IMPACT OF COVID-19 HEALTH CRISIS ON HEALTH SYSTEMS OF COUNTRIES; AN EVALUATION WITH THE DIMENSION OF GLOBAL HEALTH SYSTEMS

Öz

The countries' unpreparedness in managing the COVID-19 epidemic and the inadequacies of the global health system have turned the outbreak into a worldwide health crisis. In this study, the impact of the COVID-19 health crisis on the health systems of countries was evaluated based on the literature in terms of global health systems. Unlike other epidemics, the coronavirus has spread rapidly in all countries, regardless of income. The United Nations and the World Health Organization (WHO) stated that a joint approach is necessary for supporting global solidarity policies so that the COVID-19 process due to social, economic, and health inequalities between countries does not get worse. However, it has been seen that the disagreements between some powerful countries that are influential in global politics negatively affect the global health system and epidemic management. With the onset of the COVID-19 epidemic, some countries brought the "my nation first" approach to the fore, undermining the fair implementation of global health policies. The member countries of the World Trade Organization have also violated the trade agreements made and imposed export restrictions on the products necessary for the fight against the epidemic. It has also been reported that high-income countries disregarded public health and human rights approaches during the epidemic and reached COVID-19 vaccines proportional to their purchasing power. It has been observed that the epidemic cannot be managed effectively at the global level, although the global health system is more needed throughout the world during the pandemic process. It was emphasized that redesign is necessary for effective governance of the global health system.

Anahtar Kelimeler

• Health
• COVID-19
• Global health system
• Health policy

COVID-19 SAĞLIK KRİZİNİN ÜLKELERİN SAĞLIK SİSTEMLERİ ÜZERİNE ETKİSİ; KÜRESEL SAĞLIK SİSTEMLERİ BOYUTUYLA BİR DEĞERLENDİRME

Öz

COVID-19 salgınının yönetiminde ülkelerin hazırlıklı olmaması ve küresel sağlık sisteminin yetersizlikleri, salgını dünya genelinde küresel boyutlu sağlık krizine dönüştürmüştür. Bu çalışmada, COVID-19 sağlık krizinin ülkelerin sağlık sistemleri üzerine etkisi, küresel sağlık sistemleri boyutuyla literatür doğrultusunda değerlendirildi. Koronavirüs, diğer salgınlardan farklı olarak gelir düzey ayrımı gözetmeden tüm ülkelerde, hızla yayılmıştır. Birleşmiş Milletler ve Dünya Sağlık Örgütü (WHO) ülkeler arasındaki sosyal, ekonomik ve sağlık eşitsizliklerine bağlı, COVID-19 sürecinin daha kötüye gitmemesi için küresel dayanışma politikalarının desteklenmesinde ortak yaklaşımın gerekli olduğunu bildirmiştir. Fakat küresel siyasette etkili bazı güçlü ülkeler arasındaki anlaşmazlıkların küresel sağlık sistemini ve salgın yönetimini olumsuz etkilediği görülmüştür. COVID-19 salgının başlamasıyla bazı ülkeler "önce benim milletim" yaklaşımını ön plana çıkararak küresel sağlık politikalarının adil uygulanması yaklaşımını baltalamıştır. Dünya Ticaret Örgütüne üye ülkeler yapılmış ticaret anlaşmalarını da ihlal ederek salgınla mücadelede gerekli olan ürünlere ihracat kısıtlaması getirmiştir. Yine yüksek gelirli ülkelerin salgın sürecinde halk sağlığı ve insan hakları yaklaşımlarını göz ardı ederek satın alma gücüyle COVID-19 aşılarını elde ettiği bildirilmiştir. Dünya genelinde, pandemi sürecinde küresel sağlık sistemine daha fazla ihtiyaç duyulduğu halde salgınının küresel düzeyde etkili yönetilemediği görülmüştür. Küresel sağlık sisteminin etkili yönetişimi için yeniden tasarımın gerekli olduğu vurgulanmıştır.

Anahtar Kelimeler

• Sağlık
• COVID-19
• Küresel sağlık sistemi
• sağlık politikası

Kaynakça

1. 1. Ekpenyong A, Pacheco MS. COVID-19: reflecting on the role of the WHO in knowledge exchange between the global North and South. Global Social Policy. 2020;20(3):388-92. DOI:10.1177/ 1468018120966657.
2. 2. Kuhlmann E, Dussault G, Correia T. Global health and health workforce development: what to learn from COVID 19 on health workforce preparedness and resilience. The International Journal of Health Planning and Management. 2021;36(1):5-8. DOI 10.1002/hpm.3160.
3. 3. Braithwaite J,Tran, Y, Ellis, LA, Westbrook J. The 40 health systems, COVID-19 (40HS, C-19) study. International Journal for Quality in Health Care, 2021;33(1): mzaa113. DOI:10.1093/intqhc/mzaa113.
4. 4. Mas Bermejo P, Sánchez Valdés L, Somarriba López, L, Valdivia Onega NC, Vidal Ledo MJ, Alfonso Sánchez I, et al. Equity and the Cuban National Health System's response to COVID-19. Revista Panamericana de Salud Pública. 2021;45:e80. DOI:10.26633/ RPSP.2021.80.
5. 5. Lal A, Erondu NA, Heymann DL, Gitahi G, Yates R. Fragmented health systems in COVID-19: rectifying the misalignment between global health security and universal health coverage. The Lancet. 2021;397(10268): 61-7. DOI:10.1016/S0140-6736(20)32228-5
6. 6. Shamasunder S, Holmes SM, Goronga T, Carrasco H, Katz E, Frankfurter R, Keshavjee S. COVID-19 reveals weak health systems by design: why we must re-make global health in this historic moment. Global Public Health. 2020;15(7):1083-9. DOI:10.1080/ 17441692.2020.1760915.
7. 7. De Silva, O L, Lasaulce, & Morărescu IC. On the efficiency of decentralized epidemic management and application to Covid-19. IEEE Control Systems Letters. 2021; 6, 884-9. DOI: 10.1109/ LCSYS.2021.3087101
8. 8. Ağartan Tİ. COVID-19 opens a window of reflection for comparative health systems and global health research. New Perspectives on Turkey, Published online by Cambridge University Press. 2020;63:190-208. DOI:10.1017/npt. 2020.25.

9. 9. Zhou YR. Vaccine nationalism: contested relationships between COVID-19 and globalization, Globalizations. 2021;19(3):450-65. DOI:10.1080/ 14747731.2021.1963202.
10. 10. Coria AL, Rabin TL, Rule, AR, Haq H, Hudspeth JC, Ratner L, et al. Global health crisis, global health response: how global health experiences prepared North American Physicians for the COVID-19 pandemic. Journal of General Internal Medicine. 2022;37(1):217-21. DOI:10.1007/s11606-021-07120-w.
11. 11. Yang K. Unprecedented challenges, familiar paradoxes: COVID-19 and governance in a new normal state of risks. Public Administration Review, 2020;80(4): 657-64. https://doi.org/10. 1111/puar.13248
12. 12. Casula M, & Pazos-Vidal S. Assessing the Multi-level Government Response to the COVID-19 Crisis: Italy and Spain Compared. International Journal of Public Administration. 2021; 44(11-12), 994-1005. https://doi.org/10.1080/ 01900692.2021.1915330
13. 13. Capano G, & Lippi A. Decentralization, policy capacities, and varieties of first health response to the COVID-19 outbreak: evidence from three regions in Italy. Journal of European Public Policy, 2021; 28(8):1197-218. https://doi.org/10. 1080/13501763.2021.1942156
14. 14. Haldane V, De Foo C, Abdalla SM, Jung AS, Tan M, Wu S, et al. Health systems resilience in managing the COVID-19 pandemic: lessons from 28 countries. Nature Medicine. 2021;27(6):964-80. DOI:10.1038/s41591-021-01381-y.
15. 15. Bolcato M, Rodriguez D, Feola A, Di Mizio G, Bonsignore A, Ciliberti R,& Aprile A. COVID-19 Pandemic and Equal Access to Vaccines. Vaccines. 2021;9(6):538. https://doi.org/10.3390/ vaccines9060538
16. 16. Bambra C, Riordan R, Ford J, & Matthews F. The COVID-19 pandemic and health inequalities. J Epidemiol Community Health, 2020; 74(11);964-8. http://dx.doi.org/10.1136/jech-2020-2144 01
17. 17.Forman L, Kohler JC. Global health and human rights in the time of COVID-19: Response, restrictions, and legitimacy. Journal of Human Rights. 2020;19(5):547-56. DOI:10.1080/ 14754835.2020.181855.
18. 18. Sepulveda ER, & Brooker AS. Income inequality and COVID-19 mortality: Age-stratified analysis of 22 OECD countries. SSM-Population Health. 2021;16, 100904. https://doi.org/ 10.1016/j.ssmph.2021.100904
19. 19. Haynes K. Structural inequalities exposed by COVID-19 in the UK: the need for an accounting for care. Journal of Accounting & Organizational Change. 2020;16 (4): 637-42. https://doi.org/ 10.1108/JAOC-08-2020-0099
20. 20. Mishra V, Seyedzenouzi,G. Almohtadi,A. Chowdhury,T. Khashkhusha,A. Axiaq A, & Harky A. Health inequalities during COVID-19 and their effects on morbidity and mortality. Journal of healthcare leadership. 2021;13:19-26. DOI: 10. 2147/JHL.S270175
21. 21. Su Z, McDonnell D, Li X, Bennett B, Šegalo S, Abbas J,& Xiang Y T. COVID-19 Vaccine Donations—Vaccine Empathy or Vaccine Diplomacy? A Narrative Literature Review. Vaccines. 2021;9(9), 1024. https://doi.org/10.3390/ vaccines9091024
22. 22. Radenovič S, Radivojević V, Krstić B, Stanišić T, Živković S. The efficiency of health systems in response to the covid-19 pandemic: Evidence from the eu countries. Problemy Ekorozwoju. 2022;17(1):7-15. DOI:10.35784/pe. 2022.1.01.
23. 23. Garcia-Prats AJ, McAdams RM, Matshaba M, Thahane L, Butteris SM, Conway JH, et al. Mitigating the impacts of COVID-19 on global child health: A call to action. Current Tropical Medicine Reports. 2021;8(3):183-9. doi.org/10.1007/s40475-021-00241-6
24. 24. Liu Y, Lee JM, Lee C. The challenges and opportunities of a global health crisis: the management and business implications of COVID-19 from an Asian perspective. Asian Business and Management. 2020; 19(3):277-97. doi.org/10.1057/s41291-020-00119-x.
25. 25. Van Schaik L, Jørgensen KE, van de Pas R. Loyal at once? The EU’s global health awakening in the Covid-19 pandemic. Journal of European Integration. 2020;42(8):1145-60. DOI:10.1080/07036337.2020.1853118.
26. 26. Parker R, Ferraz D. Politics and pandemics. Global Public Health. 2021;16(8-9): 1131-40. DOI:10.1080/17441692.2021.1947601.
27. 27. Johnson SB. Advancing global health equity in the COVID-19 response: beyond solidarity. Journal of Bioethical Inquiry. 2020;17(4):703-7. DOI:10.1007/ s11673-020-10008-9.
28. 28. AlKhaldi M, James N, Chattu VK, Ahmed S, Meghari H, Kaiser K, et al. Rethinking and strengthening the Global Health Diplomacy through triangulated nexus between policy makers, scientists and the community in light of COVID-19 global crisis. Global Health Research and Policy. 2021;6(1):1-6. DOI:10.1186/s41256-021-00195-2.
29. 29. Harman S. COVID-19, the UN, and dispersed global health security. Ethics and International Affairs. 2020;34(3):373-8. DOI:10.1017/ S0892679420000398.
30. 30. González LZ. Indirect Governance of Transnational Crises: The PAHO and WHO Response to the COVID-19 Pandemic in Latin America. Global Governance: A Review of Multilateralism and International Organizations. 2021;27(4):587-606. DOI:10.1163/ 19426720-02704001.