WHO Director-General as Guest Lecture at Robert S. McNamara Lecture on War and Peace, Harvard Kennedy School – 25 February 2022
25 February 2022
Speech [Excerpt]
…The authors of WHO’s Constitution were well aware of the link between health and peace, which is why they wrote in the preamble that the health of all peoples is fundamental to the attainment of peace and security, and is dependent upon the fullest co-operation of individuals and States.

Since those words were written, the world has faced many outbreaks and epidemics. Just this century, we have seen H5N1 influenza, SARS, MERS, the H1N1 pandemic, multiple Ebola outbreaks, Zika and more.

But of course, nothing matches the scale of the COVID-19 pandemic, which has thrown the world into turmoil for more than two years. COVID-19 is a powerful demonstration that a pandemic is so much more than a health crisis. It illustrates the interconnectedness between health and the economy, security, education, and the intimate links between the health of humans, animals and our planet. There are many lessons to learn about what has worked and what has not. Let me suggest five:

The first is that science must guide policy, not the other way round.
Throughout the pandemic, WHO has convened thousands of scientists from around the world to examine the rapidly emerging evidence and distil it into the guidance we give the world.
Just this week, we have convened a research and innovation forum to identify the most pressing research priorities and chart the way forward.

Science has given us valuable insights into how this virus spreads, how it causes disease, and how to stop it. But in some countries and communities, and on social media, the marginalization and politicization of science has impeded the response to the pandemic and cost lives. Politics undermining science. My point is not that science should be the only consideration in decision-making about public health. My point is that science should be the central and guiding consideration.

The second lesson is that science can in fact widen inequalities, unless it is paired with a commitment to equity.
I’m sure that most or all of you are vaccinated. And yet as we speak, 83% of the population of Africa is yet to receive a single dose of vaccine. Vaccine nationalism, export bans and bilateral deals between manufacturers and high-income nations severely restricted the number of doses COVAX was able to ship in the first half of last year. The supply situation has now improved, and COVAX has been able to ship more than 1.2 billion doses of vaccine to 144 countries and territories.

WHO and our partners are working night and day to support countries to turn vaccines into vaccinations, to reach our target of vaccinating 70% of the population of every country by the middle of this year. To reach that target, we are calling on all countries to urgently fill the ACT Accelerator’s financing gap of US$16 billion, to ensure equitable access to vaccines, tests and treatments and PPE everywhere.

The third lesson is that a resilient health system is not the same thing as an advanced medical care system.
Even some countries with the most sophisticated medical care were overwhelmed by COVID-19.
By contrast, some middle-income countries with fewer resources fared much better, thanks to investments in public health after outbreaks of SARS, MERS, H1N1 and others, especially in the Mekong region.

For instance, the simple art of contact tracing is one that many high-income countries have struggled with, but it’s one that many low- and middle-income countries have done well, because of their experience with infectious disease outbreaks, and their investments in public health. The backbone of public health is robust primary health care, for detecting outbreaks at the earliest possible stage, as well as for preventing disease and promoting health at the community level.

The fourth lesson is that the world needs a new agreement that sets the rules of the game for responding to epidemics and pandemics.
Instead of a coherent and cohesive global response, the pandemic has been marked by a chaotic patchwork of responses, which in some cases have punished countries for doing the right thing, as in the case of the travel bans imposed on South Africa and Botswana when they first reported the emergence of the Omicron variant.

And the fifth lesson is that trust is everything.
A study published in The Lancet earlier this month examined the reasons why some countries have had higher rates of infection and death than others from COVID-19. The age profile of the country, GDP per capita, and mean body mass index were all found to play a part. But the researchers found that perhaps the single most important factor in countries’ preparedness and ability to respond effectively is trust.

The study concluded that stronger risk communication and community engagement are essential for making the world safer against future epidemics and pandemics.

Vaccines, diagnostics, therapeutics and other tools are essential, but the most effective tool is engaged and empowered communities…