Review: Wider Health Effects of Vertical Responses to COVID-19 in Low and Middle-Income Countries (LMICs) (English)

The COVID-19 pandemic has impaired capacity and efforts to address other health needs that are as urgent as the virus itself, especially in low- and middle-income countries (LMICs). Pressure on governments to act on COVID-19 and save "lives infected first" rather than "lives statistically at risk" 1 had and will continue to have serious short- and long-term consequences in other areas of health.a This document reviews the effects of vertical responses to COVID-19 on health systems and services, and people's use and access to them in LICs. There, the historical and continuing lack of investment intensifies vulnerability to multiple health threats. We use the term "vertical response" to describe decisions, measures and actions taken solely to prevent and contain COVID-19. Usually without adequately taking into account how this impacts the broader healthcare system or pre-existing resource constraints.

This document (in English) is divided into four main sections on 1) the characteristics of the vertical response, 2) the causes of the broader health effects, 3) the evidence of the effects and finally 4) the suggestions to mitigate them. Through these sections, we provide perspectives for stakeholders in government, agencies, organizations, and communities to design and implement more proportionate, appropriate, comprehensive, and socially just responses to COVID-19 without compromising other aspects of health. Usually without adequately taking into account how this impacts the broader healthcare system or pre-existing resource constraints.