WHO Deputy Director at Fiocruz: the pandemic is not over yet

Countries with high vaccination coverage are adopting a dangerous rhetoric according to which the pandemic is over or almost over. But how can one state that when there are still 70,000 people dying of COVID-19 in a week, worldwide? The warning was issued by the Assistant Director-General for Access to Medicines and Pharmaceutical Products of the World Health Organization (WHO), Brazilian Mariângela Batista Galvão Simão. At the Advanced Seminars on Global Health and Health Diplomacy, of the Fiocruz Global Health Center (CRIS/Fiocruz), Simão highlighted last Wednesday (23/2) that it is indeed possible that we will see an end to the acute phase of the COVID-19 pandemic this year - a very different situation from the one we experienced in 2020.

For Mariângela Simão, we can see the end of the acute phase of the COVID-19 pandemic this year (Image: Video reproduction)

“This is because today we have tools and know-how we did not have back then, but the end of the pandemic will not come if we are lenient”, she stated. “This is a preventable disease, because we have vaccines now, and it is also treatable, because we have drugs that prevent cases from becoming severe”.

The seminar held last Wednesday (23/2) was about Global Health Agenda: Perspectives for 2022. Mediated by Luiz Augusto Galvão, senior researcher of Cris/Fiocruz and member of the Fiocruz Strategy for the 2030 Agenda (EFA 2030), the event focused on public health and was also attended by Armenian physician Haik Nikogosian, member of the Global Health Centre and of the Graduate Institute de Geneva, and Luís Eugenio de Sousa, professor at the Federal University of Bahia (UFBA) and president-elect of the World Federation of Public Health Associations (WFPHA).

Political choices

The pandemic has made even more evident the inequity in access to health, said Simões. The WHO goal to consider the pandemic to be over was to have 70% of the world’s population vaccinated. However, while some countries are already talking of a fourth dose, only 13% of the African population have received their first shot. “It is necessary to strengthen global mechanisms, such as Covax, which is still the sole source of vaccines for 40 countries”, she said.

The Deputy Director defended the strengthening of a global health architecture so the world can be ready to prevent, prepare for, and respond to pandemics. She mentioned three pillars for this goal: a stronger governance system, as the COVID-19 pandemic has been marked by incoherency when it comes to public policies; a more robust response system; and the strengthening of the financing of public health and of the WHO.

“The WHO General-Director Tedros Adhanom Ghebreyesus said that ending the pandemic in 2022 is not a matter of luck, but of choice. I should add that this type of choice is always political in nature. This pandemic will not be over one country at a time. The political decision regarding when this is going to end must be based on scientific evidence”, she emphasized.

A pandemic treaty

Haik Nikogosian approached the perspectives for the Global Treaty on Pandemics. Late last year, WHO member states agreed to negotiate the formulation of an international agreement to control future pandemics. The WHO has defined deadlines and it is expected that the key elements of the future agreement will be defined before this year is over, moving forward in its more technical parts and dedicating the next two years to the diplomatic processes - “something more political”, according to Nikogosian. The idea is that the treaty should be in force by 2024.

“There are two important questions here: what will this treaty address beyond the WHO Charter and how will they relate to each other? Unless these questions are answered this year, this may affect future negotiations”, he analyzed. Nikogosian also stated that is necessary to establish rules so the treaty does not clash with the International Health Regulations (IHR) and that the IHR does not interfere with the treaty.

One of the advantages of such a treaty is the fact that it would draw the attention of governments, but Nikogosian also mentioned that the treaty must translate into national laws that are subject to the internal approval of each country.

Mobilization of civil society

The president-elect of the World Federation of Public Health Associations, Luís Eugenio de Sousa, also spoke on behalf of the Sustainable Health Equity Movement (SHEM) and brought the perspective of civil society agencies. He also stated that when the Ebola outbreak happened, the United Nations had asked the world to prepare for future pandemics. “This shows that we are lagging behind in an agenda of strengthening preparation and response”, he said.

Sousa defended three core aspects for the 2022 Health Agenda: equitable access to vaccines; adoption of global governance instruments and tools that are more effective than the ones available today, with the strengthening of national health systems; and the acknowledgment of the syndemic nature of COVID-19, with a widely encompassing set of actions in different flanks. SHEM and WFPHA are requesting a top-level meeting during the next UN General Assembly, to take place in September, so it is possible to “kick-start multisector actions with interventions on all these flanks”.

“It is necessary to democratize society. We must make sure that representation mechanisms are associated with participation mechanisms so we can have governments - Executive, Legislative and Judiciary - that are more in tune with the demands and needs of the population”, he highlighted. “Our challenge is to mobilize society to demand that their governments, their representatives, put these strategies into practice”, he said.

The seminar also included a homage to doctor and anthropologist Paul Farmer, who died on February 21st. Physician Arachu Castro remembered his contribution to the democratization of access to health. The webinar was co-promoted by the Latin American Alliance for Global Health (Alasag, in Spanish), by the Pan-American Health Organization (PAHO), and by the Sustainable Health Equity Movement (SHEM).