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The Covid-19 pandemic has placed enormous stress on governments, health authorities, businesses and individuals. The impact of the virus is such that the world will never be the same again.
The pertinent question now is about the shape of things to come once the virus has been normalised into the usual pathogens list. Life after the virus is likely to be worse than life in the throes of the pandemic – with aftershocks to the economy and the impact of higher morbidity on the health and earning capabilities of households.
Also read: Coronavirus is a stress test many world leaders are failing
Health on policy radar
Health as a global public good will now be on every country’s policy and political agenda — with likely beneficial impacts on scale and efficiency of health budgets. The challenge will be to ensure sufficient resources for better healthcare in a “post-apocalyptic” global economy where almost every facet of economic activity is in free-fall. Are we on the brink of a significant inflection point for humanity, especially given the continuing challenges of extreme inequality and climate change?
What can we do and what should we avoid doing in a post-pandemic world? The unpreparedness of the world to this current pandemic indicates a greater focus on health as a global public good.
New investments, strategies and innovations are required more than ever, but do we need new institutions as well? The World Health Organization (WHO) is being made the “fall guy” for the inability of many national governments, including China and the US, to act early and prevent or contain the pandemic. However, it is better to build on what already exists than start from scratch.
Recent criticisms of the WHO have been accompanied by demands for new bilateral arrangements. Last month, UK politicians called for a ‘G-20 for Public Health’. The US, which is the biggest overall donor to the WHO, has temporarily halted funding to the organisation, accusing the WHO of “severely mismanaging and covering up” the outbreak. The Japanese have also been very vocal in their criticism of the Director General of the WHO. However, these new non-multilateral criticisms and demands fail on the criteria of equity (no one is left behind), efficiency (outbreaks are contained from spreading globally), sustainability (funds, staff and operational coverage do not diminish over time) and participation (all developing countries have a voice).
Also read: In WHO, India must look past pressure to corner China
Empowering the WHO
From preparing situation reports and warnings for countries, disaster response plans, holding regular briefings and updates and launching the Covid-19 Solidarity Response Fund, the WHO has taken steps to help member countries combat the pandemic. But it needs to do more to address scepticism and demonstrate its continued relevance.
The crux of the issue is that, at present, the WHO cannot work independently of governments. The governance structure around the election of its leadership must be reformed so that no one country is seen as having undue influence.
The WHO must be able to make independent assessments and report to the highest UN bodies like the Security Council on matters such as a pandemic so that all countries can be forewarned. This may require countries to be more open to the WHO staff making independent assessments (similar to the inspections mandate of International Atomic Energy Agency) and the required upscaling of disease surveillance apparatus. For this, funds linked to steps taken for governance reform within WHO are required as is building consensus among national ministries of health to allow this new mode.
The WHO also has to have a greater focus on going beyond disease control and setting public health standards. The Covid pandemic has indicated that public health is a global public good in the sense that its benefits go beyond those who immediately require medical treatment.
Global action across social sectors, particularly in the domain of public health and hygiene will need to be ramped up. Health facilities across countries must be made to conform to International Health Regulations and there is an urgent need to establish clear clinical protocols that address potential epidemic outbreaks and 21st century challenges of anti-microbial resistance (AMR).
The One Health model that converges improved drug and dosage governance in human health, animal health, agriculture and pollution control has been introduced in India and other countries. This model now needs to be actually enforced to avoid more “superbugs” taking India and the world into the post-antibiotic era. Improved clinical and pharmaceutical governance are imperative.
Also read: Show independence from China or US will permanently cut funding, Trump threatens WHO
Now is the time
The global indivisibility of public health proves that coordinated multilateral action for people and the planet has never been needed more. This was validated last week when the European Union’s Coronavirus Global Response conference raised over $8 billion in an effort to foster global cooperation, pledging key resources to the WHO. The recent virtual meeting of the G-7 also called for continued international coordination and collaborative response on the pandemic.
We need to act in the here and now for a Covid-free future. Instead of reinventing the wheel, the mechanisms and protocols, established by the WHO for protecting, promoting and coordinating health emergencies need to be reinforced and adapted into the ‘now’ normal. After all, as Louis Pasteur stated in 1895: “The microbe is nothing. The terrain is everything”.
Dr Nitya Mohan Khemka is Affiliate Lecturer, Centre for Development Studies, University of Cambridge. Dr Suraj Kumar is Senior Visiting Fellow, Rajiv Gandhi Institute of Contemporary Studies (RGICS), New Delhi. Views are personal.
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May 25, 2020 at 03:39PM
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