12įrom a public health perspective, COVID-19 needs to be appraised as part of a much bigger health picture. 11 In some debates, climate change has become more than a risk factor, with increasing calls for the WHO to declare it a public health emergency. 10 Moreover, climate change (through increased heat waves and disasters) and atmospheric and environmental pollution are expected to increase deaths and injuries, especially in LMICs. 9 The global boom in premature mortality and morbidity from non-communicable diseases has now reached a point where some have even suggested it to be a pandemic.
8 Depression affects 300 million people globally and is the leading cause of disability worldwide, and nearly 800 000 people die from suicide every year. Whereas infectious diseases seem to inspire the most terror among the public and policymakers, non-communicable diseases are responsible for almost 70% of all deaths. 6 In the USA alone, a lower limit of 210 000 deaths per year was associated with preventable harm in hospitals. 5 In 2017, about 295 000 women died during and following pregnancy and childbirth-that is approximately 810 women each day. 4 In 2018, an estimated 405 000 people died of malaria. 3 The WHO estimates that seasonal influenza kills up to 650 000 people a year. It is estimated that, globally, four million people die prematurely from chronic respiratory disease each year in particular, one million die annually from chronic obstructive pulmonary disease pneumonia kills millions of people annually and is a leading cause of death among children under 5 years old each year 1.4 million die from tuberculosis and lung cancer kills 1.6 million people a year and is the deadliest cancer. Respiratory diseases have been leading causes of death and disability in the world before COVID-19. It is important to remember other acknowledged and preventable health conditions, when compared with the focus that COVID-19 has triggered at global and national levels. But we would like to express our concerns regarding four COVID-19-related issues, and advocate for a ‘paradigm shift’-that is, a scientific revolution encompassing changes in the basic concepts and experimental practices of a scientific discipline 2-to prepare for future crises.Ī shift in focus: COVID-19 in the broader global health picture Here we do not want to underestimate the risks caused by the pandemic, nor to question the measures taken by the WHO and governments. These responses have been adopted in an ‘emergency’ mode, and are largely reactionary, aimed at mitigating the spread of the disease while waiting for a specific cure and/or vaccine to be developed. Many countries have installed travel bans, confinement and lockdown policies. The pandemic has triggered unprecedented measures worldwide. 1 While it is seemingly nearing its end in China, where it was first reported, it is still on the rise in Europe, in the USA and in other parts of the world, including in many low-income and middle-income countries (LMICs). According to WHO’s Situation Report - 79, as of 8 April 2020, the epidemic has caused 79 235 deaths worldwide. The WHO declared the novel coronavirus disease 2019 (COVID-19) an ‘emergency of international concern’ on 30 January 2020 and a pandemic on 11 March. The current crisis calls for a paradigm shift in public and global health policies and in the in the nexus between local, national and global health policies and systems Such preventive health policies must be tailored to local specificities and local environments, and health systems must be strengthened at the local level so as to be able to respond to population needs and expectations
It is necessary to adopt a holistic approach to health reflecting both a security approach and a health development approach, tackling upstream causes and determinants, aimed at helping populations reduce their individual risk factors and augment their natural immunity To do so requires a paradigm shift in global health governance, from a specific reactional paradigm to a systemic, coordinated and preventive paradigm The COVID-19 pandemic has triggered unprecedented measures worldwide, which have often been adopted in an ‘emergency’ mode and are largely reactionaryĪlternatively, COVID-19 needs to be appraised as part of a much bigger health picture, adopting a “systems approach” that enables interactions with other acknowledged and preventable health conditions, which often receive disproportionately low attention
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