“There is this tsunami that is happening after the earthquake that was COVID-19 that is now coming to shore and hitting health systems across the world,” said Ricardo Baptista Leite, president and founder of UNITE, a global network of parliamentarians committed to addressing global health challenges.

“The pandemic also led to a huge economic crisis and even poor countries in the global South, who might have been less affected by the pandemic, are going to pay a very severe price due to economic consequences that will lead to challenges in responding to the health needs of those countries,” he said. 

A week before his organization brings together hundreds of parliamentarians from around the world to discuss the most pressing issues in public health at a global summit, the Portuguese MP, who collaborates closely with the World Health Organization (WHO), warned Health Policy Watch of the need to take swift and collective action before the next pandemic.

“This is the moment when international institutions and governments need to step up their game and tackle the global health crisis,” Leite said. “We must double up our efforts to make sure we are better equipped in the future and can respond to health needs.”

Leite is a long-time global health advocate. He is also a trained medical doctor in infectious diseases and heads the Public Health department at Católica University of Portugal.

False sense of security

He told Health Policy Watch that whenever the world has felt “capable of controlling infectious disease, we create a false sense of security that we can lower our guard. Whenever we lower our guard, infectious diseases come back with a vengeance.”

This can be seen throughout history with multiple pandemics over the centuries, but also in this century with the emergence of antibiotics and the belief that with penicillin we could control infections – a belief now being called into question with the development of antibiotic-resistant bacteria. Antibiotic-resistant bacteria are responsible for the deaths of some 700,000 people each year – with scientists predicting that these infections could kill more people than cancer by 2050.

The pandemic has set back the fight against many diseases by years. Take HIV/AIDS. In December 2020, UNAIDS released its 95-95-95 targets, calling for 95% of all people living with HIV to know their HIV status, 95% of all people with diagnosed HIV infection to receive sustained antiretroviral therapy and 95% of all people receiving antiretroviral therapy to have viral suppression by 2025. 

But during COVID-19, in many countries, measurement of these goals ceased altogether. Where tracking continued, in some cases, diagnoses were slower. 

“HIV is an interesting proxy for all infectious and communicable diseases out there,” Leite said. 

In addition, COVID-19 led to a rise in people being diagnosed with late-stage cancer, an increase in cases related to chronic diseases due to people being kept away from health systems, and a spike in mental illness globally.

“Pandemics are a strong demonstration of the case that infectious diseases can undermine our efforts toward prosperity for all,” Leite said.

He added that during his time as a medical volunteer in Ukraine he saw a huge rise in multi-resistant and extremely resistant tuberculosis in the region. Leite predicted that as the war continues, it will be almost impossible not to see the TB spillover into neighboring countries and then across the world.

“There has to be a clear understanding from the world that dealing with infectious diseases is not only something recommended but is a prerequisite for economic and social development worldwide,” he said.

The role of parliamentarians 

Part of the solution is getting parliamentarians around the table, according to Leite. In 2017, the United Nations passed a resolution on the nexus of global health and foreign policy, encouraging a multi-stakeholder approach to achieve universal health coverage.

“The voice of parliamentarians was not part of the discussion,” Leite said. “One cannot expect to build a global health architecture or move forward science-based policy making if we do not keep those who write policy in the loop. We cannot make sure money gets where it needs to if we do not include those that make and approve budgets in parliaments.”

While he admitted that UNITE is not a “silver bullet,” he said it is a valuable tool for bringing parliamentarians from more than 90 countries together to share experiences and learn how they can best bring their own country toward a more sustainable future. 

“The first step was to get the conversation going. The second was to develop regional leadership. We now have 10 regional chapters, each led by an MP or former MP. Then we developed policy hubs, specialized teams that focus on specific policy areas, so they can drill down on concrete policymaking in key areas,” Leite explained. 

“We empower policymakers to be leaders for change in their own countries.”

UNITE’s three priorities

At its founding, UNITE was focused solely on issues of infectious diseases, but COVID-19 led it to change its mandate over the summer of 2022 and the organization is now focused more generally on global health matters. 

“The pandemic has demonstrated that global health issues and infectious diseases go hand in hand,” Leite told Health Policy Watch. “We cannot solve many challenges related to infectious disease, which were the basis of our work in the  first years, without addressing all the other global health challenges out there.”

UNITE is now taking a three-priority approach, focusing on pandemic prevention preparedness and response; the future of health systems; and health as a human right. The group signed a memorandum of understanding recently with WHO to work together on these pillars and supply parliamentary feedback and insight to support WHO’s related efforts. 

Next week: UNITE Global Summit

From 5-7 December, UNITE will host its global summit in Lisbon, bringing together its parliamentarians and leaders from the global health community to expand and forge new partnerships. Members of the lawmaking, civil society, medical and academic communities will meet to talk about what they feel are the most pressing issues on the global health agenda. 

Another priority that UNITE is bringing to the forefront of the parliamentarian agenda is the use of digital health to promote universal health coverage. 

“In the last few months with the creation of the digital health hub, parliamentarians were able to discuss with other stakeholders how to build the right frameworks and increase budgets to implement digital health transformation that can promote access to millions,” Leite said.

Finally, Leite added that with its new direction in mind, UNITE members would try to answer three questions during the event: What progress have we made so far during the UN’s Sustainable Development Goals period? What have we learned to help us make even more progress by 2030? What is the role of parliamentarians in helping drive that progress?

MPs and the pandemic treaty

In the past, parliamentary involvement has helped achieve public health goals. In Portugal, Leite cited an example from 22 years ago when the parliament decided to decriminalize the use of drugs. 

“This was not making drug use legal, but now no one goes to jail for using drugs,” he explained. “We stopped looking at people who use drugs as criminals but instead as people who potentially had a health challenge that needed to be dealt with.”

Instead of jail time, drug abusers receive harm reduction and other social and health services.

When the legislation was passed, around 1% of the Portuguese population used heroin. Since then, Leite said, the numbers have dropped dramatically. Drug-related crime is down, and new HIV cases tied to drug use have fallen from as high as 60% to only 2%. 

“The fact that we provided harm reduction services and shifted from a criminal perspective to a health perspective was transformative in achieving better health outcomes and partially solving the drug problem in Portugal,” Leite said.

A more recent example was the decision by the African Union to set up the African Medicines Agency, which will become a regulatory body for access to health technologies in the continent and creates a common standard of rules based on science to ensure the safety of citizens in the region. Leite equated the AMA to the European Medicines Agency.

Moving forward, UNITE Parliamentarians will play a key role in finalizing WHO’s pandemic treaty, aimed at guiding the global response to pandemics.  

“The regulations that were in place when COVID-19 hit were not sufficient or were not properly enforced,” Leite said.

He added that “there is a lack of acknowledgement and awareness among most citizens and many parliamentarians around the world that these negotiations are taking place. We need parliamentarians involved early on. If governments agree on a document, parliaments must ratify it.”

In an era of “polarized politics and fake news,” he said that if parliamentarians are not part of the process there is a risk that such a treaty would not be ratified, and the world would be left exactly where it was in December 2019.

“Everyone is committed to finding a balanced approach to what we hope will create a toolkit from a policy perspective that can help the world be better prepared to detect outbreaks early and lock them down before they transform into pandemics,” Leite said. 

“It is not acceptable that 100 years after the Spanish flu we saw so many countries react to COVID-19 the same way as they did 100 years before,” he continued. “We have an obligation to be better prepared to constrain any risk, to keep as many people as possible safe. This is a prerequisite for economic and social development.

“We need to keep peace and prosperity as our main goal,” Leite concluded. 

Image Credits: UNITE.