The World Health Organisation (WHO) has cautioned against the straining of global health systems, as countries continue to grapple with the outbreak of the COVID-19 pandemic. As the respiratory disease outbreak rages, there is an exponentially rapid increase in demand for health facilities and health care workers, which is affecting patients with other health conditions. As a result, health systems are getting overwhelmed and become highly susceptible to becoming overstretched and unable to operate effectively. So far, over 780,000 people have been infected with the virus, while the death toll stands at 37,000 across nearly 200 countries and territories. According to WHO, previous outbreaks have demonstrated that when health systems are overwhelmed, mortality from vaccine-preventable and other treatable conditions can also increase dramatically. For instance, during the 2014-2015 Ebola outbreak, the increased number of deaths caused by measles, malaria, HIV/AIDS, and tuberculosis attributable to health system failures exceeded deaths from Ebola. “The best defense against any outbreak is a strong health system,” stressed WHO Director-General Tedros Adhanom Ghebreyesus. “COVID-19 is revealing how fragile many of the world’s health systems and services are, forcing countries to make difficult choices on how to best meet the needs of their people.” To help countries navigate through these challenges, WHO has updated operational planning guidelines in balancing the demands of responding directly to COVID-19 while maintaining essential health service delivery, and mitigating the risk of system collapse. As the pandemic keeps pace, resources are getting more and more limited. To ensure that increasingly limited resources provide maximum benefit for the population, WHO advises countries to identify essential services that will be prioritized in their efforts to maintain continuity of service delivery and make strategic shifts. Some examples of essential services include routine vaccination, reproductive health services including care during pregnancy and childbirth, care of young infants and older adults, management of mental health conditions as well as non-communicable diseases and infectious diseases like HIV, malaria, and TB. Countries also need to ensure the highest standard in precautions, especially in hygiene practices, and the provision of adequate supplies including personal protective equipment. Well-organized and prepared health systems can continue to provide equitable access to essential service delivery throughout an emergency, limiting direct mortality and avoiding increased indirect mortality, said WHO. The guidelines stress the importance of keeping up-to-date information. This requires frequent transparent communications with the public, and strong community engagements so the public can maintain trust in the system. This, WHO says, will help ensure that people continue to seek care when appropriate, and adhere to public health advice. Countries are also urged to optimize service delivery settings and platforms, establish effective patient flow (screening, triage, targeted referral) as well as identify mechanisms to maintain the availability of essential medications, equipment, and supplies. Africa has the most fragile health system in the world. With less than 1 percent of global health expenditure and only 3 percent of the world’s health workers, Africa accounts for almost half the world’s deaths of children under five, has the highest maternal mortality rate, and bears a heavy toll from HIV/AIDS, tuberculosis, and malaria. Despite a share of 11 percent of the world’s population, sub-Saharan Africa region carries 24 percent of the global disease burden.
