Regulatory policy

The Global Response to the Pandemic: High Principles but Short Plans

German Health Minister Dr Karl Lauterbach and WHO Dr Mike Ryan

Amid criticism that the World Health Summit was a ‘speed-dating for consultants’, panelists lamented the lack of practical plans to strengthen local service delivery

A more empowered World Health Organization (WHO), stronger local health systems and better surveillance are some of the weapons that will protect the world against future pandemics, according to panelists at the World Health Summit in Berlin.

“The WHO needs more powers to deal with pandemics. Isn’t there something ridiculous about the fact that the International Atomic Energy Agency can go into a war zone and inspect what’s going on in a nuclear power plant and the WHO doesn’t ‘has no absolute right to obtain visas to travel to the site of any outbreak anywhere in the world?” said Helen Clark, former prime minister of New Zealand and co-chair of the Independent Panel for Pandemic Preparedness and Response.

She was referring to how China denied WHO-appointed experts access to the outbreak of the pandemic in Wuhan.

“The International Health Regulations need to be fit for purpose and empower the WHO on very practical issues like this,” said Clark, who also asserted that “this Wasn’t the WHO that let the world down. It was the Member States that failed the WHO.

Nobody had a plan

German Health Minister Dr Karl Lauterbach said when his country took the helm of the G7 it was clear that no country had a plan for how to deal with pandemics. To better understand the gaps, he convened three informal meetings of scientists.

What emerged, Lauterbach said, were two key points of consensus: first, “we lack a better prepared workforce to recognize a possible pandemic and to prevent an outbreak from becoming a pandemic” and second , a lack of surveillance to identify a pandemic Lauterbach called for everything to be geared towards meeting these two crucial needs – and training young people to “interest them in the fight against the pandemic”.

“We will either spiral up or spiral down. If we spiral down, we will have more climate change and more pandemics because of climate change. We will have worse primary health because of climate change and pandemics and we will have more wars because all of this is happening.

“The last mile of delivery is the first mile of health security”

Dr Mike Ryan, WHO’s executive director of health emergencies, agreed that “without data you are blind and without manpower you have no capacity to act”.

However, he added that “95% of people who survive natural disasters survive because their neighbors and families dig them up under a building or pull them out of water.”

“It’s exactly the same principle in epidemics. It is local community-based monitoring, point-of-care diagnostics, the ability to understand that there is a problem in the community, and the rapid provision of support to a community before an epidemic does not become a national or global event,” Ryan said.

The “last mile” of health care was also the “first mile of health security” – and often the weakest link.

Describing the health summit as “speed dating for global consultants”, Ryan said things were very different at the country level where health ministries were “generally underfunded and the weakest ministry in government “.

“Then we come in with our vertical systems and we start pushing everybody, ‘you gotta do this and you gotta do that. We’ve decided that’s what’s best for you. How paternalistic is that? Ryan said, calling attention to “this principle of service to the people” – and humility.

South Sudan’s Minister of Health, Elizabeth Chuei, receives a COVID-19 vaccine after it was delivered by COVAX.

“Little White Cabals of the North”

He was also aimingmany unelected individuals around the world who live in their little northern white cabals who like to sit in rooms and decide what the future of global health will be.”

“The reality is that 194 ministers of health meet every year in Geneva and set, according to democratic principles, what the policies are for the world and we have to continue to invest in that,” Ryan said.

“We are an imperfect organization. But we are radically transparent and we are open. Everything we do is on the table. Everything we do is there for criticism. I would like it to be the same for other entities and institutions.

He also blamed any failure of the global vaccine delivery platform, COVAX, on “the greed of the north”, “the greed of the pharmaceutical industry” and “the self-interest of certain member states” which does not weren’t ready to share.

“COVAX has bucked that trend, and COVAX has tried its best to represent that need in the world,” Ryan said, adding that he and others often work “26 hours a day” to make in the face of the pandemic and sometimes needed to be “peeled”. off Wales.

Principles not plans

Professor Lawrence Gostin of Georgetown University in the United States said there was a need for “better governance” of the WHO.

“We need to have more honesty and stewardship, transparency and openness, most importantly, inclusive participation, effective performance monitoring benchmarks, quality improvement, accountability, and the most important is fairness,” Gostin said.

The official of the German Ministry of Health, Björn Kümmel, who leads the refinancing of the WHO as co-chair of the Intergovernmental Working Group on Sustainable Financesaid his country would like to “enable the WHO not only financially but also technically, potentially legally through new mechanisms in the IHR and obviously, the pandemic treaty, and politically also vis-à-vis other agencies global health organizations or other actors who engage in global health”.

However, Kummel conceded that “no one seems to have a plan”.

Much of the discussion focused on “principles” – such as “better governance, trust, transparency, acceptance of criticism, [ensuring] civil society voice, equity, community intelligence systems.

“All the big words that have been mentioned here, I think it’s clear none of us seem to have the right plan.”

Image credits: UNICEF.

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