In times of crisis

In times of crisis

The global challenges we face today are immense. To have a sustained impact, we must make the political choice for health in all policies, communities and countries – working through these uncertain times together to achieve a healthy future

As the organisers of one of the key global health gatherings – the World Health Summit that takes place every year in Berlin – we have the responsibility to address the key concepts and actions that are required to move global health forward. We are very aware that the field of global health is totally different today compared to when the WHS was initiated in 2009. Multiple crises are happening simultaneously and demand action: for example the world is dealing with several public health emergencies of international concern as declared by the World Health Organization: Covid-19, monkeypox and polio. Not only are the global health goals set out in the context of the Sustainable Development Goals increasingly more difficult to reach, but the world is also facing a climate crisis. The war in Ukraine has ramifications all over the world, including a global food and energy crisis. Poverty has increased significantly. 

The origins of the pandemic and the increasing risk of similar events in the future are linked to the deterioration of natural habitats by human intervention and to human-made climate change, which is why some experts speak of a new age: the Anthropocene.

A new age

The present systems for dealing with global crises – including the United Nations – seem ill-equipped to deal with the complexity and impact of such a ‘polycrisis’. Multilateralism too is facing unprecedented challenges as the global power balance shifts and the present rules-based order is weakened. Global cooperation is also endangered by increasing competition between authoritarian and democratic political systems that increasingly spills over into development aid. The national and global responses to the pandemic were strongly driven by political interests and by economic considerations, with countries choosing very divergent responses. 

At the WHS we aim to create awareness of the effects of all these challenges and interests on global health and provide a platform to reconsider well-established concepts and approaches. Health is related to nearly every aspect of human life and therefore also to many sectoral policies. It is also an important economic factor. The pandemic shut down social life, stopped travel, affected supply chains, hurt economies, separated families, and isolated high-risk individuals and social groups. It brought about incisive consequences in nearly every aspect of people’s lives all around the world, throwing a spotlight on inequalities within and between countries. In the face of crisis and uncertainty, trust in governments, established institutions and in one another turned out to be a determining factor of pandemic response. 

The polycrisis and the ensuing interface between health and politics, economy and the environment set new challenges for making health a political choice. It requires decisive synergistic measures that address climate, health, peace, security and trust. Global health can no longer be anthropocentric and focused on disease – it requires strategies for health and well-being that recognise planetary boundaries and are committed to reducing inequalities. This is why the WHS is committed to promoting the dialogue between science and policy and among the many stakeholders at national and global levels.

Functioning systems

With respect to global health, a prerequisite for strengthening healthcare systems worldwide and corresponding investments is the existence of functioning national political systems and their sustained international interaction in multilateral institutions. On the national and the international level, this requires transparency, trust and accountability. Trust is particularly key to allow governments representing a wide variety of national interests to work together in areas of global concern and to achieve changes that are accepted and supported by societies. It is here that the international community failed in the face of the Covid-19 pandemic.

It is certainly intimidating to realise the magnitude of the challenge. But at the WHS we are stimulated to contribute to practical improvements in the different settings. If countries and sectors work together, they can make a difference. Three action areas emerge.

First, the Covid-19 pandemic made it absolutely clear that neglecting health provisions and preventive measures can come at an extremely high economic and societal cost. To counteract this in the future, it is prudent to strengthen health-related structures at all levels, and specifically the WHO as the key international body. Strengthening in this context requires respecting the WHO’s advice and authority as well as ensuring adequate financing. 

Second, we must move beyond the understanding that global health can be delivered by ministries of health or multinational health institutions alone. Instead, we need a health-in-all-policies approach to address the broad range of determinants of health that exist in the economic, environmental, social and other realms.

Third, similarly, we cannot achieve Sustainable Development Goal 3 on ‘Good Health and Well-being for All’ if we try to control one disease at a time, in one country separate from the others. Health as a political choice needs to be a global and a sustainable decision, not just in times of crisis. Political action focused on health aspects has been called for repeatedly during the Covid-19 pandemic. Promises were made to finance targeted programmes for pandemic preparedness and relief. Such efforts are important and needed to tackle the very dynamic development of a global infection, but health measures alone often fail to have a lasting impact unless countries establish universal health coverage. 

The global challenges we face today are immense. We not only need to start taking strong, focused actions. We also need to act together to have sustained impact. We need to make the political choice for health in all policies, in all communities and in all countries so that we all can have a healthy future. The World Health Summit is a platform to engage policymakers to make the political choice for health based on science, evidence and political participation.