Post-COVID economic recovery: women and children first … or last?

Twenty-first century science underpinned the rapid global response to COVID-19, identifying the causal pathogen, sequencing the SARS-CoV-2 genome, developing vaccines and initiating clinical trials, within 9 months of first appearance. Although in tackling the immediate consequences of the pandemic countries responded to science in different ways, every nation now grapples with the economic consequences and the question of where to focus investment. Here, we argue that insights from 21st century science can also lead the way to economic recovery. These indicate that there should be a prime focus on healthy populations resilient to unexpected challenges and that this is to a large extent dependent on maternal, neonatal and child health (MNCH). Recovery from COVID-19 offers a unique opportunity to target investment on MNCH. Post-COVID economic recovery will have to take place against the continuing backdrop of the growing population prevalence of chronic non-communicable diseases (NCDs) that are progressively crippling health systems, societies and economies. Thus, in 2019, the USA witnessed a reversal of the rise in life expectancy and healthy longevity that characterised previous decades. Pre-COVID policies were unable to tackle these challenges; hence, restoring the status quo appears to be a doomed strategy. However, science shows clearly that MNCH is of pivotal importance to preventing and reducing the population prevalence of physical and mental NCDs.1 For example, babies born preterm, are growth restricted or born to mothers who are undernourished, overweight or with diabetes represent a large and growing proportion of all births and are at substantially increased odds of developing hypertension, diabetes, renal impairment, heart disease and other chronic NCDs in adult life.2 In …