2020, the year we understood the true value of health: Op-ed

Dr. Hans Henri P. Kluge & Dr. Batyr Berdyklychev

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The COVID-19 pandemic has shaken the world, derailed economies, and brought many countries to a standstill. It is a colossal human tragedy and a global crisis. As this year ends and we look towards 2021 as harbinger of hope, we must also reflect what 2020 and pandemic taught us in the passing year.

Experience has now shown us that health is at the center of development, a determinant of individual and collective growth. At every step of life’s journey, we need targeted, tailored support across and within sectors to promote our health and well-being. Attending school is precious for a child’s social development; providing a social safety net is vital when economies and jobs are threatened; creating supportive environments and quality care offers older people the dignity they deserve.

Responding to the pandemic has required action beyond treating the virus. Insights into human behavior and cultural norms have been critical to tackle COVID fatigue and misinformation campaigns spread through social media. We have learnt that we needed to engage communities more effectively to be part of the solutions. And that only when measures are scientifically sound and culturally acceptable will they be fully effective.

To meet varied and complex needs, health systems have had to adjust with unprecedented speed. They established dual track service delivery where essential services were provided in parallel to services focused on pandemic response. Digital solutions like tele-medicine have contributed to bridging service gaps when face-to-face services were impossible. These innovations will be crucial to catch-up for “unmet” health needs - management of heart disease, diabetes, hypertension, cancer and other disease-specific services, and to accommodate growing mental health needs.

Science and research have been indispensable in shaping our response – from developing diagnostics, exploring treatment and developing vaccines at an unprecedented pace. Old and new technologies have been used to establish the evidence for public health and social measures.

Our health care workers are cherished professionals, who deserve our unwavering respect and gratitude. They also require adequate social, mental, physical and financial support, to ensure their health and well-being, and to guarantee sustainable, functioning health systems during the pandemic response and beyond. Accordingly, the initiative fielded by Turkey to recognize Year 2021 as the Year of Health and Care Workers received unanimous endorsement by the World Health Assembly, and a multitude of activities and policy interventions are planned for next year and beyond. Frontline workers – teachers, social, community and postal workers, bus drivers, grocery and supermarket staff, and many others – who before remained invisible and undervalued, have now been rightly recognized as the unsung heroes that kept our societies functioning.

We have seen inspiring examples of community solidarity, human ingenuity, collective and individual compassion in every corner of the Region. People have shown remarkable resilience, optimism and generosity. In case of Turkey, strong pre-COVID-19 collaboration between the WHO and Ministry of Health and joint programming under Health Systems Transformation, Pandemic Influenza Preparedness, and strengthening health security capacities including IHR (2005) have helped timely, effective and efficient response to COVID-19 across many areas.

Adoption of family medicine model at Primary Health Care (PHC) level flanked by household-level information, facilitated contact tracing and other COVID-19 mitigation and containment measures at community levels. The health care coverage for COVID-19 was extended to over 4 million refugees and migrants in Turkey as early as April in accordance with health as human right especially during crises in crises compliance and living up to mantra of “Leaving NO One Behind,” of WHO European Program of Work (EPW) and its foundational principle of “United Action for Better Health.”

Local production of Rt-PCR test locally and its Emergency Use Listing (EUL) by WHO as early as February 2020 (Before the first reported COVID-19 case in the country) helped Turkey avert the otherwise testing glut that plagued majority of countries including advanced economies for the most part of Spring and Summer this year.

Adequate testing and infection prevention and control practices at Long-Term Care Facilities for elderly helped minimize mortality and morbidity in this otherwise high-risk population in indoor settings, in Spring and Summer. High volume testing capacities at national level also helped early diagnoses and timely isolation of confirmed cases and quarantining of close contacts; all helping curb spread.

Similarly using outbreak investigation and contact tracing protocols, capacities and experience of recently concluded Measles outbreak, helped health authorities at central and provincial levels re-engage the same assets and capacities for COVID-19 without a lag time. Improved case management by clinicians including reported measures as Oxygen supplementation, use of prone position for improved oxygenation in lungs, etc also helped reduce mortality and yield better clinical outcomes in COVID-19 patients.

At the global level, Turkey also lived up to its long-standing tradition of solidarity and humanitarian spirit. Turkey supported more than 150 countries and eight international organizations with personal protective equipment (PPE), SARS-CoV-2 diagnostic kits, medical devices and medication, and issued exceptional export licenses for 65 different countries and international organization to allow export of medication, PPE, and medical devices from Turkey to these end-beneficiaries.

The year 2020 has shown us that health is not only an individual concern, but it requires collective effort. As the Turkish Health Minister Dr. Fahrettin Koca also rightly emphasized, “Coronavirus Is Not Stronger Than the Measures We Will All Take.”

We all have a role to play to shape the future we need. This can only be achieved by placing health and equity at the heart of all policies. WHO/Europe’s health strategy “United Action for Better Health,” is built upon what citizens expect from their health authorities in order to thrive in healthy communities. For this, we need to guarantee people’s right to universal access to quality care, accelerate action to reduce health inequities and strengthen public health leadership at local, regional, national and international levels. This is an ambitious agenda but one we can achieve together. People increasingly – and rightly – hold their health authorities to account for meeting these expectations and to “leave no-one behind.”

To lead us in a new direction, WHO/Europe has brought together expert and political voices. The Pan-European Commission on Health and Sustainable Development comprises experts from a range of fields including former heads of state and government, distinguished life scientists and economists, heads of health and social care institutions, and leaders of the business community and financial institutions. The Commission is looking forwards, through the impact of the pandemic, to changes that are needed in society, with a view to elevating health to the top of the political agenda. It will offer guidance on how to invest in health and social care systems for the benefit of all sectors.

2020 has taught us that health is not something we can take for granted, and healthcare is only truly effective and protective if everyone has access. If we want to protect ourselves from future crises, we must leave no one behind.

*Dr. Hans Henri P. Kluge is WHO’s Regional  Director for Europe and Dr. Batyr Berdyklychev is the WHO Representative / Head of Country Office in Turkey.