Three Big Challenges Facing Global Health – and Geneva

As Geneva Solutions launches a Covid-19 Health Stream – we look at three big challenges facing Global Health: WHO, equitable, worldwide access to treatments and solving health inequalities.

Hi, this is Elaine, Editor-in-chief of Health Policy Watch. Today Geneva Solutions is launching a news stream dedicated to covering the Coronavirus pandemic, in partnership with our global health news service.

The complete Geneva Solutions platform, a digital news service highlighting key people and organizations in Geneva’s international hub confronting the major global problems – and contributing to solutions – will launch on 24 August.

That platform will include coverage across five key themes: Climate, Peace & Humanitarian issues, Sustainable Business & Finance; and Internet Governance – along with Global Health.

For now, I will update you on three key global health challenges that Geneva’s international community is grappling with during the COVID-19 emergency – and which are likely to define the discussion in coming months.

WHO – The Debate Keeps Getting Bigger and Bigger

If responding to the emergency was not enough, then criticism levied at WHO by US President Donald Trump and his political allies over the past few months has raised much deeper issues about the UN Specialized Agency’s wider role in the global health order.  Is WHO too strong, or too weak? Is the UN agency, governed by its 194 member states, subject to excessive political pressures or steering a steady, independent course?

WHO Director General Dr Tedros Adhanom Ghebreyesus has devoted lengthy  monologues in his past two COVID-19 press briefings to confronting the US allegations that WHO withheld critical information early on or provided bad advice – noting that, among other things, US government officials are embedded in the top layers of his administration.

At a webinar on Law and Covid-19, hosted this week by Geneva Graduate Institute’s Global Health Centre, legal experts stressed that WHO’s role under the mandate of the International Health Regulations, which guide global emergency response, is in fact very weak – and strictly limited to leadership and coordination.

Countries that have recently taken steps, such as banning the exports of valuable masks and other personal protective equipment that other countries desperately need, face no international repercussions from WHO or anyone else.

In upcoming months, it is likely that WHO’s mandate to respond in health emergencies will be reviewed and examined ever more closely – with some actors pressing to strengthen its capacity, and others looking for ways to water it down.

Even so, the repeated WHO admonitions to countries, rich and poor, large, and small, to aggressively test, trace contacts, and contain the virus remain as relevant as ever. And that goes for high-income Europe and Switzerland as well as developing regions, as Health Policy Watch explored this week.

Africa, is only at the beginning of its infection curve. WHO has lauded South Africa for its efficient response, but mobilization in many of Africa’s poorest countries falls far short of the mark, pointed out Dr Eric Comte, Director of the Geneva Health Forum, in an interview with Geneva Solutions.

Ensuring Equitable, Worldwide Access to COVID-19 treatments

The COVID-19 emergency – which has created new alliances across the borders of countries as well as between industry and government – seems set to throw all the old assumptions up into the air. Or will it? The question of who will hold the patents to the treatments that are created, or vaccines approved, remains unresolved.

Building on a call by Costa Rica two weeks ago, The European Union recently tabled a resolution before the next World Health Assembly calling for a COVID-19 medicines patent pool. It would likely be founded on the successful model of the Medicines Patent Pool, that was created by UNITAID, and which has enjoyed support from civil society as well as industry.

Much more immediately, the world is already facing an acute shortage of personal protective equipment in some of the places where it is most needed, including the world’s sprawling refugee camps. That was brought home at a press conference by Médecins Sans Frontières on Tuesday.  MSF warned that it would have to curtail or suspend some of its relief efforts within the next three weeks if no new supplies of masks and other equipment were forthcoming.

Health Inequalities and COVID-19

And that brings us back full circle again to one of the underlying themes of this global crisis – the huge gaps in health coverage that exist worldwide, particularly in developing economies and conflict zones, which made it even harder to provide vital services, routine or emergency.

Winnie Binyamina of UNAIDS recently expressed concerns recently that combatting COVID-19 should not erode progress on other vital global health issues, from HIV to measles, or malaria - where such great inroads have been made over the past few years. Just ahead of World Malaria Day, 25 April, WHO echoed those concerns, saying that severe disruptions to the delivery of insecticide treated nets and antimalarial medicines could lead to a doubling of malaria deaths in sub-Saharan Africa this year, as compared to 2018.

Preventing such outbreaks from occurring - through levers such as more sustainable development, climate and environmental action - is just one of the even bigger challenges faced by the international institutions clustered in Geneva. As for the full story on that, you might have to await the complete Geneva Solutions platform – as it involves actors in climate, sustainable business, and finance – as well as technology, humanitarian action and global health.