OPINION: Resilient health systems can protect us from threats beyond COVID-19

By Mami Mizutori, Head of the UN Office for Disaster Risk Reduction

* Any views expressed in this opinion piece are those of the author and not of Thomson Reuters Foundation.

The pandemic has revealed that efforts to prepare for and prevent a disaster of this scale were not adequate at all

COVID-19 is a global health crisis, a socio-economic crisis, and it is also a crisis of disaster risk management.

Five years ago, while memories were still fresh of earlier virus outbreaks of Ebola, SARS, MERS and H1N1, governments and parliamentarians of U.N. member states pushed for the inclusion of such “biological hazards” in the Sendai Framework for Disaster Risk Reduction, the global blueprint for reducing disaster losses.

The Sendai Framework did create the opportunity for integrating public health management and disaster risk management. But sadly, COVID-19 has revealed that efforts to prepare for and prevent a disaster of this magnitude were not adequate at all.

Few, despite ample warnings, were prepared for the world we live in today, where almost three million people have been infected by COVID-19 and the loss of life has exceeded the death toll of 227,000 from the Indian Ocean tsunami in 2004.

Our ability to prevent such disasters or mitigate their impacts is only as good as our risk governance and disaster preparedness.

As Dr. Michael Ryan, head of emergency preparedness for the World Health Organization (WHO), told on a webinar for parliamentarians organised with UN Office for Disaster Risk Reduction and the Inter Parliamentary Union last week, three things are essential for good emergency management: “governance, governance, governance”.

This translates into implementing the International Health Regulations and the Sendai Framework, as WHO Director-General Dr. Tedros Adhanom Ghebreyesus pointed out during the same discussion, when he called again for global solidarity in the face of the pandemic.

The International Health Regulations are embedded in the Sendai Framework, and this must act as further incentive to many states that do not comply with those regulations when it comes to an appropriate response to public health emergencies of international concern - COVID-19 being the latest of these.

Disaster dominoes

The resilience of health systems is an essential feature of disaster risk management. Even if Intensive Care Unit beds, PPE or stocks of ethanol go unused for long periods, it is essential to have them, as many countries have learned to their cost.

Resilient health systems require long-term investment in key elements such as an adequate number of trained health workers; robust health information systems, including surveillance; and appropriate infrastructure including supply chain, stocks and labs.

Global investment in research and development for medical products, vaccines and diagnostics is also critical.

Resilient health systems should integrate robust community responses that are essential to effectively fight pandemics and disasters. Community engagement has been a key pillar of containing the spread of COVID-19 through physical distancing, hand-washing and self-isolation when necessary.

The great loss of life and the global economic crisis triggered by COVID-19 will exacerbate the impact of other man-made and natural hazards. Causes for concern are the coming Atlantic hurricane season and the monsoon and typhoon seasons across Asia and the Pacific, which will likely lead to the displacement of millions in less than ideal conditions for containing the spread of infection.

Many elements need to be put in place in order to build both the resilience of health systems and to integrate disaster risk reduction into health policies and strategies. This will be especially important in the all-out effort to either avoid or to cope with any resurgence of COVID-19. 

These include enhanced cooperation between health authorities, disaster risk management agencies, the Red Cross and Red Crescent, the private sector and others.

In a world where much of the global population still cannot obtain essential health services and many millions are pushed into poverty because they must cover health expenses from their own pockets, public health management and disaster risk management are intimately linked.

This larger vision of tackling disaster risk cannot become reality without the leadership, expertise and guidance of the WHO, which has done so much in the fight against smallpox, malaria, TB, HIV/AIDS, Ebola and many other diseases, as well as responding to the public health fall-out caused by conflict, extreme weather events, earthquakes and tsunamis.   

To deny WHO the support it needs would be self-defeating and a blow to efforts now underway to stem the spread of COVID-19 in low- and middle-income countries where the battle is still in its early stages.  

The pandemic will not be over until it’s over everywhere.

*Mami Mizutori is the UN Secretary-General’s Special Representative for Disaster Risk Reduction and head of the UN Office for Disaster Risk Reduction www.undrr.org