Why global health needs a global healthcare approach
In her latest article, Archna Patel explains why our fight against the global pandemic, and future medical crises, will be doomed to fail unless we take a more united approach to global healthcare.
The emergence of the new Omicron Covid variant and the new restrictions it has brought have led me to think quite deeply about the way in which the pharmaceutical and scientific response has been managed.
I’m not about to get into the party politics of how and why decisions were taken – I’ll leave that to the media and the UK’s various instruments of government. I’m more interested in whether we’re simply coming at this from the wrong direction.
If you look back at the criticism the UK government has faced since coronavirus arrived at our doorstep, much of it has focused on what Boris Johnson might call the #dither and delay’ of not implementing measures more quickly.
He and his MPs were heavily criticised for not closing our borders more quickly, for not implementing lockdown more quickly, for not banning all international travel rather than ‘leisure’ flights and for lifting lockdown too quickly at the end of summer 2020.
Since Christmas, the government has, perhaps understandably, made much of the rapid rollout of a vaccine that has seen every adult in the UK who chose to receive the vaccine receive at least one dose, three quarters now double jabbed and about 20% of those who will be eligible for it having had one booster.
These numbers will obviously increase rapidly in the next three weeks as the government works to meet the new vaccine target announced on Sunday.
This is all very impressive, of course, when you consider that ordinarily it takes around 10 years for a new pharmaceutical drug to make it to market (and I suspect the speed that this drug was delivered will forever change that timescale).
But for all of the fervour around the vaccination programme, we are now back to wearing masks in shops and restaurants and large entertainment venues, back to working from home wherever possible, back to pre-flight lateral flow tests, back to travel red list – and back to the prospect of further restrictions that could, at their worst, see another Christmas effectively cancelled.
The Omicron variant of the virus is still too new to have generated any data that might be considered in any way meaningful.
Yet the science teams advising the government now say this variant is more transmissible, may not be controllable by the vaccines currently available, may be more deadly and may overwhelm the NHS at a time of year when it is already stretched.
These are the same concerns that were expressed when the Delta variant emerged in April.
In January, the vaccine was, you’ll remember, the route out of lockdown. And so it proved for four short months. Yet, here we are – not quite in lockdown, but close enough to it to feel uncomfortable and uncertain about the future.
So, if so much has changed since this time last year, why are we back to the restrictions that the government spent so much time, effort and money trying to reassure us would not be necessary?
And I’ve come to the conclusion that the answer to that question lies in the things that haven’t changed.
The Delta variant originated on the Indian subcontinent. The Omicron variant originated in Africa. Both are parts of the world affected by a health lottery.
Our response as a nation to the variants has to do what most countries do and adopt an isolationist stance, when maybe the cleverest response might have been the opposite.
Let me explain.
We currently have a cycle that looks a bit like this:
- New variant emerges
- We close our borders
- We control the viral outbreak
- Things return to normal
- We re-open our borders
Yet in some other part of the world, where vaccines and education are both limited, a new variant is busy developing.
And eventually, whether because of the disparate geographic nature of less developed communities or perhaps due to the infancy of effective education and communication – or a mixture of those and other factors – this newly minted variant slips quietly beyond the borders of its birthplace.
The fact is, until we take a truly global approach to managing global health challenges, we are likely forever doomed to exist in a phugoid cycle of infection and restrictions.
If we are to truly conquer the pandemic and escape this vicious and damaging circle of hand wringing politics, we simply have to take a more united and benevolent approach to international collaboration.
This isolationist approach of buying up disproportionate volumes of vaccine and hoping to keep this and future viruses at bay is fatally flawed. It is fatally flawed not on principle, which is sound (stop the vaccine crossing the border and you stop infections), but on practicality.
Viruses mutate. It’s what they do, they’ve been doing it for billions of years so they’re very good at it, and it is very hard to kill them all off completely.
When you think about it, it’s the same principle as weeding your garden. If you want to control weeds, you don’t prune the growth above the ground. You get a trowel into the soil and you dig the plant out at the root.
This is the same principle. We need to stop chasing the delusion that we can eradicate this virus and instead work together as a global community to neuter it.
We need to escalate vaccine production and make it freely available to those countries struggling to buy sufficient doses to immunise their people. We need to support those countries to run effective education campaigns to drive vaccine take up, and we need to prioritise that above everything else.
The analysis of the little Omicron data that is available seems to suggest that the widespread vaccination of UK adults may not prevent people catching Covid, but it provides enough protection to keep them out of hospital and out of the mortuary.
That should be our aim for every country, because when Covid is neutered in this way, it becomes a condition that we can live with normally in the same way that we now do with influenza – a condition that was once as deadly, if not more so, than the virus we now face.
If you follow my blogs regularly, you’ll know that I’m a big advocate of integrative health.
The basic premise of integrative health is that there isn’t always just a single correct approach to treating a patient and that sometimes a different, complementary approach, can achieve exponentially better results.
And in the end, that is the point I’m making here.
Beating Covid (or any health risk) isn’t necessarily about eradicating it from the planet. It’s about putting every person in the world in a position where his or her potential health risk is dramatically reduced to a similarly manageable and survivable level.
And that means all of us working together for the sake of the patient – whether they’re in London, Lahore or Lagos.