key: cord-0908683-u72ua4fx
authors: McMahon, Devon E.; Peters, Gregory A.; Ivers, Louise C.; Freeman, Esther E.
title: Global resource shortages during COVID-19: Bad news for low-income countries
date: 2020-07-06
journal: PLoS Negl Trop Dis
DOI: 10.1371/journal.pntd.0008412
sha: c100e02afe1506b2f30eeabe9a4960b53fd58ce2
doc_id: 908683
cord_uid: u72ua4fx

nan

by prior studies, more advanced respiratory support such as intensive care unit (ICU) care and ventilators are even scarcer [10] .

An important part of addressing the COVID-19 pandemic is adequate testing at the community level. In addition to current shortages of COVID-19 testing globally [2, 11] , the ability to offer COVID-19 testing will likely be further constrained in low-income countries due to already limited diagnostic capacity. For example, SPA data show that fewer than 20% of hospitals, besides those in Tanzania, were able to measure CD4 count for HIV monitoring. Additionally, there is limited ability to provide routine childhood vaccination in hospitals in Afghanistan (35%), DRC (14%), Haiti (57%), and Nepal (60%), underscoring the potential for gaps in the ability to transport, store, and deliver vaccines if eventually available for COVID-19.

With COVID-19 causing unprecedented resource shortages in the world's wealthiest countries, already limited healthcare commodities will likely become even scarcer in low-income countries. There have been some rapid adjustments in the global supply chain, with China increasing its output of medical masks to 12 times previous levels [3] . But with prices for PPE and respiratory devices soaring, which hospitals will be able to afford them?

In the West African Ebola epidemic, investment in high-quality PPE and infection control training were important components of halting the spread of disease [12] , and where this was lacking, nosocomial spread was clearly worse [13] . In response to the current COVID-19 challenge, countries such as Afghanistan and Nepal have started manufacturing their own supplies 

Global resource shortages during COVID-19: Bad news for low-income countries of PPE and basic life support equipment, but this is not likely to be a feasible approach for all countries [14, 15] .

Continued local as well as international action is needed to ensure access to PPE for all health workers and respiratory support for all patients, not just for those living in resourceabundant countries. As COVID-19 therapeutics and vaccines emerge, additional international commitment will be necessary to ensure global access. Equity requires no less.

Sourcing Personal Protective Equipment During the COVID-19 Pandemic

Critical Supply Shortages-The Need for Ventilators and Personal Protective Equipment during the Covid-19 Pandemic

The global effort to tackle the coronavirus face mask shortage: The Conversation 2020

Protecting health care workers from Ebola: personal protective equipment is critical but is not enough

Health-care worker mortality and the legacy of the Ebola epidemic

Scramble for Coronavirus Supplies, Rich Countries Push Poor Aside: The New York Times 2020

COVID-19 and risks to the supply and quality of tests, drugs, and vaccines. Lancet Glob Health

The Demographic and Health Surveys Program: SPA Overview

The Neglected Hospital-The District Hospital's Central Role in Global Health Care Delivery

Intensive care unit capacity in low-income countries: a systematic review

To Get Our Economy Moving, Focus On Testing For Coronavirus: Forbes 2020

Strengthening Health Systems While Responding to a Health Crisis: Lessons Learned by a Nongovernmental Organization During the Ebola Virus Disease Epidemic in Sierra Leone

Ebola virus disease in Africa: epidemiology and nosocomial transmission

COVID-19: the current situation in Afghanistan

COVID-19 Campaign by NIC Nepal