Dr David Nabarro: The Global Implications of Covid-19: A World Health Perspective

IIEA12th May 20205min
On 27 April 2020, David Nabarro, Special Envoy of the WHO Director-General for COVID-19, gave an address to the IIEA. This briefing summarises the key points of this address and provides an overview of the steps taken by the WHO in response to the outbreak, how governments are responding to the crisis and what can be done to help the developing world.

Author: Eóin O’Keeffe

Introduction

On 27 April 2020, David Nabarro, Special Envoy of the WHO Director-General for COVID-19, gave an address to the IIEA. This briefing summarises the key points of this address and provides an overview of the steps taken by the WHO in response to the outbreak, how governments are responding to the crisis and what can be done to help the developing world.

Key Points

  • There will be no back to ‘business as usual’ scenario once full lockdown ends.
  • Community-level public health defences which can test, identify, trace, isolate and protect the vulnerable are the core essential capacities.
  • There is a huge, multifaceted, simultaneous learning exercise underway across the world to anticipate the consequences of both the virus and the means to control the virus.
  • There may be a case for Ireland to consider reconvening its Hunger Taskforce. Poor and developing countries have less room to manoeuvre when it comes to dealing with this crisis. Their public health services are not as well developed to respond to the threat. Their communities cannot cope with lockdown for the same lengths of time due to hunger and malnutrition.
  • International unity is key for a strong, stable world post-crisis. Political parties working together, regional solidarity, international solidarity with leadership from multilateral organisations are all important because the virus does not recognise borders.
  • Key Challenges
    1. The damage to food, food systems and nutrition will be much greater without international cooperation.
    2. The functioning of International education and how students can study abroad will be a huge concern for universities and students globally.
    3. There will be a demand to restart international travel, especially business travel and essential political and diplomatic travel, which will require decisions on how this will be governed and whether the WHO will have a role in these discussions.

After a fascinating insight into the emergence of COVID-19 and the initial reporting of cases, Dr Nabarro explained how the WHO and its Emergency Committee identified COVID-19 as a public health emergency of international concern, the WHO’s highest level of alert. Dr Nabarro discussed the steps taken by the WHO once the alert was given, principally informing governments that interrupting transmission of the disease at the community level through public health services was essential and that governments must take steps to protect the vulnerable.

A team of WHO experts, led by Bruce Aylward, Assistant Director-General of the WHO, went to China to investigate the virus and clear findings emerged from their trip:

  • People must be fully informed of the virus as it is only with their fully cooperation that it can it be contained.
  • There is a need for strong personal hygiene in terms of hand washing and sanitation. There is also need for physical distancing of about two metres.
  • There is no substitute for a high coverage of public health services; knowing who is ill, where they are and where they have been. Protecting health workers is essential.
  • Health services need to be repurposed so that they remain open for those with the coronavirus and those without it.
  • The whole of government must work together without political tension. It is a whole of government and whole of society issue, with private businesses and civil society playing an important role.

Singapore used the above system to great success, however, they discovered outbreaks of the virus in communities of migrant workers. This led to Singapore re-imposing their movement restrictions, despite containing the virus in the rest of the society. Dr Nabarro highlighted this example as one that many countries should prepare for, that countries need to be ready for the reappearance of COVID-19 in any community and have systems in place to deal with outbreaks rapidly.

Some European countries are now starting to reopen their economies and relax their restrictions as they have set up widespread community level defences and built up their rapid response capacity. But similar to Singapore, they are prepared to reimpose movement restrictions if a new outbreak emerges. Dr Nabarro considers this a very interesting simultaneous experiment where countries are moving from full lockdown to becoming ‘Covid Ready’ and able to deal with new outbreaks.

How Donor Countries Should Adapt their Development Strategies in Light of Covid-19

Those working in development are in a particularly important position right now. This is a universal problem and donor countries and NGOs need to work with local organisations to make sure that all responses are people-centred and focus on the vulnerable. Dr Nabarro also said that is important that donor communities help to reinforce community-based, public health systems which focus on resilience and well-being.

Now, donor communities must focus their attention on war zones, areas with a high concentration of refugees, migrant centres and migratory routes, and detention centres. These are all areas of huge vulnerability and where the implementation of WHO guidance is particularly challenging. The International Crisis Group is now working as a hub for expertise and information sharing on these issues and is trying to develop best practice.

African Union

Dr Nabarro praised the role of the African Union and the coordination role it has played in suppressing the spread of the virus. He also highlighted the important work of the African Union Development Agency, the African Development Bank and the United Nations Economic Commission for Africa. However, as the virus first hit European countries, their focus and their finances have been largely tied up in restructuring their own economies and financing their own industries. Dr Nabarro questioned whether there will be enough money available from the IMF for special catastrophe funds, special drawing rights and private sector bankruptcy protections in Africa. An important challenge for the African Union will be to continue to highlight the enormous problems that African countries will face and to tie them into international institutions.

Conclusion

Despite the overwhelming crisis that the world currently faces, Dr Nabarro remains positive that the values which are embedded in the 2030 Agenda and the Sustainable Development Goals around international cooperation and solidarity will emerge strengthened. The unprecedented threat presented by COVID-19 is showing how we are all able to work together as part of communities, locally and internationally. It highlights the power of communities working together and what can be achieved, when it is done well. However, any delays in working together or attempts to work unilaterally will only enhance the threat and danger posed by the COVID-19 virus.