Autor: José Luis Castro is the President & CEO of Vital Strategies, where he has led a rapid expansion of Vital Strategies’ portfolio, working with governments to tackle the world’s leading killers, primarily in low- and middle- income countries. The organization now reaches into 73 countries and has touched the lives of more than 2 billion people.
More information: https://www.vitalstrategies.org/author/jcastro/
The global COVID-19 pandemic has exposed a harsh reality: that under-investment in public health and safety has left us all profoundly at risk. As COVID-19 continues to take its toll, we must reckon with the fact that this public health emergency could have been prevented or at least mitigated through preparedness.
However, the world´s response to the virus has laid very bare the lack of measured and informed leadership needed to meet the challenges that have come our way.
By and large, the countries that have done well in this pandemic have been those that have allowed scientists and medical experts to lead on the response policy, and at the same time communicated that evidence-based policy regularly and clearly to its citizens. Going forward, we´ll need to ensure public health approaches put politics aside, are driven by evidence-based science and led by a country´s key medical and scientific institutions.
And that will mean disease prevention being at the center of any future preparedness plans.
Take for instance, the ongoing neglect of noncommunicable diseases (NCDs) such as cancer, diabetes and high blood pressure. They account for 70% of the world’s deaths, some 42 million lives each year, yet only attract 2% of overseas development assistance for health.
As we have seen during the pandemic, this failure to invest in NCD prevention has cost us dearly.
The link between noncommunicable diseases (NCDs) and COVID-19 was identified early in the pandemic, with data showing that people living with chronic diseases being at higher risk of severe complications from the virus, more likely to be hospitalized, and at higher risk of death.
As early as April 2020, data showed that of those dying of COVID-19 in Italian hospitals, 67% were people living with hypertension and 31% with diabetes. In Spain, 43% of people who developed COVID-19 disease were living with cardiovascular diseases. In India, 73% of people who have died from COVID-19 had been living with an NCD. In Jamaica, 92% of COVID-19 deaths have occurred in patients with one or more NCD or related comorbidity. In Ghana, 32% were living with hypertension.
At the same time, COVID-19 has interrupted preventive health services and reduced the capacity of countries to meet the needs of those people living with existing NCDs. In the UK alone, it is predicted that there could be 18000 extra cancer deaths this year due to delays in screening.
But the pandemic also demonstrated just how inequitable access to health is in many countries. We need only turn to the disproportionate rates of COVID-19 infections and deaths among the Hispanic and African American communities in the U.S., driven in part by comorbidities such as diabetes, obesity and hypertension.
Systemic injustices have clearly left some people and populations at greater risk. The 110 million cases and nearly 2.5 million deaths over the past 12 months only tell part of the story—the pandemic has caused enormous economic and social dislocation around the globe.
Building back better will mean taking investment in public health more seriously than we have ever done before. As philanthropist Mike Bloomberg and World Health Organization Director General Tedros Adhanom Ghebreyesus noted recently, preparing better for future pandemics will mean better surveillance, better data collection, better research and better primary health care.
And we need to build back fairer. Doing so will also require our political leaders to put to rest the false dichotomy between health and economy, between saving lives and livelihoods.
Portuguese version published in ROM 212 (march 2021)