Broader health impacts of vertical responses to COVID-19 in Low- and Middle- Income Countries (LMICs)
This paper reviews the effects of vertical responses to COVID-19 on health systems, services, and people’s access to and use of them in LMICs, where historic and ongoing under-investments heighten vulnerability to a multiplicity of health threats. We use the term ‘vertical response’ to describe decisions, measures and actions taken solely with the purpose of preventing and containing COVID-19, often without adequate consideration of how this affects the wider health system and pre-existing resource constraints. This paper provides insights for actors in government, agencies, organisations and communities to design and implement more proportionate, appropriate, comprehensive and socially just responses that address COVID-19 without compromising other aspects of health in four main sections:
- Characterising vertical response,
- the drivers of broader health impacts,
- evidence of impacts, and
- suggestions for mitigation.
Beyond immediate action, there is a need to re-evaluate priorities and approaches in global health, both in the context of COVID-19 and beyond. If the well-being of all people is truly valued, ‘whole of health’ approaches1 which account for health trade-offs of COVID-19 response in the short-term, and address the health needs of diverse populations in the medium- to long-term are crucial.