At Davos, Lessons from COVID Help Prepare for ‘Disease X’
Health Systems 18/01/2024 •
Session moderator Nancy Brown, CEO of the American Heart Association; Michel Demaré, board chair of AstraZeneca; Brazilian Health Minister Nisia Trindade Lima, Roy Jakobs, CEO of Royal Philips; Preetha Reddy, vice-chairperson of Apollo Hospitals and Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO).

Improving disease surveillance, strengthening primary healthcare, and being able to expand quickly during a crisis are some of the important lessons from the COVID-19 pandemic that can be applied to ‘Disease X’, according to health experts speaking on a panel at the World Economic Forum on Wednesday.

“Disease X is a placeholder for unknown diseases,” said World Health Organization (WHO) director-general Dr Tedros Adhanom Ghebreyesus. “You may even call COVID the first disease X, and it may happen again.”

“We lost many people [during COVID] because we couldn’t manage them. They could have been saved, but there was no space. There was not enough oxygen. So how can you have a system that can expand when the need comes?” Tedros added.

Need to strengthen primary healthcare

Many countries spend large amounts on their healthcare but this does not always translate into superior outcomes. In the United States, the richest country in the world where healthcare spending is in trillions of dollars, maternal deaths are on the rise.

“It’s not just about spending more, it’s also spending smarter. A shocking statistic, for instance in OECD countries, is that the average spend on prevention is 3% of the budget of health systems. And obviously, if you spend so little on prevention, you end up spending the majority of your budget on hospitalization or only treatments,” said Michel Demaré, board chair of the pharmaceutical company, AstraZeneca.

Tedros elaborated that the reason for poor outcomes was also that expenditure was focussed on tertiary healthcare which meant that some countries struggled with basics like contact tracing during the pandemic, as they ignored primary healthcare.

“To prepare countries, I think renewed commitment to strengthen primary healthcare is very important,” he said.

WHO Director-General Tedros Adhanom Ghebreyesus said to prepare for the next pandemic, countries will have to focus on strengthening their primary healthcare.

Collaboration Between stakeholders

A big takeaway from the pandemic was the benefit of collaboration, said Demaré, whose company distributed more than three billion doses of vaccine at no profit, mainly to low- and middle-income countries.

“Just as a reminder, we were not a vaccine company at the time. We just decided that this was a call for action and that we had to try to use our know-how and our networks to try to help. So we signed a license agreement with the University of Oxford. We then put together a network of more than 20 contract manufacturing organizations to which we transferred technology and skills to basically help build the vaccine,” Demaré said.

He added that quick action and quick decision-making were extremely important but the partnerships were the most important aspect. “We have partnered with academia, obviously with governments, with regulators, third-party commercial contractors, and with NGOs,” he said.

Michel Demaré, board chair of AstraZeneca, who said the large number of partnerships during COVID was a spontaneous and valuable response to the situation.

Risks to healthcare workers 

The healthcare sector is facing a huge shortage of staff which the medical journal The Lancet described as “dangerous” in May 2023, adding that the “situation is worsening.”

An estimated 115,000 healthcare workers died during COVID which has also brought into sharp focus the dangers facing those delivering care.

“Very quickly we saw that actually, it became more and more challenging for the healthcare systems to actually keep the staff up and running, to keep them motivated, but also actually to protect them from the disease and keep doing their job,” said Roy Jakobs, CEO of Royal Philips.

Jakobs said that while technology to help staff is available, making sure it gets to them and is scaled up rapidly, is a challenge.

“The lack of skilled manpower is a global shortage. We just do not have enough doctors and nurses to heal the world,” said Preetha Reddy, vice-chairperson of the private Indian healthcare provider, Apollo Hospitals.

But her group found digital tools helpful during the pandemic. “Within a span of two weeks we were able to train about all 150,000 workers on ventilator management,” she said.

Preetha Reddy, vice-chairperson of Apollo Hospitals.

Push for the pandemic agreement

Tedros made a push for the pandemic agreement currently being negotiated by member states with the May World Health Assembly as their deadline.

Much of the text of the agreement on technology transfer, pricing and transparency has already been watered down as Health Policy Watch reported earlier.

“The pandemic agreement can bring all the experience, all the challenges that we have faced, and all the solutions, into one, and that agreement can help us to prepare for the future in a better way because this is about a common enemy,” he said.

Brazilian Health Minister Nisia Trindade Lima reminded everyone that countries need social systems to support individuals during times of crisis.

“Health alone cannot resolve all of the matters. So, we have to include in this agenda, the social protection systems which are vital in times of crisis, like the ones that we lived through recently,” she said.

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