An appeal for practical social justice in the COVID-19 global response in low-income and middle-income countries

摘要

The coronavirus disease 2019 (COVID-19) pandemichit the world’s wealthiest countries first, shapingglobal public health responses and messaging. As thepandemic escalates in low-income and middle-incomecountries (LMICs), there is a growing call to identifylocally tailored solutions.1,2 Because outbreaks are notonly public health emergencies, but also political andsocioeconomic emergencies, we can learn from AfricanEbola and cholera responses and avoid “biomedicaltunnel vision”3 by actively addressing wider socioeconomicand health inequities.4 Otherwise, thepandemic response might do more harm than good.Practical social justice—linking principles of justice withactions tailored to specific contexts—can help to guidedecisions. We offer five key points to inform decisionmaking in LMICs grounded in principles of social justice.First, the self-determination and agency of LMICs areimportant to uphold and respect, which means thatLMICs develop and shape contextually relevant publichealth interventions, drawing on international partnersas needed. Resource constraints should not affect theagency of LMICs to shape their responses. Althoughinternational cooperation is essential, regional networksare best placed to assess needs and lead planning.Importantly, while high-income countries are focusedon addressing the epidemic in their own countries,international support remains crucial to ensure thatdevelopment gains are not reversed.