By Inger Ashing, CEO of Save the Children International
The impacts of the COVID-19 pandemic have been felt around the world, with devastating impacts on children. Just in the first months of this year, nearly 50% of countries have experienced some level of disruptions to primary healthcare services, including child health services. 9.3 million more children could suffer wasting by 2022 and 168,000 more children could die due to malnutrition if urgent action is not taken.
Last year, up to 142 million children were in households driven into poverty, and hundreds of millions of children are still out of school, with millions at risk of not returning. This comes as we already face a climate crisis and conflicts with devastating impacts on the health, nutrition and survival of children and their families.
A light at the end of the tunnel, but not for all
Some countries are starting to see the light at the end of the tunnel, and have started to 'return to normal', with several countries making significant strides in rolling out COVID-19 vaccines.
In stark contrast, many other countries are facing second and third waves, leaving health systems depleted.
For example, the stark increase in COVID-19 cases in India has cost nearly 300,000 people their lives, and is having a devastating impact on the country's healthcare system, which was already overstretched and underfinanced. Health workers are struggling to cope, with many getting infected themselves. Hospitals are battling a shortage of oxygen, essential drugs and beds, and infections are spreading in rural areas. Disruptions to maternal and child health services are leaving children without access to life-saving healthcare.
India's neighbour Nepal has also seen a huge spike in cases this month, with concerns of disastrous impacts on children due to a disruption to essential health services, education and increasing poverty. Nepal's under resourced healthcare system is overstretched -- hospital beds are no longer available and oxygen supplies are drying up.
The deepening divide
The COVID-19 pandemic has amplified the huge inequalities in society. The economic divide between richer and poorer countries has not only meant that the former have been better equipped to provide social safety nets for their populations, but they have also had far better access to tools to help their response, whether PPE, oxygen or vaccines.
High-income countries have bought up two-thirds of the global vaccine supply, and the US and UK alone account for 30% of the 1.03 billion doses that have been rolled out globally. The roughly 68 million doses delivered so far through COVAX, aimed at access to vaccines in lower income countries, pales in comparison -- they received less than 7% of global doses. Just 2% of the global share has been rolled out in Africa.
The pandemic has sadly and once again exposed the sobering reality that wealth buys a better response to a health emergency.
Despite the rallying cry for global solidarity, so far these have been empty words trumped by national interest and self-preservation. At a time when the world should be coming together to tackle this global health threat, the actions (and inactions) of many countries and other key players has revealed the inequality of the world we live in.
Investing in health systems must be central to the response
Resilient health systems are critical to absorb the added burden from COVID-19 cases, and to ensure the continued delivery of essential care, irrespective of a person's ability to pay. A strong health system is also key to ensuring the successful and equitable rollout of COVID-19 and other vaccines.
After all, doses sitting in warehouses are of no use if countries don't have the systems to deliver them.
We must turn this crisis into an opportunity and emerge stronger from the pandemic.
At the 74^th^ World Health Assembly, which started this week, Save the Children is calling for urgent action from government and other key stakeholders to protect children's right to survive and thrive. That means donors must fully fund ACT-A, COVAX and the delivery costs to guarantee equity in COVID-19 vaccine access, and urgently contribute a proportion of already secured vaccine doses to COVAX.
In addition, governments and manufacturers must support the sharing of COVID-19 health technology, intellectual property and data, and prioritise investment and collaboration with manufacturers in other countries, to unleash the full vaccine potential.
Also, governments must increase public investment (towards 5% of GDP) to strengthen health systems, with support from donors, to prepare for public health emergencies while continuing to deliver essential health services for all, as part of Universal Health Coverage. That includes investing in the country's health workforce, which is the backbone of any health system. And lastly, donors must help to ensure that low- and middle-income countries have the medical oxygen they need to treat patients, including by supporting the ACT-A Oxygen Emergency Taskforce.
This is a pivotal moment in history to reset the trajectory towards a more equitable global response to the pandemic. But this will only happen if governments and others in a position of power step up to the plate and take urgent action.