"Russia has demonstrated the solidarity that the world lacked"

The main principle of WHO is "health for all," so the organization continues to work with Russia, supply medicines and open collaborating centers, Hans Henri P. Kluge, Director of the WHO Regional Office for Europe, told Izvestia on the sidelines of the SPIEF. The organization considers Russia to be a model of justice: during the years of COVID-19, the country showed solidarity and helped many states. About the role of Russia in solving the problems of pandemics, about what the country gives to WHO and WHO to Russia, and about the impact of social networks on health — in the Izvestia article.

"Russia's support is needed when discussing WHO's European policy"

— What is the main purpose of your visit to Russia and what topics are on the agenda?

— First of all, I would like to discuss public health issues with representatives of the Ministry of Health of the Russian Federation, to talk about changes in this area, about cooperation between WHO and the Russian Ministry, in particular on solving problems related to tuberculosis, HIV and AIDS. And we are already working in these areas. Yesterday in Moscow, we discussed the treatment of HIV infection with government officials. This afternoon, I will visit a private clinic specializing specifically in the fight against HIV.

Photo: IZVESTIA/Sergey Lantyukhov

In addition, I consider it important to be prepared for threats, such as epidemics. Therefore, another topic for dialogue with Russian representatives is the discussion of an international agreement on actions in cases of pandemics (Russia did not support the adoption of the document — Ed.). The support of the Russian Federation is also needed in the discussion of the new five-year WHO European health policy.

"Our principle is 'health for all'"

— Currently, the political situation in the world is complicated. Thousands of sanctions and other restrictions have been imposed on Russia. Do they prevent WHO from working with our country?

— WHO is neutral. Our principle of "health for all" or "health for everyone" is based on impartiality and humanity. Therefore, we continue to work with Russia, a country that has a shortage of medicines due to the restrictions imposed. To mitigate the effects of sanctions, we regularly supply Russians with medicines. Patients should not suffer. Another obstacle is attacks on healthcare facilities, and the number of such cases is growing. However, this applies not only to the Russian-Ukrainian conflict. There is a problem wherever international humanitarian law is violated.

— How does the World Health Organization cooperate with the Russian authorities in order to integrate healthcare solutions?

— This is not the classic WHO assistance provided to the Russian Federation. I call it a partnership. Russia is a very developed country. We are adopting some Russian innovations, for example, digital healthcare, and in return we are giving away other know-how, in particular, we are opening WHO cooperation centers. There are 22 of them in Russia today. There is, for example, a center for the development of geriatrics and care for the elderly, and a center for palliative care.

"The key lesson of COVID-19 is to be fair"

— You said that one of the main topics on the agenda is a possible future pandemic. In May of this year, WHO member countries adopted a historic pandemic agreement. Someone described it as a document that includes all the lessons of COVID-19. What are these lessons, in your opinion?

— When a virus of unknown origin appeared, many countries defended only themselves. Russia has helped others: it has provided vaccines, gloves, and medical equipment to more than 50 countries. Russia has demonstrated the solidarity that the world lacked. In 2020, we created the Commission on Health and Sustainable development, among other things, to learn from the experience of the Russian Federation. And the key lesson from COVID-19 is to be fair. Today, we still have to finalize the WHO agreement on combating pandemics, and Russia, in particular, is working constructively on it.

"What the next pandemic will be is unknown, but there will be a new pandemic."

— What will be the next pandemic?

— It is unknown, but we know for sure that there will be a new pandemic. 75% of the pathogens that can cause it come from animals. Therefore, the concept of "unified health" is important, which includes healthcare, animal husbandry and environmental protection. Besides, until everyone is safe, no one will be safe, because the world is becoming one village. Therefore, the key aspect is preparation. And there are three main points here. The first is global surveillance. If there are unusual outbreaks of diseases, then we must act very quickly. Therefore, the exchange of knowledge and data is very important. The second point is research. We need to create a common prototype vaccine for a family of viruses that can cause a pandemic. This way we can quickly adapt to it. A global network of clinical trials is needed. Third, we need to strengthen people's health and the healthcare system. This can be done with the help of strong primary healthcare. We must fight against disinformation.

"Obesity is a 'silent' pandemic"

— What diseases are currently most threatening Europe and the whole world?

— We must not forget about infectious diseases, for example, the incidence of tuberculosis is growing again. Among infectious diseases, it causes the majority of deaths. Measles is also spreading. Last year, 123 thousand people died from measles in the European region due to the growing movement against vaccination. But most people die due to chronic non-communicable diseases: cancer, diabetes, diseases of the cardiovascular and respiratory systems. Every fourth child in elementary school is already overweight or obese. I consider obesity to be a "silent" pandemic. Interestingly, this problem is more common in Southern Europe, Greece, Cyprus, Portugal, and less so, for example, in Tajikistan and Kyrgyzstan. But it's coming. The third issue that worries me as a father of two daughters is the mental health of young people: 28% of girls aged 15 say they always feel lonely. In addition, the world's population is aging and every fourth elderly person lives alone. And loneliness is a killer.

"Incredible positive dynamics"

— What is the situation with tuberculosis in Russia?

— Yesterday I talked with the chief phthisiatrician of Russia Irina Vasilyeva. There is an incredible positive trend. Between 2015 and 2023, tuberculosis-related deaths decreased by 60%. Russia has a lot of experience, but there are also difficulties. For example, resistant tuberculosis. That's why yesterday I discussed with experts the possibility of shorter treatment regimens. When I worked in Kemerovo, I had to treat people with painful injections for two years. Now the treatment can be carried out completely orally (by injecting drugs into the mouth — Ed.) and at home for six months. Efforts should be made not only to treat tuberculosis, but also to prevent it, especially in high-risk groups. These are prisoners, migrants. No one should be stigmatized. Everyone has the right to health care. Healthcare for everyone.

"We need to empower those who inspire trust"

— You have already touched upon the topic of the anti-vaccination community. What will WHO do about this threat?

— This is a big threat, so we need to deal with it. It is important to build people's trust in vaccination, to be honest, to say what we know and what we don't. During covid, people didn't trust government agencies, but they trusted doctors and nurses because these doctors were the closest to them. Therefore, it is necessary to empower those who inspire people's trust. For example, my daughters have sports idols. When they saw that the idol was wearing a mask or getting vaccinated, the girls wanted to wear masks and get vaccinated too. And in some countries, the archbishops have high authority. Therefore, it is necessary to find out in which communities and who is trusted and to give these people special powers.

"Social media can have a positive impact, we need a balanced approach"

— Last year, WHO warned that social media is harmful to the health of adolescents. How to solve this problem? Will a total ban on social media for children help?

— We recently conducted a survey in Europe. One in ten teenagers says they have problems because of social media. These are sleep disorders, cyberbullying, and depression. But we can't point to just one social group. This applies to the whole society. Digital literacy programs should be introduced in schools. We need to support parents, not blame them, train healthcare workers, work with young people, as well as with digital giants.

Governments must hold these companies accountable. Sweden and the Netherlands, for example, are considering banning phones in schools or limiting the age of Internet access. Each country decides in its own way, but the approach must be comprehensive. As an optimist, I want to say that social media can also have a positive effect, for example, on children who are isolated and discriminated against. Imagine what would have happened if we hadn't had the Internet during the pandemic and lockdown! After all, doctors conducted a lot of online consultations. So we need a balanced approach.