Policy responses to COVID-19 present a window of opportunity for a paradigm shift in global health policy: An application of the Multiple Streams Framework as a heuristic.

Drawing on Kingdon's Multiple Streams Framework as a heuristic, this article reviews the three streams - problems, policies, and politics - as applied to the adoption of economic policies in response to the socioeconomic impacts of COVID-19. In doing so, we argue that we are currently presented with a window of opportunity to better address the social determinants of health. First, through assessing the problem stream, an understanding of inequity as a problem gained wider recognition through the disproportionate impacts of COVID-19. Second, in the policy stream, we demonstrate that appropriate and unprecedented policies can be enacted even in the face of changing evidence or evidentiary uncertainty, which are needed to address upstream factors that influence health. Lastly, in the politics stream, we demonstrate that addressing a public health 'problem' can be well-received by the public, making it politically viable. However, it is important to ensure the 'problem' is clearly relayed to the public and that this information is not perceived to change, as this can undermine trust. The social, political, and behavioural lessons presented by the COVID-19 pandemic should be drawn on in this pivotal moment for global public health.

Scoping review of the World Health Organization's underlying equity discourses: apparent ambiguities, inadequacy, and contradictions.

BACKGROUND AND OBJECTIVE: Given the heightened rhetorical prominence the World Health Organization has afforded to equity in the past half-century, it is important to better understand how equity has been referred to and its conceptual underpinning, which may have broader global implications. ELIGIBILITY CRITERIA: Articles were included if they met inclusion criteria - chiefly the explicit discussion of the WHO's concept of health equity, for example in terms of conceptualization and/or definitions. Articles which mentioned health equity in the context of WHO's programs, policies, and so on, but did not discuss its conceptualization or definition were excluded. SOURCES OF EVIDENCE: We focused on peer-reviewed literature by scanning Ovid MEDLINE and SCOPUS databases, and supplementing by hand-search. RESULTS: Results demonstrate the WHO has held - and continues to hold - ambiguous, inadequate, and contradictory views of equity that are rooted in different theories of social justice. CONCLUSIONS: Moving forward, the WHO should revaluate its conceptualization of equity and normative position, and align its work with Amartya Sen's Capabilities Approach, as it best encapsulates the broader views of the organization. Further empirical research is needed to assess the WHO interpretations and approaches to equity.