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A review of prospective pathways and impacts of COVID-19 on the accessibility, safety, quality, and affordability of essential medicines and vaccines for universal health coverage in Africa.
Amimo, Floriano; Lambert, Ben; Magit, Anthony; Hashizume, Masahiro.
  • Amimo F; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. florianoamimo@gmail.com.
  • Lambert B; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique. florianoamimo@gmail.com.
  • Magit A; MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, W2 1PG, UK.
  • Hashizume M; Human Research Protection Program, University of California San Diego School of Medicine, San Diego, California, USA.
Global Health ; 17(1): 42, 2021 04 08.
Article in English | MEDLINE | ID: covidwho-1175328
ABSTRACT

BACKGROUND:

The ongoing pandemic of coronavirus disease 2019 (COVID-19) has the potential to reverse progress towards global targets. This study examines the risks that the COVID-19 pandemic poses to equitable access to essential medicines and vaccines (EMV) for universal health coverage in Africa.

METHODS:

We searched medical databases and grey literature up to 2 October 2020 for studies reporting data on prospective pathways and innovative strategies relevant for the assessment and management of the emerging risks in accessibility, safety, quality, and affordability of EMV in the context of the COVID-19 pandemic. We used the resulting pool of evidence to support our analysis and to draw policy recommendations to mitigate the emerging risks and improve preparedness for future crises.

RESULTS:

Of the 310 records screened, 134 were included in the analysis. We found that the disruption of the international system affects more immediately the capability of low- and middle-income countries to acquire the basket of EMV. The COVID-19 pandemic may facilitate dishonesty and fraud, increasing the propensity of patients to take substandard and falsified drugs. Strategic regional cooperation in the form of joint tenders and contract awarding, joint price negotiation and supplier selection, as well as joint market research, monitoring, and evaluation could improve the supply, affordability, quality, and safety of EMV. Sustainable health financing along with international technology transfer and substantial investment in research and development are needed to minimize the vulnerability of African countries arising from their dependence on imported EMV. To ensure equitable access, community-based strategies such as mobile clinics as well as fees exemptions for vulnerable and under-served segments of society might need to be considered. Strategies such as task delegation and telephone triage could help reduce physician workload. This coupled with payments of risk allowance to frontline healthcare workers and health-literate healthcare organization might improve the appropriate use of EMV.

CONCLUSIONS:

Innovative and sustainable strategies informed by comparative risk assessment are increasingly needed to ensure that local economic, social, demographic, and epidemiological risks and potentials are accounted for in the national COVID-19 responses.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Vaccines / Drugs, Essential / Universal Health Care / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Reviews Topics: Vaccines Limits: Humans Country/Region as subject: Africa Language: English Journal: Global Health Year: 2021 Document Type: Article Affiliation country: S12992-021-00666-8

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Vaccines / Drugs, Essential / Universal Health Care / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Reviews Topics: Vaccines Limits: Humans Country/Region as subject: Africa Language: English Journal: Global Health Year: 2021 Document Type: Article Affiliation country: S12992-021-00666-8