Equity in epidemic response: an action-oriented framework for guiding public health in equitable responses to major infectious disease emergencies

Background: A rapid and equitable response is paramount to mitigating the spread and impact of an infectious disease public health emergency. Unfortunately, public health responses often integrate equity as a secondary component rather than a foundational one—a decision that can result in disproportionate effects of the epidemic on vulnerable populations and that may further fuel or worsen the ongoing health emergency. This paper introduces a framework grounded in health equity principles to guide the design and implementation of response efforts during infectious disease emergencies. Methods: The Equity in Epidemic Response framework was developed by critically appraising and synthesizing several established models into an integrated framework, with active engagement from health professionals specializing in epidemiology, medicine, global health, mental health, community health, and health policy. Results: The framework covers six high-impact areas that should be addressed during an infectious disease public health emergency: community partnerships and engagement; communication; social and economic conditions; data systems and methods; health infrastructure and supply chains for preventives, therapeutics, and diagnostics; and accessibility of outbreak resources and essential health services. Key priorities and assessment indicators within each area were identified. Conclusions: Given the increasing threat of emerging and re-emerging infectious diseases, this framework reinforces the need to prioritize equitable approaches in responding to infectious disease public health emergencies to minimize health consequences, particularly among vulnerable populations. This framework is designed as a practical tool for public health professionals to guide major aspects of an epidemic response, ensuring thorough and equitable implementation of response efforts.