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Archive for 17 mayo 2021

We all saw it on TV, and many of us still remember: The Director General of the WHO declaring the SARS-CoV-2 a pandemic on 11TH March 2020. The observation, that carried no legal or official importance, triggered into action most governments and civil society.

Notwithstanding, it was on the 31st of December 2019, that the WHO country offices in China picked up a media statement on cases of “viral pneumonia”. From there on, the WHO had been tirelessly gathering information and giving advice to governments and civil society on how to overcome what was coming.

The single most important tool the WHO has to fight a health emergency is the Public Health Emergency of International Concern (PHEIC). The PHEIC is triggered by the International Health Regulations (IHR) of the WHO. On 22-23 January 2020, the WHO Director General convened an IHR Emergency Committee, which on 30th January 2020 declared the coronavirus outbreak a PHEIC. This was the moment when governments should have been taking actions to fight the outbreak.  At that time, 99% of reported cases were in China, while there were only 176 in the rest of the world.

It took the entire month of February and a good part of March for European Governments to take measures to stop the spreading of the virus. The call by the WHO on 3th March 2020, for industry and governments to increase manufacturing of personal protective equipment (PPE) by 40% was mainly ignored. The result was that most governments had to rely on China for PPE, creating a fight among them for the scarce supply.

It is all very nice to look for the scapegoat when things do not go as we expect. The exercise gets into full gear when we can point at somebody outside our jurisdiction. How many times have we blamed the UN for not stopping a war, or the EU for countless evils? Now it is the turn of the WHO. But we forget that National Governments are the masters of those international bodies. National Governments do not like transferring any of their power to an international body. The UN cannot act if the five powers do not agree on the issue. The EU has no jurisdiction over health problems because National Governments are keen on keeping those issues under their wing. And the WHO can trigger the PHEIC but has no power to make governments abide by its recommendations, or even to collect data once the PHEIC is declared. So it cannot follow up on the emergency and can only guess what is going on.

If only we could learn from the Covid-19 pandemic and realize that some problems are better solved with international collaboration, maybe something positive will have come from this ordeal.

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I have tried very hard not to write about the Covid-19 pandemic. Today I am giving up. I was going through some old documents about resilient societies and the Hyogo Framework for Action 2005-2015 came to the fore. Page 11 of the framework says, “Integrate disaster risk reduction planning into the health sector; promote the goal of ‘hospitals safe from disaster’ … and implement mitigation measures to reinforce existing health facilities, particularly those providing primary health care.” Faced with the actual international response to the pandemic, my only possible reaction is an unmitigated cry of desperation.

It is obvious that only those countries in Asia that suffered the previous avian flu pandemic were ready for the new SARS‑CoV‑2 pandemic. As for Europe, nothing was prepared and nothing was done. Not even the most basic Individual Protection Equipment was available. The recommendations of the Hyogo Framework were ignored and the Sendai Framework, which covers 2015-2030, has been no more than another document to be shelved in the library.

I am not too convinced that, once this pandemic passes, the healthcare sector is going to focus on preparing for the next one. That will require thinking about the future and not being caught in the day-to-day business of caring for the immediate. For many years, due perhaps to budget restrictions or to lack of political willingness, healthcare has been losing ground in most countries. According to Eurostat “… 16 of the EU Member States reported a lower ratio of healthcare expenditure to GDP in 2017 than in 2012 …. In the Member States where the ratio was higher in 2017 than it had been in 2012, the increase was 0.6 percentage points or less, …”

It was with those resources that Europe’s healthcare had to face the pandemic. No wonder, according to Eurostat,  there have been 700, 000 additional deaths in the EU and EFTA countries between March 2020 and the end of February 2021, against the average number of deaths in the previous three years, of which 25%  were in the period from mid-March to end of May 2020.

But now the point is: will Europe learn and adequately resource healthcare for the future or will it keep driving with dipped headlights?

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