World health, solidarity and multilateral diplomacy under serious test

The context

In the midst of the most horrendous global health crisis to confront the entire human family in recent decades, the World Health Organizations (WHO) and the United Nations (UN) are under an unprecedented political attack from many directions. Why such attacks , when there is a consensus that international organizations cannot be better than the countries composing them?

Indeed, the novel coronavirus (officially named COVID-19) is now an obvious global danger, and there are strong reasons to ask to what extent the world community of nations is prepared to successfully cope with this pandemic.In a memorable sentence , Henry Kissinger summarized the situation as follows :"The reality is the world will never be the same after the coronavirus".

However, the question is not a new one , as 193 UN Member States attempted several times to answer it in advance .On 11 December 2019 in a comprehensive resolution (11 pages,41 operative paragraphs) adopted by consensus and circulated worldwide on 28 January 2020 under the title Global health and foreign policy: an inclusive approach to strengthening health systems offered persuasive warnings and recommendations which deserved universal attention.

That resolution was prepared, negotiated and promoted with the active

participation of the WHO (194 members) and is a positive result of the efforts of multilateral diplomacy practiced under the auspices of the UN system, WHO being a specialized agency in this global family.

Today ,as estimated, at the highest political level , the world faces its gravest test since the founding of the UN in 1945.

At present, when mass-media inform us every day about the dangerous proliferation of COVID-19 on all continents, it is unexplainable and inexcusable to keep that document/resolution only in the files of persons directly involved in the negotiations, consultations, drafting and adoption process of the above-mentioned diplomatic instrument .

The efficient implementation of this resolution must be on the priority list of all competent factors at the local , national, regional and planetary levels. The resolution specifically warns that many of the underlying determinants of health and risk factors of communicable diseases are associated with social, economic, environmental and behavioural conditions.

The coronavirus demonstrates in a persuasive manner the topicality of the strong reminder of the resolution under consideration about the real need for health systems to be strong, resilient, functional, well- governed, responsive, accountable, integrated, community-based, people-centred and capable of quality service delivery, supported by a competent health workforce, adequate health infrastructure, enabling legislative and regulatory frameworks, as well as sufficient and sustainable funding.

The ordinary readers of the resolution might be tempted to think that its recommendations belong to the area of wishful thinking. They would be right in their pessimism , if this resolution is not put into effect by the decision-making bodies at the national level. The UN General Assembly acknowledged that, owing to antimicrobial resistance, many achievements of the twentieth century are being gravely challenged, in particular, the reduction in illness and death from infectious diseases.

Hoping that an anti- COVID-19 vaccine will be soon available, it is vital to fully implement the UN recommendation according to which all states and relevant organizations are expected to reinforce immunization and vaccination as one of the most important ways to reduce the number of deaths caused by preventable diseases and also to reinforce in their societies the safety and efficacy of vaccines, aiming at eliminating vaccine preventable diseases. All states should strengthen public health surveillance and data systems, improve routine immunization and vaccination capacities, including by providing evidence-based information on countering vaccine hesitancy, and expand vaccine coverage to prevent outbreaks, as well as the spread and re-emergence of communicable and non-communicable diseases, including for vaccine-preventable diseases already eliminated.

Under the current emergencies provoked by COVID-19, special attention should be paid to the recommendation that states should enhance cooperation at the national, regional and global levels to address antimicrobial resistance, using an integrated and systems-based one-health approach, including through health system strengthening, capacity-building, including for research and regulatory capacity, and technical support and ensure equitable access to affordable, safe, effective and quality existing and new antimicrobial medicines, vaccines and diagnostics, as well as effective stewardship, as antimicrobial resistance poses a challenge to achieving universal health coverage.

A promise

It should be reminded that in a lucid assessment of the situation, the WHO came to the conclusion that it is still possible to interrupt coronavirus spread, provided that countries put in place strong measures to detect disease early, isolate and treat cases, trace contacts, and promote social distancing measures commensurate with the risk.

At the same time, the WHO formulated an imperative prerequisite for the success of robust collective efforts. Yes, the global community should continue to demonstrate solidarity and cooperation, in supporting each other on the identification of the source of this new virus, its full potential for human-to-human transmission, preparedness for potential importation of cases, and research for developing necessary treatment.

It is not the purpose of these pages to present in detail all the relevant provisions of the resolutionGlobal health and foreign policy: an inclusive approach to strengthening health systems which must be on the mandatory reading list of all decision -makers in nearly 200 states and territories.

But it is also appropriate to remind that as early as on 19 February 2000 the United Nations Conference on Trade and Development (UNCTAD) adopted by consensus a document entitled Bangkok Declaration: Global Dialogue and Dynamic Engagement which containsrelevant provisions fully applicable during coronavirus times.

According to this Declaration "Solidarity and a strong sense of moral responsibility must be the guiding light of national and international policy. They are not only ethical imperatives, but also prerequisites for a prosperous, peaceful and secure world based on true partnership".

In the light of this requirement, in 2020 multilateral diplomacy must be aware that more inclusive, transparent and participatory institutional arrangements are necessary to fight COVID-19 at the global level.

What is really urgent is to put into practice the recommendations contained in the recent report of the UN Secretary -General Antonio Guterres, - a document insufficiently publicized by mass-media,- entitled Shared responsibility and global solidarity in response to the impacts of COVID-19.In the final part of this report, the UN Secretary -General stated :"What the world needs now is solidarity. With solidarity we can defeat the virus and build a better world."The same idea was strongly reiterated before the UN Security Council on April 9, in an informal meeting. Antonio Guterres re-emphasised the idea that to prevail against COVID-19, we will need to work together. That means heightened solidarity. At the end of this meeting, the Security Council issued a statement expressing support for the Secretary-General's efforts concerning the potential impact of the pandemic to conflict-affected countries, and the need for unity and solidarity with all those affected.

From this new perspective, it appears that multilateral diplomacy in international organisations can be successful if and when it is animated by global solidarity.

In the Extraordinary G20 Leaders' Summit Statement on COVID-19 it is clearly reaffirmed that "Global action, solidarity and international cooperation are more than ever necessary to address this pandemic". Why ? G20 answered : "The unprecedented COVID-19 pandemic is a powerful reminder of our interconnectedness and vulnerabilities. The virus respects no borders".

Diplomacy is obliged to work under these stressful conditions.For doing that, it has to be fully involved in catalysing changes at the deepest level of beliefs, assumptions, and values, as well as behaviours of nations.

The COVID-19 has already illustrated the fact that even a single dramatic/tragic event could easily change the face of life on this planet as we know it. Diplomats have to be prepared to move in several directions at once, both responding to whatever opportunities present themselves for positive and effective work for global health, and also by being pro-active in turning existing challenges into real opportunities.

A perspective

What multilateral diplomacy practiced under the auspices of the UN and WTO can offer is to give people a perspective of what is possible, help them do what they can do to fight an invisible enemy , to do it faster and better and consolidate their capacity to use appropriate tools and skills. In short, multilateral diplomacy should be able to motivate, catalyze, inspire, instruct, facilitate, encourage, support, assist and demonstrate.

In this regard, a persuasive test on solidarity as practiced through the instrumentality of multilateral diplomacy will be visible in September this year, when the most significant world organization will start the 75^th session of the UN General Assembly during which 193 Member States will consider a report prepared by the UN Secretary-General, in close collaboration with the Director General of the WHO, in which they have to address, inter alia, the challenges and opportunities of inclusive approaches to strengthening health systems in the context of universal health coverage.

This report and its consideration cannot be any more a routine exercise. "Business as usual" approach while discussing global health issues must be past history. Multilateral diplomacy must find specific answers to the fundamental question about how to identify ways and means to give tangibility to the ideal of global solidarity in a world characterized by unprecedented vulnerabilities, perplexities and discontinuities. Bilateral diplomacy is already deeply affected ( many embassies are closed to the public), while multilateral diplomacy is under terrible stress, functioning on line, with all imaginable and non-imaginable difficulties.

This will be a formidable test in the diplomatic process which may succeed if , at last, the world community of nations demonstrates its political capacity to overcome temporary disagreements and contradictions and work together in harmony for the benefit of humanity. This success is essential for future general trust , as , to quote again Henry Kissinger, "Sustaining the public trust is crucial to social solidarity, to the relation of societies with each other, and to international peace and stability".

Trust is not a spontaneous phenomenon, and an imperative prerequisite for its authentic birth is a genuine good faith understanding between the five permanent members of the UN Security Council to fight together, in a spirit of solidarity, the COVID-19, as a common enemy threatening human life at the planetary level.

A moderate optimism can be expressed on this promising ideal.