Yesterday, Dr. Margaret Chan, Director General of the World Health Organization addressed The United Nations Secretary General’s Forum on Advancing Global Health in the Face of Crisis.
Her speech was a call for equity in health as a progress indicator. She drew the world’s attention to the recently declared influenza pandemic and the razor-sharp example of health inequities underway:
“How can you practice home quarantine in the extended African family? How can you practice social distancing in a bustling African market, the heartbeat of social and economic life?
How can we expect poor people to practice respiratory and hand hygiene when we know that millions lack even the most basic access to safe water and sanitation?”
Dr. Chan’s call is true at an international level, as well as right here in Ontario. Our attention must be in both places. How can you practice home quarantine in a homeless shelter in downtown Kingston? How can you practice social distancing when two families share an apartment in Kitchener?
Last week the world’s attention focused on living conditions in Manitoba’s First Nations reserves, as an outbreak of H1N1 meant both evacuation and hospitalization as well as over 100 confirmed cases. Over half of hospitalized H1N1 patients in Manitoba are Aboriginal.
Now is an opportunity for the Ontario Ministry of Health to focus its efforts on health equity in influenza pandemic response. This could include:
- Including medications that are the Ministry’s recommended treatments for influenza, such as oseltamavir and zanamavir, on the formulary for Ontario Drug Benefits so more can benefit.
- Providing screening guidelines for the health care system that include health care scenarios most relevant to disadvantaged populations, including home visits, drop-in facilities, street outreach and interpreted services.
- Including information on living conditions of patients as an important consideration in treatment decisions
- Working with municipalities to designate and prepare for alternative care facilities for people who are homeless who become infected.
- Prioritizing populations who are unable to implement recommendations such as social distancing in provision of alternative infection control methods (personal protective equipment, hand sanitizer, antiviral medications and eventually immunizations).
- Ensuring that provincial and local plans account for the needs of people without insurance as a health equity and a public health strategy.