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'Depoliticisation is an investment in global health'

Medical workers tend a Covid-19 patient in the Nouvel Hospital Civil of Strasbourg, eastern France, 15 Sept 2020. (AP Photo/Jean-Francois Badias)

The difference between an epidemic and a pandemic—between a national and an international crisis—rests on whether our world can get its global act together.

Pathogens are apolitical.  Coronavirus does not discriminate between right and left, between democracies and dictatorships.  Pandemics, on the other hand, are inherently political - feeding on discord and divisiveness, of racism and nationalism. That is how the virus wins. 

WHO's mandate is to help all people in all countries achieve the highest attainable standard of health. Today, it looks more like the field of conflict resolution. As if WHO's first task is to persuade all countries to recognise the collective threat posed by this pathogen, their interdependence, and the need to work together to fashion a defence and marshal a truly effective response.  Criticising the WHO for its' reluctance to criticise governments is misplaced. Fundamentally, no coordination process begins with the alienation of arguably the central figure, or chastising of parties. 

Even in the best of circumstances, the complex coordination required to respond to the coronavirus would be a serious test of global public-health institutions.  But these are not the best of circumstances. 

Meanwhile, all 194 member states are all infected, all managing their own domestic emergencies.  Globally, Covid-19 has infected at least 23,5 million people and killed more than 810,000 people. Covid-19 shows that global health is central to getting anything done. It also shows the loss of our global contract with terrifying clarity. 

Instrumentalising the coronavirus - scoring points at the expense of public health- is inimical to efforts to contain it. This isn't new-we know what happens when pathogens are politicised. 

That stark truth was illustrated in the eastern Democratic Republic of Congo, when the Ebola outbreak was speciously used to cancel voting in opposition areas in December 2018, against the WHO director-general's advice. The violent backlash led to a massive rise in transmission and kickstarted a year of attacks on healthcare workers. It took more than another year to stop the outbreak.

According to the International Committee of the Red Cross, more than 600 healthcare workers have been attacked because of Covid-19 in 130 countries. More than 100 of these attacks have occurred in India. This makes control at the national level much harder. 

At the international level, although accurate and timely information is essential for control of global threats, cover-ups are standard operating procedure for governments around the world. Recent cover-ups include CoV2 and SARS in China, polio in Syria, cholera in Zimbabwe and Ebola in west Africa. In Saudi Arabia, authorities fired the doctor who whistle-blew on MERS and forced him into exile. India suppressed and punished the doctor who first published on the NDM multi-drug resistant superbug. 

Other governments are sowing misinformation and conspiracy theories that are harder to contain than the coronavirus itself.  While manipulation of global emergencies for political interests is hardly new, the power of the Internet has made it more damaging. 

This epidemic has come at a time when the world’s diplomatic relations are seriously strained. WHO was not built to bridge the growing fissures in international diplomacy. Nonetheless, our effectiveness depends on surmounting them.  

It is a damning commentary on the state of international relations when states find it easier to close borders, invest in vaccine nationalism, and blame WHO than share information. Instead of promoting a collective focus on curbing the virus these unhelpful approaches dangerously flatten complex diplomatic issues into binary, even adversarial frames.

Epidemics offer the opportunity for all of us to put aside partisan politics and act for the collective good. Our success in fighting this threat depends on our seizing this opportunity. The cost of failing to act collectively is measured in preventable deaths and suffering, school closures, and lost education, economic and social devastation. At the global level, now that the virus has made it through summer in both southern and northern hemispheres, there is nothing to stop it becoming endemic as well as an epidemic-- like seasonal flu, with annual outbreaks. 

Depoliticisation is an investment in global health. The difference between an epidemic and a pandemic—between a national and an international crisis—rests on whether our world can get its global act together. Despite several dress rehearsals -- avian and swine flu and dodged bullets -SARS - the Covid-19 is our first real pandemic. But it is not our last. Emerging threats are inherent and accelerating. What about Covid-25? the next pandemic flu? We are already in the midst of the less visible but mounting pandemic of antimicrobial resistance, with its annual global toll of at least half a million deaths, and growing.

Historically, catastrophic loss has inspired investment in global institutions and shared governance. Our most important international ethical standards and institutions were founded in the aftermath of World War II. How much suffering must we endure, how many lives must we lose, before we pull together?

Annie Sparrow, MBBS, MRCP, FRACP, MPH, MD is a pediatric intensivist and public health specialist. She is associate professor at Mount Sinai, a practising aid worker in Congo and Syria, advisor to the Director-General WHO and advocate for marginalised and vulnerable children everywhere.

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