From the President: September 2020

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As the latest waves of the COVID-19 pandemic continue to develop across our world many professionals are engaged in research on sources, spread, treatments, longer-term impacts on health and a range of other related issues. Journals are reporting massive increases in submitted articles and research projects. All of these will make a contribution to our collective knowledge and enable us to better prepare for future pandemics – we hope. But did we learn from previous threats such as ZIKA virus or SARS? In those previously affected countries lessons were certainly learned, less so in countries which were less or unaffected. In the case of COVID-19 every country in the world has been affected, at least to the extent of trying to prevent transmission, as well as dealing with the terrible effects when the virus takes hold.

During our regular WONCA Webinars it was clear that getting access to reputable information was an issue for many. A key problem was trying to differentiate the reliable information from the fake information or panic-inducing rumour. What we all agreed was the importance of sharing our knowledge and the importance of working closely with our professional colleagues, right across the globe.

This virus, though most unwelcome, has generated a desire – maybe even a need – for us to work collaboratively across nations, across specialities, across cultures, to help address issues of global importance. What is important and challenging in one country can quickly become important and challenging in many others.

Much of the data already available and being produced from across the world is being challenged in terms of accuracy (of numbers affected, of numbers tested and testing positive, of deaths, of particularly vulnerable groups of people). Challenging the data is not a bad thing per se: it encourages countries to ensure accuracy that they can defend. Of course, there are different methods of counting and accounting; parameters for data sets are different in different countries and even in different states in the same country. There has been enough criticism of nations to share around, with a few laudable exceptions. But it is only with collaboration and respect for each other that a lasting response to this pandemic is feasible.

As Richard Horton, editor of The Lancet, wrote in his recent article in the UK Guardian Online: "At moments of geopolitical stress, it is surely better to intensify, not weaken, personal and institutional relationships. It is surely better to build better understanding between peoples. … A pandemic is a moment for solidarity between peoples, not conflict between governments(1)". In his recent book ‘The COVID-19 catastrophe: what’s gone wrong and how to stop it happening again(2)’ he reiterates the idea that "a pandemic is a moment for conciliation, respect and honesty between friends". He suggests that "in order to enhance vigilance for new infectious threats, countries will come to view health not merely as a domestic concern but as a foreign policy issue foundational to national security. They will collaborate to ensure that all nations make progress towards the goal of universal health coverage, since individual health security is indispensable for global health security. Countries will cooperate to share data and defeat disinformation. And they will find ways, slowly, to strengthen their accountability to meet the stringent requirements of the IHR" (WHO’s International Health Regulations).

We can do more than hope that this will happen. We can, each of us, as individual family doctors working with and for our patients, actively contribute to the collection, collation and analysis of data which will inform our future preparedness and response to emerging risks. Our often-stated goal is to achieve universal health coverage, based on access to quality, comprehensive primary care, delivered by qualified and trained health professionals. Improving primary care systems and services, coupled with clinically-driven referral mechanisms to secondary care, will provide better and more informed ammunition against the real enemy of the next unexpected, insidious, virus which threatens and will help us deal with the ongoing threat through which we are currently living.

Donald Li

References
1. The threat of coronavirus should kindle global cooperation not a new cold war, The Guardian online 23.08.20
2. The COVID-19 catastrophe: what’s gone wrong and how to stop it happening again, Richard Horton, Policy Press, 2020 ISBN-13:978-1-5095-4645-9/ 4646-6 (pb)