Chapter 9 274 address overarching drivers of the substantial socio-economic and cultural inequalities that lead to health disparities in the Netherlands[34]. This is even more important given that measures such as lockdowns disproportionately influenced populations of lower socio-economic status and with migration backgrounds[35]. On a global scale, unequal access to SARS-CoV-2 vaccination both within countries[36-38] and internationally[39] further widened health inequalities. Efforts such as the COVAX programme[40] strived to achieve vaccine equity worldwide by redistributing donated vaccine stocks from HICs to LMICs. Led by the WHO, Gavi, The Vaccine Alliance[41] and the Coalition for Epidemic Preparedness Innovations (CEPI)[42], the COVAX initiative foresaw that countries with greater financial means would be most likely to procure sufficient vaccine doses for their populations before anyone in low-income nations would have had the chance to. However, at the time of writing, stark global differences remain in the proportion of populations to have received a primary vaccination series for COVID-19, whilst additional boosters continue to be administered in high-income nations[43]. This inequity in the distribution of vaccines resulting in-part from a lack of high-level political commitment will live on as one foremost criticisms of our global response to the COVID-19 pandemic[44, 45]. In addition, a recent analysis by the WHO revealed that the pandemic significantly affected access to therapeutics for non-communicable diseases (NCDs), more frequently in low-resource settings with pre-existing weaknesses in the supply chain[46]. Sadly, these observations are not unique. For instance, gross inequity in access to antiretroviral therapy for the treatment of human immunodeficiency virus (HIV) still exists, four decades after the HIV epidemic first arose[47]. Meanwhile, it is estimated that 20% of children worldwide lack access to essential vaccinations[48]. Improving our global health infrastructure in order to foster equitable distribution of life-saving tools such as vaccination and essential medicines (not only for COVID-19) should to be one of the key “lessons learned” from this pandemic[49]. 9.2 LONG-TERM CLINICAL FEATURES OF SARS-COV-2 INFECTION In the first part of this general discussion, we discussed the epidemiology of acute COVID-19 in Amsterdam, the Netherlands. A substantial proportion of these individuals went on to develop persistent symptoms. Here, I outline several key findings on ‘long COVID’ or post-acute sequelae of COVID-19 (PASC).
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