Mario Monti leads WHO Pan-European Commission: “One Health for One Planet”

The only way out is overcoming it together. How many times have we heard this sentence in the past year? Before dismissing it as if it were, at best, a well-meaning promotion of solidarity in the face of the pandemic’s collective drama, let’s try and broaden its scope and impact. Imagine if this all together went beyond the borders of a single country or an international community, and even beyond the human race to embrace our ecosystem and the planet as a whole. And that it is not only about hopes and ideals, but that it actually mandates practical political action by perceiving the big picture.

This new perspective has a name: One Health, and it is the perspective taken by the Pan-European Commission on Health and Sustainable Development. Created by the World Health Organization, the Pan-European Commission has just appointed Mario Monti - President of Bocconi University, former Prime Minister of Italy and former European Commissioner - at its helm. Among the 23 members of the Commission, coming from various countries in the WHO Pan-European Region, is the director of SDA Bocconi’s Center for Research on Health and Social Care Management (CERGAS) Aleksandra Torbica, acting as a special advisor. EMMAS Director Francesca Lecci introduced both Torbica and Monti to the participants of the Executive Master in Management of Health and Social Care Organizations’ 2019 and 2020 editions so that they could share this new and challenging experience.

“As head of the Italian government I was able to see how complex health policies are, but I do not view myself as an expert in the field,” said Monti, “and I was rather surprised when I received this proposal from Hans Kluge, the Director of the WHO Pan-European Region (which numbers 53 countries). What made me accept the chair was the Commission’s ‘subtitle’: Rethinking Policy Priorities in the light of Pandemics.” It all starts from a simple and dramatic observation: the global crisis generated by Covid-19 definitely exceeds the boundaries of the health sector. It is a threat not only to our health but to our entire social and economic fabric, and must become an opportunity to understand and tackle systemic gaps in all sectors.

The pandemic should thus teach us to broaden our perspective, and join the dots: “At the Commission we are convinced it is necessary to achieve a deeper integration of health systems in economic and social systems, at three different levels,” Monti said. “The first level relates to the multi-disciplinary approach we have called One Health: we can no longer think of human health as disconnected from animal and environmental health. It is now key that the four major international organizations dealing with these matters work together – in addition to the WHO, FAO for food, UNEP for the environment and OIE for animal health.”

Next comes action by national governments. Here, too, structural coordination between economic and health policies is needed, the latter’s dominance over the former now being highlighted by the pandemic. “When health policies are overlooked, in the long run they ‘take revenge’,” Monti warned.

The third level of integration is an international one. Monti underlined that “a joint effort by governments is required to restore economic and social systems today” as it was during the financial crisis in 2008. “Our proposal is to create a Global Health Board at the G20 level, a light and effective body modeled on the Financial Stability Board that was established to counter another global emergency, a financial one, chaired by the then President of the ECB Mario Draghi.”

Then it was Aleksandra Torbica’s turn to go into more detail about the work of the Commission, whose mandate is to find solutions to strengthen the resilience of our social and political systems, not just healthcare ones. We should go beyond mere management of the present pandemic to prepare and respond to more possible shocks (those brought about by climate change, for example). Torbica recalled that “there is a two-way link between health and economic development, as well as between health and security.”

Awaiting the final report, which is scheduled for next September, the Commission issued a Call to action for governments covering five points:

• Operationalize the concept of One Health at all levels, creating an Intergovernmental Panel on Health Threats, scaling up public investment in prevention measures and early warning systems, and developing a Pan-European System for Disease Control that integrates with existing structures.
• Take action at all levels of society to fix the fractures that left so many people vulnerable to the pandemic with more inclusive health systems, a greater female presence in decision-making bodies, interoperability of health data, achievement of universal health coverage.
• Make changes to the global financial system by incorporating the concept of One Health in risk evaluation, and differentiating consumption and investment expenditure to foster more inclusive and innovative services – “Healthcare should not be considered just a cost,” insisted the CERGAS Director.
• Promote public goods at a global level, via a potential International Pandemic Treaty and the creation at the G20 level of the Global Health Board, which can evolve into a Global Board for Public Goods.
• Support innovation in health systems, encouraging research on new drugs, medical technologies, digital solutions and organizational innovations, as well as the alignment of regulatory systems and the development of effective and transparent public-private partnerships.

These are all vital issues for EMMAS participants, who are health managers working in different fields but with a common problem: how to coordinate the various levels of government – central, regional, local – to close the gap between rules and execution. This gap can be bridged with competences and daily work, but an urgent question emerged from the audience: how can we ensure the points in the call to action won’t end up as mere statements of principles? And in particular, how to ensure that the National Recovery and Resilience Plan is not a wasted opportunity for both healthcare and our country?

“It is important to have the eye of Europe and a good level of Italian politics,” Monti answered. He is convinced “without being blindly optimistic” that both are in place: The EU is cooperative and the Italian government is competent and resolute. But in order to get back on our feet after being “punched in the face” by the pandemic we need a substantial change in mindset at all levels. That is to say – a significant expression for participants in an executive master’s program – capitalizing the lessons: “When we experience a strong shock, there also is a strong activation of our minds – technical and political ones as well as the general public’s – looking for solutions. Instead, our goal should be minimizing damage and making the effects of the shock lasting, both on our awareness and our ability to revisit our priorities.”

SDA Bocconi School of Management.