Global health is more than emergency defence and quarantine


Foto: Levi Kollwitz

Responsible safety policy for the global public’s health must act outside the box and address upstream determinants of health

Once again, the current, rapid spread of the coronavirus impressively raises awareness of the global dimension of health. The virus, which, according to current knowledge, first appeared at a meat market in the Chinese city of Wuhan, has used the established channels of the globalised economy to spread across almost the entire globe in no time at all. Initially, it followed the tracks of the global production of goods, which transnational companies relocate to the cheapest locations according to exclusively microeconomic criteria, and the biggest dregs of mass tourism, the modern crusaders. The extensive transport of goods, services and merchandise across the globe opened all doors and gates for the new virus variant to spread rapidly.

After many states had criticized the Chinese government's consistent crackdown in the outbreak region, almost all countries are now following suit, closing their borders and intervening massively in social life and civil liberties. The statement that there is a risk of infection even before the outbreak of the symptoms, which is true for many infections, and the overflowing statistics of corona victims fuel the increasing panic, without anyone being able to explain why anyone dies from infection with the virus. And no one is asking whether people actually die from the virus or with it, because no one is testing anything other than COVID-19. The prevailing debate about the corona pandemic is exclusively determined by the biomedical perspective.

From a health science perspective, however, this is far too limited. Much more worrying than the current outbreak is the continuing refusal of political decision-makers to take action between epi- or pandemics with the same consistency with which they restrict people's social life in the event of a crisis. The Ebola outbreaks were already a direct consequence of the exploitation of natural resources: the intensive fishing of the oceans drives the coastal population in western Africa deeper and deeper into Ebola-affected rainforests to secure their protein supply. At the same time, the huge palm oil plantations provide ideal living conditions for the flying foxes that transmit Ebola. The current coronavirus epidemic is also a consequence of the globalised food industry, which is exclusively geared towards profit maximisation and which is eliminating natural ecology with monocultures optimised for business management. The efforts of the expanding agribusiness of the rich countries of the world to dominate the global food market are leading to land theft and increasing displacement pressure in the global south. People have to move deeper and deeper into inaccessible primeval forests in order to survive. In doing so, they destroy the functional complexity of untouched areas and release previously isolated pathogens that can then spread to animals and humans.

Responsible health and safety policy should not be limited to quarantine and emergency measures, but must take these interrelationships into account. However, it is obviously easier to restrict people's freedom of movement than to put a stop to capital-oriented agriculture, whose profit motives promote the development of particularly virulent and infectious pathogens - all the more so because it also causes considerable environmental pollution through livestock farming and transport and directly damages human health through its often harmful products.

A commentary by Professor Holst published in German in the FRANKFURTER RUNDSCHAU of 17 March 2020 refers to these questions and stresses the outstanding importance of social, political and economic influences on people's health. In addition, Professor Holst repeatedly expressed his views in the Spanish programme of Deutsche Welle (DW TV), for example on 6 March in the news programme DW NOTICIAS ¿Está justificada la alarma mundial por el coronavirus? and the talk show A Fondo on the topic of ¿Cómo prevenir el pánico? on 11 March this year.

The International Health Sciences course at the Department of Nursing and Health Sciences at Fulda University of Applied Sciences prepares students for this and other complex relationships of Global Health.