“There is a desperate and urgent need for regional and global action to effectively tackle the climate crisis, which poses an existential threat to the human race. Crucially, we must involve the youth, because they are truly engaged on the climate issues they are inheriting, often bursting with ideas and solutions,” Dr Hans Henri P. Kluge, WHO Regional Director for Europe said in an interview with the Athens-Macedonian News Agency released on Monday.
The interview was given in the context of Kluge’s planned visit to Greece, which had to be postponed due to the recent devastating floods.
The full interview is given below:
Why did WHO choose Greece and specifically Thessaloniki and Aristotle University for the establishment of its Collaborating Centre for Well-being? What are the objectives of the Centre and which sub-areas of well-being may it include?
I am both excited and honoured to be here to inaugurate this new WHO Collaboration Centre on quality of life and wellbeing, including mental health and nutrition. It is a major milestone and achievement for both WHO and the Aristotle University of Thessaloniki.
The best science is collaborative. WHO will benefit from the advanced expertise and research conducted at the Medical School and other partner institutions of the University while the new Centre and its researchers will gain from the exposure to other leading health organizations in Europe and beyond.
The new Centre will help WHO/Europe to provide technical assistance and support to countries to ensure quality in Mental Health services, support WHO in promoting quality of life indicators to evaluate mental health outcomes, work with WHO to promote quality of life and well-being (including Mental Health, Diet and Nutrition, Nutrition Education, and Public Health Nutrition) training as part of education activities and to support WHO in promoting quality in nutrition research (preventive nutrition and nutritional support) through the development of systematic reviews & Meta-analysis and policy briefs.
Overall, both Greece and its population as well as other countries will ultimately greatly benefit from this new Centre of Excellence.
You have said that 1 in 30 Europeans may have developed Long Covid in the first three years of the pandemic. Is it possible to estimate the social and economic impact of this parallel pandemic on the European community?
A great deal more research is needed into the social and economic impacts of Long COVID on our societies, as well as more medical research into Long COVID itself.
Some data is beginning to emerge. We know for example, that Long COVID has become the leading cause of inability to work, which in turn can have knock-on effects on financial stability, with risks of falling below the poverty line. In the US for example, the Brookings Institute has estimated that with 4 million Americans out of work due to Long COVID, the annual cost of lost wages is around $ 200 billion a year, and this is likely to rise. In the UK, the Institute for Fiscal Studies found that in 2022, roughly 110,000 people were out of work due to Long COVID, at a cost of nearly $ 2 billion a year in lost earnings.
The mental health impacts on individuals and their families/carers are immeasurable. We are hearing stories of so many individual tragedies, of people in financial crisis, facing relationship problems, losing their jobs, and falling into depression. Many health workers who risked their lives on the frontlines of the pandemic now have this chronic and debilitating condition as a result of infection acquired in the workplace. They, and millions of others, need our support. The consequences of long COVID are clearly severe and multi-faceted.
Have governments in the WHO European Region started to build support systems – both at diagnostic and therapeutic level – for the health of people suffering from symptoms of Long Covid? Do you find that mental health issues are prioritised in this planning?
I can’t blame people for wanting to put COVID-19 behind them. As we emerge from the acute emergency phase of the pandemic, and with life returning to normal, people understandably want to get on with their lives and consign the pandemic to history. But COVID-19 is still with us, and this means that so is Long COVID. Yet many countries in Europe have greatly reduced or stopped COVID-19 surveillance, which means we are increasingly blind as we try gather valuable evidence and design treatment programmes for Long COVID.
For the most part, those experiencing Long COVID are not getting the support they need from their health systems, and this includes mental health support. This is what we are hearing from various Long COVID civil society groups that have sprung up over the past few years. This needs to change. We can’t allow this shadow pandemic to continue disrupting so many lives while the rest of us move on from the COVID-19 pandemic.
New modelling conducted for WHO/Europe by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington’s School of Medicine in the United States, shows that in the first three years of the pandemic, an estimated 35,739,661 individuals across the 53 Member States of the WHO European Region experienced post COVID-19 condition, also known as Long COVID. Put another way, nearly 36 million people – equivalent to the combined populations of Sweden, Denmark, Norway, and Austria – met the WHO criteria of a new case of Long COVID with symptom duration of at least three months in 2020, 2021 or 2022.
Together with Long COVID patients and advocates, WHO/Europe has developed three goals – the 3Rs – jointly calling upon governments and health authorities to focus attention on long COVID and people living with it through greater:
– Recognition and knowledge sharing, where all services are adequately equipped, and no patient is left alone or having to struggle to navigate through a system that is not prepared, or not capable of, recognizing this debilitating condition.
– Research and reporting, through data gathering and reporting of cases, and well-coordinated research with full participation of patients needed to advance understanding of the prevalence, causes and costs of long COVID.
– Rehabilitation, that is based on evidence and effectiveness, and is safe for both patients and carers.
For these goals to be achieved, we need all countries in the WHO European Region to recognize that long COVID is a serious problem, with serious consequences and requires a serious response to stop the lives of those affected from getting any worse – and not just on a physical health level, but also on a mental health and social level.
Is an awareness campaign about vaccinations still necessary, although the risks of not being vaccinated seem obvious and Covid remains among the leading causes of death in most countries and it keeps mutating?
In short, yes. COVID-19 is still with us, it is still evolving and mutating, and it could still disrupt our lives. We are starting to see a small yet steady rise in hospitalizations in some countries in Europe, and this is worrying considering we are still a few months away from winter, when we expect case numbers to increase further.
COVID-19 vaccines continue to be the most effective tool to prevent serious illness, hospitalization and death from COVID-19. There is evidence of waning protection against severe disease over time following vaccination, which makes booster doses especially important for those at higher risk. WHO encourages countries to continue to use COVID-19 vaccines to protect the most vulnerable groups and to undertake additional efforts, including raising public awareness, to increase COVID-19 vaccination uptake.
Is immunization coverage considered adequate when it includes most of the vulnerable to serious diseases?
Thanks to extensive efforts made in all countries, COVID-19 vaccination has saved many lives and prevented serious illness for many more people. To protect every individual at higher risk more efforts are needed to increase vaccination coverage among these target groups. Worryingly in our region, just over a third of the eligible population has received their first booster dose, and just 11% have received their second booster shot.
Another critical area which demands our attention is routine childhood immunization, which suffered during the pandemic years. It’s vital that health authorities don’t lose sight of this immunization-gap and offer all children (and adults where appropriate) with catch-up vaccines for preventable diseases like measles, mumps, rubella and polio.
Is it possible to make predictions about the evolution of the epidemic if the immunization rate in the general population is further reduced?
It is not possible to predict the future, but we do know that the epidemiological pattern of the COVID-19 pandemic continues to evolve. It is therefore likely that periodic booster doses of COVID-19 vaccines for vulnerable population groups will be needed, in the months and even years ahead.
Which priority actions should be adapted by governments and national health systems to address the health impacts of climate change?
First of all, I would like to pay tribute to the Greek first responders and firefighters who risk their lives to keep people safe from wildfires and other extreme weather events. They have my unwavering admiration and support.
The climate crisis is a health crisis and politicians need to recognise this. Greece is one of very few countries to have a ministry of Climate Crisis (and Civil Protection) and I want to take this opportunity to once again congratulate the Greek government and Prime Minister Kyriakos Mitsotakis for the titanic effort they are making in this area.
Climate change is destroying our health – and our world. And for far too long, we’ve been standing by and letting this happen. But we have opportunities to act – let’s seize them urgently.
As we grapple with the immediate effects of climate change on our health and wellbeing, we must look ahead to the future by making our health systems more climate-resilient, both in terms of their capacity to respond to extreme weather events (like heatwaves, flooding, and storms), while also making them more carbon-neutral and less polluting. At the same time, we need to make our food and transportation systems healthier, sustainable and climate neutral.
We can’t address climate change alone. That’s why European Member States, among them Greece, adopted the Budapest Declaration back in July, committing to addressing the health impacts of climate change, in partnership with each other. International cooperation and support are crucial, especially for low-income countries, to address climate change’s health consequences effectively. There is a desperate and urgent need for regional and global action to effectively tackle the climate crisis, which poses an existential threat to the human race. Crucially, we must involve the youth, because they are truly engaged on the climate issues they are inheriting, often bursting with ideas and solutions.
Action on climate change cannot be predicated on a particular government or political party – it truly needs to be a non-partisan issue championed by all sides of the political spectrum, from left to right. That’s why back in July, I convened European Region Member States in Hungary, where the Budapest Declaration was adopted. Countries have committed to raising awareness about the health impacts of climate change within their populations, while strengthening their capacity to respond to extreme weather events, like the heatwaves we are seeing now, including across Greece.
What does your appointment as “ Doctor Honoris Causa” of the Medical School of the Aristotle University of Thessaloniki mean to you? Which topic will you choose to present in your speech?
Being appointed as ‘Doctor Honoris Causa’ of the Medical School is a profound honour for me. It not only recognizes my contributions and dedication to global public health but also reinforces the responsibility I feel towards continuing my work and making further advancements to achieve health for all leaving no one behind. I am humbled by this recognition, and it serves as a powerful reminder of the difference each of us can make when we are driven by passion and purpose.
In my acceptance speech, I have been asked to outline the biggest health crises of our times, the challenges in responding to them, and the opportunities we have going forward. I always stress though that despite challenges and crises, I am a born optimist – and am convinced that when people and countries come together to tackle difficulties, great things can – and do – happen.
Concluding, I would like to thank the President of the Medical School of the Aristotle University of Thessaloniki, Professor Kyriakos Anastasiadis, Professor of Psychiatry Konstantinos Fountoulakis and all the faculty of the Medical School and the Senate for doing me this exceptional honour!