As we look forward into 2021 and beyond, we see glimmers of hope that the world is getting to grips with the pandemic and that we can start to think about returning to “normality”. Most of us are looking forward to being able to meet up with family, friends and colleagues, watch sport, enjoy live music, visit the cinema, and have a drink inside a pub. Of course, normality includes dealing with other problems and challenges, many of which will have been substantially worsened as a result of COVID. There are also many lessons, good and bad, to be learnt from responses to the pandemic. On the good side, harm reduction approaches have shown their value in dealing with vulnerable populations and I hope we can build on these. But, as we emerge from the pandemic, the big global challenges will remain: notably, climate change, and the disparity of access to good healthcare.
The rollout of COVID vaccines is a reminder of what humans can achieve when we collaborate. Developing the vaccines obviously requires scientific collaboration, benefits from international cooperation, and needs significant investment. It also relies on complex infrastructures, both formal and informal. The brilliant minds working in laboratories were nurtured decades ago in nurseries and primary schools. Getting the vaccine from the lab, into production, and then into the arms of the public also requires a complex web of agencies and individuals. All the individual parts are needed to achieve maximum benefit.
Vaccination centres in the UK are being set up in a variety of settings. They are being staffed and supported by medical professionals, volunteers, members of the armed forces, and local authorities - it’s a cast of thousands. We are seeing celebrities and influencers being used to encourage take up of the vaccine, to help overcome doubts and challenge false narratives being circulated on social media. Cutting edge science needs help to achieve its potential. There are elements that are chaotic, that could have been better planned, but progress is being made. However, this progress is not even. Some groups are more hesitant in taking up the vaccine offer, often having poorer experience of healthcare alongside barriers such as lower registration rates with General Practitioners. Of course, vaccination programmes are a good reminder of the need for universal approaches. To achieve optimum benefit, we need maximum take up. If certain groups are left behind and neglected, then it creates risks beyond those communities.
We surely need a “one world” approach that recognises that a virus doesn’t care about lines on a map or the colour of a passport
This dynamic is, of course, played out internationally. The UK and the EU are working out their squabbles over access to vaccines as part of the Brexit sequel. Some politicians have been guilty of the crassest nationalistic chauvinism. Within the UK, access to and rollout of vaccines has become a focus for political point scoring. Now obviously some countries have secured better access to vaccines than others, and some are further advanced in getting it into the arms of their populations than others, but I would suggest that it will be some time before it is clear who has done best in protecting their population. And this “competition” is largely restricted to higher income countries, ignoring both the nature of COVID and the reality of our connected world. The fact that vaccine access in much of the developing world in negligible is a moral issue, has potentially significant economic impacts, and poses a risk in terms of providing a reservoir of future COVID infections. We surely need a “one world” approach that recognises that a virus doesn’t care about lines on a map or the colour of a passport.
If the developed world shows not just sympathy but meaningful practical support for the developing world in tackling COVID, it could provide a hugely positive foundation for future work on climate change and make the world a healthier, more sustainable place.
We need global health organisations that are focussed, effective, open to innovations, and transparent. Not well-padded bureaucratic entities, obsessed with their own structures and hierarchies, who seek to suppress alternative views
After the pandemic, people will inevitably want their lives back. But we may also have a unique opportunity to build upon a greater consciousness of health and how our personal wellbeing is inextricably linked to that of others - not just in our local area, region or country, but across the world. To realise the great potential this offers, many of the existing global structures and strategies need to be consigned to the bin. We need fewer egos, less self-serving competition, and much more collaboration. We need to embrace opportunities for immediate health gains and then build on these, rather than setting distant, high sounding targets, of which the 1998 UNGASS aim of a drug free world is one example. We need global health organisations that are focussed, effective, open to innovations, and transparent. Not well-padded bureaucratic entities, obsessed with their own structures and hierarchies, who seek to suppress alternative views and have done nothing to significantly improve health inequalities around the world.
To use what is becoming something of a buzz-phrase, we must build back better - nationally and internationally - after this pandemic. It is the only fitting way to acknowledge those who have suffered as well as those who have worked so hard to save others. It is also the best hope we have for meeting the challenges ahead.