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Calls for equitable, community-driven public health responses to COVID-19 ahead of UN summit

Introduction by Croakey: The United Nations General Assembly will hold a special session on responses to the novel coronavirus pandemic this week, as the virus continues to surge in the Northern Hemisphere, with uncontrolled spread across the United States and mounting tolls in Europe.

The UNGA Special Session in Response to the COVID-19 Pandemic, to be held from December 3 to 4 at United Nations Headquarters in New York, will examine Member State experiences of the coronavirus outbreak as well as the health and humanitarian response to date, the road to a vaccine, socioeconomic impacts and recovery plans.

It comes as the pandemic continues to accelerate in Europe and North America, with almost 63 million cases worldwide and nearly 1.5 million deaths.

The situation in the United States is particularly grim, with every state except Hawaii now experiencing uncontrolled spread, averaging 170,000 new cases every day or 1.2 million per week across the nation, according to the Johns Hopkins Center for Health Security. Average daily COVID-19 mortality in the US is approaching 1,500 deaths, and this appears to be increasing exponentially, according to Johns Hopkins.

In its preamble to the special session, the UNGA describes COVID-19 as “not only the greatest global health crisis since the creation of the United Nations 75 years ago”, but a “humanitarian, socio-economic, security and human rights crisis”.

As global leaders converge on New York, a collective of public health, social justice and human rights crisis have issued a call to action urging governments to put stronger, more equitable public health approaches at the centre of their COVID response.

Explains Professor Kent Buse, director of The George Institute for Public Health’s Healthier Societies program:

Early in the pandemic, the dominant response from global leaders was biomedical, top-down, command-and-control oriented, with people and civil society largely ‘locked-out’ of meaningful decision-making. We cannot afford the same narrow and limited approach.

We all stand to gain if leaders ensure that all parts of society are actively engaged in shaping the pandemic response.”

More than 250 individuals, organisations and networks have so far signed onto the call, including Australian groups such as ACON, ACFID and the UNSW Medicine School of Population Health. It will be presented to the UNGA President to inform this week’s discussions.

The full text of the call is published below, with details at the end on how you can sign on. The collective will also be tweeting from the UNGA session at @WePublicHealth this week.


Advocates for reclaiming comprehensive public health write:

We, the undersigned, reiterate the concerns raised by others, as cited in ‘Reclaiming comprehensive public health’, regarding missed opportunities to build cooperation, public trust and effective responses to the COVID-19 pandemic, and regarding the resulting suffering and rights violations endured by people across the world.

We call on heads of state and government at the Special Session of the United Nations General Assembly in response to the COVID-19 pandemic, and all those involved in shaping the response, to promote comprehensive, equity-focused and participatory public health approaches in countering the pandemic.

Responses to the COVID-19 pandemic and future public health emergencies must equitably draw on and use diverse sources of knowledge, disciplines and capabilities; protect human rights; and be guided by the following principles:

  1. Co-develop and implement comprehensive public health interventions based on collaboration, partnership, shared responsibility, policy dialogue, communication and solidarity at all levels, within and across countries, as the most effective and equitable basis for the widest population health protection and benefit.
  2. Recognise the agency of, and critical contributions made by communities to co- designing, co-implementing and monitoring context-appropriate pandemic responses and mitigatory measures. Ensure the meaningful and proactive engagement of health care and frontline workers and their associations, community leaders, civil society, and of diverse communities, especially those that are marginalised or vulnerable and at increased risk in such responses.
  3. Ensure the public availability, in local languages, of timely, accurate, accessible and disaggregated information drawn from diverse sources of evidence. Transparently report reliable information on the pandemic modelling, morbidity and mortality, including the social distribution, limitations and diverse analyses and interpretations of such data, as well as on the intervention measures, resources deployed and the impact and distribution of intervention effects. Value, use and share knowledge and evidence from a wide range of disciplines and from communities and implementers to design, communicate and evaluate measures applied and to enhance their effectiveness, equity, acceptability, uptake and local ownership. Enable independent and transparent review and oversight of responses by legislature and civil society.
  4. Set clear goals relevant to local contexts. These should aim to promote universal and equitable population health and well-being and to ensure the continuity of essential health services for population health needs in both public and private sectors. Adapt public health guidance to local conditions, context, cultures, evidence, beliefs and knowledge, using measures that facilitate gender and social equity, participation and that build and sustain trust amongst communities, implementers, organisations and authorities.
  5. Avoid coercive, militarized interventions; discriminatory measures; and actions that undermine dignity in public health responses. Ensure that national laws and practices, including criminal laws, recognise and comply with international and regional human rights treaties and the International Health Regulations. Do no harm while applying measures to prevent, control or mitigate the pandemic and do not incite fear or anxiety, discriminate, stigmatise, harass, limit peoples’ freedoms, including through evictions, arbitrary arrests, detentions or other forms of repression.
  1. Ensure that any restrictions on individual freedoms required to control risks to public health and safety conform with the United Nations’ Siracusa Principles. Restrictions must be clear, legitimate, proportionate and scientifically based with a public health purpose. They should be developed with community participation, be well-targeted through the least restrictive but effective alternative and be based on the precautionary principle. Measures should be of limited duration, subject to review and applied with respect for human dignity.
  2. Protect and support the health workforce and other frontline workers and their families, including lay, contract and community health workers and volunteers. Provide safe and comfortable working conditions; personal protective equipment and infection control measures; access to accurate and timely information, guidance and training; and access to free testing, treatment, care and psychosocial support with social security and guaranteed compensation for injury at work.
  3. Ensure that all people, especially those who are most vulnerable, can equitably and safely access essential health products (personal protective equipment, diagnostics, therapeutics, vaccines and related technologies) for the prevention and control of the pandemic, as global public goods. Promote, invest in and strengthen capacities for local production and citizen-led technology and system innovations for health promotion, prevention and care as well as for support of livelihoods, food security and social protection. Support local learning, evaluation and dissemination of innovations. Ensure that digital technologies for pandemic control are free, accessible to all, respect human rights, including the Siracusa Principles, and are not misused for other purposes.
  4. Implement and monitor multi-sectoral actions to address the socio-economic and environmental determinants of risk and vulnerability. Provide comprehensive social and economic support to all people whose rights and livelihoods are being restricted through efforts to control the pandemic, ensuring access to food, water, sanitation, shelter, livelihoods, education, digital access and health services, including prevention and care and access to support for mental health concerns, loneliness, gendered violence and other forms of abuse. Enable civil society organisations, media and legislatures to assess the impact of such actions, to give voice to those affected and to publicly report situations where controls have been imposed but less restrictive measures are feasible.
  5. Ensure increased, sustained and equitable funding for comprehensive public health, health care and social protection from local to global levels, and for the systems, and research and development, that support the above-mentioned principles and approaches.

These principles and approaches should inform laws, standards, systems, programmes and actions, from the local to global levels, and should be reflected in any future updates to the International Health Regulations and the Siracusa Principles.

For our part, we as signatories, commit to the realization of these principles and approaches and invite others to join us.

To add your name or organisation to the call, contact the organisers here or sign directly at Reclaiming Comprehensive Public Health

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Acknowledgement
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PIJ Commissions 2021
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Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
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AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
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#CRANAplus15
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