Author : Shoba Suri

Expert Speak Health Express
Published on May 15, 2020
Covid19 and implications on global health governance Countries around the world are working to extenuate the vast challenges posed by the Covid-19 pandemic. International cooperation is crucial to face this global challenge. The Covid-19 is affecting public health and the global economy. Endemic diseases contribute to the economic burden by impacting health, livelihoods, agricultural production and ecosystems. The 2003 SARS epidemic showed the impermeable restrictions for infectious diseases due to the lack of global governance of public health. A pandemic reflects the global failure in transparency and coordination, and calls for a strong response system. No wonder health experts have said that “another pandemic whose speed and severity rivaled those of the 1918 influenza epidemic was a matter not of if but of when.” The Covid-19 virus, seemingly transferable at an exponential rate, can affect healthy adults and pose risks to elderly people with underlying conditions. It is transmitted by asymptomatic humans (those with mild symptoms), making it more difficult to curb than other viral epidemics like SARS or MERS. The Covid-19 pandemic has worsened inequalities in and among countries, adding to the burden of the poor and vulnerable. The recurrence of pandemics such as Ebola suggests a compromised access to healthcare, thus calling for a continued commitment from the international community to strengthen healthcare. The Covid-19 pandemic has generated unforeseen chaos in the global health and development community. It has both short- and long-term implications—affecting access to resources, the disruption of services and supply chain, and financial pressure. According to the United Nations, the pandemic could shrink the global economy by up to 1 percent.

WHO’s lack of leadership

The WHO has a strategic role to play in global health governance, but it seems to have failed this time. Two factors that led to the WHO’s failure were its role in disease surveillance and response coordination, and the assumption that infectious diseases only affect developing countries with poor sanitation and governance. The call for the innovation, and not renovation, of institutional forms of collective action through multi-stakeholders holds true today. According to a study, global health is critical to “agreement about what we are trying to achieve, the approaches we must take, the skills that are needed, and the ways that we should use resources.” The global Covid-19 mortality rate has remained low (4.7 percent) in comparison to previous pandemics such as SARS (10 percent), MERS (34 percent), and Ebola (40 percent). Comparing Covid-19 to other pandemics shows SARS being highly contagious with Ro<1> averaging at 3, followed by Covid-19 (Ro between 2-2.5) and MERS (Ro at less than 1) being mildly contagious. This coupled with the quick movement of people and goods amongst countries, has resulted in Covid-19 spreading at a much faster rate, affecting 212 countries and territories, infecting over 3 million people and causing 2,00,000 deaths. According to the Global Trends 2025 report, the potential emergence of a global pandemic by 2020 will cause cross-border tension and conflict as countries struggle to regulate the movement of people to prevent the spread of infection. The report goes on to say that “If a pandemic disease emerges, it probably will first occur in an area marked by high population density and close association between humans and animals, such as many areas of China and Southeast Asia, where human populations live in close proximity to livestock”. Sounds similar?

Improving global healthcare

Despite the world seeing many epidemics in recent years, health risks seem to be low on priority and have not provoked a significant global conscription. Global health expert Alanna Shaik believes “coronavirus is our future” and suggests improving healthcare, investing in infrastructure and disease surveillance, strengthening supply chain and better education on diseases as possible response measures to pandemic outbreaks. International cooperation seems an effective way out of the Covid-19 crisis and to lessen its impact on our lives and livelihood. Spain's foreign minister believes international disunion weakened the world's initial response to COVID-19. This is easy to believe in today’s time. According to the World Bank, good governance for health requires a change in minds and policy by bringing health system reforms. What is required is evidence on what works, political will, investment in healthcare system and transparency and accountability. A report by the Institute of Medicine highlights six key challenges to global health governance—leadership; harnessing creativity, energy and resources; collaboration and coordination between global health actors; funding and priorities; basic survival needs; and accountability, transparency, monitoring and enforcement. The WHO has failed in its leadership role. Evidence suggests the ‘One Health’ approach can diminish the risk of emerging infectious diseases. The key to the success of the One Health governance system and its effective implementation is in knowledge integration. The World Bank suggests that adapting to the One Health approach will “yield added value from the collective strengthening of human, animal, and environmental health systems to enable their coordination and collaboration to address threats at the human-animal-environment interface for effective prevention, detection, response, and recovery.” In a globalised world, there is growing interaction in humans and animals, which could potentially lead to the emergence and spread of diseases. Nations must build a strong health system to minimise the risk of infectious diseases and their reoccurrence.
<1> Ro is a mathematical term to measure how contagious and reproductive an infectious disease is as it displays the average number of people that will be infected from a contagious person.
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Shoba Suri

Shoba Suri

Dr. Shoba Suri is a Senior Fellow with ORFs Health Initiative. Shoba is a nutritionist with experience in community and clinical research. She has worked on nutrition, ...

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