National Covid-19 Commission
I AM proposing the setting up of a ‘National Covid-19 Commission’. Why? The rearview mirror is an important metaphor for learning and planning. “We drive into the future using only our rearview mirror.” It can be lifesaving.
Challenges do bring opportunities, only if they are taken.
A splintered world, a battered economy, human suffering, losses, some accounted for and mostly unrecognised — it will take a very long time to recover. Notwithstanding the damage done, we can build back better to be more prepared and resilient the next time around.
I propose the setting up of a national commission on Covid-19 as somebody who had an opportunity to set up and lead the national response during the first two waves. I know where we stood and what we went through. Despite all the hard work, had the situation been anywhere near what we saw in some Western countries, we would have been ruined. Covid-19 is still not over as a global pandemic. The virus is mutating and this is not the only virus that can cause the next global pandemic.
We can build back better to be more prepared and resilient the next time around.
Bill Gates’ new book How to Prevent the Next Pandemic and based on it his recent TED talk are something to read and listen to. He says that “…even though Covid-19 isn’t totally behind us, this is the right time to be discussing how the world can make sure no one ever has to live through anything like this again”. He has proposed a three-pronged strategy at the global level. One, establishing a ‘Global Epidemic Response and Mobilisation’ (GERM) team of 3,000 full-time professionals to pick up early warning signals and nip in the bud any epidemic rearing its head anywhere in the world within the first 100 days. He says that if the Covid-19 pandemic had been curtailed in the first 100 days, the world could have avoided 98 per cent of the deaths. Two, promoting R&D for new and more effective tools to diagnose and control diseases — for example, vaccine patches and the much cheaper, easy-to-do but equally effective alternatives to PCR tests. Three, investing in strengthening health systems to become more resilient and responsive as they are the bedrock on which any public health emergency response is built and sustained. IMF estimates the cost of the Covid-19 pandemic to be $14 trillion. To avoid such an economic disaster in the future, spending a few billions on health systems is worth a deal.
The Lancet Covid-19 Commission has also been set up under the chairmanship of Prof Jeffrey Sachs with a mission to promote solutions to improve global public health and support an equitable, transformative, green and digital recovery. More on this global commission some other time.
Notwithstanding the wisdom and importance of global solutions, the action takes place at a national level. Without committed national takers, global advice and initiatives have no effect. There is a real danger, especially in low- and middle-income countries that despite more than 6.2 million deaths and the deep dent in the global economy, we will still not pay the required attention to building robust national disease prevention and control systems. As a result, we may still be as unprepared and vulnerable when we face the next pandemic. We may still have to start from scratch and lose the first vital 100 days and lose lives unnecessarily. Somebody is always responsible for every preventable death!
Through setting up a ‘National Covid-19 Commission’ in Pakistan, we should, deliberately and systematically take stock of the national experience of dealing with the global pandemic. We should do this while the pain is fresh and while we are still living through myriad of losses, including but not limited to economic losses.
For the sake of firewalling Pakistan against future pandemics, the new government should announce the establishment of such a commission. This may sound very out of place with a political crisis that has no peaceful and amicable end in sight. It may not be seen as a priority at this time but this is what leadership is all about — to have a longer and transcendent vision and bring round all parties, including opponents, to accepting that vision. And opponents must cooperate for the sake of the very people they care for.
The prime minister must consider this as a priority, and the Ministry of Planning, Development and Special Initiatives should establish and convene a commission. The composition of the commission can be worked out by defining the required expertise and experience and by approaching senior and credible experts. The terms of reference can be formulated at the granular level but the overarching aim of the commission should be two-fold: to review the national Covid-19 response by recording all its strengths and weaknesses and, in the light of this experience, recommend actions that Pakistan must take to be better prepared in order to generate a timely and effective response to future pandemics and other public health emergencies. The commission should be diverse, independent, technically capable, well-resourced and time-bound.
The planning ministry should initiate the necessary homework by starting a consultative process within itself and with the development partners. I am sure the partners would very much welcome the idea. The World Health Organisation would be a natural collaborator which would also allow access to the best technical expertise within and outside the organisation. It can also help to understand how Covid-19 recovery work is taking place in different countries and what we can learn from these experiences. Other development partners can also help in different ways.
Can we rise above the political chaos and in the midst of it set an example as a responsible country that cares about its people? Despite difficulties, we generated a good response to Covid-19 in relative terms. Can we also generate a good example for others to emulate by setting up a ‘National Covid-19 Commission’?
The writer is a former SAPM on health, professor of health systems at Shifa Tameer-i-Millat University and WHO adviser on UHC.
Published in Dawn, May 6th, 2022