Covid is here to stay. How does the world respond to this? – 01/27/2023 – Balance and Health

“Covid-19 is here with us to stay.” The speech is by Maria Von Kerkhove, technical leader of the WHO (World Health Organization) Covid-19 emergency program, in a video published on December 20, 2022.

As humanity enters its fourth year of dealing with the disease, a question that lingers is what it means to live with the infection. Von Kerkhove mentions WHO’s work in trying to integrate Covid and other diseases into joint surveillance and control systems.

A similar point is reiterated by Flávio Fonseca, president of the SBV (Brazilian Society of Virology). He says that there are already initiatives for genomic sequencing that share information on Sars-CoV-2, the virus that causes Covid-19, on international platforms such as Gisaid.

But Fonseca believes that a better structured process is needed. By doing so, it would be easier to monitor the spread of the virus, identify new variants, the risks they may bring to new peaks of infection, and even more quickly control its spread.

Better tracking is also useful for updating vaccines, an aspect that Fonseca sees as something that will become routine in humanity’s coexistence with Covid-19. “It needs global leadership, a role that falls under the WHO, which can regulate laboratories that are continental references”, she says.

One example that the WHO is already spearheading is the Global Influenza Surveillance and Response System (GISRS). The model is formed ‘by a network of laboratories that monitor the influenza virus. The information collected by them is used annually to update flu vaccines.

In addition to influenza, centers that are part of the GISRS network were used during the Covid-19 pandemic. Furthermore, it is in WHO’s interest that the system be part of an approach to respiratory viruses –not just influenza– that have the potential to cause health emergencies.

“WHO is committed to working with countries to expand the scope of GISRS beyond influenza to other new respiratory viruses,” said Tedros Adnahom, in the organization’s October 2022 promotional video.

But the stage at which the organization’s plans are is not clear. THE Sheet questioned the WHO about the expansion of GISRS to other diseases, and whether this could result in long-term effects on humanity’s coexistence with Sars-CoV-2. Until the publication of this report, however, there were no responses.

New instrument, reform of what already exists

Deisy Ventura, a professor at the Faculty of Public Health (FSP) at USP, says that a surveillance system for Covid-19 similar to that which exists in the case of influenza is important, but not sufficient. Prior to that, she sees reform of the International Health Regulations (IHR) as essential to more effectively address global health crises.

The RSI dates from 2005 and describes actions that must be taken in the face of health crises with global potential – the Covid-19 pandemic is an example. Ventura explains that the current document already expresses a series of adoptable points in relation to global health problems, such as border control, laboratory structures and notification in risk scenarios.

However, in practice, it doesn’t work that well. Many countries do not have sufficient capacities considering the IHR prerogatives. Other nations even have this structure, but they don’t use it the way they should. “The system is there. There is no wheel to invent. What you have to do is give power for this system to work”, says Ventura.

For her, an opportunity for a more robust RSI is the group set up to include amendments to the regulation. The forecast is that debates will be held throughout 2023 and, in May 2024, the new regulation will be approved.

It is through these changes that Ventura sees the potential to develop actions that can respond to adversities in global health, such as new outbreaks of Covid-19.

“Only the development of national capacity in certain countries would already prevent outbreaks from gaining proportion. So, if you manage to develop detection, control and rapid response capacity in those states, you already prevent that outbreak from spreading”, he says.

Similar action is an instrument that will define measures for prevention, preparation and response to pandemics. The group working on the document was established in December 2021 by the World Health Assembly, the highest body of the WHO. The forecast for the instrument is similar to the RSI reform: deliberations in 2023, with completion in May 2024.

Jarbas Barbosa, who will assume the direction of PAHO (Pan American Health Organization) from February 2023, says that the active participation of the countries in the new agreement is necessary. “There are feasible measures that need to be agreed upon.”

One example is inequality in access to vaccines. Barbosa explains that one of the reasons we are still facing the Covid-19 health crisis is the fact that some countries have very low immunization rates. “It is no use for a rich country to vaccinate itself completely, because a new variant may appear in a country where vaccination is low”, he says.

He mentions that, in the case of an influenza pandemic, there are already rules that must be applied. In situations like this, vaccine manufacturers need to share their production: a portion destined for direct sale to countries and the other needs to be donated to the WHO or be marketed at affordable prices. Technology transfer should also be adopted.

The dilemma is that, for now, this principle is applicable only to pandemic influenza. With the new instrument under debate, the expectation is that it will be used for all other pandemics.

If this were applied to the case of Covid, it would be a possibility in controlling the disease, as it would overcome vaccination shortages in poor countries. In addition, Barbosa says that extensive testing and adequate communication of what to do in case of positive results are necessary measures in living with Sars-CoV-2.

“It is possible to reduce the impact that Covid has on the lives of societies”, he concludes.