Médecins du Monde recommendations -To protect human rights and medical care.

These are tough times for us all globally. The COVID-19 outbreak has turned into a deep concern for many, a life or death situation for some but also an extraordinary challenge for the fulfilment of the Right to Health for All, and fair access to healthcare should be guaranteed to everyone.
The fundamental state of health governance at the national and global levels is questioned, the challenge of an international framework that transcends the nation, where the access of rights protection for all is not impeded, is now facing us.

Since the official announcement of the World Health Organization (WHO) Pandemic Declaration, society has faced difficult challenges.

To which extent national health systems are ready to manage such a huge crisis? How the States, through their public health systems can ensure the fulfilment of the Right to Health for all, non-discrimination, equitable and affordable access to health for all leaving no one behind, regular and sufficient funds to cover the expenses of supplies, facilities, trained health workforce, efficient information systems, adequate service delivery, access to essential medicines and democratic governance…to deal with the pandemic? What will happen with the health systems of those countries in the Global South already weakened?

Destruction of Social Welfare State public services (privatization, commercialization, underfunding and regionalization), has led to the undermining of public health systems globally. The weakness health systems are facing now are reflecting on the difficulties and challenges they are struggling with to tackle the pandemic and guaranteeing equitable access and treatment for all. Confinement measures for a large amount of population and the declaration of the state of emergency or alarm in many countries are just the result of the lack of resources and capacities of healthcare centres and hospitals to deal with so many infected people.

Besides, amongst the most vulnerable population, imprisoned, homeless, drug users, refugees and migrant populations are traditionally excluded from public national health systems due to their social, cultural or legal status and are the most vulnerabilized during health crisis. People who are alienated from public health care and public health services cannot even receive medical treatment until their symptoms become serious, and sometimes fall into a life-threatening situation. If stigma is widespread and the medical system itself is confused, vulnerable groups will be excluded from health care and forced into social isolation. This social rejection lead to more difficult access to health and a higher probability of transmission. Finally, they might find additional difficulties when following the preventive measures recommended as hand washing. Special consideration should be given to the discrimination to access healthcare services and treatment by women and girls, especially in poorer countries. Social, culture and gender norms, roles, and relations influence women’s and men’s vulnerability to infection, exposure, and treatment.

One of the biggest challenges to an effective COVID-19 response is when public health systems are weak or broken as a result of conflict and chaos. In conflict affected areas, the pandemic can have disastrous impacts, adding a crisis onto the crisis. Refugees and displaced populations, weakened by months and years of violence and lack of health services and living in crowded settings, are particularly at risk. In humanitarian crisis contexts, this pandemic is having an enormous impact on the accessibility of supplies and staff.

We can learn from COVID-19 that strong public health systems are capable to resist before massive threats to health with the required collective responses. Likewise, it shows the importance of having a real and genuine universal health system, ensuring the Right to Health and access to healthcare for all regardless their location or their administrative/legal situation, as the most effective strategy to face these health crises.

Médecins du Monde recommendations -To protect human rights and medical care.

■ Ensure the response to COVID-19 does not reproduce or perpetuate harmful gender norms, discriminatory practices and inequalities. We request educational activities for stigma and biased society.

■ Establish special measures for the most vulnerable: homeless, migrants, refugees, imprisoned population and those with difficulties to access primary health care services

■ Health care should not be restricted by legal, social, or racial positions, and request that medical data including medical examination records should not be shared for any purpose other than medical purposes.

■ Acknowledge the crucial role health workers play when crisis like this arises. There’s an urgent need to support them, their trade unions and their requests for adequate staffing ratios and the provision of appropriate protective equipment. We demand prompt financial support for medical welfare institutions, priority supply of goods, and disclosure and sharing of information.

What is needed all over the world now is a democratic health governance both at national and international levels. The threat of infectious diseases cannot be tackled if there is someone somewhere who is excluded by public health measures.

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