The “Spanish Cooperation’s Joint Response Strategy to the COVID-19 Crisis. Tackling the crisis to ensure a transformative recovery”, approved by Spain’s Council of Ministers in July 2020, stems from an initiative that grants all actors the opportunity to contribute to threading together a comprehensive and impactful report in the medium and long term. Its first success was to consider a dialogue-based response and broad participation from all actors.
The second positive action was to consider, through global diagnostics, the existence of a more uncertain world, in which the health and socio-economic crisis brought about by the COVID-19 pandemic deepens the problems already pinpointed, for instance inequality, environmental degradation, conflicts and humanitarian crises, or processes of democratic backsliding. This correct diagnostic affords clarity in the need to balance medium- and long-term work set out by the aforementioned Strategy and gives meaning to the priorities put forward: saving lives and strengthening public health systems; protecting and recovering rights and capacities; preserving and transforming socio-economic systems; recovering the system of production; and reinforcing democratic governance.
The consideration of work on the consequences of the pandemic and on the profound causes of major, interlinked problems that go beyond COVID is a praiseworthy ambition which entails complex challenges that also extend beyond possibilities which, at the current time, demonstrate clearly limited economic resources and come second to those required to make the Strategy goals more effective. Moreover, required instruments available to develop multi-actor actions are limited and should facilitate a connection between science, research and health, as much in cooperation as humanitarian action.
If we focus on health aspects in the Strategy, as part of the organisations drafting this report, we applaud the fact that health is considered a universal right which must also be provided under equal conditions, in addition to considering future COVID-19 vaccines and treatments a global public asset. Consequently, as we have reiterated on numerous occasions, health action should be centred on backing stronger public health systems, as a guarantee of universal coverage and access, and on considering primary health care as a cornerstone of these systems given that it constitutes a more accessible level of care for people in the most vulnerable circumstances. We also feel it is important for the Strategy to acknowledge and seek to remedy, as we previously highlighted in the campaign on human resources in health, the alarming shortage of male and female health workers in the developing world — 18 million from this point to 2030 — and to look into enhancing their training and recruitment to guarantee continual care services to deal with the pandemic and other health emergencies.
Beyond the pandemic, there are other diseases in the world that kill millions of people each year: in 2019, 690,000 people died from HIV/AIDS; 405,000 from malaria; 1.4 million from tuberculosis; and 1.4 million from hepatitis, to name a few examples. The advance of the pandemic has given rise to the need for specific commitments to ensure the fight against these and other diseases are upheld and to address a twofold difficulty in the future in relation to care: deadly synergies through the effects of the pandemic and diminishing resources. Spain allocates around 3% to health-related Official Development Assistance (ODA) when the Development Assistance Committee (DAC) average is 13%.
In terms of the humanitarian approach, we feel it is particularly relevant that the main goal is to “save lives” and considers the benefits of undertaking multi-sectoral actions for emergency relief to confront the expansion of the pandemic and its effects. Reference must also be made to the tracking and tracing commitment in line with the “Grand Bargain” and the pandemic response carried out using the humanitarian nexus and inside the framework of Spanish Cooperation’s Humanitarian Action Strategy 2019–2026, which would, in addition to health, allow essential issues to be addressed, including nutrition, food security, access to safe drinking water, sanitation and hygiene, livelihoods, etc.
Another area the Strategy has got right is its commitment to multilateralism at a time in which there is a need to strengthen the multilateral system, calling for greater presence of Spanish Cooperation in international organisations and forums. A further positive is the backing of global governance, as demonstrated decisively in the support of the World Health Organisation (WHO) to lead the world’s public health response against the pandemic, and with it still entailing the advocacy of an urgent reform of the institution to fulfil its mission to promote “health for all” from a rights-based approach.
Moving deeper into this multilateral perspective, we embrace Spain being an active part of mechanisms and alliances that add dynamism to and coordinate international efforts to guarantee and facilitate access to diagnoses, treatments and vaccines, for instance with its presence in Gavi (the Global Alliance for Vaccines and Immunisation) and CEPI (the Coalition for Epidemic Preparedness Innovations). Some of the concerns include guaranteeing universal and equitable access to future vaccines, as well as the tepid approach to transferring knowledge — beyond prevention stages — and the absence of references to promote intellectual property policies, which support open, shared and non-exclusive licences, especially that which concerns results stemming from public money.
Finally, we wish to emphasise the correct decision to include citizens, granting them an active role, calling for their mobilisation based on responsibility and solidarity in the face of shared problems. There must be ongoing activities from everyone involved to raise awareness and educate, for this is the only way in which people with decision-making capacities will commit to the objectives put forward by the Strategy.