Inequalities in the health sector have existed for many decades and have led to unjust consequences in morbidity and mortality in the continent. These have become even more apparent during the COVID-19 pandemic with individuals from black and minority ethnic groups, poorer socioeconomic backgrounds, urban and rurally deprived locations, and vulnerable groups of society suffering the full force of its effects.

Homeless people are among individuals who experience health consequences in the current COVID-19 pandemic. Their living arrangements whether formal (shelters or halfway houses) or informal (encampments or abandoned buildings) make them susceptible to worse health outcomes.

Various governments have developed policies to address health inequality and its social determinants. Academics and practitioners have given considerable attention to efforts aimed at improving overall population health and reducing the burden of diseases as well as eliminating health disparities based on socioeconomic status, race, geography, gender and ethnicity. Despite significant efforts to address the socioeconomic issues that aggravate health inequalities, striking disparities in "health status still exists within and among countries”.

We cannot ignore the importance of making hygiene services accessible to vulnerable populations in sub-Saharan Africa. As the WHO-UNICEF data reveals, about 370 million Africans have no basic handwashing facility. In the Democratic Republic of Congo, over 68 million people, more than three-quarters of the country’s population, have no handwashing facilities.

The situation in Nigeria, an oil-rich country where nearly 50 million people have no handwashing facilities, is unspeakable. Health disparities in Nigeria affect the distribution of water and hygiene services among poor populations, which can lead to a disproportionate impact on public health outcomes during a pandemic outbreak such as COVID-19. Ethiopia is another country where the health disparity is appalling, as 43 million people have no handwashing facility.

Health systems strengthening should be everybody’s business. This cannot be left to the government alone. I would love to thank WHO for their continued support in providing policy, evidence, and guidelines during this pandemic.

Private sector need to come on board in partnerships that can strengthen the health systems in the continent. Provision of hand washing stations, public education on COVID-19 awareness and prevention, training, and empowering community health workers to reduce the burden of the disease at the health facilities, keeping safe and social distancing, provision of accurate data to inform policy and action could go a long way.