(Source: European Economic and Social Committee)
The European Union needs not only to strengthen the preparedness of its health system but also to address inequalities within the Union and globally. It needs to assess rapidly the sanitary efforts taken to date.
Health challenges in the EU in the pandemic context was the subject of a high-level conference held by the European Economic and Social Committee (EESC) on 31 March, which focused primarily on the conclusions learnt from COVID-19.
The conference brought together top officials from the European institutions, the EU French presidency, WHO, ECDC, civil society organisations focusing on health and academics.
Opening the conference, EESC president Christa Schweng said: First and foremost, it is crucial to improve the Union’s capacity to prevent, detect, prepare for and effectively manage cross-border health threats. This can be achieved by strengthening health systems in all EU countries to make them more resilient. We need more investments, including prevention and a stronger role for primary care.
Margaritis Schinas, Vice President of the European Commission and keynote speaker at the conference, recalled the EU’s bitter experience at the beginning of the pandemic. “At least now, contrary to 2020, we now know the direction of travel. But, first, we must continue striving toward Europe’s strategic autonomy and secure our supply of critical resources. It took a pandemic to realise that the EU was not a place where we have production of personal protective equipment of masks or ventilators. And we do not want to see such shortages of vital, protective equipment again,” Mr Schinas said.
He pointed out that the EU has already created the Health Emergency Preparedness and Response Authority (HERA), which is modelled on a US example, that would ensure EU’s readiness in case of health emergencies.
Michel Kazatchkine, a member of the WHO Independent Panel for Pandemic Preparedness and Response, complained that the international community had acted sluggishly to implement lessons from previous major epidemics, including SARS and swine flu. Mr Kazatchkine pointed to the need for stronger leadership and better coordination at all levels, including rapid negotiation of the Pandemic Treaty. We need to invest in preparedness now and not when the next crisis hits. We need a pre-negotiated platform to produce vaccines, diagnostics, therapeutics and supplies. This will prevent us from negotiating only after the suppliers have presented us with ready products for the market, he said.
Andrea Ammon, director of the European Centre for Disease Prevention and Control (ECDC), stressed that the pandemic so far is not over. We still see a very high virus circulation in several countries and a high number of cases, but the death rate remains low thanks to the vaccines. But the vaccination rate has been plateauing since the end of last year, Ms Ammon said. It is exactly the possibility of a recurrence of further waves of COVID-19, which makes it all the more urgent to undertake a robust evaluation of sanitary decisions taken by public authorities to date. Ms Ammon argued, for example, that while mandatory vaccination is “a measure that might give a momentary increase in people to get vaccinated, but in the long run, it’s a very polarising measure.”
The biggest mistake – draconian lockdowns and lack of randomised evidence
Scientists who took part in the conference criticized some of the measures taken to curb the pandemic, such as major lockdowns, closure of schools and mandatory vaccine mandates which in their view had a tremendously negative effect on education, treatment of diseases other than COVID or public trust. Also, despite an unprecedented volume of work on COVID, much research was of poor quality and lot of a very needed research was never done.
Peter C. Gøtzsche, Director of the Institute for Scientific Freedom in Denmark, argued that during the pandemic so far we never have done a single randomised trial in which we would compare major lockdowns with minor lockouts. This is a missed opportunity we should not miss next time, Mr Gøtzsche said.
Professor John Ioannidis from Stanford University called for taking the lessons learned from past actions and for focusing on more targeted measures regarding social distancing in the future. It’s very likely that this fall and winter we will have a high number of cases again, but this doesn’t mean that we should go into draconian lockdown again. We need measures, which society might tolerate in much longer durations of time, Mr Ioannidis said.
Both spoke against blanket approaches targeting the whole of society and in favor of tackling factors underlying COVID-19 deaths such as smoking, obesity or dysfunctional health systems. In low and middle income countries, 8.6 million deaths per year are attributed to poor health care or non-use of health services, Mr Ioannidis said.
The Conference pointed to social inequalities in access to health care in emergencies, which translate into treatment effectiveness also for non-communicable diseases. There is a very strong gender dimension to health inequalities, with pandemic reversing years of progress and women’s rights, with particular impacts on mental health, reproductive health, and gender-based violence, said Ines Bulic Cojocariu, Director, European Network on Independent Living.
The Conference echoed the global debate on intellectual property (IP) and vaccines. Tania Buzek, EESC International Trade Follow-up Committee Chair, drew attention to the mismatch between the IP framework under TRIPS (WTO’s framework for IP) and the needs of the public to respond to global health threats such as a pandemic. In contrast, Antony Taubman from WTO stressed that there are also other issues, including supply materials or technology transfer, that must be considered in terms of access to vaccines in addition to the IP issue. Only these factors taken together can determine whether countries or individuals will have access to health technologies.
The importance of health as a key public good was also stressed, as was the proper implementation of the European Green Deal which has a potential of enhancing people’s health and contributing to avoiding future pandemics.
Jérôme Weinbach from French Ministry for Solidarity and Health pointed out that the current Presidency in the field of health – in addition to COVID-19 issues – also emphasises occupational health issues. We highlight prevention and combating workplace-related cancers. We want to protect workers, including mental health, alongside our Social Partners, Mr Weinbach concluded.