Public Health
Resilient Institutions in Times of Crisis: Transparency, Accountability and Participation at the National Level Key to Effective Response to COVID-19
The coronavirus (COVID-19) pandemic presents a risk to key dimensions of national institutions highlighted in Sustainable Development Goal 16 (in terms of limiting transparency and access to information, eroding safeguards to accountability including integrity violations, fraud and corruption, and restricting participation and engagement). However, these institutional dimensions are also critical to providing a resilient response to the crisis. In many countries, governments, accountability institutions and civil society are innovating to mitigate institutional disruptions while ensuring an effective response to the pandemic. In the aftermath of the crisis, drawing lessons in terms of the resilience of national institutions will be a key undertaking in order to ensure effective and accountable government.
The Impact of COVID-19 on Older Persons
The COVID-19 (coronavirus) pandemic is causing untold fear and suffering for older people across the world. As of 26 April, the virus itself has already taken the lives of some 193,710 people, and fatality rates for those over 80 years of age are five times the global average. As the virus spreads rapidly to developing countries, likely overwhelming health and social protection systems, the mortality rate for older persons could climb even higher. This policy brief elaborates on the impacts and identifies both immediate and longer-term policy and programmatic responses needed across key priorities for action. The e-book for this policy brief has been converted into an accessible format for the visually impaired and people with print reading disabilities. It is fully compatible with leading screen-reader technologies such as JAWS and NVDA.
Responses to the COVID-19 Catastrophe Could Turn the Tide on Inequality
This brief identifies inequalities around the COVID-19 (coronavirus) pandemic in exposure, vulnerabilities and coping capacity. It suggests that crisis responses in four areas could turn the tide on inequality. These include expanding systems for the universal provision of quality social services; identifying and empowering vulnerable groups; investing in jobs and livelihoods; and acting through the multilateral system to respond to disparities across countries.
The COVID-19 Pandemic Puts Small Island Developing Economies in Dire Straits
COVID-19 (coronavirus) is posing significant health and economic risks to small island developing economies, given their small economic base, high degree of openness and extreme dependence on economic performance of a few developed economies. Amid sharp falls in tourism revenues and remittances flows, small island economies are likely to experience the most pronounced contraction in 2020, further exacerbating their vulnerability to economic and climatic shocks. Disproportionately high debt-servicing burdens of many small island economies will weaken their external balance, potentially increasing the likelihood of debt defaults. Many small island economies—highly dependent on food imports—face the added challenge of ensuring food security during the health and economic crisis. The pandemic response will constrain the fiscal space of small island developing economies and exacerbate their vulnerabilities to natural disasters brought about by climate change. Scaled-up international development cooperation will remain critical for ensuring that small island economies can strengthen their health response to the pandemic, while safeguarding food security and averting an economic crisis.
The COVID-19 Pandemic: A Wake-up Call for Better Cooperation at the Science–Policy–Society Interface
This brief suggests five early lessons from the response to the pandemic that can strengthen how science and technology are harnessed, not just in this case but also for meeting other global challenges. These include strengthening national capacities for science-based decision making, enhancing public trust in science, sharing knowledge for more collaborative research, ensuring universal access to solutions, and acting with greater urgency on global scientific assessments.
Protecting and Mobilizing Youth in COVID-19 Responses
The COVID-19 (coronavirus) pandemic has resulted in severe economic and social impacts around the world. Young people are particularly vulnerable to the disruptions the pandemic has caused, and many are now at risk of being left behind in education, economic opportunities, and health and well-being during a crucial stage of their life development. Young people are more likely to be unemployed or to be in precarious job contracts and working arrangements, and thus, lack adequate social protection. At the same time, young people are responding to the crisis through public health promotion, volunteering and innovation. Young people will form a key element in an inclusive recovery and the achievement of the Sustainable Development Goals (SDGs) during this Decade of Action. However, the response and recovery must be done in a way that protects the human rights of all youth.
The Impact of COVID-19 on Indigenous Peoples
Indigenous peoples in many regions have a long history of devastation from epidemics brought by colonizers, from the arrival of the first Europeans in the Americas who brought smallpox and influenza to a measles outbreak among the Yanonami of Brazil and Southern Venezuela in the 1950s/60s that nearly decimated the tribe (Pringle, 2015). COVID-19 (coronavirus) presents a new threat to the health and survival of indigenous peoples. Indigenous peoples in nearly all countries fall into the most “vulnerable” health category. They have significantly higher rates of communicable and non-communicable diseases than their non-indigenous counterparts, high mortality rates and lower life expectancies. Contributing factors that increase the potential for high mortality rates caused by COVID-19 in indigenous communities include mal – and under-nutrition, poor access to sanitation, lack of clean water, and inadequate medical services. Additionally, indigenous peoples often experience widespread stigma and discrimination in healthcare settings such as stereotyping and a lack of quality in the care provided, thus compromising standards of care and discouraging them from accessing health care, if and when available.
The Impact of COVID-19 on Children
Children are not the face of this pandemic. But they risk being among its biggest victims. While they have thankfully been largely spared from the direct health effects of COVID-19 (coronavirus) - at least to date – the crisis is having a profound effect on their wellbeing. All children, of all ages, and in all countries, are being affected, in particular by the socio-economic impacts and, in some cases, by mitigation measures that may inadvertently do more harm than good. This is a universal crisis and, for some children, the impact will be lifelong. Moreover, the harmful effects of this pandemic will not be distributed equally. They are expected to be most damaging for children in the poorest countries, and in the poorest neighbourhoods, and for those in already disadvantaged or vulnerable situations. Now is the time to step up international solidarity for children and humanity— and to lay the foundations for a deeper transformation of the way we nurture and invest in our world’s youngest generation. The e-book for this policy brief has been converted into an accessible format for the visually impaired and people with print reading disabilities. It is fully compatible with leading screen-reader technologies such as JAWS and NVDA.
Shared Responsibility, Global Solidarity: Responding to the Socio-economic Impacts of COVID-19
This report is a call to action, for the immediate health response required to suppress transmission of the virus to end the COVID-19 (coronavirus) pandemic; and to tackle the many social and economic dimensions of this crisis. It is, above all, a call to focus on people – women, youth, low-wage workers, small and medium enterprises, the informal sector and on vulnerable groups who are already at risk. The e-book for this policy brief has been converted into an accessible format for the visually impaired and people with print reading disabilities. It is fully compatible with leading screen-reader technologies such as JAWS and NVDA.
The Impact of COVID-19 on Latin America and the Caribbean
Latin America and the Caribbean has become a hotspot of the coronavirus (COVID-19) pandemic, exacerbated by weak social protection, fragmented health systems and profound inequalities. COVID-19 will result in the worst recession in the region in a century, causing a 9.1% contraction in regional GDP in 2020. This could push the number of poor up by 45 million (to a total of 230 million) and the number of extremely poor by 28 million (to 96 million in total), putting them at risk of undernutrition. In a region which experienced a significant number of political crises and protests in 2019, increasing inequalities, exclusion and discrimination in the context of COVID-19 affect adversely the enjoyment of human rights and democratic developments, potentially even leading to civil unrest, if left unaddressed. Recovery from the pandemic should be an occasion to transform the development model of Latin America and the Caribbean while strengthening democracy, safeguarding human rights and sustaining peace, in line with the 2030 Agenda for Sustainable Development.
The Evolving Epidemiologic and Clinical Picture of SARS-CoV-2 and COVID-19 Disease in Children and Young People
The initial impression that pediatric SARS-CoV-2 infection is uncommon and generally mild has been replaced by a more nuanced understanding of infectious manifestations in children and adolescents across low-, middle-, and high-income countries and by demographic structure, with recognition of a widening disease spectrum. Critical knowledge gaps, especially in low- and middle-income countries remain, that have significant public policy and programme implications. Insufficient data dis-aggregated by age, geography and race/ethnicity are hindering efforts to fully assess prevalence of infection and disease in children and adolescents and their role in transmission. Potential biologic differences in susceptibility to infection and transmissibility between children and adults need to be assessed. Determination of mother-to-child SARS-CoV-2 transmission during pregnancy or peripartum requires appropriate samples obtained with proper timing, lacking in most studies. Finally, predictors of disease progression, morbidity and mortality in children need to be determined particularly as the pandemic moves to low- and middle-income countries, where poor nutritional and health conditions and other vulnerabilities are more frequent among children than in higher-income settings. Countries, UN agencies, public health communities, donors and academia need to coordinate the efforts and work collectively to close the data and knowledge gaps in all countries (high, middle and low income) for better evidence to guide policy and programme decision-making for children and COVID-19 (coronavirus) disease.
Global Climate Change and Child Health
This paper reviews the published evidence of pathways and impacts of global climate change on child health. The review was occasioned by the recognition that most of the work to date on climate change and health lacks clear focus on the children’s dimension, while the climate change and children literature tends to be brief or imprecise on the complex health aspects. Studies were identified by searching the PubMed database for articles published before April 2009. Publications by agencies (e.g., UNICEF, WHO, IPPC) were also included based upon review. A list of references was developed that provide evidence to the linkages between climate change and health outcomes, and on specific health outcomes for children. The analysis explores the hypothesis of disproportionate vulnerability of children’s health to environmental factors, specifically those most closely related to climate change. Based upon scientific and policy research conducted to date there is found to be substantial evidence of disproportionate vulnerability of children in response to climate change. The diseases likely to be potentiated by climate change are already the primary causes of child morbidity and mortality, including vector-borne diseases, water-borne diseases and air-borne diseases. For this reason further research, assessment and monitoring of child health in respect to climate change is critical. Proposals are made for governments to integrate environmental health indicators into data collection in order to accurately assess the state of child health in relation to other age groups and its sensitivity to climate change.
COVID-19 and Conflict
This brief addresses the importance of women’s full, equal, and meaningful participation to an effective pandemic response and to peacemaking efforts, and how the women, peace and security (WPS) agenda can provide a critical framework for inclusive decision-making and sustainable solutions. While efforts to flatten the pandemic’s curve unfold around the globe, violent conflict remains a deadly reality for far too many people. In March 2020, the UN Secretary-General called for a global ceasefire to allow the world to address COVID-19 (coronavirus). Since the outbreak of the pandemic, women have been at the forefront of effective COVID-19 prevention and response efforts—from frontline service delivery to the highest levels of decision-making. With women’s participation central to achieving sustainable solutions, the pandemic has brought into sharp relief how critical the WPS agenda is to inclusive and effective decision-making. This brief recognizes the vital role of women’s civil society organizations in mobilizing support for an urgent cessation of hostilities, inclusive ceasefire processes, and comprehensive peace talks. It also provides a preliminary analysis of the impact of COVID-19 on women’s participation in ceasefires and peace processes and offers a series of recommendations, including on “building back better”.
Long-Term Care for Older People
Population ageing is a global reality. So is the fact that, as people age, they tend to require greater care and assistance in activities related to daily living. Nevertheless, current debates about long-term care for older persons are remarkably narrow. First, long-term care is yet to be recognized as a burning policy issue in low- and middle-income countries, which is where the majority of older persons live. Second, even in developed countries where long-term care has been on the public agenda for some time, it is rarely discussed in gendered terms. Instead, debates are dominated by concerns over its fiscal implications. As this brief shows, however, long-term care always has costs, even if it is provided by family members on an unpaid basis. Currently, the societal costs of policy inaction in both developed and developing countries are borne disproportionately by women: the elderly women who do not receive the care that they deserve, and the women of all ages who are overrepresented among those who provide care under inadequate and exploitative conditions. Finding ways to share these costs more equitably across society is paramount. This brief underlines the need to build long-term care systems that are financially and socially sustainable and discusses a set of measures that can be taken to improve the situation of care-dependent older persons as well as their caregivers.
Promising Practices for Equitable Remote Learning
The COVID-19 (coronavirus) pandemic has had an unprecedented impact on societies globally. To help contain the spread of the disease, schools around the world have closed, affecting 1.6 billion learners – approximately 91 per cent of the world’s enrolled students. Governments and education stakeholders have responded swiftly to continue children’s learning, using various delivery channels including digital tools, TV/radio-based teaching and take-home packages for parent or caregiver-guided education. However, the massive scale of school closures caused by COVID-19 has laid bare the uneven distribution of the technology needed to facilitate remote learning. It has also highlighted the lack of preparedness and low resilience of systems to support teachers, facilitators and parents/caregivers in the successful and safe use of technology for learning.
How can Investors Move From Greenwashing to SDG-enabling?
Companies must adapt their business model to reflect growing risks and uncertainties, and help build a sustainable world; doing so is necessary to preserve their financial performance in the long run Investors have the financial resources to push companies to change, but lack the necessary tools given limited reliable data on non-financial issues. A common definition of Sustainable Development Investing (SDI) would be a first step in ensuring that investments presented as “sustainable” make a meaningful contribution to the global goals but implementing such definition will require strengthened mandatory reporting requirements.
Research with Disadvantaged, Vulnerable and/or Marginalized Adolescents
Disadvantaged, vulnerable and/or marginalized adolescents (DVMAs) are individuals aged 10–19, who are excluded from social, economic and/or educational opportunities enjoyed by other adolescents in their community due to numerous factors beyond their control. This brief summarizes the health and well-being inequities experienced by DVMAs and the need for research with this group. It reviews the challenges and barriers to their inclusion in research; shares practical implications and best practices for their inclusion in research; and addresses ethical challenges and approaches to research with DVMAs. The brief is one of seven on research methodologies designed to expand and improve the conduct and interpretation of research on adolescent health and well-being in low- and middle-income countries (LMICs). Building on the recent Lancet Commission on Adolescent Health and Wellbeing, these briefs provide an overview of the methodological quality of research on adolescents. They cover topics including: indicators and data sources; research ethics; research with disadvantaged, vulnerable and/or marginalized populations; participatory research; measuring enabling and protective systems for adolescent health; and economic strengthening interventions for improving adolescent well-being.
The Impact of COVID-19 on Food Security and Nutrition
The COVID-19 (coronavirus) pandemic is a health and human crisis threatening the food security and nutrition of millions of people around the world. Hundreds of millions of people were already suffering from hunger and malnutrition before the virus hit and, unless immediate action is taken, we could see a global food emergency. In the longer term, the combined effects of COVID-19 itself, as well as corresponding mitigation measures and the emerging global recession could, without large-scale coordinated action, disrupt the functioning of food systems. Such disruption can result in consequences for health and nutrition of a severity and scale unseen for more than half a century.
Online and ICT Facilitated Violence Against Women and Girls during COVID-19
The brief highlights emerging trends and impacts of COVID-19 (coronavirus) on online and ICT facilitated violence against women and girls (VAWG). It provides examples of strategies put in place to prevent and respond to online/ ICT facilitated VAWG and makes recommendations on how different actors can best address this issue. It is a living document that draws upon the knowledge and experience of a wide range of experts who support solutions to end online VAWG and violence facilitated by ICTs.
The World of Work and COVID-19
The COVID-19 (coronavirus) pandemic has turned the world of work upside down. It is having a dramatic effect on the jobs, livelihoods and well-being of workers and their families and on enterprises across the globe, particularly the small and medium sized. While certain sectors and industries have successfully moved online, pointing the way towards exciting innovations in the world of work, millions of workers have lost their livelihoods and many more – especially women who are concentrated in highly exposed sectors – remain at risk. This policy brief presents the stark consequences of COVID-19 in an already precarious world of work and provides practical options to recover better.