In August 2022 Dr Hans Henri P Kluge, WHO Regional Director for Europe, outlined three actions on three public health emergencies. Addressing the public on the topics of Covid-19, monkeypox, and polio, he expressed the importance of applying a “distinct response strategy and aims” to each.
In the apparent “post-pandemic” era in which the general instruction seems to be “learn to live with it”, many health leaders are concerned about cases and complacency. For Dr Kluge, this is a serious matter. The European Region, he stated, is “projected to reach 250 million confirmed cases” since the start of the pandemic. He acknowledges that “great strides” have been made. However, his fears about the virus’ continued circulation are evident when we consider that people are still being put into hospital and dying. He refers to 3000 “preventable deaths” in the week preceding his statement, but also considers with apprehension the colder European seasons. He anticipates a “surge in cases – with or without a resurgence of seasonal influenza”.
How, therefore, can we prepare for this darkly disease-ridden future? For Dr Kluge, a Covid-19 autumn into winter strategy is essential. For him, this strategy outlines “what we know works” with “new tools and tactics”. Surely a winning combination, yet this is easier said than executed. Dr Kluge emphasises the importance of “community-level surveillance, case detection, and care”. He also identifies the importance of issues like “mental health and burnout” among health providers. On an individual level, masking and ventilating, as well as thorough hygiene practices, are recommended.
“These are not new messages but remain critical to personal safety. As requirements have been lifted, the choice to use these simple but effective measures is with each of us.”
Vaccination will be a central tenet of this strategy. Although roll-out is continuing, “millions remain unvaccinated” in the European region alone. We must, he demands, find “better ways to reach them”. In doing so he also calls for the prioritisation of vulnerable groups. Alongside this continued vaccination campaign, he hopes to see the administration of the influenza vaccine “whenever feasible”.
Dr Kluge’s second action is “elimination – in the context of monkeypox”. The European Region represents more than a third of the global total of cases with over 22,000 confirmed across 43 areas. As well as acknowledging the significance of this outbreak, Dr Kluge recognised the “agonising pain it can cause”.
“The anguish experienced by many patients cannot be underestimated – it can be a truly horrible time.”
Despite “encouraging early signs” that the “outbreak may be slowing” he wants to push for an increased effort in the region. To this end, he announced 2 “comprehensive policy briefs”. The first identifies “the policy objectives and steps needed for the control and eventual elimination of monkeypox”. The second focuses on the use of monkeypox vaccines. Dr Kluge suggests that these briefs offer a “clear roadmap” for leaders to “mount an effective outbreak response”.
“All countries – whether they currently have cases or not – need to implement a set of combined interventions towards this end.”
For Dr Kluge it is imperative to “target our response”. This is a sensitive issue, as stigma and discrimination infiltrate productive public health discussions, yet he emphasises that the outbreak remains “centred” among “men who have sex with men, often through sex with anonymous or multiple partners”. In order to meet the challenges faced by this “long-marginalised population” he has “actively engaged” with activists and organisations to provide information and advice.
Dr Kluge’s third and final action (for now, at least) is eradication of polio. He recalls the sobering past prevalence of polio.
“As we look forward to celebrating the 20th year of polio-free status in the European Region we are reminded that the momentous progress made towards global eradication is very fragile.”
He stated that vaccine-derived polioviruses have been detected across the world. His reflection was that the “interconnected world” enables genetic links between viruses detected in different locations. The virus, he warns, has “found its way to susceptible individuals in under-vaccinated communities”.
“This is a wake-up call for us all. It is our shared responsibility to eradicate polio”.
He reminds us that the vaccines are “proven to be very effective and very safe”. Dr Kluge’s conclusion is that it would be “foolish” to ignore the escalation from localised disease threat to globalised disease threat.
To hear from Dr Kluge’s WHO colleagues on current health threats at the World Vaccine Congress in Europe get your tickets at this link.