World Health Day: Are We On The Right Track?

Our ineptitude and ignorance, and worse, our selfish utilitarianism must not endanger others. As the WHO says sagely, health is physical, mental, and social wellbeing, and as a resource for living a full life.
 


by Dr. Ruwantissa Abeyratne

Montreal

 

On World Health Day, 7 April 2021, we will be inviting you to join a new campaign to build a fairer, healthier world… World Health Organization

There are four key words in this clarion call of the WHO: new campaign; fairer; healthier.  This invitation  for a new campaign seemingly suggests that there has been an old campaign.  If this be so, what happened to it? why do we need a fairer campaign?  Again, given that a fairer campaign would mean that there was a fair campaign, wasn’t that fair campaign good enough? and why so? And how could we attain a healthier world?



When one reads the web page of WHO further,  one finds that the WHO is suggesting that the basic premise underlining this call for a fairer, healthier world is because “[A]s COVID-19 has highlighted, some people are able to live healthier lives and have better access to health services than others - entirely due to the conditions in which they are born, grow, live, work and age”. This is an ineluctable fact and WHO is absolutely correct.  Also, it must be mentioned  that throughout its tenure as the specialized agency of the United Nations on matters of global , health WHO has diligently addressed public  health issues right up to the current pandemic and continues to do so.  If WHO did not exist, it would have to be invented. 

Arguably, with the mention of COVID-19, WHO can justify its call for a new campaign to build a fairer, healthier world. WHO has said the right thing but seemingly for the wrong reason Here’s why.

The thrust of WHO’s call hinges basically on its statement that  “[A]ll over the world, some groups struggle to make ends meet with little daily income, have poorer housing conditions and education, fewer employment opportunities, experience greater gender inequality, and have little or no access to safe environments, clean water and air, food security and health services. This leads to unnecessary suffering, avoidable illness, and premature death. And it harms our societies and economies. This is not only unfair: it is preventable. That’s why we are calling on leaders to ensure that everyone has living and working conditions that are conducive to good health.  At the same time, we urge leaders to monitor health inequities, and to ensure that all people are able to access quality health services when and where they need them”.

One cannot contest this truism. This is a well-worn platitude and WHO must encourage leaders to monitor health inequities, not only from a local perspective but also in a global context. In this regard, leaders must be commended for their support for research and development which led to an unimaginably short time taken for the vaccine rollout. We are seemingly in good shape, if only we can see something insidious that is going on right in front of our eyes. The virus is mutating into variants at a rapid pace and is being facilitated by our own feckless insouciance.

Richard Gray, in an article on BBC (27 January 2021) titled This is how new Covid-19 variants are changing the pandemic reportswith almost every person it infects, the virus changes very subtly – picking up a letter in its genetic code here, another being deleted there or swapped for something different. These occur usually because of tiny errors as the virus takes over the cell's molecular machinery to copy itself. Most have little effect other than helping scientists to trace how the virus is spreading around the world. But occasionally a mutation occurs that alters how quickly the virus spreads, how infectious it might be or even the severity of the disease it causes.

This is leading to new variants of the virus emerging. The most recent of these – the South African and Brazilian variants – are already showing signs that the virus might be adapting to evade immunity in some people. Although many of the tests are still preliminary on these new Covid-19 variants, it is giving some clues about what might happen in the future”.

Much more ominous is a prediction by a Brazilian doctor that the alarming rate at which the virus is spreading in Brazil mostly due to a flagrant disregard by the multitudes of the need to wear personal protection equipment and distance one another as prescribed by the scientific community, we can expect a rapid proliferation of new versions of variants. BBC has reported that: “Brazilian public health institute Fiocruz says it has detected 92 variants of coronavirus in the country. Experts say that the development of new variants is not surprising: all viruses mutate as they make copies of themselves to spread”.

Incontrovertibly, this catastrophe would affect the whole world and we would be back to where we started. WHO has quite rightly invoked the might of world leaders on World Health Day to address health inequities.  However, to effectively preclude the virus from continuously devastating the world, much more needs to be done and a much firmer hand is needed to harness an epicurean public. When most of us are struggling in the third wave, this is no time to be popular at the expense of grave danger to those who look up to a leader. What we need is Machiavellian sensibility - that it is better to be feared than be loved if you cannot be both. On World Health Day, as Winston Churchill notably  said,  when we are going through hell, we must keep going,  But to do this, the philosophy of Machiavelli, as paraphrased by the gigantic intellect of Isiah Berlin, that “To know the worst is not always to be liberated from its consequences; nevertheless it is preferable to ignorance. It is this painful truth that Machiavelli forced on our attention, not by formulating explicitly, but perhaps the more effectively by relegating much uncriticized traditional morality to the realm of utopia… If you object to the political methods recommended because they seem to you morally detestable, if you refuse to embark upon them because they are, to use Ritter's word, "erschreckend," too frightening, Machiavelli has no answer, no argument. In that case you are perfectly entitled to lead a morally good life, be a private citizen (or a monk), seek some corner of your own. But, in that event, you must not make yourself responsible for the lives of others or expect good fortune; in a material sense you must expect to be ignored or destroyed " 

Our ineptitude and ignorance, and worse, our selfish utilitarianism must not endanger others. As the WHO says sagely, health is physical, mental, and social wellbeing, and as a resource for living a full life. It refers not only to the absence of disease, but the ability to recover and bounce back from illness and other problems.  Each one of us has the right to this definition and that right must not be denied to us by the negligence of others.  This should be the paramount message on World Health Day.


Dr. Abeyratne is the author of AIR TRANSPORT AND THE PANDEMIC: LEGAL, ETHICAL AND ECONOMIC  ISSUES, to be published later this year.