‘Covid hasn’t gone away’, says former director of the UK’s public health system

Europe sees a new wave of Covid-19 cases. Among the newly infected is Nigel Crisp, former executive director of the NHS (National Health Service, a kind of British SUS) and former UK Health Secretary.

“I tested positive for [a Covid] two hours ago”, says Crisp in an email interview with Sheet held this Friday (4).

Crisp speaks this Monday (7th) at Conahp (National Congress of Private Hospitals), which takes place in São Paulo.

The former director of the NHS also highlighted the main challenges in the area of ​​health that President-elect Luiz Inácio Lula da Silva (PT) will need to face in the next four years. Covid is cited, as is decreasing the shortage of health professionals and increasing international cooperation to mitigate global health problems.

One such example of cooperation would be between the SUS and the NHS, two public health reference systems. For Crisp, collaboration between Brazil and the United Kingdom in this area exists, but it is far from what is desired. “We can all learn from each other,” he says.

Waves of new Covid cases were recorded, as in Europe. Does the scenario pose a risk to global health? Yup. Covid has not gone away. In fact, I tested positive for her two hours ago!

Our concern in Europe is that we will see an increase in Covid infections during the winter, at the same time that the flu (which has been low in recent years and is likely to spread this year) is on the rise, as well as other typical winter problems. This results in enormous pressures on health services.

As with the Covid waves of 2020 and 2021, it means that other conditions are overlooked. Noncommunicable diseases – cancer, heart disease, diabetes and others – were particularly affected. The same is true of elective surgeries – leading to rising levels of disability and more people unable to work.

It mainly affects the poorest and most marginalized of society compared to the richest. It keeps people out of work and hurts the economy. It means that the world’s richest countries will be more introspective and less willing to support other low- and middle-income countries.

Every pandemic has major social and economic impacts. This is not over and remains a threat to global health.

Even with this new wave, the Covid-19 pandemic has cooled down. The WHO has already said that the end of it may be near. US President Joe Biden has even declared that the pandemic is over. For you, the health emergency ended? Not. However, we are closer to the end than the beginning and we need to redefine our health systems using all the knowledge we have gained from this pandemic – about vaccine development, treatment, surveillance, preparedness for future pandemics – and recognize the mistakes around the pandemic. preparation, response time, cooperation between regions and globally and correcting them for the future. We need to get our health systems up and running.

The management of the pandemic in Brazil had many problems, such as delays in vaccination and defense of ineffective treatments against the disease. What can Brazil and other countries learn from this? As stated above, identify the issues clearly (don’t pretend they didn’t happen – we have a formal inquiry led by a judge in the UK who is looking into how the inquiry was managed and the decisions made by politicians, health leaders and scientists). Learn from the experience of others around the world, strengthen global response systems at all levels, from surveillance to reporting and rapid development and sharing of data and knowledge.

Brazil went through a presidential election recently. The current president, Jair Bolsonaro, was not re-elected. Lula, the president-elect, assumes the presidency in 2023. What are the biggest challenges that Brazil’s next government must face in relation to public health?

• Covid –as explained above– dealing with any resurgence, learning the lessons, repairing the damage to the healthcare system and other services, preparing for future pandemics.
• Tackling shortages of all different groups of healthcare workers – this is one of the biggest global problems.
• Develop a new approach to health, which includes: combating diseases and accidents through health services; prevention of illness and accidents by addressing the cause of illness; and health development, which is different from prevention because it is concerned with the causes. It’s about creating the conditions for people to be healthy — in their homes, communities, schools and workplaces.
• Work with the WHO (World Health Organization) and other international bodies to develop better cooperation.

In his book “Turning the world upside down again”, Mr. explores how rich countries can learn about health management from poorer regions. How the Brazilian reality can contribute to that? Brazil has created a very interesting family health system, including the appointment of community health workers.

Here in the UK, we have recently named some health workers inspired by the Brazilian example. They are even being monitored by Brazilian agents! I hope we will see this expanded in the coming years as an essential part of primary care.

The United Kingdom and Brazil have a common point of public health on account of the public health systems: the NHS and SUS, respectively. How is the cooperation between the two countries to improve these systems? I think there is relatively little cooperation between the two — although the example above shows that there is room for it. We can all learn from each other.

I hope that Brazil and the UK, both under new leadership, will work together and with other countries to promote solidarity and global sharing. It is vital for the future of all of us.

Brazil has a public vaccination system recognized worldwide, the PNI. However, the country struggles to achieve high levels of coverage of different vaccines, such as against polio. Is this a particularity of Brazil or do other countries also face the challenge of massively vaccinating the population? This is a very common problem. There are logistical problems in a very large country like Brazil, mainly to reach the most remote and vulnerable populations.

Just as importantly, there is a great deal of misinformation, which means that some people are reluctant to be vaccinated. This is extremely harmful to yourself and others.

Brazil, with the Amazon rainforest, is a centerpiece in controlling climate change, but has been registering high rates of deforestation. How does this pose a problem for global health? This is a huge problem. Climate change affects our global health in many different ways – from changing patterns of disease to the loss of agricultural land, water shortages, mass human migration, sea level rise and economic damage. Brazil has a key role to play in helping to mitigate the damage.

X-ray

Lord Nigel Crisp, 70

A graduate of Cambridge University philosophy, Lord Nigel Crisp is an independent member of the House of Lords in the UK Parliament, where he co-chairs the All-Party Parliamentary Group on Global Health. He also co-chairs the Nursing Now campaign, which seeks to improve nursing practice globally. Prior to that, he was Executive Director of the British NHS and Permanent Secretary of the UK Department of Health.