This week, I joined online with over 1700 delegates from 120 countries for Lives in the Balance: A covid-19 summit to explore ways of improving and increasing investment in health systems and social protection policies for women, children, and adolescents as the world rebuilds in the wake of the pandemic.

As we came together, we reflected on the fact that the world had recently hit the grim milestone, of over 500,000 deaths from covid-19. Yet the World Health Organisation warns us that the worst of the pandemic is yet to come, and we see the deepening global public health crisis compounded by full blown social and economic crises with implications for global peace and security.

Only last week, the International Monetary Fund predicted that the world economy would shrink by 4.9 per cent in 2020—a dip which evokes memories of the Great Depression of the 1930s.

That depression was devastating. In parts of the world, including in my own country New Zealand, however, it proved to be a catalyst for creating a new social contract between states and citizens, and the establishment of comprehensive social protection and universal health coverage.

Many years from now, when people look back to the pandemic of 2020 and beyond, how will our response to it be remembered? Will it have ushered in a new world—or not?

The decisions we take now will echo down the generations. With so many lives in the balance, we cannot afford to get this wrong.

Lessons learned from this pandemic can be a catalyst for unprecedented social policy change, if the right choices are made.

First, this could be the moment when the inacceptable inequities in societies are tackled. To do that, governments need to adapt, extend, and scale-up social protection programmes such as cash transfers, food assistance, social insurance, and child benefit schemes.

Ultimately, we should aim for a world with universal social protection, which offers a shield against future shocks. We know that this is not the last pandemic the world will see, and the climate crisis also looms large. We must be better prepared to face these new global threats.

Second, this pandemic could be a turning point for achieving universal health coverage for all, at long last. We must be relentless in our drive to build resilient health systems that provide accessible, high quality services to all.

Let’s begin by massively scaling up investment in public health, and in primary health services which are the closest to where people live and are so important to women, children, and adolescents.

Finally, let this be a watershed moment for introducing genuinely inclusive policy debate and decision-making.

It’s a simple, yet profound idea: at this time of crisis, we should be asking those who use health services what they most need from health services, and then co-design those services around their needs. We need to amplify their voices, and upend decision-making structures and processes so that they are truly inclusive of all voices.

The Partnership for Maternal, Newborn & Child Health (PMNCH), whose Board I am proud to chair, has over 1,000 partners with a reach across almost all countries in the world.

Drawing on voices and lived experiences from around the globe, our Partnership is coming together to call on governments to take urgent action to mitigate the devastating effects of the pandemic on the health and well-being of women, children, and adolescents, and to build back better health systems that take full account of their self-articulated needs.

PMNCH consulted widely across its partnership, and has developed a seven-point Call to Action on covid-19, urging governments to strengthen political commitment, policies and financing to support:

• Sexual, reproductive, maternal, newborn, child and adolescent health services, supplies and information, including contraception, safe abortion, immunization, safe delivery, stillbirth prevention, and mental health;
• Advancing sexual and reproductive health and rights and gender equality;
• Quality, respectful and dignified care;
• Recruitment, training and better working conditions for frontline health workers, notably nurses and midwives;
• Social protection nets for marginalized and vulnerable groups, guided by enhanced data to address disparities for the most vulnerable, including adolescents, refugees, migrant and indigenous communities, and those living with disabilities;
• Functional, safe and clean toilet and hand-washing facilities, as well as safe drinking water; and
• Prevention of violence against women, children and adolescents.

These seven demands are straightforward and reflect basic human rights. Yet they remain unmet. And during these turbulent times, with systems and resources under great strain, they can easily get lost in the noise.

We owe it to all who are facing the hardships of this pandemic, and to the generations which follow, to listen to women’s, children’s, and adolescents’ voices and to make the changes they need to be able to lead healthy, fulfilled, and productive lives going forward.

Helen Clark, Chair, Partnership for Maternal, Newborn & Child Health.

Helen Clark was the prime minister of New Zealand for three successive terms from 1999–2008. Helen Clark was also the first woman to lead the United Nations Development Programme, and served two terms as Administrator. Helen continues to speak widely and be a strong voice on sustainable development, climate action, gender equality and women’s leadership, peace and justice, and action on non-communicable diseases and on HIV. 

Highlights from Lives in the Balance: A COVID-19 Summit can be viewed at https://livesinthebalancesummit.org/