A reaction on Martin Paul’s blog from the UM Global Health Team at Health Ethics and Society
Being right in the middle of the COVID-19 storm, everyone is hoping for a quick fix such as a vaccine. In his blog Martin Paul suggests that finding a magic bullet has the highest priority. We, the Global Health Team at Health Ethics and Society of Maastricht University, don’t want to question the priority of working on acute and effective medical solutions in itself, however, with regards to framing the crisis, some more nuances can be made. Do we really just have to sit and wait, complying to some frustrating public health measures, for the new Nobel Prize candidate, like Paul Ehrlich, or for any outbreak-movie-like-action-hero to valiantly save us from the invisible threat?
We all wish that they would exist, these magic bullets (simple solutions with extreme effectiveness). However, just as Bill Gates already abandoned this idea, we teach our Global Health students that they do not. Sadly, none of the solutions to health problems are in and of themselves magic or heroic. All medical interventions and technologies, whether drugs, vaccines, ventilators or diagnostics need daily human handwork (engaging relationships between healthcare workers, decision makers and patients) to function at all. If there is any magic at play, it is created through this human work and collaboration. This work shapes how these solutions are put to use and how effective they are in the end. Yet, this work is not prioritized or talked about when we search for magic bullets. Instead, the belief in magic bullets and their heroes leads to a single focus on targeted and vertical solutions to global health issues. Such vertical solutions are limited in scope and distributed unequally over populations defined by fuzzy and messy lines of affluence and access.
Importantly, the belief in magic bullets and its effect on innovation processes is directing funding and attention away from other things that highly matter, such as focusing on the structural and causal issues that helped the virus spillover and spread into the human population at the first place. We have been warned long in advance by epidemiologists and environmentalists that - due to our high global connectivity and the ways in which we are disrupting ecosystems and exploiting wildlife and other animals - it was not a question if a pandemic would strike, but when it would strike. This also means that one imagined magic bullet against COVID-19 will not prevent the next zoonotic virus to spill over into the human world.
We should address this crisis with urgent and immediate measures, yes. However, we should also emphasize the importance of not losing sight of addressing the more structural and systemic questions and issues that emerge if we look at the larger picture of this disease. Think for example of the need for the strengthening of health systems, of reducing inequalities that possibly exacerbate the effects of the virus in ways we do not yet understand, and of thoroughly questioning the way we are currently meddling recklessly with our planetary ecological health support system.
We should not just mention prevention and public health measures as if they were just a temporarily and frustrating sidekick of the hero with its bullet-gun. This would be following and promoting the strategy that averts attention from one of the most crucial questions raised by our present situation: what should we do to create a global society that will be less vulnerable for future pandemics to occur?
We need concerted efforts and interdisciplinary approaches, including the social sciences, to understand our current situation and to prepare ourselves for the future.
Carijn Beumer, Nora Engel, Alana Helberg-Proctor, Iris Fraikin, Ricky Janssen, Gonnie Klabbers, Anja Krumeich, Agnes Meershoek, Remco van de Pas, Avanti Wadugodapitiya: The Global Health Team at Health Ethics and Society