The recent epidemic of mpox —known as monkeypox— contains the essential elements of the great infectious crises of our time: victims concentrated in the lower-income strata and countries; response resources —vaccines, treatments and diagnostics— in the hands of a handful of rich or emerging regions; and a terrifying inability of the international community to put the latter at the service of the former. When the cases officially reported since the beginning of the year They are approaching already at 20,000 and deaths since 2022 – mostly girls and boys – exceed 1,400, the mpox crisis suggests a monumental déjà vu.
Five years after the first news about the pandemic that will mark our generation, its fundamental lessons remain to be learned. As one journalist explained, recent analysis According to a study published by ISGlobal, a set of demographic, climatic, economic and sociocultural variables have raised the risk of a new global infectious crisis to an unprecedented level. No less than 60% of the emerging diseases reported since 1940 have a zoonotic origin and are likely to evolve in a similar way to SARS-CoV2. This escalation of risk, however, has not been met with an equivalent adaptation of our preparedness and response capabilities. Not even after 29 million dead and an unprecedented financial catastrophe.
Few issues better illustrate this failure than the so-called Pandemic Agreement. Three years of talks and seemingly unstoppable international pressure have so far resulted in a rhetorical, non-binding text that is fatally burdened by the interests of the pharmaceutical industry. The decision to extend negotiations for another year offers the possibility of reversing this mess, but no one seriously thinks that will happen. In the absence of binding multilateral response mechanisms, we are dependent on the holy will of each of the actors.
Spain has taken a commendable step forward with the donation of 20% of its vaccine stock: 100,000 vials, equivalent to 500,000 doses
And this crisis is no exception. The declaration of mpox as international health emergency has been accompanied by the traditional rosary of requests for financial and material resources, with the priority objective of preventing new infections through the immunization of the populations at greatest risk. In this process, Spain has given a meritorious step forward with the donation of 20% of its stock: 100,000 vials, equivalent to 500,000 doses. A similar response by the rest of the OECD countries would be an effective shock measure against the expansion of mpox. At least, for now. In the medium and long term, experts insist on the transfer of technology and production capacity in the affected regions, which would allow prices and response times to be reduced.
The good news is that this decision by the Spanish State is not an isolated event. Since the beginning of the pandemic, our authorities have displayed a refreshing commitment in the field of global health. Led by the good work of the Ministries of Foreign Affairs and Health, Spain has been able to provide a distinctive value, beyond the financial one. Because the contributions – modest, but growing – to international initiatives such as Covax, GAVI, the Global Fund or the Pandemic Fund itself have been accompanied by the construction of a political framework that supports this participation and links it with national experience and capabilities.
Spain knows, for example, that investment in solid primary and preventive health systems is an essential part of a good pandemic preparedness and response model. The defence of this priority has not only been made evident in global forums such as that of the World Health Organization (WHO), but also in decentralised technical assistance programmes. like the one who developed the Basque Government in Peru during the pandemic.
This commitment constitutes an indisputable asset for our soft power, at a time when the priorities of the great powers are elsewhere.
Spain has the opportunity to become in this legislature Spain is one of the world leaders in health. To do this, it can take advantage of several fronts that are now open and that must be closed. The first of these is the so-called Global Health Strategy. This is a political document that must establish the thematic priorities, the tools and the roadmap for Spain in this field. Other countries – such as Germany and Franceas well as its own European Commission— have carried out similar exercises, which reflect the political relevance of global health in the wake of the pandemic. The Spanish strategy should have been published some time ago and its absence weakens our country’s position in some important discussions — such as the one regarding the future of global health architecture — so it is desirable that it be completed as soon as possible.
The second is the implementation of the State Agency for Public HealthThis institutional tool has been conceived with the purpose of preventing and addressing health risks and guaranteeing effective and equitable responses to health crises. That is why it is urgent that it be rescued from the limbo of the Health Commission of Congress, where it has been dormant for six months. The five priority areas of the new agency are focused in particular on the national territory, but it is easy to understand that they will also support Spain’s participation in international debates. One only needs to imagine the role of coordination and action that a resource of this type could have played during the mpox alarms, avian flu or the pandemic itself.
Thirdly, the Government is working on the upcoming approval of a royal decree which develops the State Plan for Preparation and Response to Threats to Public Health. This legal text not only defines the mechanisms for coordination and action in the event of a threat, or the capacities for preparation and response to risks, but also establishes protocols for the detection and evaluation of these risks and the possible declaration of an emergency. Once again, a resource as relevant as it is urgent.
Add to these processes Spain’s renewed commitment to the Vaccine Alliance, GAVI (the promise of a 25% increase with regard to the 2021-2025 contributions), the leading role in the debates on the European position in this area or the more than possible incorporation from the Minister of Health to the Executive Board of the WHO. Designed or not, this accumulation of political, financial and institutional initiatives could place Spain among the most active and proactive countries in the debate on global health. It is the responsibility of the entire country, which forces the Government to listen to and incorporate the opposition and the autonomous communities. But it constitutes an indisputable asset for our soft power, at a time when the priorities of the great powers are elsewhere. Precisely because there is a shortage of nations that propose a strengthening of multilateral avenues and the sustainable development agenda, Spain’s role is more important than ever.
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