WITHOUT UNIVERSAL HEALTH COVERAGE WE ARE SITTING DUCKS WHEN THE NEXT PANDEMIC STRIKES

We live in a different world to the one we inhabited six short months ago.

With more than 4 million people infected and over 290,000 dead globally by mid May 2020, Covid-19 has ruthlessly exposed the vulnerability of a globalised world to pandemic disease. People are slowly coming to terms with the frightening and heartbreaking death toll, and we are still not out of danger.

The Greek philosopher Herophilus said, “When health is absent, wisdom cannot reveal itself, art cannot manifest, strength cannot fight, wealth becomes useless and intelligence cannot be applied.” 

The bio-threat has already upended our notions of community interaction, with face masks, latex gloves and physical distancing becoming the new normal. Science has been challenged and experts in various fields struggle to understand the short and long-term consequences of the pandemic.

Lack of robust global public health systems has proven to be a chink in the world’s armour. It has also revealed a truth that we ignore at our peril: healthcare systems around the world have been sorely tested in managing this outbreak, and without substantial reprioritisation of investment in health and research globally, we will be no better equipped when the next pandemic strikes.

Describing COVID 19 as a threat multiplier, the UN Deputy Secretary General, Ms Amina Mohammed said, “We have a health emergency, a humanitarian emergency and now a development emergency. These emergencies are compounding existing inequalities”.

While no country has been spared, the impact upon families and individuals has varied around the world, exposing huge global and local inequalities. 

The consequences of high uninsured rates and high out-of-pocket health costs are being revealed. Even before the Covid-19 outbreak, more than 100 million people per year risked being plunged into poverty by a ‘shock’ in terms of unanticipated expenditure on medical treatment.

World Food Programme analysis shows that, due to the Coronavirus, an additional 265 million people are marching towards the brink of starvation by the year end because of the virus’s effects on jobs and family finances.

The social and economic upheaval we face today has changed the world and will go on changing it for many years. Behind the headlines of an economic decline that might rival the Great Depression of the 1930s are families separated by closed international borders, some mourning relatives they never managed to see and comfort and millions who no longer have jobs.

What must we do to prevent the next pandemic striking the world.

Like rain that exposes a leaking roof, the coronavirus crisis has revealed unanticipated problems inherent in our dependence on global supply chains and amplified longstanding structural deficiencies in health systems around the world. We can see now that under-investment in public health in one country is a threat to global health security everywhere. Responses to health emergencies cannot succeed if any part of the world is left behind. 

The central importance of universal health coverage and ensuring healthy lives and promote wellbeing for all at all ages, as manifested in Sustainable Development Goal 3,(SDG3) by 2030, is clear.

With Africa’s population expected to grow to 2.3 billion by 2050, for Africa to reap a demographic dividend, as well as prevent disease outbreaks, Governments should:

1. Reassess policy priorities and direct greater funding to health.
2. Invest more in disease prevention.
3. Improve working conditions for medical staff.
4. Offer fit-for-purpose health insurance to their people.
5. Harness big data, technology, and innovation to leapfrog universal health coverage.
6. Forge public private partnerships to address the gaps to attain SDG 3.
7. Create an army of community health workers. 

The WHO Chief, Dr. Tedros Adhanom Ghebreyesus, a public health champion, who as Minster of Health in Ethiopia, a country once notorious for the highest maternal and child mortality in Africa, ensured the country achieved the health related Millennium Development Goals, by unleashing the full potential of community health workers. He said that, “By fully harnessing the potential of community health workers, including by dramatically improving their working and living conditions, we can make progress together towards universal health coverage and achieving the health targets of the Sustainable Development Goals.”

Doctors, nurses, carers and paramedics around the world are facing unprecedented workload in overstretched health facilities. The heroism, dedication and selflessness of medical staff allow the rest of us a degree of reassurance. In fact health workers are the frontline soldiers battling the pandemic. They deserve the same recognition and respect as women and men from the Armed Forces who are sent into battle in service of their country.

Additionally, the creation of robust health surveillance infrastructure in low-income countries will benefit the whole world in terms of early warning of disease outbreaks, and the ability to focus resources where and when they are needed.

To achieve this, new models of multilateral and public private partnerships must develop, as well reform, invest and give greater power to the World Health Organisation to protect the world from disease.

As citizens of the world we depend on one another. We are linked by trade and migration and the fact of our humanity as much as we are sometimes divided by politics and faith.

Consider this. Maria Branyas is a 113 year old COVID 19 survivor from Spain. It means she has lived through the flu pandemic of 1918-19, the two World Wars, the 1936-39 Spanish Civil War and now the coronavirus. When asked what was the secret of her long life, she said, “good health”.

In a post-Covid-19 world, global health must be seen as a key component of national and global security as well as of the global economy.

SDG 3 must become pivotal in our post COVID 19 response or we may be sitting ducks, when another pandemic strikes, whose velocity and virulence could surpass what we are witnessing now.

Siddharth Chatterjee is the United Nations resident coordinator to Kenya. He has served in various parts of the world with UNFPA, UNICEF, UNDP, UNOPS, UN Peacekeeping and the Red Cross Movement. A decorated Special Forces veteran, he is an alumnus of Princeton University. Follow him on twitter-@sidchat1

The views expressed in this article are the author’s own.​​​​​