Written by: Kartik Tyagi
The COVID-19 pandemic has transformed what health equity looks like, especially for population-wide health outcomes in low and middle income countries (LMICs.) But how has a data-driven response supported COVID-19 health outcomes in these countries, in partnership with ministries of health, non-governmental organizations, and research-based groups?
Photo by The Interacademy Partnership
COVID-19 & Low and Middle Income Countries (LMICs)
In a time where countries around the world are grappling with societal inequities and systemic injustices, it becomes clear that COVID-19 does not discriminate. The pandemic has ravaged countries around the world—developed or not. Although in the early months of the pandemic a large number of cases were attributed to developed countries, low testing capacity, among other factors, has resulted in uncertainty and potential underestimation of cases and deaths (Gupta et al., 2020).
As it relates to social and community wide impacts of the pandemic in LMICs, it is seen that marginalized groups are most affected, the lack of response data exacerbates inequity, that spaces in which marginalized groups can be heard are being closed, and the pandemic has the ability to reverse decades of gender and women’s rights progress (Rohwerder, 2020). With relatively little information relating to epidemiology or the population effects of COVID-19 and minimal data to inform pandemic response, coupled with limited testing capacity, low and middle income countries face several significant challenges as it relates to COVID-19 response.
An Equitable and Data-Driven COVID-19 Response in Low and Middle Income Countries (LMICs)
The challenges that LMICs face within COVID-19 response bring to light several questions, including what the specific burden of COVID-19 is within these countries, how the pandemic has affected at-risk or marginalized groups, specifically, and how health outcomes and care is affected in these settings. Research-based groups have partnered with national health systems and local ministries of health in LMICs, as well as non-governmental organizations like Partners In Health (PIH) to support LMIC COVID-19 response. One of those groups is the Global COVID-19 Response Technical Support Group, housed in Harvard Medical School’s Global Health Research Core.
As a member of this wider group, I serve as part of a team of faculty, postdocs, and students from multiple institutions and affiliations working together to support the data needs for an informed COVID-19 response in multiple low and middle income countries. The work we do is driven by real-world problems and firsthand issues seen and witnessed in these countries. In collaborating with our partners and local officials, we work to find solutions to the issues exacerbated by the pandemic in LMICs, through determining implementable solutions, be it through syndromic surveillance work to identify geographic areas and indicators associated with high COVID-19-associated symptoms, investigating changes in the use of important health services such as maternal care and vaccines/immunizations, conducting varied cohort research study designs to assess the impact of the pandemic on specific patient populations, or through determining efficient techniques for estimating COVID-19 community seroprevalence.
Moving Forward: Forging Global Health Partnerships
Through the COVID-19 pandemic, the need for a novel and holistic outlook to the fields of global and public health is clear, focused on long-term solutions and continuous partnerships, especially in LMICs. Evidenced by these times, the global health community must change what it prioritizes. As we move towards an uncertain future, we must alter who or what we work for and shift the ways by which we hope to achieve our goals to reflect these priorities. As we move forward and recover from the aftermath of the pandemic, it is imperative to continue working within and forging continuous non-profit, research-based, global health partnerships, as evidenced through the era of COVID-19.
In being able to reflect on experiences in supporting a data-driven COVID-19 response group, a forward-moving field of public health, characterized by its equitable and collaborative response to community-wide and population-based health outcomes, can be envisioned. We must, as the future starts to approach the present, hold to a high degree our shared responsibility to support our global health community—a responsibility, as seen through the era of COVID-19, we dare not take lightly.
References
Gupta, M., Wahl, B., Adhikari, B., Bar-Zeev, N., Bhandari, S., Coria, A., . . . Peters, D. H. (2020). The need for COVID-19 research in low- and middle-income countries. Global Health Research and Policy, 5(1). doi:10.1186/s41256-020-00159-y
Rohwerder, B. (2020). Social impacts and responses related to Covid-19 in low- and middle-income countries. K4D Emerging Issues Report 35. Brighton, UK: Institute of Development Studies.
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