London School of Hygiene & Tropical Medicine

Professor Dame Anne Mills, Provost and Vice Director:

The COVID-19 pandemic has highlighted yet again the importance of health systems infrastructure and its resilience to major shocks. But it brings to the fore three particularly vital emphases within health systems development. The first is the critical importance of basic public health measures – use of face masks, hand hygiene and physical distancing, together with the social solidarity and political leadership that is critical to ensuring widespread adherence. The second is the vital role of health systems in providing continuity of care – previously emphasised in the context of the rise of chronic conditions, but now highlighted by the longterm effects of COVID-19. The third is the critical connection between the health system and the social care system in countries where older people make up a significant proportion of the population. As countries recover from the COVID-19 pandemic, we should not forget these lessons.

Professor Liam Smeeth, Director of LSHTM:

Prior to effective vaccines being introduced, one of the most extraordinary things about COVID-19 was that all of our effective measures to control the spread of the virus - social distancing, mask wearing, self-isolation and contact tracing - relied on individual cooperation. This has made public information critically important so that people know what they need to do. It is also about individuals taking selfless actions for the collective good: so public confidence in the policies have also been crucial. To control the epidemic, whole countries need to be united in a collective effort. When information has been unclear, and when public confidence has been dented, we have repeatedly seen control measures fail.

Sadly, a false dichotomy has emerged in some countries, characterised by people who are concerned about the economy being presented as being at odds with people concerned about health impacts. This dichotomy is both harmful and unnecessary. Everyone has a single shared aim: to minimise the health, social and economic impacts of this terrible pandemic. Scientists do not advocate increased control measures because they like restricting peoples’ freedoms or want to damage the economy. COVID-19 is the single root cause of all the harms and controlling the virus tackles the root cause. Of course, there needs to be debate and differing opinions about how best to reduce spread, but this must not be allowed to undermine the unity of purpose that we share.

Professor Sir Andy Haines, Professor of Environmental Change and Public Health and Former Director of LSHTM:

During the COVID-19 pandemic, air pollution and greenhouse gas emissions have fallen in many countries as a result of lockdowns and dramatic declines in travel. However, these reductions will not be sustained as economies emerge from COVID-19. Effective vaccines for the virus have made the prospects look increasingly bright, but there are no such prospects for the climate emergency, and, as far as we know, the effects are irreversible.

While the COVID-19 pandemic is a grave human tragedy, it can be used as an opportunity to implement sustainable economic recovery policies that safeguard the health of the current and future generations, including by supporting rapid reductions in greenhouse gas emissions. Opinion polls in 16 countries have shown that most people support the prioritisation of climate action in recovery packages. Large majorities of respondents also agree that we have a responsibility to protect the planet for future generations and that environmental degradation poses a major threat to health. In May 2020, representatives of 40 million health professionals wrote an open letter to the heads of G20 governments urging investments in a zero-carbon, healthy recovery.

Work at LSHTM has documented the health benefits of decarbonisation policies, including reduced air pollution and consumption of healthy, sustainable diets. The Pathfinder initiative, launched in November 2020 and funded by the Wellcome Trust with the support of Oak Foundation, will synthesise evidence of health and environmental benefits from the implementation of policies to decarbonise various sectors including energy, transport and health care.

This interview is from the 2021 Alumni News.