During this completely life-altering, history-transforming global pandemic, non-essential health care has stopped, and many non-emergency doctors and nurses are being quickly trained to treat patients infected with COVID-19. We literally owe these health care workers our lives. Many of them are becoming infected themselves, in the process of treating sick patients. Some of them have died. Many more will die as the months drag on.
April 7 is World Health Day, and because 2020 is the Year of the Nurse and the Midwife, as designated by the World Health Assembly, the theme for this year’s World Health Day is “Support Nurses and Midwives.”
Ignorant to the plight people face during pandemics, civil wars, and natural disasters, pregnancies and births continue to happen, convenience be damned. In many humanitarian settings, pregnancy prevention is difficult to achieve due to collapsed health infrastructure, increased sexual violence, and funding shortfalls, so pregnancies and births often occur at even higher rates in these situations than in non-crisis settings. The shelter-in-place orders put on much of the world’s population to prevent the spread of COVID-19 have caused an increase in reported domestic violence cases, and, according to WHO, women who experience physical or sexual abuse are twice as likely to have abortions (which, in crisis settings, are often unsafe).
For women who were already living in humanitarian settings before the coronavirus outbreak, the risks are multiplied. A UNFPA technical brief states, “For the nearly 48 million women and girls, including 4 million pregnant women, identified by UNFPA as in need of humanitarian assistance and protection in 2020, the dangers that COVID-19 outbreaks pose will be magnified.” Speaking of UNFPA (the United Nations Population Fund), the global agency that delivers reproductive health care in over 150 countries worldwide, Donald Trump decided to stop funding that organization when he took office, just as he cut funding last fall to pandemic prevention efforts. The United States is the only country in the world that doesn’t contribute to UNFPA for non-budgetary reasons. We have been requesting for the past three years that the U.S. resume funding to UNFPA, at $111 million, as part of a broader increased investment in international family planning programs.
Population growth is only projected to increase the incidence and severity of pandemics, due to the pressures it places on wildlife habitats (see my blog post about zoonotic disease transmission here) and the increase in population density as more of the globe urbanizes.
We hope that the one silver lining to come out of this catastrophic coronavirus contagion is a massive increase in investments in global health, starting with an increase in skilled providers. According to WHO, half the global health workforce is made up of the existing 22 million nurses and 2 million midwives. WHO says that in order to achieve and sustain universal health coverage by 2030, we need another 18 million providers—9 million of them being nurses and midwives.
We also need to respect and invest in planetary health, in order to prevent the transmission of zoonotic diseases in the first place. World Health Day might implicitly refer only to human health, but if we’ve learned anything from this incident it’s that human health, animal health, and environmental health are crucially interconnected.