EFPIA Guest Blogpost: Nobody Left Outside

The Nobody Left Outside (NLO) initiative was created in 2017 when MSD reached out to NGOs representing the most marginalised communities in Europe including people experiencing homelessness, LGTBI people, people who use drugs, prisoners, sex workers and undocumented migrants. Since then, the NLO coalition has been showing great efforts to raise awareness of the challenges marginalised communities face in access to healthcare.

These efforts materialise through various activities such as conferences, articles, exhibitions, proposals and reports to World Health Organisation and the EU institutions.

Today, the NLO coalition is recognised as a single voice for the most marginalised and stigmatised communities through open dialogues with EU institutions and major health organisations.

Boris Azaïs, the Director of Public Policy Europe for MSD shares NLO's journey on this blogpost for the European Federation of Pharmaceutical Industries and Associations (EFPIA).

Read the blogpost here.


NLO publishes open letter on vaccine equity

The Nobody Left Outside initiative published an open letter calling on European policymakers to ensure equitable access to COVID-19 vaccination among marginalised communities.

We emphasise the critical importance of including marginalised groups in ongoing vaccination programmes if they are to achieve their goal of herd immunity and public health protection.

To this end, NLO recommends that policymakers:

  • Take a stronger stance on vaccine equity as the guiding principle for the design and implementation of national COVID-19 vaccination strategies
  • Implement specific outreach measures to reach and vaccinate people who face barriers to mainstream healthcare – the NLO Service Design Checklist can help here
  • Address vaccine hesitancy and lack of trust in government and health bodies
  • Assure access to health services for people who are undocumented or face criminalisation without fear of repercussion
  • Combine COVID-19 vaccines with other inclusive public health measures, including public engagement and test, trace and isolation measures that are accessible and suitable for everybody
  • Ensure equitable and sustainable access to all forms of healthcare and health information, fostering community engagement to help achieve this
  • Support calls for a strong European Health Union with explicit health policy competences for the EU.

Read the full letter here


NLO receives honourable mention for 2021 World Changing Ideas awards

We are proud to announce that the Nobody Left Outside Coalition has been recognized with an honourable mention by the Fast Company World Changing Ideas Awards.

The contest in its 5th year honours products, concepts, companies, policies and designs striving for the good of society and the planet.

The NLO Coalition has received an honourable mention in the Social Justice category for its work to increase access to health and social services for marginalized communities.

More on Fast Company 2021 World-Changing Ideas here

More on the finalist and honourable mentions here


NLO celebrates World Health Day 2021

April 2021

Building a fairer, healthier world – where nobody is left outside

Today we celebrate World Health Day 2021, with its motto “Building a fairer, healthier world“, during an ongoing global pandemic.

COVID-19 has severely impacted the health, lives and livelihoods of many millions of people worldwide. Marginalised groups such as people experiencing homelessness, undocumented migrants, sex workers, people who use drugs, lesbian, gay, bisexual, transgender and intersex (LGBTI) people and prisoners are among those hardest hit by the pandemic and yet are among the least protected.

The problems are not new, or specific to the COVID-19 pandemic. The aforementioned marginalised communities already faced difficulties accessing healthcare, social care and support services well before the pandemic, as did others subject to racism and other forms of systemic discrimination. And yet, while the problems were clear, there has been limited, effective action to address them.

COVID-19 has emphasised that nobody is safe until everybody is safe. In order to protect our societies from this and future pandemics, and to deliver better health for all, healthcare must once and for all be truly and equitably accessible to everybody.

The recent Call to Action of the Pan European Commission on Health and Sustainable Development, convened by Dr Hans Kluge (WHO Regional Director for Europe) and chaired by Mario Monti, states that:

“We cannot achieve a sustainable future for health and development in Europe if we fail to address the conditions that allowed the COVID-19 pandemic to inflict unprecedented damage on lives and economies. We need to accept that the global system has failed.”

This Commission calls for action at all levels of society to fix the fractures that left so many people vulnerable to the pandemic. This includes:

  • Making health systems more inclusive, ensuring that everyone can participate in decision-making at all levels and access health and social services, and
  • Re-emphasizing the Sustainable Development Goal of achieving universal health coverage (UHC), which is key to ensuring societal cohesion, economic growth and sustainable societies.

The Nobody Left Outside (NLO) initiative welcomes and supports this Commission and its Call to Action. The recommendations reflect the core goals of NLO to address the social determinants of health and to achieve equitable access to health and social care, including underserved, marginalised communities – as expressed in our Joint Statement.

We call on EU and national policymakers to institute policies that protect everyone from the effects of the COVID-19 pandemic, future pandemics and other health threats based on the principles of evidence-based public health, human rights and equity, as further explained in the NLO COVID-19 briefing paper.

In 2021 we must build a fairer, healthier world – for good.


NLO Week 2020 Webinar

Webinar “COVID-19 in Marginalised Groups – Challenges, actions and voices”

October 2020

The COVID-19 pandemic has created an unprecedented crisis for governments and health systems, and has severely impacted the health, lives and livelihood of millions of people worldwide.

While COVID-19 has affected everyone, it has had particular impact among marginalised communities such as homeless people, LGTBI people, people who use drugs, prisoners, sex workers and undocumented migrants. The pandemic has amplified existing challenges among these groups, who already face a high risk of poor health and various barriers in accessing healthcare and support services. The Nobody Left Outside (NLO) initiative recently explained these challenges and issued policy recommendations in a briefing paper for the WHO European Office for Investment for Health and Development.

The webinar “COVID-19 in Marginalised Groups – Challenges, actions and voices” organised in collaboration with the European Health Forum Gastein concludes NLO Week 2020 – a week of online activities focusing on the unmet healthcare needs of marginalised communities. It took place on Friday, 16 Oct from 14h00 – 15h30 CEST. You find the recording of the event here and below.

In this webinar, NLO civil society participants, academics and policymakers will discuss the impact of COVID-19 on marginalised groups, the gaps and unintended consequences of government responses, and how we can ensure future health systems and recovery measures reach everyone.

We invite the audience to ask questions throughout the webinar and to share their reflections and ideas.

Speakers include:

  • Stella Kyriakides, Commissioner for Health and Food Safety, European Commission (Video Address)
  • Dr Hans Kluge, Regional Director, WHO Europe
  • Dr Vytenis Andriukaitis, NLO Goodwill Ambassador
  • Luca Stevenson, International Committee on the Rights of Sex Workers in Europe (ICRSE)
  • Cianán Russell, European Region of the International Lesbian, Gay, Bisexual, Trans and Intersex Association (ILGA-Europe)
  • Roberto Perez Gayo, Correlation – European Harm Reduction Network
  • Rosaline M’Bayo, Member Representative, European AIDS Treatment Group and Project Coordinator, Afrikaherz
  • Denis Onyango, Africa Advocacy Foundation (AAF)
  • Alyna Smith, Platform for International Cooperation on Undocumented Migrants (PICUM)
  • Freek Spinnewijn, European Federation of National Organisations Working with the Homeless (FEANTSA)
  • Prof. Jeffrey Lazarus, Barcelona Institute for Global Health (ISGlobal), Hospital Clínic - University of Barcelona
  • Dr Julie Gedberding, Chief Patient Officer representative, MSD USA

Moderator: Boris Azaïs, Director, Public Policy Europe & Canada, MSD

 


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NLO COVID-19 Paper

August 2020

The coronavirus disease (COVID-19) pandemic has created an unprecedented crisis for governments, health systems and societies at large, and has severely impacted the health, lives and livelihood of millions of people worldwide.

Marginalised groups are among people the hardest hit by the COVID-19 pandemic, and yet are among the least protected from it by governmental actions to date. Indeed, the COVID-19 crisis has brought into sharp focus the stark inequities that exist in access to health and social support services for marginalised people who live precariously in Europe, often outside formal healthcare systems and social, labour and legal protection measures.

The Nobody Left Outside coalition has developed this briefing paper for the WHO European Office for Investment for Health and Development to:

  1. Explain to policymakers the particular challenges and impacts of the COVID-19 pandemic and government responses among marginalised groups in Europe. This is done via a unique exercise mapping the inter-related impacts associated with homelessness, sex work, undocumented status, drug use, LGBTI identity and imprisonment according to the framework of the WHO Health Equity Status Report (HESR) essential conditions for a health life
  2. Recommend solutions to help improve government responses, recovery measures and inform preparedness plans
  3. Present the voices and actions of marginalised communities and civil society organisations currently working on the frontlines to support them through the pandemic and beyond. This section signposts to a variety of resources highlighting lived experiences and ongoing community-led responses across Europe

NLO Service Design Checklist published in BMJ Open

A peer-reviewed article reporting the NLO Service Design Checklist has now been published in the BMJ Open journal.

The article explains the rationale for the Checklist to help all stakeholders overcome inequalities in access to health and support services faced by marginalised communities, in alignment with principles of person centricity and universal health coverage. The result of this collaborative project is a versatile, easy-to-use and practical tool that policymakers, public health bodies, healthcare authorities and practitioners, peer support workers and non-governmental organisations are encouraged to use when developing, updating or monitoring action plans and local services for target groups. It is also intended for civil society workers to use in wider advocacy efforts to improve access among underserved communities. The article was downloaded over 1200 times within a month of being published in April 2020, and has particular relevance in light of the impact of the COVID-19 pandemic on marginalised communities. It is freely available here. NLO participants have also published a BMJ Opinion article discussing the Checklist and the NLO Thematic Network Joint Statement in context with international political efforts toward universal health coverage.

Full details:

Lazarus JV, Baker L, Cascio M, et al, on behalf of the Nobody Left Outside initiative. Novel health systems service design checklist to improve healthcare access for marginalised, underserved communities in Europe. BMJ Open 2020;10:e035621. doi:10.1136/bmjopen-2019-035621

Lazarus JV, Onyango D, Spinnewijn F. Leaving nobody outside our healthcare systems - in Europe or elsewhere. BMJ Opinion, 25 Nov 2019


Nobody Left Outside (NLO) initiative statement on COVID-19

The Nobody Left Outside (NLO) coalition calls for national governments to act urgently to protect communities facing high levels of marginalisation, social exclusion and vulnerability during the COVID-19 pandemic. EU and national government COVID-19 responses must reach everyone - including marginalised people. “Let us support those who have no chance to stay home – providing support to those people in hostels, in charities and in shelters helping them survive in time of COVID-19 pandemic”, says Dr Vytenis Andriukaitis, NLO Goodwill Ambassador and former European Union Commissioner for Health and Food Safety.

Read the full text here : NLO statement on COVID-19