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Search for honest appraisal with trust

Publication date: 28.07.2021
Author: Jeffrey Levett

Jeffrey Levett, International Gusi Peace Prize Laureate

I have seen flowers come in stony places, And kind things done by men with ugly faces, And the gold cup won by the worst horse at the races, So I trust too.

I can calculate the motion of heavenly bodies, but not the madness of people said by Newton.

Let me kick off with a suggestion to travellers: look at where you want to go, check out how many cases of COVID are being currently registered and what variants are on the rampage as well as what is the vaccination rate at your destination. Make sure first that you are vaccinated and keep all necessary documentation handy. If youngsters are going with you run it by your pediatrician before setting out. We are not yet out of the Woods of COVID. There are still unknowns and no place is herd immune. I would also make sure to have the most extensive weather forecast for the region to be visited. 

While working with what we have in information and knowledge or with the best of and most up-to-date evidence available, we need to know the origin of the coronavirus and society needs to come to terms with the multiple aspects of the pandemic’s passing. In its still reverberating aftermath ASPHER has a crucial role to play. There are three theories for COVID’s birth: natural transmission from animals to humans, entirely laboratory produced and somehow released or thirdly, naturally occurring but genetically modified by accident or design. While viruses have been shown to jump from animals to humans this pathway has not beyond a shadow of doubt been demonstrated for SARS-CoV-2 and viruses are being experimented on within the laboratory and all around the world. To cover both ends of the problem needs spectrum, we need to design two strategies, one to examine nature’s pathways that potentially lead to  pandemics (preventive public health), the other to better regulate and shield genetic manipulating laboratories, today. A killer, who escaped from what was once known as an asylum, creates a dangerous local situation. The only thing I’m willing to accept is that COVID is not a result of carnal sin. My fail-safe cards are that man throughout his sojourn on earth, seems overall to have had an uneasy but viable truce with microbes, bacteria and viruses and has developed a binary system of immunity but while domesticating animals he can transport them by travel with disease spreading faster with increased contact and congestion as with urbanization and now with large scale events. We should also acknowledge that the tragedy of the pandemic has already shed light on how to prevent future outbreaks and pandemics. A crisis in public health can have its vulnerability increased by authoritarian figures who belittle threats, reject scientific data and support improvised solutions or charlatan prescriptions. Unfortunately, experts whose thinking or findings differ from officialdom can be censored.

The pandemic is real but there is little consensus as to what actions ought to be taken while frustration grows with what seems inaction. Autocrats erode good governance and public well-being and expertise is ignored. At the same time lawyers and physicians in Germany have initiated legal proceedings against the CDC, WHO & the Davos Group for crimes against humanity. They argue that vaccination for COVID among other things, fails to provide immunity to the virus or  protect its recipients from getting sick. The alleged illegal action of the German government to lock down, is based on imposed social-distancing and mask-wearing and was taken, it is claimed on the basis of a single opinion. Meanwhile in Canada, legal proceedings are ongoing and some cited in the brief are Pope Francis, Queen Elizabeth II, Bill and Melinda Gates and the Prime Minister Trudeau. Following a citizen’s petition in Portugal, it has been reported that a Lisbon court was forced to provide verified COVID-19 mortality data and according to the ruling, the number of verified COVID-19 deaths from January 2020 to April 2021 is only 152, not about 17,000 as claimed by government ministries. Recently, a related request was made to the International Criminal Court (ICC) asking that allegations of genocide, crimes against humanity and breaches of the Nuremberg Code by the UK Government and its advisors, be accepted by the ICC and investigated. Lockdown, which I have called a fuzzy logic is a measure that does help to reduce deaths when applied well, while the establishment of herd immunity with vaccination  adds further constraint. Fuzzy logic is a precise logic of imprecision and approximate reasoning that combines reasoning and rational decision making, which can be applied when information is insufficient or uncertain.

There are many questions to be conclusively answered a most recent one being whether the Delta variant is a mutation, or a consequence of the new vaccines or is Covid  just another flu. There areolder ones such as  data beingtweaked to maximize the number of Covid deaths with death from one agent listed as a Covid death because the deceased had a positive PCR test.  Two points; Germany has not yet fulfilled its obligations to Greece regarding its WWII war crimes against civilians during its brutal occupation while the most important legal instrument of Nuremberg did not prevent escape or disappearance of war criminals through well-developed nets neither did it significantly impact fascism. Furthermore, Ottoman Turk atrocities of Pontiac Greeks more than a century ago have been pushed aside.

Genocide takes place, violence is the order of the day, racism prevails, and bombs fall. Children are being mutilated, freeze to death and die from hunger, heat and dehydration. Infrastructure is destroyed, fear is inflicted on populations and promotion of mystification, obfuscation, cover-ups all take place. Earth is over-exploited and greed and egocentricity rule the roost. In short, we are committing suicide. Is Thomas Jefferson’s worst dream that no one is listening coming true?  Is social dementia our future with the reptiloids of Kondrashin inheriting the earth?

I recall two exciting and dramatic moments within ASPHER; the first was a three year long moment while attempting to develop a Mediterranean Network for public health. Jacque Bury was Secretary General. Athens and Tunisia were major players. The cherries on the cake were visits to the Tunis Pasteur Institute with the erudite Koussay Dellagi, and the Merrieux Foundation in Lyon with a most gallant Charles. The Institute’s mission was public health development, vaccine and sera production and training. There the typhus virus was isolated-discovered and a Nobel Prize in Physiology and Medicine went to its then director Charles Nicolle. Charles Mérrieux ran a functioning biosafety level 4 laboratory and where you might run into the giants of viral hunters and we did. Mérrieux received the coveted Štampar Medal posthumously, when Pascal Chevit, Rennes gave an appraisal of his life and work. The second moment recalled, is the genome project put together by Helmut Brandt. It seems even more important today. Rosa Adany was a  key genomist player. ASPHER has its own giant viral hunter in the name of Peter Piot!

Because natural zoonotic events are inevitable, we must establish much better global surveillance and warning systems, and of course early response systems when outbreaks occur. We need credible communication channels to prevent rapid global transmission of newly emergent strains and we must create institutional mechanisms that enable the speediest search for potential treatments, diagnostic tests, vaccines, and other tools and best practices to contain an outbreak. In short, we must be better prepared to share relevant scientific and technological know-how in a more honest, transparent, and credible manner than much of what we have seen during the current pandemic. This whole field is an open arena for ASPHER and its COVID Task Force.

In response to a question asked by Robert Otok, what should be our highest purpose in public health today and which I presume he meant ASPHER. It would be to fully participate in all societal processes and functions. ASPHER should give citizens a value based and altruistic approach to education and a positive sense of their personal health so that they can make the most of their physical, mental and emotional competences throughout the lifespan. It should promote engagement in lifelong learning and continually imbue a sense of life’s worth and its need for fulfillment according to the principles of Socrates and global citizenship. Health transcends frontiers and cultures, which is a powerful message. Two poles would be prevention of disease and incapacity or special needs and a focus on health promotion. Not only should public health add years to life but it must add philosophy to living and ensure that primary health care is reinforced according the needs of each community. Only in this way can health be achieved by the people for the people. Note that the symbols for persuasion, public health and Europe are all feminine; Peitho, Hygiene and Europa. If ASPHER manages these issues well, its training programs at all levels will be brilliant. The Honors Committee, currently presided over by Jose Moreno and Casia and recent  deliberations  of the  Public  Health  Collaboration  Network  in  South  Eastern  Europe (PH-SEE) of the Stability Pact directed by Ulrich Laaser are powerful institutions.

Upfront in my mind are two positive sentiments and strong messages, one by Chinese visitors to Italy during COVID and reported by EUPHA: we are waves from the same sea, leaves from the same tree, flowers from the same garden and the other a succinct balanced appraisal by James Naismith, of the Great Barrington Declaration and the phrase humility and willingness to consider alternatives are hallmarks of good science. In my mind I hear also the long past words of ASPHER’s third Secretary General, Frada Eskin who in her despair with the organization saw behaviors, not adhering to and out of sync with the values of public health. Her battle cry was commitment, competence, compassion to which I would add perseverance. Think also of the earlier three D’s of denuclearization, decolonization and development of the UN.  Frada’s management training seminars at White Hart, Harrogate were elegantly creative and intensely interactive. Her work stimulated ASPHER’s training efforts with the three Hanks, one being Leliefeld who was trained in psychiatry. The other two Hanks were immensely learned, philosophical and sociologists. Our discussions then was on systems with unannounced goals, powerful agents within them with  different and sometimes rogue agendas as well as garbage can models of organization and mainly impenetrable, which seem even more important today ay a time of rapid developments in AI. Inside  any system there are many well-resourced agents that can make things happen (or not happen), bonafide politicians, autocrats, oligarchs, bureaucrats. The work of the three Hanks was extremely beneficial to my efforts in Greece and with my parachute still open in the developments of management of health services and biomedical technology as well as interdisciplinary public health or multidisciplinary training. It was 1984. I was privileged later to work with them again in ESST through the good offices of the Sociologist Demos Agrafiotis and the support of Marrieta Gianakou then Minster of Health and later Greek MEP and a supporter of ASPHER. Another inspiring voice was Ricardo Petrella.

Uncertainty and mindlessness characterize a portion of our current moment in history. While there are limited prospects for a better life for many and little space for the international community to work to lessen future hostility something can always happen to pull us back from gloom. Hannah arrived at Covenant House, New York weighed down by unimaginable trauma. She lived with parents who misused drugs and they floundered in a sea of uncertainty. Once she escaped into homelessness, life became even more risky. Fortunately, she found a support system, what she called her own cheering squad and which shows enormous gratitude. Hannah now has a degree in Psychology, plans to pursue a doctorate and now, has never imagined dreams for the future. She might have been resentful and developed a destructive passion but the positive passion of her Covenant mentors prevailed. The Selling of Olga is another of the myriad and painful stories of human suffering to read. Louisa Waugh lets Olga tell her own story in all its angry and heartbreaking detail. This, in the Balkans where ethnic cleansing and war have resulted in poverty.  Louisa visited Moldova, Serbia, Albania and other Balkan states to learn about trafficking of victims, how trafficking works, how this immoral commerce operates and thrives while analyzing the response to this humanitarian crisis. She helps us understand this type of crime hasn’t disappeared and why, in spite of everything, there is still hope for change. Condemnation of the trafficking in human beings was strongly made in the Skopje declaration on public health, peace & human rights, (SD, 2001).

The Declaration was written as a codified expression of the social conscience of public health. It proclaimed a union between public health, peace and human rights in close keeping with the value system of the United Nations, World Health Organization and the Council of Europe. It represented hope and the promise of public health as a more cognitive element of society and was signed by no more than 50, cited about a dozen times and was essentially ignored. It saw public health  as an early warning system for sudden or gradual changes in vulnerability and envisioned it as an initial step to a more equal, stable and democratic world. It emphasized   our belief in the sanctity of all life, the wealth of diversity in our one and only world and acknowledged our moral obligation to preserve and improve our one and only world for the benefit of our offspring and our children's children who will inherit it.

Stampar chided governments for being in the hands of gangsters and kidnappers and likened Balkan banditry to disease as he saw malaria killing of the population annually while fertile land was transformed into cemeteries. He promoted unity at home and universal social justice.  An award in his name brought renewal to the Association. Its long list of outstanding Stampar Laureates found on its elegant web-page is witness to its significance.

Luka Kovacic provided elements of Štamparologija (note the Greek) or the phrases that grew up around Stampar while Ulrich Laaser cut the first medals that were given to Léo Kaprio,  Halfdan J Mahler and Donald Acheson. Of interest Mahler said that in the race towards HFA by 2000, the European Region has a head start in the work of Kaprio. It was Kaprio you will recall that in 1966 saw a bright future for ASPHER.

Looking back I have a regret and one disappointment. Since the latter is said to be good for youth I will start there by saying that ASPHER never followed through on an award in the name of Eleftherios Venizelos whose name is attached to the development of two public health institutions. Of breaking interest Greek institutions of higher education institutions are taking steps and in the name of Aristotle to defend academic freedom and the rights of scholars in Greece and worldwide. Unfortunately, not one institution, nor the Academy protested when political executioners cut down the 90 year old tree of public health in Athens (2019). The Aristotle University of Thessaloniki has recently signed a Memorandum of Understanding with the international Scholars at Risk network (SAR), which is good. Now holding the Presidency of the South-East European Cooperation Process (SEECP) and only regional co-operation scheme that exclusively involves all countries of Southeastern Europe, Greece can strengthen good neighborly relations in the Balkans and draw attention to, herein touched upon issues within the context of Euro-Atlantic institutions within the concepts of the rule of law, human security andespecially public health.

My regret is that the late Joe Asvall, whose life was the WHO, never received the Stampar medal. His life, his world, his passion and a true lead  in European health policy and public health and to whom we owe so much, this according to Zsuzsanna Jakab, Stampar Laureate. Stampar knew that public health can help build a resilient, peaceful world. Autocrats do not support that while democrats do not always fully support it or simply pay it, lip service.

In October of 2019 European Center Peace and Development  (ECPD), Belgrade held its fifteenth international conference entitled ‘The UN Agenda 2030 to Transform the World’, with the participation of scholars, diplomats and public figures from many countries.  Rector Rojas of UN UPEACE, Costa Rica  gave a keynote speech in which he spoke eloquently about shared global visions for the future roles of UPEACE and ECPD its European arm. It ran in parallel with ECPD’s annual Global Youth Forums Acting on the Earth Charter with an insightful concept note by Arthur Lyon Dahl.

ASPHER like Stampar should worry that the work of public health is considered largely unnecessary to decision makers and as he said especially to those afraid of loosing crumbs from their opulent tables. ASPHER today needs a creative reset in terms of public health after COVID and my suggestion would be let Stampar be our guide and ASPHER’s programme ASSET be a work horse with adequate hay provided from the European Union, water from WHO and pasture sufficient for ASPHER’s experts to graze. In the face of complex challenges ASPHER must bridge that-which-is and that-which-ought-to-be.

• Andrija Stampar Summer Educational & Tutoring school (ASSETS)

• Public health genomics

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