The WHO, between two waters: manage the omicron alert and avoid stigmatizing countries that detect new variants | Society

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The World Health Organization (WHO) maintains the alert about the new variant of the omicron coronavirus, detected in South Africa a few days ago. The scientific community is still not sure that this version of the virus is more transmissible and escapes vaccines, but the first signs have set off the alarms of the WHO, which this Monday warned in a technical document that the global risk of the omicron “is evaluated as very high” and has asked for extreme precautions. Although, yes, without stigmatizing the countries that have discovered the new variant. The director of the WHO, Tedros Adhanom Ghebreyesus, insisted on Monday that South Africa “should be thanked and not penalized” for this finding. Part of Europe, Australia, Morocco and the United States, among others, have already closed borders with several southern African countries to prevent the omicron from entering their territory. But, for now, there are already at least nine European countries – Spain included – that have detected it.

The WHO dances between two waters: on the one hand, to keep alert of the potential danger posed by this new variant and, at the same time, to prevent the search for new versions of the virus from being discouraged by the measures taken by the rest of the countries to protect themselves to themselves. All this, in an international gear where its operational capacity is limited – it cannot intervene in the national sovereignty of the 194 member countries – and there are no common guidelines at the global level. Each country rules its own. But the coronavirus does not understand borders, the WHO director recalled: “Although stable or declining trends are observed in other regions, if there is something we have learned, it is that no region, no country, no community, or no individual is within reach. except until we are all safe. “

South Africa notified the WHO of the detection of the new variant on November 24 and, in just two days, the Technical Advisory Group on the Evolution of the Sars-CoV-2 Virus (TAG-VE), an independent team of experts that periodically monitors and evaluates the evolution of the virus and its mutations, recommended cataloging it as a variant of concern. That is, it has a risk for global public health because it can lead to an increase in transmissibility, an increase in virulence or circumvent the effect of protection measures, such as vaccines.

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For Daniel López-Acuña, former Director of Emergencies of the WHO, the actions of South Africa and the international health organization have been adequate: “South Africa and the WHO have done what was appropriate with transparency and speed. The WHO has launched an alert, it has not alarmed with panic or paranoia. The problem is that with that information the bunkerization of the countries, which have chosen to isolate South Africa, but not with a sense of public health, but almost paranoid and political, to show that they are doing something ”. The health worker insists that the closure of borders does not make sense because the variant is already in Europe – the United Kingdom, Portugal, Belgium and the Netherlands, among others, have confirmed cases. “To stop the variant, less reduction of flights and more protection and surveillance measures within the countries. You cannot stigmatize South Africa. Variations are emerging and as long as we do not control the incidence and increase vaccination, they will continue to appear ”, López-Acuña ditch.

The closure of borders in response to the appearance of the omicron has also raised the concern of the WHO. Precisely, this Monday, in the framework of an extraordinary assembly of the health organization to negotiate a treaty to prepare for pandemics, Tedros lamented: “The omicron variant shows why the world needs a new agreement on pandemics: our current system discourages the countries to alert others to threats that will inevitably land on their shores ”.

WHO is at the mercy of countries and its room for maneuver is very limited. It can alert and recommend, but not order, the WHO regional director for Europe, Hans Kluge, explained to EL PAÍS a few weeks ago, regarding the criticism that the international body received for its role in investigating the origin of the coronavirus in China. : “Today, I do not have the mandate to go independently to a country and analyze all the data and all the equipment. The WHO is not an international inspection, we are simply there to help the countries and it is the member states that govern us and those that should give us more capabilities ”, defended Kluge. López-Acuña agrees that the WHO “is not a health Interpol”: “The problem we have is that many countries do not want to give up national sovereignty in health matters. The WHO is not an independent entity, it is an association of 194 countries ”.

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Unlike the beginning of the pandemic, when the WHO was harshly criticized for its slowness in assessing the risk posed by the coronavirus, the experts consulted admit that this time, the international entity has acted with agility. Alberto Infante, emeritus professor of International Health at the National School of Health of the Carlos III Health Institute, points out that, after those first days, the WHO “did some self-criticism and now they are more proactive in the need to act more quickly” . And South Africa has also been diligent, insists Rafa Vilasanjuán, member of the board of directors of Gavi, the global alliance for vaccination: “South Africa’s reaction has been exemplary: in 36 hours it has detected the group and transmitted the information. China, for example, did not do so at the time, “he recalls.

The next few days will be key to ascertaining whether this variant is as problematic as the first indications suggest. For now, Infante points out that the cases detected in different countries in less than a week “may be an indirect indication of the spread of the variant.” “It is not to be calm. The evidence is enough to declare it as a variant of concern ”, insists the health worker, although he admits that the credibility of the WHO may be affected if in the end the threat comes to nothing. It is a risk, however, that must be taken, he points out: “If the variant behaves as they say in South Africa, we will not have time to react. With what is known today, everything indicates that it is better to be too cautious ”.

Tedros has also reproached this Monday in his inaugural speech at the WHO assembly, the obstacles that were found in the first days of the pandemic: “The lack of information and data exchange by many countries in the first days of the The pandemic hampered our collective ability to get a clear picture of your profile and track record. The lack of sharing of biological samples hampered our collective ability to understand how the virus evolved. And the lack of a consistent and coherent global approach has resulted in a fragmented and disjointed response, generating misunderstandings, misinformation and mistrust. The fabric of multilateralism has unraveled ”.

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Equity in vaccination

The rise of new variants is motivated, to a large extent, by inequity in access to vaccines: Europe has 70% of the vaccinated population and Africa, 7%. According to Tedros, “more than 80% of the world’s vaccines have been destined for the G20 countries, while low-income countries, most of them in Africa, have received only 0.6% of all vaccines” .

In a globalized world, there are no valid borders and the more a virus replicates, the more possibilities there are for mutations to appear that jeopardize what has been achieved so far to contain the pandemic. “We are like this because it has not been understood that it is necessary to carry vaccines where there are none. And donations are not the solution because the big problem is that, while here [en los países ricos] there is a high demand for vaccines, there are not enough vaccines for other countries ”, laments Vilasanjuan. Covax, the Global Access Fund for Vaccines against covid, has sent 550 million doses to developing countries, but the initial commitment to reach the end of the year with 20% of the population of all countries vaccinated, is a impossible, admits Vilasanjuan: “There is an over-demand from high-income countries. There is a lack of commitment to end the pandemic and a push is needed. Tedros has been saying it for a long time and the position is clear, but the WHO can do nothing more ”.

Tedros, for his part, insisted on Monday that equity in vaccination “is not charity”, but the best solution to get out of the pandemic: “The more inequity with vaccines persists, the more opportunities this virus will have to spread and evolve in ways that we cannot predict or prevent ”, he warned. The WHO has called for better governance and funding from the international body.

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George Holan

George Holan is chief editor at Plainsmen Post and has articles published in many notable publications in the last decade.

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