Global and regional analyses indicate that health systems have done their utmost to facilitate access and coverage of COVID-19 cases. However, due to the unusual situation, they still do not demonstrate a balance in promoting and preserving public health in its broadest sense. The 213 affected countries have so far failed to balance the coverage of demand for COVID-19 with other health demands, without loss in efficiency and quality of regular care. A recent WHO non-communicable disease survey shows that more than half of the 155 countries studied have discontinued all or part of the treatment services for several chronic diseases. Specifically, in relation to cancer, 42% of these countries have indicators of reduced access, treatment and screening.
These are indeed unprecedented impacts. But one cannot deny the tremendous difficulty that has been facing the severe cases of the unforeseen virus and, at the same time, maintaining the integrity and full operability of the care structure for cancer, hypertension, diabetes, also leprosy, tuberculosis, cases of dementia, mental disorders, among so many other worrisome patologies.
The dilemma is greater when we see that economic, demographic and social forces have put increasing pressure on health systems not only to provide universally access-level, effective and scientifically reliable health care, but also to ensure that services are planned and delivered in a way that respects the rights of patients and their families, and is tailored to their needs for information, psychosocial support and participation in decision-making for their own care. Therefore, at a time like now, the quality of and response to multidimensional needs, the legitimate demands and expectations of patients and their families are projected not only into the scope of individual rights but above all into the fundamental respect for human dignity that every system should have as its principle.
Thus, it is to be expected that from the process of slowing down the pandemic will emerge innovative, balanced, holistic and people-centred approaches to health care as proposals for a “neo-reform” of national, regional, state and municipal health systems around the world. That public health and healthcare networks be redesigned to include the entire structure of education, prevention, promotion and care, without losing sight of the convergence of public policies that guarantee the logic that health is a transversal catalyst for the quality of life of citizens. Therefore, a universal right and a social commitment of those who govern. And even if we wait for the post-Pandemic period, thinking about reviewing standards of planning, management and delivery of health systems and services will be a sign that starting again will be worthwhile.