of the disease on its population. However, this has had both positive and negative implications for the country's overall health system. This paper aimed to understand the pandemic's impact and develop lessons for future response by identifying the key challenges and opportunities Kenya faced during the pandemic. We conducted a qualitative study with 15 key informants, purposefully sampled for in-depth interviews from September 2020 to February 2021. We conducted direct content analysis of the transcripts to understand the stakeholder's views and perceptions of how COVID-19 has affected the Kenyan healthcare system. The majority of the respondents noted that Kenya's initial response was relatively good, especially in controlling the pandemic with the resources it had at the time. This included relaying information to citizens, creating technical working groups and fostering multisectoral collaboration. However, concerns were raised regarding service disruption and impact on reproductive health, HIV, TB, and non-communicable diseases services;poor coordination between the national and county governments;shortage of personal protective equipment and testing kits, and strain of human resources for health. Effective pandemic preparedness for future response calls for improved investments across the health system building blocks, including;human resources for health, financing, infrastructure, information, leadership, service delivery and medical products and technologies. These strategies will help build resilient health systems and improve self-reliance, especially for Countries going through transition from donor aid such as Kenya in the event of a pandemic.

4.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-309459

ABSTRACT

Background: Ending the COVID-19 pandemic requires effective implementation of vaccination programs in all countries. Information on the cost of vaccine procurement and delivery is paramount for effective planning and budgeting, especially in low- and middle-income countries (LMICs) given their budget constraints.Methods: We estimated regional and national costs to scale up COVID-19 vaccinations in 132 LMICs under different scenarios. We defined three priority groups: 1) healthcare workers;2) population at high risk of severe COVID-19;and 3) adults with low risk of mortality and morbidity. We assumed that 70% of the population needs to be vaccinated to reach vaccine herd immunity. We used publicly available data on procurement pricing, delivery costs, and population size. We compared the price tag estimates to the countries’ historical annual immunization spending.Findings: We estimated a total cost of US$74 billion to reach vaccine herd immunity in LMICs. Of this total, 67% (US$50 billion) is for vaccine procurement, 33% (US$24 billion) is for vaccine delivery, 6% (US$4·2 billion) is to vaccinate high-risk populations, and 0.6% (US$0·46 billion) is to vaccinate healthcare workers. Twenty percent of LMICs have a price tag that is at least 10 times their baseline annual immunization spending.Interpretation: COVID-19 vaccination will have a major impact on LMIC national healthcare budgets. Substantial investments by governments and donors are needed for vaccine procurement and vaccine delivery infrastructure.Funding: Duke Global Health Institute pilot grant.Conflict of Interest: Dr. Dixit reports grants from Bill & Melinda Gates Foundation, outside the submitted work, all other authors have nothing to disclose.

5.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-314515

ABSTRACT

Background : Health systems strengthening (HSS) and health security are two pillars of universal health coverage (UHC). Investments in these areas are essential for meeting the Sustainable Development Goals and are of heightened relevance given the emergence of the 2019 novel coronavirus disease (COVID-19). This study aims to generate information on development assistance for health (DAH) for these areas, including how to track it and how funding levels align with country needs. Methods : We developed a framework to analyze the amount of DAH disbursed in 2015 for the six building blocks of the health system (‘system-wide HSS’) plus health security (emergency preparedness, risk management, and response) at both the global (transnational) and country level. We reviewed 2,427 of 32,801 DAH activities in the Creditor Reporting System (CRS) database (80% of the total value of disbursements in 2015) and additional public information sources. Additional aid activities were identified through a keyword search. Results : In 2015, we estimated that US$3.1 billion (13.4%) of the US$22.9 billion of DAH captured in the CRS database was for system-wide HSS and health security: US$2.5 billion (10.9%) for system-wide HSS, mostly for infrastructure, and US$0.6 billion (2.5%) for system-wide health security. US$567.1 million (2.4%) was invested in supporting these activities at the global level. If responses to individual health emergencies are included, 7.5% of total DAH (US$1.7B) was for health security. We found a correlation between DAH for HSS and maternal mortality rates, and we interpret this as evidence that HSS aid generally flowed to countries with greater need. Conclusions : Achieving UHC by 2030 will require greater investments in system-wide HSS and proactive health emergency preparedness. It may be appropriate for donors to more prominently consider country needs and global functions when investing in health security and HSS.

8.
Lancet Glob Health ; 10(1): e142-e147, 2022 01.
Article in English | MEDLINE | ID: covidwho-1575199

ABSTRACT

There is increasing evidence that elimination strategies have resulted in better outcomes for public health, the economy, and civil liberties than have mitigation strategies throughout the first year of the COVID-19 pandemic. With vaccines that offer high protection against severe forms of COVID-19, and increasing vaccination coverage, policy makers have had to reassess the trade-offs between different options. The desirability and feasibility of eliminating SARS-CoV-2 compared with other strategies should also be re-evaluated from the perspective of different fields, including epidemiology, public health, and economics. To end the pandemic as soon as possible-be it through elimination or reaching an acceptable endemic level-several key topics have emerged centring around coordination, both locally and internationally, and vaccine distribution. Without coordination it is difficult if not impossible to sustain elimination, which is particularly relevant in highly connected regions, such as Europe. Regarding vaccination, concerns remain with respect to equitable distribution, and the risk of the emergence of new variants of concern. Looking forward, it is crucial to overcome the dichotomy between elimination and mitigation, and to jointly define a long-term objective that can accommodate different political and societal realities.


Subject(s)
COVID-19 Vaccines , COVID-19/prevention & control , COVID-19/epidemiology , Disease Eradication/methods , Humans , Pandemics/prevention & control , SARS-CoV-2 , Vaccination
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16.
BMJ ; 373: n1249, 2021 05 17.
Article in English | MEDLINE | ID: covidwho-1232350
20.
Nature ; 590(7847): 529, 2021 02.
Article in English | MEDLINE | ID: covidwho-1100784
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