On her first visit back to Geneva since leaving her post as WHO Director-General in 2017, Dr Margaret Chan urged public health students to recognize “the power of collaboration” and to  “use their voice” to hold policymakers accountable for the changes that the promises that they make. 

“When I was in WHO, there were a lot of negotiations, a lot of resolutions.  But do you think countries kept their promises?” she asked. “We are waiting for the day when leaders of countries walk their talk. But you have a voice. Use your voice in a system that you know well, to advocate.” 

Chan, now Dean of the Vanke School of Public Health in China, was speaking at last week’s event “One Planet One Health”  co-sponsored by the University of Geneva and the Geneva Health Forum.  

The event brought together Chinese students from Vanke with counterparts from the University of Geneva’s Institute of Global Health – as part of an academic collaboration forged between the two institutions after Vanke opened its doors under Chan’s leadership in 2020.   

Geneva at the heart of ‘One Health’ efforts 

In a presentation preceding her panel discussion with three Geneva and China-based students, Chan declared that Geneva, home of the WHO, the World Meteorological Organization and countless other civil society and research institutions, needs to also be the heart of One Health efforts. 

Those efforts bring together action on climate change with action on new disease threats that are emerging at an evermore rapid pace, with changes in climate, deforestation and the loss of biodiversity, she said.  

“One cherished memory I have of my time in Geneva was the sight of my friends heading to ski,” she recalls, of her 15 years living in Switzerland, beginning with her first WHO appointment in 2003 as the director of the Department of Public Health and Environment.  

“Their faces were aglow with excitement as the world around them was painted in a pristine blanket of white. 

“Yet this year paints a different picture,” she said, referring to the weeks of rain that the city has seen this November. “The familiar white landscape … and the thrill of skiing is replaced by a visible absence of snow. 

“This … my friends, is climate change, reshaping the city and the world we all love. This is a reflection of a broader global shift -from the dwindling expenses of the Amazon rainforest and the melting Siberian permafrost to the receding snow cover of the Tibetan plateau and the vanishing ice sheets in West Antarctica. And these aren’t isolated incidents. They are interconnected sides of our earth’s transformation.

“As of 2023, we have surpassed nine out of the 14 tipping points of our earth’s system, changes that are irreversible and leading to abrupt shifts in our environment. 

“Climate change, as I have said many times, is a defining issue of the 21st century. Climate variables affect the air we all breathe, the water we drink, the food we eat and even where we are able to live.  Extreme weather events are becoming the norm and records are constantly being broken, she said ravages of the past summer in the northern hemisphere. 

“Beijing, the city I know better, suffered record-breaking heat waves. Then, Beijing again was inundated by the heaviest rainfall in 140 years. Another example. Hawaii. It is known for its beauty.  Now it is scarred by wildfires that ravaged Maui. Florida’s ocean temperature reaches a staggering 38 °C. And right here in Geneva, the World Meteorological Organization delivers sobering news of the hottest June ever recorded. 

“As UN Secretary-General Antonio Guterres commented, ‘The era of global warming has ended. The era of global boiling has arrived’.”

Nature never deceives us

“Grand challenges require grand actions,” Chan added. “In the historic 2015 Paris Agreement on climate change, countries made important commitments to cut greenhouse gas emissions and scale up adaptation, adaptation to climate change. 

“The Paris Agreement is not just a treaty for saving the planet from severe and irreversible damages. It is also a significant public health treaty with a huge potential to save lives worldwide,” added Chan, speaking just two weeks before the UN Climate Conference COP 28 in Dubai launches the third global “stocktake” of progress made, eight years on.  

And despite the critical importance of a more rapid fossil fuel phase-out, “the energy transition, switching from fossil fuels to renewable renewable energy are just a part of the solution,” Chan pointed out. 

Interconnected web

The other side of the climate coin is a ‘One Health’ approach recognizing that “humans along with the animals and plants around us, and the environment that nurtures us, are all part of a single interconnected web, Chan said. 

Even before arriving in Geneva, Chan had considerable experience with the threats that nature can unleash on human health.  As the Director of Public Health in Hong Kong, she had to meet the challenges there of the first H5N1 (Avian flu) outbreak in 1997, followed by the SARS outbreak in 2003.  

Arriving at WHO in 2003, she oversaw some of the agency’s early initiatives on climate, health and biodiversity as head of the Department of Public Health and Environment. Later, as Director-General, she was faced with the unprecedented challenge of the West African Ebola outbreak between 2014 and 2016, one of the most deadly seen on the continent in modern times. 

Recognizing the intricate relationship between animal-borne pathogens and human infections, she helped advance the early phases of the  “Tripartite” Collaboration on One Health involving  WHO, the Food and Agriculture Organization and the World Organization for Animal Health. 

“The majority of new pathogens are caused by diseases of animals that spread to humans, such as flu, rabies, SARS and COVID 19,” said Chan in her lecture. “This is especially an issue in the context of climate change.  Why?  Because climate change is a threat multiplier.  Existing threats can be spread to a new geographically area.  

“For instance, the emergence of Nipah virus and Hantavirus as human pathogens has been traced to extreme weather events that forced more animal hosts to leave their ecological niches and invade human settlements.

“In the past 30 years. of the new human pathogens identified, and an astonishing 75% can be traced back to animals,” she said.

“The message is loud and clear. We need to adopt the One Health approach recognizing and respecting a symbiotic relationship between humans, animals and our shared environment. 

“The one health approach is an integrated approach to tackle global health threats,” Chan declared. “Prevent, predict, and respond. It is high time we adopt a holistic perspective.”

Along with climate action and action to preserve the integrity of the natural world that is the fundamental basis for human life, equity is yet one more dimension to the One Health approach, said Chan. 

“We often delve into the deep interconnections between humans, animals and the ecosystem. Yet, at the core of this idea, lies another profound truth – the essence of not distinguishing one human from another,” she said. 

“Regardless of our diverse backgrounds, culture and beliefs, we are all Homo sapiens. It is high time we adopt a holistic perspective, looking at humanity as one cohesive unit right here in the heart of Geneva.

From dean to student  

In a subsequent panel discussion, Chan and three students from Tsinghua University exchanged views on how they, as young people, could act on the challenges in public health, their own professional path and facing their generation. 

Youjia Liu, a student at Tsinghua University, described her experience last summer carrying out public health research in the remote mountain villages of Cambodia, which sensitized her to the difficulties of people accessing regular health care at a time when there is also a lot of migration along the border and changing patterns of malaria.

“We always talk about this access to health care,” she said. “And it seems like something that only local governments can really work on. But what can we do? This is related to the topic, One Climate, One Health. People live in remote areas and are actually very vulnerable groups.”

“I don’t really have a good answer for you,” said Chan, noting that the lack of healthcare workers in ‘last mile’ regions of the world is a longstanding problem happening in many countries of the world. 

“But you mentioned the local government. These people need to speak out. And your duty is to teach them to speak up. Okay? Don’t take things for granted. And of course, that is easier said than done. This is the reality we live in. 

Citing the collaboration between the two universities as an example of cross-cultural collaborations, Chan urged students to “take the lead to address these global challenges.

“In English, Tsinghua’s University’s motto translates into ‘self discipline and social commitment’,” Chan stated. 

“Young people in universities are privileged, and it is their duty to confront these challenges. The path may be arduous, but with determination and unity, there is no summit we cannot reach. 

“I urge you, don’t give up hope.  Can you imagine? I was Director-General in the era of the MDGs [Millennium Development Goals] remember? The world is a better world now compared to the time when we were dealing with MDGs. So continue to make the effort. Don’t give up.”