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The pot blames the kettle for seeing black
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Reconstruction #Corona outbreak.Three times the Netherlands was warned of a pandemic, but the government opted for isolationFollowing the Ebola outbreak in Africa, the Dutch government was advised three times to develop an approach to combat pandemics internationally. But she chose isolation.He already feels that little will happen to his advice on how to tackle pandemics. And that is why Ger Steenbergen provides his highly critical report with a stimulating spell by Johan Cruijff in 2018. “Often something has to happen before something happens.”Yes, he says now, “that two years later we were going to face a global coronary crisis, I didn't know that at the time. But that something was about to happen, and that we had to protect ourselves from it.” Steenbergen is a specialist in epidemics and infectious diseases after a long stay in Africa and Asia and works as a consultant at Dutch embassies in these continents for years. In 2014, he was in the direction of tackling the Ebola outbreak in West Africa.
Finally, as a health advisor in 2018, he will be commissioned by the Ministry of Health to write an opinion on how the Netherlands can best defend itself against pandemics. In that last year of his employment, Steenbergen is doing a good job, but not after he has made a big round of dozens of policy officials, development workers and scientists working on this subject. Everyone for himself, for this is summarized by Steenbergen's conclusion: although there is a great deal of knowledge and expertise in our country about the detection and control of epidemics, it is hardly used because of its total fragmentation.
The same also plays internationally. A pandemic blazes the world and must therefore be combated globally, but at that time each country is using its own fire hose. Steenbergen notes: 'Both Dutch and international parties note that the use of expertise does not currently involve a clearly visible broad involvement of the Dutch government. '
Finally, as a health advisor in 2018, he will be commissioned by the Ministry of Health to write an opinion on how the Netherlands can best defend itself against pandemics. In that last year of his employment, Steenbergen is doing a good job, but not after he has made a big round of dozens of policy officials, development workers and scientists working on this subject. Everyone for himself, for this is summarized by Steenbergen's conclusion: although there is a great deal of knowledge and expertise in our country about the detection and control of epidemics, it is hardly used because of its total fragmentation.
The same also plays internationally. A pandemic blazes the world and must therefore be combated globally, but at that time each country is using its own fire hose. Steenbergen notes: 'Both Dutch and international parties note that the use of expertise does not currently involve a clearly visible broad involvement of the Dutch government. '
Certainly not the first warning to the Cabinet
“What I noticed two years ago was that Dutch policy is mainly determined by the disagreement between the Ministry of VWS and Foreign Affairs,” says Steenbergen now. “Vws believes that they are about the Dutch health situation and that the international health situation falls under foreign affairs. But that department doesn't see health as an international theme. I was hoping to break that stalemate with report by advocating a broad coalition.” But that was not successful, he notes two years later. “Already at the meeting at which my opinion was presented, senior foreign officials said they did not feel for it.”
“What I noticed two years ago was that Dutch policy is mainly determined by the disagreement between the Ministry of VWS and Foreign Affairs,” says Steenbergen now. “Vws believes that they are about the Dutch health situation and that the international health situation falls under foreign affairs. But that department doesn't see health as an international theme. I was hoping to break that stalemate with report by advocating a broad coalition.” But that was not successful, he notes two years later. “Already at the meeting at which my opinion was presented, senior foreign officials said they did not feel for it.”
The Steenbergen report is the last warning to the cabinet, but certainly not the first. In fact, the Ministry of Foreign Affairs will present an evaluation itself in March 2016. After the Ebola outbreak, the relationship between the Netherlands and the World Health Organisation (WHO) between 2011 and 2015 is examined. This UN organisation is on the front line when it comes to preventing and combating global health crises. The report bears the significant title: 'Prevention is better than cure'.The Development Cooperation and Policy Assessment Inspectorate (IOB) of this department points out that the WTO's strength has been eroded because member countries mainly provide 'earmarked' money for projects they consider important, so that the basic task — the overall concern for the quality of health systems in particularly poor countries — has declined. With all the ensuing consequences. Pandemics often arise and thrive in the weakest links of the world chain.
Because the Netherlands has invested mainly in the fight against specific diseases such as HIV/AIDS and polio, and through the WHO is committed to sexual health and human rights, it has 'had little eye for strengthening health systems in a broad sense', according to the evaluation. The Netherlands is' co-guilty 'of the current problems of the WHO. This also shows that Foreign Affairs has little to do with international health as a theme, but according to this own report, that needs to be changed. An increasing number of countries have developed a global health strategy. That is what the Netherlands should do, is the clear message.
“Threats do not stop at the border”
That is a mouthful, acknowledges Paul van den Berg, political adviser at aid organisation Cordaid. “Yet a global health strategy simply means that you are trying to protect the BV Netherlands against external health threats.
That is a mouthful, acknowledges Paul van den Berg, political adviser at aid organisation Cordaid. “Yet a global health strategy simply means that you are trying to protect the BV Netherlands against external health threats.
The Netherlands currently tends to look at the global health situation through a straw, focusing on its own country.”
But, of course, threats and protection against them do not end at the border. “You therefore have to come up with a plan in which all expertise is connected within the Netherlands, after which it can be used internationally to prevent and combat health crises.” But after that highly critical report, this comprehensive approach has not been achieved,” concludes Van den Berg. “In the countries around us, we do. Look at Germany.”
Remco van de Pas is a researcher at the Institute of Tropical Medicine in Antwerp, and also teaches global health at the University of Maastricht. He just came out of a digital college, and that's where the coronacrisis comes back all the time, again today. “I said that there must also be well-functioning health systems in poor countries to provide the care to tackle the coronary crisis. Rich countries like the Netherlands have to invest in this, certainly also in their own interests.”
According to Van de Pas, the Netherlands cannot do without European and even global cooperation in this context. But according to him, there has been an opposing movement going on in recent years. “The funding of the WTO has been proportionally lagging behind, while this organisation is on the front line.” The money that goes there is 70 percent earmarked, as health advisor Steenbergen said. “In addition, countries prefer to put their money in all kinds of funds with concrete and short-term goals, but this also reduces the structural contribution. Finally, there is the budget for development cooperation. Ten years ago, the Netherlands spent 0.8% of gross national product on this, now only 0.54%. While today it also pays for the reception of refugees and climate measures.”
The core of the WHO has been 'eroded', says Van de Pas, and we can criticize the slow response of this UN organisation to the Ebola crisis and the current Corona outbreak, but we owe it all to ourselves. “The donors did not respond to the decline in time by reinvesting in the protective function of the WTO, and we are now getting that on our roof.”
Remco van de Pas is a researcher at the Institute of Tropical Medicine in Antwerp, and also teaches global health at the University of Maastricht. He just came out of a digital college, and that's where the coronacrisis comes back all the time, again today. “I said that there must also be well-functioning health systems in poor countries to provide the care to tackle the coronary crisis. Rich countries like the Netherlands have to invest in this, certainly also in their own interests.”
According to Van de Pas, the Netherlands cannot do without European and even global cooperation in this context. But according to him, there has been an opposing movement going on in recent years. “The funding of the WTO has been proportionally lagging behind, while this organisation is on the front line.” The money that goes there is 70 percent earmarked, as health advisor Steenbergen said. “In addition, countries prefer to put their money in all kinds of funds with concrete and short-term goals, but this also reduces the structural contribution. Finally, there is the budget for development cooperation. Ten years ago, the Netherlands spent 0.8% of gross national product on this, now only 0.54%. While today it also pays for the reception of refugees and climate measures.”
The core of the WHO has been 'eroded', says Van de Pas, and we can criticize the slow response of this UN organisation to the Ebola crisis and the current Corona outbreak, but we owe it all to ourselves. “The donors did not respond to the decline in time by reinvesting in the protective function of the WTO, and we are now getting that on our roof.”
A third warning to the CabinetVan de Pas prefers to describe these international health situations as 'global public goods' for which there is no market interest, and should therefore be financially embraced by countries that have the potential to do so. As far as he is concerned, the Netherlands should be at the forefront of this, because of the norms and values that our country stands for. “We believe in an open free world where trade and mobility are paramount. That's what we make our money. But that multilateral system is now cracking. That is why I would expect more from the Dutch Government. The opposite is true.
On the contrary, the government has neglected this protection against a global health crisis.”Van de Pas co-wrote in September 2016 a report by Clingendael Institute in which it advocates a 'more coherent Dutch response' when it comes to global challenges in the field of healthcare.
This report, together with the opinion of Steenbergen and the internal evaluation of Foreign Affairs, is the third warning to the Cabinet. Clingendael speaks of a 'patchwork' of policy, in which a 'coherent strategy' is lacking. It is' indiscriminate ', and' malleable 'under the influence of the fashions of the day.
Three folk singers from the Westland, Ronnie Ronaldo, John Dame and Mark Verkade, sing for the residents of the Wijndaelercentrum nursing home in the Loosduinen district of The Hague. The singers decided spontaneously to make a tour of five nursing homes in order to give the elderly a heart during the corona crisis.
Clingendael also advocates a broad strategy, but in the meantime there is international wonder and amazement at the fact that the once successful health component of Dutch development cooperation has been narrowed and marginalised, writes Steenbergen in his report. The absence of the Netherlands is so noticeable that the Bill&Melinda Gates Foundation even makes funds available to aid organisation Cordaid to lobby 'so that Dutch support for development cooperation and global health issues increases'. With this subsidy, the Netherlands is, so to speak, regarded itself as a developing country.
In The Hague, the responsible politicians are not impressed. Minister Lilianne Ploumen (PvdA, until 2017 Minister of Foreign Hands and Development Cooperation) and Edith Schippers (VVD, then Minister of Health) answered the House in 2016 that they see no added value in a new overarching health strategy. And in 2018, Plouman's successor Minister Sigrid Kaag in her turn refers to the literal answer of her predecessor in a letter of parliament. That's not going to hurry.
'European countries could have jointly prepared a policy years ago'
“Nowhere in the world are comparatively so many virologists and epidemiologists around as in the Netherlands,” says health advisor Ger Steenbergen. “But also economists, sociologists and anthropologists. And I mention the latter, because not the professionals, but the citizens of the countries are the real heroes. They can make or break a pandemic with their behavior. The knowledge about combating such a health crisis is in all kinds of disciplines, and you need to bring them together.”
He says not only in solidarity with the rest of the world, although that is a noble motive. But also to get better from that as the Netherlands. In the current crisis, all countries have their own policies that end at the border, with their own (shortage of a) stock of mouth caps, ventilation equipment. One country tests a lot, the other doesn't. One country counts corona deaths from the nursing home as well, the other only in the hospital.
“We are now responding to attacks by the pandemic in our own interests, while as European countries we could have prepared a policy together years ago,” says Steenbergen. A European strategy had also launched funding flows towards our research institutes, which would have been able to perform even better. “There's even a revenue model to it. If our innovations had led to new products, we would not have been dependent on others now, but would have been able to sell them to help other countries.”
This cooperation is not that difficult at all, says Steenbergen. There must be political will. “In the field of international control of antibiotic-resistant bacteria, the ministries of VWS, agriculture and foreign affairs did find each other. But then there was the direct interest of intensive livestock farming and international trade that was at stake.” The Netherlands is now at the forefront of this. “But,” says Steenbergen, “is the economic damage caused by corona not much greater?”
Clingendael also advocates a broad strategy, but in the meantime there is international wonder and amazement at the fact that the once successful health component of Dutch development cooperation has been narrowed and marginalised, writes Steenbergen in his report. The absence of the Netherlands is so noticeable that the Bill&Melinda Gates Foundation even makes funds available to aid organisation Cordaid to lobby 'so that Dutch support for development cooperation and global health issues increases'. With this subsidy, the Netherlands is, so to speak, regarded itself as a developing country.
In The Hague, the responsible politicians are not impressed. Minister Lilianne Ploumen (PvdA, until 2017 Minister of Foreign Hands and Development Cooperation) and Edith Schippers (VVD, then Minister of Health) answered the House in 2016 that they see no added value in a new overarching health strategy. And in 2018, Plouman's successor Minister Sigrid Kaag in her turn refers to the literal answer of her predecessor in a letter of parliament. That's not going to hurry.
'European countries could have jointly prepared a policy years ago'
“Nowhere in the world are comparatively so many virologists and epidemiologists around as in the Netherlands,” says health advisor Ger Steenbergen. “But also economists, sociologists and anthropologists. And I mention the latter, because not the professionals, but the citizens of the countries are the real heroes. They can make or break a pandemic with their behavior. The knowledge about combating such a health crisis is in all kinds of disciplines, and you need to bring them together.”
He says not only in solidarity with the rest of the world, although that is a noble motive. But also to get better from that as the Netherlands. In the current crisis, all countries have their own policies that end at the border, with their own (shortage of a) stock of mouth caps, ventilation equipment. One country tests a lot, the other doesn't. One country counts corona deaths from the nursing home as well, the other only in the hospital.
“We are now responding to attacks by the pandemic in our own interests, while as European countries we could have prepared a policy together years ago,” says Steenbergen. A European strategy had also launched funding flows towards our research institutes, which would have been able to perform even better. “There's even a revenue model to it. If our innovations had led to new products, we would not have been dependent on others now, but would have been able to sell them to help other countries.”
This cooperation is not that difficult at all, says Steenbergen. There must be political will. “In the field of international control of antibiotic-resistant bacteria, the ministries of VWS, agriculture and foreign affairs did find each other. But then there was the direct interest of intensive livestock farming and international trade that was at stake.” The Netherlands is now at the forefront of this. “But,” says Steenbergen, “is the economic damage caused by corona not much greater?”
Source: Hans Marijnissen15 April 2020, 8:00
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