Inclusive and resilient health care for all – are we closer?

Statement on World Health Day
Strasbourg 06/04/2022
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It has been over a year since I published my Issue paper on protecting the right to health. In February 2021, as Europe was gripped by the multiple impacts of COVID-19, I addressed recommendations to member states on how to secure access to the highest attainable standard of physical and mental health for all through inclusive and resilient health care systems.

Today all our attention is focused on a brutal war in the middle of Europe, raising urgent health-related concerns for the injured, those unable to evacuate, and those fleeing the war as well as host communities. Still, we should not forget about COVID-19, which remains very present in our daily lives. Despite important advances, the development of multiple vaccines against the virus, the production of new and more effective treatment options, and, most importantly, an overall decline in grave illness and mortality caused by the virus, reported infections remain high globally and the threat of new variants still looms. Societies in Europe remain deeply divided about what strategies to adopt ahead of the next winter and how to exit the pandemic phase while fully protecting the right to health.

The effective implementation of my twelve recommendations remains crucial. To become more resilient against pandemics and other health emergencies, member states must overcome existing health inequalities and, among others, invest in sustainable public health care systems, prioritise patients’ dignity and rights, and treat health professionals in accordance with the essential services they provide.

On the occasion of World Health Day, I want to reflect on the lessons we can draw from the successes and mistakes of two years of living with COVID-19, highlighting three areas:

First, we have learned that prompt and accurate information is essential in handling health emergencies. Member states must focus on rebuilding trust in scientific research and public health policy through inclusive and adaptable health communication policies. Free access to information and pluralistic discussion thereof, including in the media, are vital to allay public concerns and much more effective in addressing an “infodemic” than unsubstantiated warnings or administrative overreach. It is especially crucial to be truthful about the fluidity of evolving research and remaining uncertainties when imposing virus containment measures. The superficial dismissal of questions surrounding the necessity and proportionality of certain measures without adequate discussion only results in more doubts and suspicion, hindering uptake and ultimately undermining their effectiveness. Recent research tracking the success of different countries’ responses to COVID-19 points to a striking correlation between trust in the government and lower mortality rates. Outreach and persuasion have also shown to be more successful in obtaining higher vaccination rates than vaccine mandates.

Second, targeted and timely focus on particularly vulnerable groups is essential and largely more effective in lowering mortality than blanket measures. Official data on excess mortality in Europe show that people over the age of 65 accounted for 91% of all excess deaths in 2020, and 84% of those in 2021. People in long-term care accounted for 40% of all COVID-19 deaths and they remain particularly vulnerable today. It is essential that the special health needs of often overlooked groups, including older persons, persons with disabilities, prisoners, persons in institutions, and migrants, are prioritised to ensure that their heightened risks are adequately addressed, particularly during periods of transition when general lockdown measures are eased. To devise targeted and effective protection measures for particularly vulnerable groups, sustained efforts must be made to improve systems for monitoring and collecting forward-looking and disaggregated data that help identify emerging health needs and gaps. Inter-disciplinary health research is indispensable to address, for instance, the impact of ageing on overall demand and access to health in Europe, the fast-growing number of people, including many children, with mental health conditions, or, crucially today, the acute and longer-term health needs of people stranded in, or fleeing the war in Ukraine.

Third, leaving no one behind does not stop at the borders of Council of Europe member states. One of the failures over the last two years is that a common, global threat was not met with a common response but with a patchwork of sometimes contradictory approaches, often leading to confusion and division. The international vaccine campaign has not succeeded, despite laudable attempts to promote the manufacturing and distribution of vaccines and treatment by some actors. We have all learned now that we need a comprehensive ‘one health’ approach that is based on multilateral leadership, cooperation, and the transfer of technology and science. International rivalry only compounds health inequalities and risks and the focus of Council of Europe member states should be on fostering inclusive health partnerships. Enhanced support for COVAX and other initiatives aimed at the creation of global health risk-sharing mechanisms will be a good indicator of the European commitment towards universal solidarity, and a recognition of the fact that testing, treatment, and vaccines must be available everywhere for everyone to be safe.

We cannot afford to lose the momentum generated by COVID-19 and its impacts for building greater awareness of the centrality of health for the exercise of human rights everywhere. We must expand global solidarity to build effective resilience against current and future health threats.