The head of the World Health Organization has emphasized the need for global coordination in working to end the coronavirus pandemic. Speaking to VOA Africa's Linord Moudou via Skype, Tedros Adhanom Ghebreyesus said equitable distribution of the vaccine is key. Below is an edited transcript.
VOA: Dr. Tedros Adhanom Ghebreyesus, thank you so much for joining us today.
TEDROS: Thank you. Thank you very much for having me.
VOA: On January 30, 2020, you yourself declared the coronavirus a public health emergency of international concern. WHO described it as a pandemic on March 11. What are your thoughts on the experience this past year with COVID-19?
TEDROS: Thank you. Thank you very much. First of all, the highest level of public health emergency is what we declared on January 30. And as you know, we have the international health regulations, and in that regulation, the highest level is what we declared on January 30. What we did, as you said, in March, is describing, you know the situation, since it was really increasing in terms of geography that, you know countries affected, and also in terms of the number of cases.
And the lessons learned, I think: One very important lesson is, you know, the importance of investment in public health. When I say public health, it covers many of the aspects that we are saying now, which are very important for emergency preparedness and response.
As you may know, and as you know, many countries, high-income countries, were surprised by the pandemic because they have been investing in medicine, in secondary, tertiary services, subspecialty services. But their investment in primary health care, in public health, the basic of public health, was really minimal. So countries should really give attention to public health to primary health care in order to prepare for the future and also finish this pandemic.
And the other important lesson from the last one year is when politics and science is not aligned, there is a danger. In some countries, we have seen that the expert advice goes one side while the political decisions were going the other side. And that was actually helping the virus to spread.
So it's very important that we don't politicize outbreaks, epidemics or pandemics. And the political support or the political commitment should be aligned with the, you know, with science and expert opinion.
And then the other important element is a lesson in the past year, not only the national capacity in terms of preparedness and focus on signs and helping politics to support signs, but also the global coordination has to be strengthened. And also you know when we say global coordination, starting from early strengthening, from early warning systems.
And the other lesson could be the One Health approach [in which, as the U.N. explains, “multiple sectors communicate and work together to achieve better public health outcomes”]. As you know, this virus — of course, it's being studied — could have originated from animals or it could be other. But in any way, it's within the animal, human and the environment interaction that, you know, new diseases could emerge. So taking the One Health approach seriously is very important.
So these are some of the lessons, of course, the many lessons we have learned. If I continue to outline, it will be a very, very long list. But one thing I would like to say is before even COVID, we were we have started transformation in WHO. And based on this experience, we will add more ideas to improve our system.
And we have many mechanisms now, several mechanisms that is helping us to evaluate the situation in this pandemic and understand the lessons and then incorporate them into our systems, be it at national, regional or global level for future preparedness.
VOA: OK, now let's talk about how countries are experiencing COVID-19, specifically [in] Africa. Although the continent has not been spared by the deadly coronavirus, Africa has seen fewer cases of infections and deaths compared to the rest of the world. What do you make of that?
TEDROS: Thank you, that's a very important question. I think the combination of many factors actually helps. One, the population is young, so a young population. And second, Africa actually started as early as possible, you know, preparing itself and responding, so that early, quick action really helped that, too.
And then the third is the early action was not just individual country-level only, but it was a continental-wide, coordinated effort. That also helps. And the fourth is, Africa, our continent is regularly challenged by many infectious diseases. It could be yellow fever or meningitis, cholera, Ebola, you name it. So the primary health care or the public health system is better prepared so it can respond faster. So these are the four, I think, reasons that that probably helped Africa to be better compared to other regions.
VOA: Now, South African President Cyril Ramaphosa was appointed as the African Union champion for the COVID-19 response. The country has been hardest hit in Africa by COVID. What is the significance of this appointment for the response on the continent?
TEDROS: Thank you. By the way, instead of starting from his appointment as champion, maybe we need to go back and see what he did to be chosen champion. I mean, I can say that he earned that position or that championship because of what he did in the past one year.
One of the reasons I said, you know why Africa did better is because of the quick action, and this would not have been possible without his leadership. As you know, the past year he has been chairing the African Union. And I remember the first meeting the ministers of health had — the continental ministers of health of the African Union — was in February 20 [2020]. I attended that meeting and to design a continental strategy.
During that time, there was only one confirmed case, I think in Egypt. So the rest was still OK and no reported cases. And he [Ramaphosa] pushed for that early, quick response and that meeting resulted into a continental strategy. And then he formed a bureau of leadership that's composed of regional leaders from all corners of our continent. I attended also a couple of these meetings. And then he immediately appointed special envoys that can take care of the supply of medicine, mobilizing resources, and people who can lead in other efforts — very renowned Africans, actually, as special envoys.
And he was coordinating that as chair of the African Union. And his, you know, continental leadership was very, very significant and it really helped Africa to fare better. But not only continental. But he also was leading the global effort, as you know, South Africa and Norway. President Ramaphosa and Prime Minister Erna Solberg, co-chair of the Facilitation Council of the Accelerator, and he contributed also to the global response. [Full name is Access to COVID-19 Tools (ACT) Accelerator Facilitation Council.]
So, I mean, now he's designated as a champion. And it's well deserved because of what he did and with the understanding that he will continue to do, but I'm really proud of him. I'm very proud of President Ramaphosa and what he did. And that's why Africa really fared well. And I know through this appointment he will continue to lead with his colleagues, heads of state, head of government leaders in our continent.
VOA: And speaking of the way things are being done on the continent, Dr. Ghebreyesus, how do you assess COVID response in Africa?
TEDROS: I think the COVID response is going OK. The first wave was the better for our continent, for Africa, actually. The second phase was more serious and that started in January 2021. And then there was a period of, starting from late January, [infections] started to decline. And now we see some tendency again to increase.
I think the focus from this what we can understand is that the focus on the made the basic public health measures should continue. We need to do the basic things, like what we have been doing: You know, the use of masks, you know, the physical distancing, the hand hygiene, and we need to continue to do that. And we need to continue our surveillance. Also, we need to find where the virus is and try to address it, you know, attack it, continue to attack. So continuing with the public health measures will be important.
But I have some concern that there is a slight increase now. It's not a significant one, but the tendency should be taken seriously. But this is not just for Africa alone. If you see the global trend, it was declining until mid-March. Now we can see the last three weeks, some slight increase.
So the trend globally and in Africa is almost the same with a slight trend in the, you know, on the increase. This could be explained in many ways. As I said, maybe some countries are lowering their guard that they have to be very careful. Second, it's going to be the variant.
And there could be other issues, so we have to understand why. But at least we have to continue to implement the proven public health measures while addressing the other additional challenges we're facing.
VOA: How concerned should we be about the variants? How much of an impact is it having on the global strategy?
TEDROS: We have to be really concerned because the concern we have is, of course there is a variant report from the United Kingdom, South Africa and Brazil. But one question is: Are these the only variants we have? And the other question is, you know, whatever number of variants we have, you know, are the vaccines we have now really effective?
And then the third question is, you know, how is the behavior of the virus changing with the changing variants? Is it becoming more lethal or is it becoming less so? I think continuing to understand, you know, the variants is very important, starting from the surveillance to find out as early as possible when we have variants, understand what their behavior is in terms of their transmissibility and severity of disease.
And then we have to understand also in terms of the effectiveness of the vaccines that we use. And we have a network now that's coordinated by WHO and we're trying to strengthen the surveillance system and also studying the other things which I have already said. But it's a serious concern — and with mutation, as you know, there could be more challenges ahead of us.
VOA: So you mentioned the vaccine. We're seeing the vaccine being deployed around the world. What do you make of the access to vaccines across the board, especially in Africa and developing countries? And the impact of COVAX?
TEDROS: The COVAX started, as you may know, with two objectives. And two objectives were, one, to accelerate the development of products like vaccines, diagnostics and therapeutics; and the second objective was to, you know, [facilitate] fair distribution [of those products].
I think the first objective is achieved as you know, in less than a year, we have proven vaccines and, you know, diagnostics and also treatments. The second objective, especially fair distribution, is facing some challenges, especially with regard to vaccines.
The first challenge was high-income countries — some high-income countries, not all — started vaccination in mid-December, while the first [lower-income] country, for instance, that started, that received the vaccine, which is Ghana, is in late February. So there is almost how many? Three months' gap, three months' delay. That's one problem.
That's a problem of vaccine equity. And from the WHO side we were raising the alarm, saying this is not right and we should really share and the only way to end this pandemic is by making everybody safe. So equity of vaccines is in the interest of all of us, in the interest of all countries.
So anyway, we started now the vaccination also in low-income countries. And the number of countries who are receiving the vaccines through COVAX is actually on the increase.
So in our continent, I think so far we have around 20 I think have received [vaccines]. And the target we have is before April 7. April 7 is when we will observe the World Health Day to have at least all countries start vaccination and vaccinating their health workers and elderly. We have 31 days to go, I think — 31 days, yes? And we hope all countries in Africa, other regions will start before then. We have that target.
And the second challenge is the number of people who are being vaccinated in the rest of — in especially high-income countries is on the increase, while the Africa and countries in, you know, low-income countries in other continents are only starting. So we're … expecting that another challenge ahead of us because even with the start of the vaccine, the low-income countries may get less. And their coverage — in terms of coverage, population coverage of vaccination — could be significantly lower than [in] the high-income countries and the gaps could be big. So we are now working on narrowing the gap by increasing production.
And production can be increased by, you know, making use of all the manufacturing capacity we have globally.
We have never, you know, we have never experienced anything like this. You know, it's really unprecedented. And all options should be used, including intellectual — waiver of intellectual property. If we cannot use it now, then when?
As you know, if we go back and try to see anything like this is 100 years ago in 1918, to be correct 103 years ago when we had the 1918 flu which immediately after the [First] World War that affected the whole world and killed tens of millions of people, estimated is between 50 to 100 million. And now we are seeing another unprecedented pandemic. So whatever we have, we have to give it and to increase production and narrow the gaps of rates of vaccination between the haves and have nots. So we will continue to advocate for that. But the world should really give whatever it has in order to finish this pandemic as soon as possible so that people can get back their lives and livelihoods.
It's affecting the whole world and the whole world can only lift up together. If there are areas where the response is weak — because, for instance, lack of equity of vaccines — then the virus will get a chance to circle. And that's why I said it's in the interest of everybody to use whatever means we have to end this pandemic.
VOA: Dr. Tedros, having access to vaccine is one thing. Getting the people to get vaccinated is another thing. There've been a lot of issues around vaccinations globally and in Africa. What do you make of vaccine hesitancy, distrust even, and what can be done about it?
TEDROS: Yeah, you're right, I mean there is vaccine hesitancy in many countries. And I think there is a reason to study even in Africa that the people who say they can take the vaccine right away are around 70 percent. So we need to understand why those who don't want to take the vaccines are saying this. Most of it could be because of misinformation and disinformation. And we have to address that.
And we have a very strong partnership now with the tech industry and to address some of the misinformation which is circulating in the social media. So trusted resources can have the presence in the social media so people get the right information. And the other is, you know, leaders should be at the forefront to show that these vaccines are safe and effective. And I have seen many leaders — heads of state, heads of government in our continent — who have been taking the vaccinations, you know, at the launching of the vaccination [campaign], which is which really encourages the citizens to follow their leaders. So I think this way we can address the hesitancy.
But for now, to be honest with you, more than the hesitancy, the problem I see is the lack of vaccine equity. So the No. 1 challenge is, you know, having the vaccine. So if we can have the vaccines and if there is equitable distribution of the vaccines and, you know, Africa gets its right share and other countries in developing countries in other regions also get their share, that's the most important for me and that will be my priority, to be honest.
And the hesitancy can be addressed. So let's have the vaccines and also if we can fight the hesitancy.
VOA: And finally, Dr. Tedros Adhanom Ghebreyesus, the U.S. recently rejoined the WHO after an exit by the previous administration. What are your thoughts on this decision and how big a difference will the U.S. return make in the fight against COVID as a whole?
TEDROS: The decision by the U.S. government, the new administration, is very, very crucial, actually. And, you know, on January 20, the president had signed the letter and I received the letter actually the morning of January 21. And then I had a call from the vice president. And Dr. [Anthony] Tony Fauci attended the board meeting to also, you know, present the same message.
And so this is very, very telling how committed the administration is to global health and to multilateralism. And this will be very important for the whole world because the leadership and the global role of the U.S. is very, very crucial.
So it's good for the world for global health, and it's good for the U.S. also. Because the U.S., by working with others, can be better protected and it's good for WHO, too, to do its job.
But coming back to the first one, its global role and global leadership, as you know, HIV AIDS pandemic was a major global health problem and the U.S. leadership and support and the global role was very crucial, as you know through the president's PEPFAR initiative on HIV, when, you know, drugs were made available actually to developing countries and also support in other ways and also through Global Fund. The US contribution to Global Fund was a third of the total volume. So it makes a difference.
But not just the finance, but its role, its leadership is really key and it has shown it in the past and in the pandemic now, this unprecedented COVID-19 pandemic, we expect that the U.S. will play its global role, too, and that's what we are seeing now, and we have good engagement, good partnership, a very constructive one, and we hope the world will benefit from it — and the U.S. will also benefit from it, because it's by working with others that U.S. citizens could also be safe. So it's an investment not just for the rest of the world, it's for the U.S. itself. And that's how, I think, the administration sees this, and it's very important.
And the world is getting smaller and smaller. We are interdependent, intertwined. We are closer than anyone can imagine now, and at the same time to really move from one place to the other, the connections that we have is really bringing vulnerability, too. So that's why working together is the only option we have. So we're so connected, but at the same time we're so vulnerable also. So that's why we need to work together. And that's why WHO is saying national unity is important [but] don't politicize this virus, and global solidarity is important. When the two are in action — national unity and global solidarity — then the virus will not find cracks to exploit, because, you know, not only the technical expertise but the politics will also be healthy to drive the virus out.
