Why we need better rural and remote health, now more than ever

As the world desperately attempts to mount a coordinated and effective response to the recent pandemic outbreak of COVID-19, it is becoming recognised that the greatest impact will likely be felt by the most vulnerable populations. This includes people who live in rural and remote communities with less access to critical health services. For example, although it may be possible to instigate a drive-through testing centre in a city, how do small rural communities manage testing without putting at risk the same clinicians and facilities that are needed for treatment? What happens when local clinicians have become deskilled due to health service role changes and there is suddenly a need for high-level care for more people than can be retrieved to a larger centre? How do we scale up home care, clinic care and hospital care when funding and training has been separately focused on either the clinic or the hospital, yet the same clinicians are required for all? How do we avoid stigmatising and discriminating against rural patients? How do we ensure people living in remote areas do not feel isolated from the national responses? What will be the impact on the large numbers of immune-compromised people with TB and HIV in rural Africa? If the elderly are more at risk, what will be the impact on the large number of elderly clinicians remaining in rural practice because they have been unable to find younger replacements?