The Ford School of Public Policy and School of Public Health hosted Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, to reflect on the lessons learned during the COVID-19 pandemic and discuss preventative steps to make sure the same mistakes are not repeated. The event began with an introduction of Ghebreyesus from Public Policy Dean Michael Barr.
Ghebreyesus began his presentation by stating, “I have often said that health is a political choice.”
He reminded viewers that regulations involving pandemic response such as, isolation and quarantine guidelines were already put in place before the pandemic started. In addition, he recognized that low-income countries and minority groups have suffered from the pandemic at disproportionately higher rates in comparison to affluent countries and citizens. He attributed the failure of handling the pandemic to medical systems only focusing on whether they were advanced through research and practice, not whether the systems were stable enough to handle catastrophe. According to Ghebreyesus, this factor is what contributed to many advanced medical systems, like the United States, feeling overwhelmed when the virus was rapidly spreading. In light of these issues, Ghebreyesus laid out three lessons the pandemic has taught health care policymakers and how countries can move forward:
- A strong healthcare system is not the same as an advanced healthcare system.
The underinvestment in public health and primary healthcare is one of the main factors why healthcare systems were swamped when the pandemic started. Ghebreyesus said that “primary health is good for providing mental health and mitigating the effects of social, economic and environmental health.” Investing in primary care has shown lower rates of emergency department visits, lower mortality rates and higher rates of patient satisfaction. In addition, investing in primary care allows health problems to be discovered early, so patients can avoid drastic outcomes later down the line.
- Increased funding for resources to help countries recover and be prepared for another pandemic.
Money needs to be put towards helping low and middle-income countries get out of the pandemic. According to Ghebreyesus, the money should be allocated for surveillance, laboratory, communication, contact tracing and preparedness using the one health approach. The one health approach analyzes how people’s health is related to their environment. For example, the one health approach would study how climate change impacts access to water and food within a community. Using the one health approach to understanding health allows health care officials to see how environments influence one’s health and allows citizens to see how what they consume or how they live is either benefitting their health or causing harm.
- We need better global governments that are inclusive, equitable and accountable.
Ghebreyesus discussed how minority countries were ignored when distributing vaccines. The United States hoarded over 500 million excess vaccines, preventing low-income countries from administering shots to their citizens. Ultimately, this led to rising COVID-19 cases and deaths in over-exploited nations, specifically in the Global South. Ghebreyesus highlighted the United States, who has moved on to providing its citizens with booster shots, in contrast to countries within Africa that have less than a 5% vaccination rate, meaning that 95% of their population has yet to receive even their first dose.
When explaining why it is important that countries providing booster shots should think of other countries with lower vaccination rates and inadequate access to vaccines, Ghebreyesus said there is inconclusive evidence on the usefulness of boosters. Therefore, vaccine resources are being wasted on booster shots in higher-income countries: “It is like having a life jacket, wearing another one on top of that, while leaving your friend next to you without a life jacket.” Furthermore, it is important to recognize that global unity is a necessity in order to beat the virus. As Ghebreyesus noted, “Unless there is equity and others are vaccinated, this virus cannot be beaten. So even those countries with a high percentage [of community vaccination] … of 60 to 70% will not be safe.”
The audience was also given the opportunity to ask Ghebreyesus questions directly. The question that stood out to me the most was, “Public health has been politicized — public health workers have had incidences of mistreatment and threats. What have you learned about navigating this kind of climate?”
Ghebreyesus answered this question by stating that the pandemic “has been politicized throughout.” There is no lie here, especially when examining the way the United States has handled the pandemic. The steps to staying safe provided by the American government depended on what party was in office. For example, during the Trump Administration, there were disagreements between Dr. Anthony Fauci, the director of the National Institute of Infectious Disease, and former President Donald Trump on how to navigate the situation. In addition, wearing masks, social distancing and vaccination status were all aspects of the pandemic that were equally politicized. Ghebreyesus stated the effects of a divided country in its approach to resolving a pandemic, saying that if there is a divide in opinion on how to handle the pandemic, there will be a divide amongst those who listen to public health officials and those who listen to their political leaders.
According to Ghebreyesus, this divide ultimately leads to citizens not abiding by public health guidelines, giving the virus the opportunity to grow and mutate further. This was evident in the United States when the Trump Administration continuously ignored public health officials’ advice to wear masks in public and when interacting with others. Not treating the virus as “the common enemy” like Ghebreyesus advised, led to one’s vaccine status, whether they decide to wear a mask or social distance being associated with a certain political party’s ideologies.
Ghebreyesus used Finland as an example of a country that handled the COVID-19 outbreak very well. Through forming a joint community and fighting the virus as a country, Finland was able to manage COVID-19 transmission rates better than other European countries. Finland serves as an example to all countries because their community solidarity proved to be most effective at fighting the virus. Ghebreyesus stated that if nations adopted unity, like Finland, it would influence global solidarity in efforts to end the pandemic.
After hearing his call to other countries to adopt global solidarity, I couldn’t help but think of how foreign these ideals would be to many Americans. It is no secret that Americans have an individualistic outlook on life, meaning we prioritize individual needs and wants over community safety and prosperity. Examples of this can be found during the height of the pandemic, where Americans refused to wear masks, threw large birthday parties with many guests and traveled to foreign countries for personal pleasure.
The American government barely offered monetary assistance or put in strict public health regulations. It simply continued to ingrain bootstrapping and individualism into the lives and mentalities of Americans, forcing individuals to conceptualize the struggles brought on by the pandemic as personal failures and to view handouts as the “easy” way out. Many families were laid off when everything shut down, forced to take matters into their own hands. In low-income communities, many became essential workers in grocery stores or took up grocery delivery to make ends meet. Students across the country were sent home from their college campuses and forced to quickly adapt to the ways of online learning even when some of them were losing their own homes. While people indoors stood on their balconies and clapped for healthcare workers every night, healthcare workers were forced into the belly of the beast with inadequate PPE, long hours and unsafe conditions. While it is understandable that March 2020 was an unprecedented time, the lack of support provided by government officials proved that it was up to us to pick ourselves up during times of turmoil.
At the end of the presentation, Ghebreyesus was asked if the elimination or eradication of COVID-19 was something the world was heading towards. He stated, “I think from what we see now, the virus is here to stay with us. It is going to be endemic from what we see, from the behaviors it is showing.” He cited the virus’s ability to be transmitted throughout all four seasons for the last two years as the main reason why the virus is something we will learn to live with.
He ended the conversation with a call to action for the development of a pandemic treaty or agreement. The pandemic agreement would entail rules and regulations that countries should follow to control outbreaks if another pandemic should happen: “It is a framework that can help us to define the rules of the game for the future so we prepare in advance.”
Through investing in primary health care, local facilities that produce vaccines and contact tracing, we will definitely be more prepared to fight the next pandemic. However, like Ghebreyesus says, “To fight this pandemic, you need unity and it starts at national level.” Therefore, no matter what regulations and rules are put in place to fight the next virus, if there is no unity, then the same patterns are likely to repeat.
MiC Columnist Anchal Malh can be reached at anchalm@umich.edu.