7.2
PREPARING FOR A SAFER WORLD TOGETHER
Reshaping global health
to all, not just to LMICs. The risk is not just to our health and well-being but also to the global economy and trade. We have both a moral and economic imperative to rectify these issues. To do so, we must critically address politics, power imbalances, institutional effectiveness, gender equality and inclusivity. We have talked for too long about analysing the problem and developing the solution. Now is the time for action. Through collaborating, empowering the marginalised and fortifying health systems, we can reshape the global health framework to be fairer and more effective. This is not merely an appeal for justice. This pertains to our survival and that of our shared planet. Global health is often overshadowed by political and power imbalances catering to influential countries, leaving the vulnerable exposed. Mitigating this requires equitable resource allocation, improved global governance and the use of existing commitments such as the Abuja Declaration to guide our actions. Gender equality and voices from the Global South must be integral to our efforts. This is crucial for sustainable progress and combating fragmentation. Effective coordination among governments, international organisations, civil society and the private sector is key to overcoming fragmentation and ensuring equitable access to health care. TAILORED RESPONSES Responses must be tailored to the context and address the social determinants of health. Empowerment of marginalised groups and their representation in decision-making processes are essential for health equity. Community-led initiatives, as in Ethiopia’s and Rwanda’s health transformations, attest to the power of this approach. Involving diverse sectors to promote transparency, accountability and shared responsibility is vital. Nigeria’s
Cohesion, equity and justice in our health systems can only be achieved by overturning the divisive paradigm of ‘donor countries’ versus ‘recipient countries’ – and bringing all voices to the table is essential for our survival and that of our shared planet I n thinking about global systems, mechanisms, power and equity, I often think of Ursula K Le Guin’s philosophical allegory The Ones Who Walk Away from Omelas, where the prosperity of a utopian city relies on the perpetual suffering of a single child. While most of the city’s people eventually accept this moral tradeoff as necessary for their communal happiness, some are unable to reconcile this reality and walk away. This is a potent metaphor for the relationship between the Global North and the Global South, particularly low- and middle-income countries, left behind and often treated as a mere inconvenience in global affairs. Proposed partnerships for aid and development ring hollow when the necessary far-reaching reforms that could grant LMICS an equal seat at the global table are rarely implemented. Much like the city of Omelas, the world is content to thrive while silently accepting the deplorable inequities and frameworks that keep LMICs in need. Indeed, maintaining the status quo of LMICs keeps the development industry in business. The Covid-19 pandemic revealed to me – an African humanitarian and advocate for health, education and girls and women’s rights – the stark vulnerabilities of our global and national health systems. Largely resulting
By Ayoade Olatunbosun- Alakija, WHO Special Envoy for the Access to COVID-19 Tools Accelerator, and chair, Foundation for Innovative New Diagnostics
from fragmented approaches, political apathy and insufficient collaboration, these burdens pose a risk
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Health: A Political Choice – from fragmentation to integration
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