There are emerging hopes that sometime in 2023, WHO can declare that the COVID-19 global health emergency is over, said WHO Director General Dr Tedros Adhanom Ghebreyesus, speaking at a pre-holiday press briefing on Wednesday.
Meanwhile, however, the world continues to invest some $2 trillion in wars and “killing each other” – but not nearly enough in preparing for pandemics and humanitarian crises like SARS-CoV2 that rocked the world, said Tedros, making a plea for more investment in health, during a detailed ‘year-in-review’ briefing with other top WHO officials at the agency’s Geneva headquarters.
He later told journalists that he had almost cancelled the pre-holiday meeting after recently learning that his own younger uncle had been “murdered” by Eritrean troops during an incursion into Ethiopia’s blood-soaked Tigray region – one of the areas of the world that has been rocked by violence over the past year. Despite a November truce between Tigrayan rebels and Ethiopian government forces, Eritrean forces aligned with Addis Ababa have continued attacks in some areas.
“It was a difficult moment for me. I was struggling, but we went ahead,” he confided just before the end of the briefing.
Against that sobering personal news, however, Tedros’ comments on the declining rate of deaths from COVID, Mpox and in Uganda, Ebola, and struck some upbeat notes as the year comes to a close.
“At this time a year ago, COVID-19 was killing 50,000 people a week. Last week, less than 10,000 people lost their lives,” Tedros said. “There is still a lot that all countries can do to save lives. But we have come a long way. We are hopeful that at some point next year we will be happy to say that COVID 19 is no longer a global health emergency.
“The criteria for declaring an end to the emergency will be among the topics of conversation when the [WHO] Emergency Committee meets in January,” he added. That date will mark three years since COVID was first declared a “public health emergency of international concern” by WHO on 30 January, 2020, followed by a statement on March 11 that the virus had reached pandemic proportions.
That does not meet that the world has met that mark quite yet, Tedros cautioned: “This virus is here to stay, and more countries will need to learn to manage it alongside other diseases, including influenza and RSV [Respiratory Syncytial Virus], both of which are circulating intensively in many countries.
Despite the massive global vaccine roll-out, only one in five people in the world’s lowest income countries have been vaccinated, he added, while COVID diagnostics and treatments remain inaccessible for many in low-income countries, meaning that “the burden of long COVID is only likely to increase.”
Surveillance of new SARS-CoV2 as well as other disease threats also remains exceedingly weak in many countries, Tedros said.
Some countries are even dismantling COVID surveillance systems that they had set up, with WHO support, during the height of the pandemic, because they simply cannot afford the costs, Mike Ryan, Executive Director of Health Emergencies, warned.
“Many of the systems that we established have in some countries been dismantled,” Ryan lamented. “Many countries have disinvested in surveillance capacity, disinvented in their genomics capacity because their systems are under such pressure because of the … energy crisis and economic crises.
“We’ve left blind spots on surveillance in different parts of the world,” Ryan added, comparing the disproportionate investments by rich and poor countries in tracking SARS-CoV2 and other emerging threats, to those of a community that puts “100 smoke detectors in one house, and no smoke detectors in the other houses.
“And that’s what we do when we increase the intensity of surveillance and genomics in an industrialized country, while leaving a gap in the South,… which is going to affect not only that country, but the whole world’s ability to react to a new signal.
“That’s the world we’re in right now. So I think we need to be really careful because if we do want to match our [new] vaccines to the circulating strains, we still have work to do, and it’s not just on vaccine development. It’s not losing sight of surveillance.”
Related to the emergence of SARS-CoV2, Dr Tedros also renewed his calls upon China “to share the data and the studies on the origins of this virus.
“As I have said many times, all hypotheses remain on the table,” he added. He was referring to the still-unresolved debate over whether the virus first emerged as a result of animal transmission to humans in a natural setting or the Wuhan market that housed and slaughtered wild animals – or whether it could have somehow escaped as a result of a biosecurity failure at the Wuhan Institute of Virology, which was studying bat-borne coronaviruses, similar to SARS-CoV2.
He welcomed, however, the collaboration displayed by WHO member states so far in the initial stages of negotiations of a new pandemic accord, or treaty.
“One of the other key lessons of the pandemic is the need for much stronger cooperation and collaboration rather than the competition and confusion that was the global response to COVID-19.
“So, I’m very pleased that last week, WHO Member States agreed to develop the first draft of a legally binding accord on pandemic prevention, preparedness and response, based on the principles of equity, solidarity and sovereignty. Member States will begin discussing this “zero draft” of the pandemic accord, in February.”
WHO member states have generally refrained from describing the potential agreement as a “treaty”, preferring more nuanced terms such as ‘accord’, or even ‘convention’. However, if the new agreement is indeed binding according to international law, as the current talks suggest, then it will in fact have the force of a “treaty,” added WHO legal counsel Steven Solomon.
Tedros also expressed hopes that WHO could pronounce an end to the Mpox global health emergency. A virus belonging to the smallpox family that was largely unknown outside of Africa, it caught the world off guard last spring, when clusters of cases first began appearing in Europe and the United States.
Since then, “more than 82,000 cases have been reported from 110 countries, although the mortality rate has remained low, with just 65 deaths,” Tedros said.
But number of weekly reported cases has declined by more than 90% since July, when WHO declared another public health emergency of international concern (PHEIC) for the virus.
“If the current trend continues, we are hopeful that next year we will also be able to declare an end to this emergency,” he predicted.
And meanwhile, a deadly outbreak of the Sudan species of Ebola virus in Uganda, for which no approved vaccine exists, also is fading, with no new cases in more than two weeks.
“If no new cases are detected, the outbreak will be declared over the 10th of January,” he said. “So we end a difficult year with some encouraging news: COVID-19, mpox and Ebola are all declining.”
However, against those successes, a series of new threats are looming, he warned. Those include an expanding band of cholera outbreaks, now affecting 29 countries, including violence-wracked Haiti which has more than 14,000 suspected cases, and 1200 confirmed.
Severe drought in the greater Horn of Africa, is driving an acute crisis of hunger, and with that, surging disease.
And worldwide, wars and violence in regions across every continent are costing the global economy about $2 trillion annually, pointed out Tedros, who later mentioned that his own uncle had recently been killed during a raid by Ethiopian army on a community in the region of Tigray – despite the recent peace treaty signed between the rebel groups and the government.
The WHO Director General has spoken out repeatedly about the conflict that led to a months-long Ethiopian blockade of the region, cutting off vital humanitarian and medical aid.
“The question is, does the world have money? The answer is yes. military expenditure is expected to cross $2 trillion a year this year,” he said.
“Just think of it,$2 trillion US dollars of global expenditure a year to kill people, to kill each other.” he said, adding that during COVID, too, countries came up with tremendous sums to support their economies during lockdown, as well as vaccine development and rollout.
“So there is money, the issue is commitment,” Tedros said, who admitted that he, himself, was “not in good shape” for the press briefing after hearing about the “murder” of his uncle during a raid by Eritrean forces on a village in the Tigray region. A truce between Ethiopia’s central government and rebels in the Tigray region was declared in November, but Eritrea was not party to the agreement, and its forces have continued to wage war in neighboring areas of Tigray under their sphere of influence or control.
“We have no problem purchasing 10 years advance, an aircraft carrier, for which we’re paying $30 to $40 billion, added Ryan. “There’s absolutely no problem whatsoever in making that decision, 10 years in advance, for an operation that’s only part of a foresight exercise.
“And if those particular platforms of war are not used, … we declare success. We say the world is a safer place. We do not apply the same principle when it comes to protecting and securing the health and welfare of our populations against just as insidious [disease] effects.”
However, recent moves by the UN Secretary General, the World Bank, and the G-20 to create new finance initiatives and mechanisms to fund health offer hope that more money can be mustered for preparedness, as well as during emergencies, Ryan added.
“I think we have to look at how to spread the burden of humanitarian response activity across the breadth of member states that we have.” While a small group of rich country donors may be criticized for shifting priorities abruptly or not giving enough “there are many other countries out there that are barely giving anything,” he noted.
“So the fact that the G-20 has managed to get that process of the G-20 [health and finance] ministers together, with a Secretariat based here in Geneva, and that we will continue the conversation between the people that have money and the people that need to get the money, doesn’t guarantee success. But the right conversations are happening with the right people.
“And ín my memory, that’s the first time that’s happened, in a permanent way that’s going to continue. We’re going in the right direction; but we have to get into the development funds, the multilateral funds, the development banks have got to put pandemics and public health and health systems at the center of the investment case for societies.
“Not just economic development, but health systems development as a central pillar for prosperity, stability, in the future.
He added that defense departments also can and should be recruited for support – “When we make the case that protecting biosecurity, the ability for us to defend ourselves against pathogens, natural and otherwise, is mainly mainly delivered through the health system, mainly through the public health system.
“That defense is not delivered due to military intervention. It is delivered through civilian systems. We need to be sure that the resources are there to be able to do that.”
Image Credits: E Fletcher/Health Policy Watch, WHO Afro, Matt Taylor, @PeterDaszak, WHO/Twitter , © UNFPA/Sufian Abdul-Mouty.
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