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Covid-19: “Health in all policies” will help protect world from future pandemics, says commission

BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n2217 (Published 10 September 2021) Cite this as: BMJ 2021;374:n2217
  1. Zosia Kmietowicz
  1. The BMJ

The health of humans, other animals, plants, and the environment must be considered together by all agencies and in all policies to protect the planet from a future pandemic, an independent commission has recommended.1

Although the idea of “one health”—which considers the effects on public health of activities such as deforestation, trade and consumption of wildlife, and international travel—is not a new one, said the Pan-European Commission on Health and Sustainable Development, it has not been widely adopted.

In its final report published on 10 September the commission said, “Covid-19 has demonstrated how, when one part of One Health is at risk, the other pieces are also in danger. Now, more than ever, we urgently need to implement a One Health approach to respond to threats to human health and progress towards sustainable development.”

The commission, which was established to “rethink policy priorities in the light of pandemics,” published an interim report in March, in which it urged European leaders to “learn the lessons from this crisis” and implement change accordingly.2

In its final report it recommended that countries establish cross government strategies, to be based on the concept of “health in all policies,” to safeguard future generations. It also called for governments to tackle health inequalities; invest more in primary care, mental health, social care, and health and care staff; and to strengthen surveillance and data collection to reduce threats to health.

The report said that the covid pandemic had shown the existing model of innovation in health, where most of the risk is borne by the public sector and most of the returns flow to private companies, to be not fit for purpose. “The scale of the pandemic meant a huge amount of resources were available for vaccine development and R&D, which is not the case for products where there is only a small market, for example medicines to treat rare diseases,” it said.

The commission recommended that governments back innovation that was based on partnership between the public and private sectors and where risks and returns were shared.

The pandemic had seen countries resorting to responses informed by politics rather than science and had highlighted the lack of a global taxation system and sanctions for countries that did not contribute to advancing global public health, the commission said. To close these gaps it called for a Global Health Board to be established under the auspices of the G20 and for the development of treaties on handling a global pandemic, including vaccine policies.

Hans Henri Kluge, regional director for WHO Europe, who convened the commission, said, “We can’t allow another pandemic to bring the world to its knees and must do everything in our power to prevent a catastrophe on the same scale from happening again. Our main challenge has not been identifying strategies for success—we know what we need to do—but our collective inability to implement them effectively. A significant obstacle has been reluctance on the part of governments to share decision making powers or to agree shared governance arrangements for the benefit of all. It’s time to learn some important lessons so we don’t make the same mistakes again.”

Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine, who chaired the commission’s scientific advisory board, said, “Perhaps our most important message is that everything is interlinked. We can no more isolate science from politics than we can recreate eggs from an omelette. We can no longer place the health of humans, animals, and the natural environment in silos and hope for the best.

“Just as in previous large scale disease outbreaks throughout history, this pandemic will bring about many changes, in science and in society. Our report, based on an exceptionally wide ranging evidence review, makes a series of important recommendations that, if implemented, can help to create the resilience we need at a time of increasing uncertainty.”

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