Perspectives from China- in Wuhan, patients who suffered from COVID-19, were covered by any of the medical insurance funds and government subsidies, which averaged 65% insurance rates. Due to services provided to people with COVID-19, hospitals have exclusive insurance funds beyond their usual budgets so that they don’t have any financial concerns to accept patients or serious cases in need of ICU. Regarding pharmaceuticals and services for treatment of COVID-19 which were not included in the national drug/services reimbursement lists, they were temporally granted reimbursement.
Perspectives from Sub-Saharan Africa-The burden of deaths from covid-19 has been unequally borne by old people and those with pre-existing chronic conditions. Faced with just over 16,200 cases and 873 deaths as of April 16th, which accounted for less than 1% of global infections and 0.6% of deaths, the corona virus cases in Africa have grown faster than the global average, increasing almost 5 folds in Africa, standing at 75,380 as of May 16 -- many times higher than the global average growth. While it is noteworthy that drastic interventions have been taken by governments in Africa, like in other parts of the world to contain the virus, governments are beginning to relax these interventions given the discussion that such interventions may cause more deaths from hunger and other diseases than the Corona virus itself. A careful application of interventions and lockdowns is still required to slow down the rate of transmission to levels which health systems can handle, while at the same time avoiding excessive lockdowns that may hurt the poorest. Although discussions are beginning to emerge, there has been less attention on how covid-19 and the accompanying interventions may disproportionately affect the poor and other vulnerable groups, and what measures can be put in place to mitigate their suffering. A focus on equity is important given that reducing inequality is one of the fundamental sustainable development goals (SDGs). Unlike the high-income countries of Europe, North America, and Northern Asia, most countries in sub-Saharan Africa (SSA) already bear a substantial burden of infectious diseases like HIV/AID, Malaria, and Tuberculosis.
Perspectives from the USA- The high volume of coronavirus cases the U.S. is now facing, coupled with shortages in medical equipment and supplies, demonstrate the chilling consequences of neglecting public health and preparedness in fighting against pandemics such as COVID-19 and the disconnect between public health and healthcare delivery. Lack of preparation and lackadaisical attitude towards the outbreak led to an inability to take action early on. The U.S. is now the country with the most COVID-19 cases and deaths in the world, despite having weeks and even months to prepare.
COVID-19 cases have skyrocketed among vulnerable populations. In Chicago, for instance, African Americans account for over 50% of all COVID-19 cases. The infection rate in predominantly black counties in the U.S. is also over three times that of predominantly white counties. The Native American population is also at severe risk – the Navajo Nation currently has more per capita cases of COVID-19 than any state in the country. With high rates of chronic disease, shortages of medical personnel, and poor access to basic necessities such as running water, Doctors Without Borders has dispatched a team to help mitigate the unfolding Navajo health crisis. This international humanitarian organization, which typically works in war-torn regions around the world, has never sent teams to the U.S. prior to COVID-19.
America’s 2.3 million prison population further presents a challenge. Correctional facilities do not have the medical capabilities to treat those who fall seriously ill from COVID-19; prison health care systems are also generally understaffed and ill-equipped to handle a surge in patients. A high prevalence of chronic disease and elevated risk of transmission from being in such close, enclosed quarters make these facilities high-risk breeding grounds for virus transmission.

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