World leaders have compared the current COVID-19 crisis to a war. This analogy is perhaps not entirely accurate, as war is a conscious act, while a pandemic may be the result of an unfortunate coincidence.
However, there is a common message: “United we stand, divided we fall.” COVID-19 has demonstrated a significant flaw in the EU’s current health policy considerations: unlike in Europe’s and NATO’s military security strategy, there is no preparedness, no prevention, no ‘pre-positioning’ of hardware and no exercises to defend literally all European citizens.
The EU was unprepared and its initial response uncoordinated. We must answer the question of what caused this flaw sooner or later, but right now our task is to establish what must be done about it.
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The first requirement is to analyse how the European Commission acted upon its own ‘One Health’ concept.
According to a recent report by the European Court of Auditors on Antimicrobial Resistance (AMR), “there is little evidence to date that the health burden of AMR has been reduced in the European Union” despite the Commission and the European Centre for Disease Prevention and Control’s support to help Member States develop their own One Health approach.
Furthermore, despite a sizeable financial investment in the programme, most notably in research and development, significant breakthroughs have yet to occur, particularly in the development of desperately needed new antimicrobial drugs.
“The EU was unprepared and its initial response uncoordinated. We must answer the question of what caused this flaw sooner or later, but right now our tour task is to establish what must be done about it”
Finally, one of the pillars of the One Health Approach, the environment, has so far been barely addressed. In other words, the European Commission and EU leaders were preoccupied with other issues than the safety and security of Europe’s citizens.
Reflections of this are equally present in the Dieselgate scandal, in EDCs (Endocrine-Disrupting Chemicals), in pesticides and Forex dossiers. Each case led to the fundamental conclusion that industries are there to generate profit and that governments and the Commission are there to protect Europe’s citizens.
COVID-19 has made it clear that in ‘peacetime’ there was no interest in investing in non-profitable vaccines, medicines, and personal protective equipment (PPE). So, this cannot be left only to industry.
While the One Health policy approach is laudable, it simply misses one key dimension: the state as the ultimate guarantor of health security through preparedness, prevention, and protection.
The United Nations Inter-Agency Coordination Group on AMR projects unthinkable numbers of deaths and financial damage: ten million deaths per year and $80-90 trillion by 2050.
Unfortunately, the newly-appointed Director General of the WHO refused to enable this high-level group to do its work failing to equip it with adequate funding and secretarial support.
“COVID-19 has made it clear that in ‘peacetime’ there was no interest in investing in nonprofitable vaccines, medicines, and personal protective equipment”
In the meantime, a series of smaller-scale outbreaks of multiple or totally resistant bacteria (MCR-1, NDM-1, etc..) have sounded alarm bells around the world.
Is the world ready to combat an AMR pandemic? The world is rapidly running out of effective antibiotics and the continued overuse of antibiotics in animal husbandry and in public health could usher in a post-antibiotic era in which surgical operations are no longer possible and simple infections will once again become deadly.
Most health experts expected an AMR pandemic, but COVID-19 was there first. The human, economic and financial costs of COVID-19 are phenomenal, but investors and banks are already forecasting a V-shaped recovery.
Hopefully, this is not based on wishful thinking. Nevertheless, can we then go back to what we were doing before? Or do we need to change something? The answer is prepared already, in two documents.
The first is an article in The Guardian newspaper of 27 March 2019 by the world’s top AMR expert: Lord Jim O’Neill. This implies that Europe, for its health security, can neither make itself dependent on industry nor on any non-European entity.
The second document is a decision of the European Parliament and of the Council from October 2013, which provided the grounds for closer European cooperation – it also established the European Health Security Committee.
This decision “shall apply to public health measures in relation to the following categories of serious cross-border threats to health: a) threats of biological origin (communicable diseases, antimicrobial resistance, biotoxins); b) threats of chemical origin; c) threats of environmental origin; d) threats of unknown origin; e) events which may constitute public health emergencies.”
This is not the time for today’s Commission to smooth-talk itself in and out of its true obligations to EU’s citizens. It is time to learn why there should be no place for backroom agreements.
It is time to realise that there should be no difference between dying from a bullet or dying from a virus or bacteria.
We are lucky to have a President of the European Commission who is a former Defence Minister of a critically important EU Member State. As such, she is aware of the importance of preparedness, prevention, and protecting European citizens.
However, she must now integrate health into the EU’s overall security concept and make this vital approach part of the ‘One Health’ strategy.