Original Article published on 12 March 2020 by La Tribune in French
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The coronavirus, or the story of an announced pandemic? After the warning shots from SARS in 2003, “H1N1” or swine flu in 2009 and Ebola in 2015, supported work by the Gates Foundation in 2017 and the WHO in autumn 2019 predicted a major pandemic “ within 15 years ”. They will have been right very early. If the epidemics are not new, the demographic and ecological pressure on ecosystems, the human flows of globalization, reinforce their probability and their diffusion. However, humanity is not destitute and it is time to endow health security with the best tools for global governance.
Nations put in place common governance endowed with objectives, procedures and means for financial stability or for the climate. Health security also deserves ambitious, permanent collective treatment, prior to crises.
Financial stability has been strengthened in its means since the 2007-2008 crisis: quantitative easing policies, awareness of the need for a debate on banking re-regulation, raising of a hierarchical notch for the G20 of Argentiers who now bring together the heads of state. The climate has its panel of experts (the IPCC), dedicated funds (the Global Green Fund), national plans to stay below 2 degrees. Improved but necessary devices. Health security deserves similar tools.
We call for permanent networking of research centres (for Ebola, many of them never mobilized, for the coronavirus it was not until mid-February), a global network of industrial capacities for drugs and medical equipment immediately re-orientable at the request of the WHO, a “WHO Academy”, a project already under discussion, but which adds to the medical profession a permanent panel of multiple expertise (crisis management, expertise data, skills of philanthropic and emergency organizations), a dedicated fund to finance any acceleration of crisis, an annual report of risks and good practices. Finally, reflection must link biodiversity and pandemics.
These tools are realistic and necessary for health to have real global governance, the most commonly accepted principle of which is based on the concept of global public good: what is useful for all can only be organized by all. Global health security is clearly a global public good: the dissemination of COVID-19 demonstrates that each country will benefit from the good health of the others; to contain the contagion on a lasting basis, the only local containment is illusory when any weak link threatens a possible pandemic recovery. Only a vaccine will definitively stop the virus and the national or private race for sesame would be a mistake: not to pool research shifts for everyone its implementation. From today
If the world has been slow it is because the concept of global public good (GPG) reverts to a broad progressive debate: should food security, the fight against poverty, even inequalities, preservation be included in the list of GPGs cultures and identities? Should they be hardened in fundamental rights, such as a right to food sovereignty? The dissonant concert of nations is not ready to agree on the list. But the question is today, in our opinion, decided for health: the legitimate fear of the people, science, is rocking health security on the side of the global public good.
If the concrete definition of series of containment and treatment measures questions today each country, all political and social organizations combined, it is essential to exchange, to pool a set of responses jointly implemented from the first outbreaks. Time is key: let’s set up an intermediate level of alert when a WHO “international public health emergency” is declared. Multilateralism remains more than ever in order.
The urgency is to take back the field on a scientific basis and by a community of means, by avoiding the political double-play with an inevitable boomerang effect. The fight against the coronavirus will be tough, followed by others; it is not too early to draw the first lessons together in organizing global health governance.
