The world witnessed the wrath of highly infectious Corona Virus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 1 (SARS-Cov-2), which was never experienced in the last century. The case fatality ratio for COVID-19 has been lower than SARS of 2003, but the transmission has been significantly greater, with a significant total death toll. It all started in December 2019 in Wuhan, Hubei, China and engulfed the whole world by August 2020. More than 637 million people have been affected by COVID-19 across the globe and counting. The COVID-19 virus is frequently mutating and new variants spreading fast and re-infecting people. Countries have witnessed COVID-19 waves, during that time span number of infections and death rose high, and there are 6.6 million deaths reported so far and deaths in Asian countries is more than 1.4 million. This is when underreported death cases due lack of tests and treatment in many low income countries.

The whole world was taken off guard, as similar situation was never experienced in memorable history. Even countries with well-developed health infrastructure and advanced healthcare systems failed to cope with the crisis. The situation in low and middle-income countries with underdeveloped health systems and poor health infrastructure was devastating. Along with checking the spread of COVID-19, there is no proper treatment for the novel coronavirus. Supply of medical products and equipment are found to be in short supply, and low income countries find it hard to access diagnostics and therapeutics. Apart from access to vaccines, tests and treatment (including Long COVID) are major challenges the Asian countries are facing.

To contain the spread of COVID-19 and subsequent devastation, in absence of treatment, many countries imposed restrictions and lockdowns impacting the life and livelihoods of all. Apart from health, there is a devastating effect on the economy and society at large. All businesses and industries were closed down, affecting most of the informal sector. There are 147 million who lost jobs in Asia alone and 148 million were pushed into extreme poverty (Oxfam). Ukraine war and uncontrolled inflation, further add to the woe of low income countries and poor and marginalised within many Asian countries. The impact of COVID-19 is all encompassing, children are still recovering from learning loss. On the other hand, administrations are clueless about how to check dropout rates among children belonging to socially vulnerable categories. In the whole process, whether health or economy it was the weaker section of society who bear the maximum burnt due to COVID-19.

Governments were criticised for a surge in hospitalisation and deaths, which resulted partly due to improper management, unscientific and irrational decisions. They were also criticised for the long neglect of the health sector mainly in Asian countries and the overwhelming poor health system that struggled to manage the general health system along with the huge demand for COVID-19 related hospitalisation and treatment. However, many also acknowledge the good work, progressive policy decisions and stimulus policies of Asian governments. Provisions for treatment despite the stressed health system, incentivising the poor, strengthening the social security measures and providing people with cash and food stuffs at subsidized rates or free are some of the commendable works from various Asian governments.

Containing the spread of COVID-19 is still a real challenge when vaccinating the masses (mostly free of cost) is the need of the hour. Dealing with vaccine hesitancy, short supply due to vaccine hoarding and stockpiling by high income countries, profit-seeking multinational pharmaceutical companies and prioritising the vulnerable to vaccination are some of the challenges the low income countries are still facing.

Against this backdrop, free, universal and equitable vaccination is a concern. Under-reporting of death cases due to lack of tests and treatment needs to be addressed. Now bridging the gaps in COVID-19 vaccine, diagnostics and therapeutics among low income and high income countries through relaxing the trade and transportation is critical. The international initiatives from WHO (COVAX and C-TAP) need to be followed in letter and spirit. Technology transfer and open sharing of vaccine, science, technology and knowledge through TRIPS waiver are needed so that all could access the vaccine, diagnostics and therapeutics. The pandemic is far from over, countries need to learn to end inequality within and between countries and ensure “leave no one behind”. Political leadership should understand “No one is safe until everyone is safe” well and lead everyone to safety.

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