Building back fairer in public health policy requires collective action with and for the most vulnerable in society

Abstract

The COVID-19 pandemic reveals how public policy is shaped by a ‘competition for ideas’, where problems are raised and framed differently by different actors located within hierarchies of power, networks and resources.

Despite statistical data revealing inequalities in the distribution of burden and risk, it remains relatively uncommon to amplify the voices of those most directly affected.

The pandemic has also revealed monopolies of knowledge production, with global burdens estimated by institutions in the global north developed through methodologies that lack transparency, this disempowers low-income and middle-income countries.

In many so-called developed democracies, the responses to the pandemic have been inadequate with cutbacks to health and social services limited commitment to equity in leadership and poor governance, ensuring some issues make it onto policy agendas while others are suppressed.

Building and maintaining equitable and resilient health systems reconciling COVID-19 with high-quality, timely care for all people, with and without COVID-19, and particularly vulnerable groups requires community voices to be regarded as critical sources of evidence for policy learning.

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© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/'>http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/'>http://creativecommons.org/licenses/by-nc/4.0/.

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Identifiers

DOI

https://doi.org/10.1136/bmjgh-2021-005555

Repository URI

https://aura.abdn.ac.uk/handle/2164/16055