[{"command":"openDialog","selector":"#drupal-modal","settings":null,"data":"\u003Cdiv id=\u0022republish_modal_form\u0022\u003E\u003Cform class=\u0022modal-form-example-modal-form ecl-form\u0022 data-drupal-selector=\u0022modal-form-example-modal-form\u0022 action=\u0022\/en\/article\/modal\/7254\u0022 method=\u0022post\u0022 id=\u0022modal-form-example-modal-form\u0022 accept-charset=\u0022UTF-8\u0022\u003E\u003Cp\u003EHorizon articles can be republished for free under the Creative Commons Attribution 4.0 International (CC BY 4.0) licence.\u003C\/p\u003E\n \u003Cp\u003EYou must give appropriate credit. We ask you to do this by:\u003Cbr \/\u003E\n 1) Using the original journalist\u0027s byline\u003Cbr \/\u003E\n 2) Linking back to our original story\u003Cbr \/\u003E\n 3) Using the following text in the footer: This article was originally published in \u003Ca href=\u0027#\u0027\u003EHorizon, the EU Research and Innovation magazine\u003C\/a\u003E\u003C\/p\u003E\n \u003Cp\u003ESee our full republication guidelines \u003Ca href=\u0027\/horizon-magazine\/republish-our-stories\u0027\u003Ehere\u003C\/a\u003E\u003C\/p\u003E\n \u003Cp\u003EHTML for this article, including the attribution and page view counter, is below:\u003C\/p\u003E\u003Cdiv class=\u0022js-form-item form-item js-form-type-textarea form-item-body-content js-form-item-body-content ecl-form-group ecl-form-group--text-area form-no-label ecl-u-mv-m\u0022\u003E\n \n\u003Cdiv\u003E\n \u003Ctextarea data-drupal-selector=\u0022edit-body-content\u0022 aria-describedby=\u0022edit-body-content--description\u0022 id=\u0022edit-body-content\u0022 name=\u0022body_content\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea ecl-text-area\u0022\u003E\u003Ch2\u003EQ\u0026A: Coronavirus has shown the need for a global health system \u2013 but revealed its weaknesses too\u003C\/h2\u003E\u003Cp\u003EHe ran a project called \u003Ca href=\u0022https:\/\/cordis.europa.eu\/project\/id\/230489\/en\u0022 target=\u0022_blank\u0022 rel=\u0022noopener noreferrer\u0022\u003EGHG\u003C\/a\u003E that looked at how best to collectively protect and promote health in a globalised world, and says that coronavirus should be tackled not just as a health emergency but as an economic and development crisis too.\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EWhy is it important to view health as a global issue?\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EThere is a widespread recognition now that health issues and health resources are no longer totally within the control of individual states. Urbanisation and the rise of megacities in many parts of the world where people still keep chickens and other animals in close proximity allows new diseases to emerge and spread very quickly. People can get on aircraft and spread diseases internationally with remarkable speed too. Before coronavirus, it was estimated that at any time there were around one million people on planes in the air. Our ability to control the spread of disease is compromised by all this, so what we have to do is spot it at an early stage, which requires a global surveillance regime.\u003C\/p\u003E\u003Cp\u003EAnd as we have seen with Covid-19, (some of) the response is international too. The efforts to look for an antiviral treatment and a vaccine is an international effort between drug companies. Scientists around the world are working together on the disease. The supply of personal protective equipment (PPE) also relies on global supply chains. In Europe there was \u003Ca href=\u0022https:\/\/ec.europa.eu\/info\/live-work-travel-eu\/health\/coronavirus-response\/public-health_en\u0022 target=\u0022_blank\u0022 rel=\u0022noopener noreferrer\u0022\u003Ea joint procurement scheme for PPE, ventilators and testing kits\u003C\/a\u003E.\u003C\/p\u003E\u003Cp\u003EBut with coronavirus, we have also seen a shift in the global governance of health. If anything, we have now got this tension between the Emmanuel Macron view of the world that buys into the idea that we need strong global mechanisms, versus the US and Brazilian view, which is that this is someone else\u2019s fault and they need to prioritise their own national interests first above all others \u2013 it is a rejection of globalism.\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EHow do you manage health on a global scale?\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EIf health threats are no longer in the control of individual states, then you really need to have some sort of global governance to ensure there is fair and equitable access to resources, to monitor what is going on and to coordinate disease surveillance so we can have an early warning of new diseases. This has led to a proliferation of international agencies involved in global health. The most obvious is the World Health Organization (WHO), but it is not the best funded of these \u2013 that is actually the World Bank. Then we have a number of other very heavily funded international initiatives all with different interests in global health.\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EHow have these stood up in the face of Covid-19?\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EWhat we are seeing at the moment is really a failure of global health governance. The warning signs have been there for a while. The WHO has been monitoring national preparedness for a number of years now and the status (of countries from their annual reports) suggests that across the globe more states are unprepared for major disease outbreaks than are well prepared. And I think what Covid-19 has actually shown is that states that we thought were well prepared were not actually well prepared. They were prepared for pandemic flu but not for coronavirus.\u003C\/p\u003E\u003Cp\u003E\u003Cblockquote class=\u0022tw-text-center tw-text-blue tw-font-bold tw-text-2xl lg:tw-w-1\/2 tw-border-2 tw-border-blue tw-p-12 tw-my-8 lg:tw-m-12 lg:tw--ml-16 tw-float-left\u0022\u003E\n \u003Cspan class=\u0022tw-text-5xl tw-rotate-180\u0022\u003E\u201c\u003C\/span\u003E\n \u003Cp class=\u0022tw-font-serif tw-italic\u0022\u003E\u2018What we are seeing at the moment is really a failure of global health governance.\u2019\u003C\/p\u003E\n \u003Cfooter\u003E\n \u003Ccite class=\u0022tw-not-italic tw-font-normal tw-text-sm tw-text-black\u0022\u003EProf. Colin McInnes, Aberystwyth University, Wales, UK \u003C\/cite\u003E\n \u003C\/footer\u003E\n\u003C\/blockquote\u003E\n\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EThe WHO\u2019s future has been thrown into question after \u003C\/strong\u003E\u003Ca href=\u0022https:\/\/www.bbc.com\/news\/world-us-canada-52289056\u0022 target=\u0022_blank\u0022 rel=\u0022noopener noreferrer\u0022\u003E\u003Cstrong\u003EPresident Trump announced that he would halt funding\u003C\/strong\u003E\u003C\/a\u003E\u003Cstrong\u003E. What\u2019s your view?\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EThe \u003Ca href=\u0022https:\/\/globalizationandhealth.biomedcentral.com\/articles\/10.1186\/s12992-018-0436-8\u0022 target=\u0022_blank\u0022 rel=\u0022noopener noreferrer\u0022\u003EWHO\u2019s funding\u003C\/a\u003E itself is only about twice that of a large metropolitan hospital. A lot of that funding is also ringfenced for particular programmes, so it doesn\u2019t always have the agility (or finances available) to respond to a particular outbreak.\u003C\/p\u003E\u003Cp\u003EThe weakness of the WHO in \u003Ca href=\u0022https:\/\/time.com\/4123858\/ebola-crisis-who-response-failure\/\u0022 target=\u0022_blank\u0022 rel=\u0022noopener noreferrer\u0022\u003Eresponding to the Ebola crisis\u003C\/a\u003E was \u003Ca href=\u0022https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736%2815%2900946-0\/fulltext\u0022 target=\u0022_blank\u0022 rel=\u0022noopener noreferrer\u0022\u003Ea clear signal that something wasn\u2019t right\u003C\/a\u003E.\u0026nbsp;The WHO have applied a band aid to something which needs something much more significant if they are to provide effective global leadership.\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EWhat else have you noticed? \u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EWe haven\u2019t seen the level of global cooperation that we might have expected to see. The \u003Ca href=\u0022https:\/\/foreignpolicy.com\/2020\/03\/27\/un-security-council-unsc-coronavirus-pandemic\/\u0022 target=\u0022_blank\u0022 rel=\u0022noopener noreferrer\u0022\u003EUN Security Council has been very silent on this\u003C\/a\u003E, for example. What I would have liked to see is the director general of the WHO standing shoulder to shoulder with the heads of the World Bank and other organisations to give a clear message about what needs to be done.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EWhy aren\u2019t these organisations better at working together?\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EWe ran a \u003Ca href=\u0022https:\/\/cordis.europa.eu\/project\/id\/230489\u0022\u003Eproject a few years ago\u003C\/a\u003E that tried to understand why there are all these different bodies when superficially at least there should be an overriding interest in promoting global health. The strapline of our findings was that \u2018health is not enough\u2019 \u2013 most of these organisations are interested in health plus something else. Some were interested in health and development. The World Bank\u2019s interests are in macro-economic development and a necessary precondition of that is to promote good health. The UN Security Council is interested in health issues \u2013 \u003Ca href=\u0022https:\/\/www.unaids.org\/research-and-innovation\/sites\/default\/files\/hm\/sub_landing\/files\/20110607_UNSC-Resolution1983_0.pdf\u0022 target=\u0022_blank\u0022 rel=\u0022noopener noreferrer\u0022\u003Eparticularly HIV\u003C\/a\u003E and \u003Ca href=\u0022https:\/\/www.un.org\/press\/en\/2014\/sc11566.doc.htm\u0022 target=\u0022_blank\u0022 rel=\u0022noopener noreferrer\u0022\u003Elater Ebola\u003C\/a\u003E \u2013 because of the \u003Ca href=\u0022https:\/\/academic.oup.com\/ia\/article\/93\/6\/1313\/4568585\u0022\u003Erole it can play in destabilising peace and security\u003C\/a\u003E.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EThis has meant, however, that there is no coherent global governance for health as no one agency was in charge. And this was a problem when Covid-19 appeared.\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EHow can the global response be improved?\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EOur main finding when we did our research was that you cannot \u003Ca href=\u0022https:\/\/www.tandfonline.com\/doi\/abs\/10.1080\/17441692.2012.733950\u0022 target=\u0022_blank\u0022 rel=\u0022noopener noreferrer\u0022\u003Esee a global health or a health crisis on its own\u003C\/a\u003E, independent of other sectors. It has to be viewed in the context of global economics, global development and international security because the other concerns will impinge upon the decision-making in global health. We are already seeing the pressure coronavirus is putting on economies and people\u2019s lives.\u003C\/p\u003E\u003Cp\u003EInstead, global institutions need to stand much more closely aligned to frame the measures against the pandemic as being both good for health and good for the economy rather than treating them as competing pressures.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EWith the world focused on Covid-19, are other diseases being overlooked?\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EDisease outbreaks tend to capture the imagination in a way that obscures endemic conditions. This is something that has predated coronavirus \u2013 it happened with Swine flu ten years ago and Zika at the Rio Olympics. They captured the political imagination well beyond the actual impact they had.\u003C\/p\u003E\u003Cp\u003EOne of the things I like to point out is that in excess of half a million children die each year in Africa from diarrhoeal disease, and very little is done about this. Yet, we know how to deal with these diseases, it is not like AIDS or Covid-19 which don\u2019t have a cure.\u003C\/p\u003E\u003Cp\u003ESo there were losers before the coronavirus came along, and there will be losers afterwards too. It has to do with how diseases that will affect affluent countries tend to be prioritised over those that affect only those in middle- and low-income countries.\u003C\/p\u003E\u003Cp\u003EBut we may see some setbacks where progress was being made. We are seeing problems with polio already \u2013 the people who administered polio vaccines have had their movements restricted and so are not able to deliver these vaccines.\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EWhat do you think a post-Covid-19 world will look like?\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EWe could see a new emphasis and interest in global health governance or we might instead see resurgent nationalism and an attempt to provide national solutions to health.\u003C\/p\u003E\u003Cp\u003EHistorically when you get these sorts of interruptions, if they are relatively short, life tends to return to normal. On the other hand, these events can jolt the way we think about the world, the way we live, the way we work. We have seen people working from home more and using transport less, which has direct impacts on attempts to achieve carbon neutral emissions, for example. But is this crisis going to have that kind of galvanising effect that leads to long term change? The jury is still out.\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EThis interview has been edited and condensed for clarity.\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003E\u003Cem\u003EThe research in this article was funded by the EU\u0027s European Research Council. 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