Stronger together
As the world collectively recovers and rebuilds from the devastation of the Covid-19 pandemic, there are five priorities it should focus on to create stronger, more equitable, and resilient health systems and societies that are equipped to cope with future crises
The world is at a critical juncture. Even as countries reopen now that the Covid-19 pandemic appears to be receding, danger lurks. We face a great risk that the world moves on to the next crisis and forgets the painful and costly lessons the pandemic has taught us. At this year’s World Health Assembly, I outlined five priorities for our member states and for the World Health Organization, as we collectively recover and rebuild.
The first is promoting health, by making an urgent paradigm shift to address the root causes of disease and create the social, economic and environmental conditions for health to thrive. This shift begins with recognising that health starts not in the clinic or the hospital, but in schools, streets, supermarkets, households and cities. Much of the work that health systems deal with are the consequences of poor diets, polluted environments, unsafe roads and workplaces, inadequate health literacy, and the aggressive marketing of products that harm health. Even more fundamentally, the existential threat of climate change puts us all at risk. Shifting to a focus on health promotion and disease prevention could cut the global disease burden in half, but it would also offer massive economic gains, by reducing the burden on health systems and increasing the productivity of populations.
The second priority is providing health, by reorienting health systems towards primary health care as the foundation of both universal health coverage and health system resilience. The pandemic has demonstrated that a resilient health system is not the same as an advanced medical care system. Some countries with the most sophisticated medical care were overwhelmed by Covid-19. By contrast, some middle-income countries with fewer resources fared much better, thanks to investments in public health after outbreaks of SARS, MERS, H1N1 and others. The backbone of public health is robust primary health care, for detecting outbreaks at the earliest possible stage, as well as for preventing disease and promoting health at the community level.
The third priority is protecting health, by strengthening the global architecture for health emergency preparedness, response and resilience. The pandemic has exposed serious vulnerabilities in the world’s defences against epidemics and pandemics, while the collective failure to address neglected diseases in neglected communities puts us all at risk. In May, the WHO published 10 key proposals for making the world safer, in the areas of governance, financing, and systems and tools, under the umbrella of a new legally binding international instrument on pandemic preparedness and response, which our members are now negotiating.
Funding required
The WHO and the World Bank estimate that $31 billion is needed each year to fund an effective global health emergency architecture. About $20 billion of this could come from existing and projected domestic and international resources, leaving an annual gap of $10 billion.
To help plug this gap, a Financial Intermediary Fund was recently established to provide catalytic and gap-filling funding, with financial leadership from the World Bank and technical leadership from the WHO. It is also important to expand the WHO Contingency Fund for Emergencies, to ensure rapidly scalable and sustainable financing for response.
The fourth priority is powering health through science, research, innovation, data and digital technologies. Digital technologies offer huge potential for delivering health services to more people, especially in hard-to-reach areas. At the same time, the lesson of this pandemic is that the tools of science and technology are only as good as those who use them. The profound inequities we faced in the distribution of vaccines and other life-saving tools must not be repeated.
The fifth priority is performing and partnering for health, by building a stronger, empowered and sustainably financed WHO. At the World Health Assembly in May, the WHO’s members made a historic commitment to gradually increase assessed contributions to 50% of the base budget over the next decade, from the current 16%. This commitment will transform the WHO’s ability to deliver results where it matters most – in the lives of the people we serve.
Of course, it is incumbent on us to return the trust our members have put in us with strong governance, accountability, transparency and efficiency. Even before the pandemic, we had already made major progress in these areas, and we are committed to further improvements. Our focus is to significantly strengthen our country offices to support greater country capacity and greater country ownership.
The world must heed the lessons of this pandemic. Among the most important of those is the knowledge that we have it in our power to avoid unnecessary deaths and illness, and create stronger, more equitable and resilient health systems and societies that can deal with the crises of the future.
That is why it is especially appropriate that at the G20’s Bali Summit, under Indonesia’s presidency, the main priorities include the need for collective action, a strengthened global health architecture, and a sustainable and inclusive economic recovery. The world must learn the lesson of these pandemic years: we are stronger together.
