Masu shakka game da haɓakar '' rigakafin annoba, shirye-shirye da mayar da martani '' (PPR) ajandar da aka yi bikin kwanan nan, suna sanar da abin da ake gani'shan kashi' na Hukumar Lafiya ta Duniya (WHO) mai cike da cece-kuce ga Dokokin Kiwon Lafiya ta Duniya (IHR).
Duk da cewa gyare-gyaren da aka tsara ba shakka za su faɗaɗa ikon hukumar ta WHO, wannan mayar da hankali kan hukumar ta WHO na nuna ɗan ra'ayi mai ɗanɗano game da lafiyar duniya da masana'antar annoba. WHO ta kusan zama dan wasa mafi girma a cikin babban wasa na haɗin gwiwar jama'a da masu zaman kansu da kuma tallafin kuɗi waɗanda ke haifar da bala'in bala'in bala'i.
Yayin da WHO ke aiki a cikin tabo, masana'antar cutar ta yi girma sama da shekaru goma kuma haɓakarta tana ƙaruwa ba tare da tsayawa ba. Sauran manyan 'yan wasa irin su Bankin Duniya, haɗin gwiwar ƙasashe masu arziki a G7 da G20 da abokan hulɗarsu suna aiki a cikin duniya da ba ta da gaskiya; duniyar da ƙa'idodin sun fi annashuwa, kuma rikice-rikice na sha'awa ba su da ƙarancin dubawa.
Idan ana son al'ummar kiwon lafiya ta duniya su kiyaye lafiyar jama'a, dole ne su fahimci faffadan tsarin da ake gudanarwa cikin gaggawa tare da daukar matakin dakatar da shi. Dole ne a dakatar da bayyanar cutar ta hanyar nauyin shaida da ka'idodin kiwon lafiyar jama'a.
Bayar da kuɗin bureaucracy na annoba ta duniya
'FIF na iya zama ginshiƙi a cikin gina ainihin tsarin PPR na duniya a cikin mahallin Yarjejeniya ta Duniya game da Rigakafin Cutar, Tsari da Amsa, wanda Majalisar Lafiya ta Duniya ta dauki nauyin.' (WHO, Afrilu 19, 2022)
Ana gaya wa duniya ta ji tsoron annoba. Ƙirar tattalin arziƙin zamantakewa na rikicin COVID-19 ana ɗaukarsa azaman hujja don ƙara mai da hankali kan tallafin PPR. kira don matakin 'gaggawa' gama gari don kawar da cutar ta gaba 'na gaba' an ƙaddara ta akan ''rauni' na tsarin da ake zaton COVID-19 ya fallasa. Kamar yadda WHO ta ci gaba tare da yunƙurin sa na sabuwar yarjejeniya 'yarjejeniya' a cikin 2021, membobin G20 sun amince da kafa Rundunar Haɗin gwiwar Kuɗi da Kiwon Lafiya (JFHTF) don 'ƙarfafa haɗin gwiwa da haɗin gwiwar duniya kan batutuwan da suka shafi rigakafin cutar, shirye-shirye da mayar da martani.'
Rahoton Bankin Duniya da WHO da aka shirya wa rundunar hadin gwiwa ta G20 kimantawacewa za a buƙaci dala biliyan 31.1 a kowace shekara don PPR na gaba, gami da dala biliyan 10.5 a kowace shekara a cikin sabbin kuɗaɗen kuɗi na ƙasa da ƙasa don tallafawa fahimtar gibin kuɗi a cikin ƙasashe masu ƙanƙanta da matsakaita (LMICs). Ayyukan da ke da alaƙa da sa ido sun ƙunshi kusan rabin wannan, tare da dala biliyan 4.1 a cikin sabbin kudade da ake buƙata don magance gibin da ake gani a cikin tsarin.
A cikin sharuɗɗan kiwon lafiyar jama'a, tallafin da aka gabatar don faɗaɗa kayan aikin PPR na duniya yana da yawa. Sabanin haka, shirin da WHO ta amince da shi na biennium kasafin kudin 2022-2023 matsakaiciyar dala biliyan 3.4 a kowace shekara. Asusun Duniya, babban mai ba da tallafi na kasa da kasa na zazzabin cizon sauro, tarin fuka da AIDS - wanda ke da yawan mace-macen shekara-shekara. 2.5 miliyan - a halin yanzu yana ba da dala biliyan 4 kawai a kowace shekara don cututtukan guda uku a hade. Ba kamar COVID-19 ba, waɗannan cututtukan suna haifar da mutuƙar mace-mace a cikin ƙananan ƙasashe da kuma a cikin ƙungiyoyin ƙanana, shekara zuwa, shekara.
A cikin Afrilu 2022, G20 amince don kafa sabuwar'asusun tsaka-tsakin kudi(FIF) ta zauna a Bankin Duniya don magance gibin dala biliyan 10.5 na PPR. FIF an yi niyya ne don ginawa a kan tallafin bala'in cutar don 'ƙarfafa tsarin kiwon lafiya da ikon PPR a cikin ƙasa da yankuna masu karamin karfi da matsakaicin kudin shiga.' Ana hasashen WHO za ta kasance jagorar fasaha, inda za ta ba su tabbacin taka rawar gani ba tare da la'akari da sakamakon tattaunawar 'yarjejeniya' na yanzu ba.
Kafa asusun ya ci gaba da sauri, kuma ya kasance amince a ranar 30 ga watan Yuni ta kwamitin gudanarwa na bankin duniya. Wani ɗan gajeren lokaci na Shawarwari ya rigaya ƙaddamar da ake tsammanin a watan Satumba 2022. Har zuwa yau, gudummawa jimla Gwamnatoci, da Hukumar Tarayyar Turai, sun yi alkawarin ba da dala biliyan 1.3 da wasu masu zaman kansu da masu zaman kansu, ciki har da gidauniyar Bill & Melinda Gates, gidauniyar Rockefeller, da Wellcome Trust.
Yankunan farko na asusun suna da ɗan haɗaka, gami da sa ido kan cututtuka na matakin ƙasa; tsarin dakin gwaje-gwaje; sadarwar gaggawa, daidaitawa da gudanarwa; ma'aikatan lafiya masu mahimmanci; da haɗin gwiwar al'umma.'
Gabaɗaya, asusun yana da bayyanar sabon 'Kungiyar Lafiya ta Duniya' don cututtukan cututtukan cuta - don ƙarawa zuwa cibiyar sadarwa na ƙungiyoyin kiwon lafiya na duniya kamar WHO; gavi. da Hadin Kai don Cike da Cigaba da Shirye-shirye (CEPI); da kuma Asusun Duniya. Amma wannan ƙarin kashe kuɗi akan PPR ya dace? Shin hauhawar farashin tattalin arziki na COVID-19 ne saboda a rashin yin aiki ta hanyar al'ummar kiwon lafiya ta duniya, kamar yadda ake yadawa da'awa; ko kuma saboda sakaci ne ayyukan gazawa ta WHO da gwamnatocin duniya, lokacin da suke jituwa jagororin tushen shaida na baya?
COVID-19: gaza yin aiki ko ayyukan gazawa?
A cikin muhawarar da ke tattare da ci gaban masana'antar annoba, ana mai da hankali sosai ga babban aikin hukumar ta WHO. Ana iya fahimtar wannan kulawa idan aka yi la'akari da matsayin hukumar ta WHO a matsayin hukumar da ke da alhakin kula da lafiyar al'umma a duniya da kuma yunkurin da take yi na samar da sabuwar yarjejeniya ta duniya. Koyaya, yadda WHO ke tafiyar da martani ga COVID-19 yana haifar da shakku sosai game da cancantar shugabancinta kuma yana haifar da tambayoyi game da bukatun su waye ƙungiyar ke bayarwa.
Kasawar WHO ta bi nata Abubuwan da ke gaba jagororin cutar ta hanyar tallafawa kulle-kulle, gwajin jama'a, rufe iyakokin da dala biliyan-biliyan COVAX Shirin alurar riga kafi ya samar da kudaden shiga mai yawa ga masu kera maganin rigakafi da masana'antar biotech, wanda kamfanoni da masu zuba jari ne manyan masu ba da gudummawa ga WHO. Wannan tsarin yana da gurgunta tattalin arziki, lalata shirye-shiryen kiwon lafiya da ake da su da kuma kara kafuwar talauci a kasashe masu karamin karfi.
Shekaru goma na ci gaba a lafiyar yara yana iya yiwuwa lalace, tare da lalata rayuwar miliyoyin yara na dogon lokaci, ta hanyar rasa ilimi, auren yara da rashin abinci mai gina jiki. A cikin watsi da ka'idodinsa na daidaito da kuma al'umma ta kori kiwon lafiya, WHO ya bayyana ya zama dan wasa kawai a cikin wasan PPR, ga waɗanda ke da iko na gaske; hukumomin da suke samar da ita samun kudin shiga da kuma wanda ke kula da albarkatun da ake kai yanzu zuwa wannan yanki.
Gudanar da lafiyar jama'a na duniya
Hukumomin lafiya da aka kafa kwanan nan sun sadaukar da allurar rigakafi da annoba, kamar gavi da kuma CEPI, ya bayyana yana da tasiri sosai tun daga farko. CEPI shine kwakwalwa na Bill Gates, Jeremy Farrar (darektan Wellcome Trust), da sauransu a wurin pro-kulle Tattalin Arziki na Duniya. An ƙaddamar da shi a Davos a cikin 2017, an ƙirƙiri CEPI don taimakawa kasuwa don rigakafin annoba. Ba asiri ba ne cewa Bill Gates yana da manyan sirri alakar kudi ga masana'antar harhada magunguna, ban da nasa kafuwar. Wannan a fili yana sanya alamar tambaya a kan yanayin jin daɗin jarin nasa.
CEPI ta bayyana a matsayin mafarin abin da WHO ke karuwa zama - kayan aiki inda mutane da kamfanoni zasu iya yin tasiri da inganta dawowa ta hanyar yin garkuwa da muhimman wuraren kiwon lafiyar jama'a. CEPI kasuwar kasuwa model, wanda ya haɗa da masu biyan haraji suna ɗaukar mafi yawan haɗarin kuɗi don bincike da haɓaka rigakafin alurar rigakafi yayin da Big Pharma ke samun duk ribar, an kwafi shi musamman a cikin rahoton Bankin Duniya-WHO.
Gavi, ita kanta muhimmiyar mai ba da gudummawa ta WHO da ke akwai kawai don ƙara samun damar yin rigakafi, kuma yana ƙarƙashin tasirin Bill Gates kai tsaye, ta gidauniyar Bill & Melinda Gates. Shigar Gavi (tare da CEPI) tare da shirin COVAX na WHO, wanda ya karkatar da albarkatu masu yawa zuwa yawan rigakafin COVID-19 a cikin ƙasashen da COVID-19 ƙaramin nauyin cuta ne, yana ba da shawarar ƙungiyar tana da ƙarfi sosai ga tallace-tallacen rigakafin fiye da ainihin sakamakon lafiyar jama'a.
Tallafin annoba - yin watsi da babban hoto?
A kallo na farko, ƙarin tallafin PPR ga LMICs na iya zama amfanin jama'a. Rahoton Bankin Duniya-WHO ya yi iƙirarin cewa 'yawan yawaitar cututtuka masu saurin kamuwa da cutar na karuwa.' Duk da haka, gaskiya ta karyata wannan, kamar yadda WHO ta lissafa 'cututtuka' guda 5 kawai a cikin shekaru 120 da suka gabata, tare da mafi yawan mace-mace da ke faruwa a cikin 1918-19 H1N1 ('Spanish') cutar mura, kafin maganin rigakafi da magungunan zamani. Baya ga COVID-19, barkewar cutar 'Murar alade' a cikin 2009-10, wanda kashe kasa mutane fiye da shekara guda na mura, ita ce kawai 'annobar' a cikin shekaru 50 da suka gabata.
Irin wannan mayar da hankali kan haɗarin cutar ba zai yi wani abu ba don magance mafi munin abubuwan da ke haifar da rashin lafiya da mutuwa, kuma ana iya sa ran zai yi muni ga mutanen da ke fuskantar mafi girman nau'ikan nakasu na zamantakewar al'umma. Gwamnatocin kasashe masu karamin karfi za su kasance 'ƙarfafawa' don karkatar da albarkatu zuwa shirye-shiryen da ke da alaƙa da PPR, ƙara haɓaka rikicin bashi.
Matsakaicin matsakaici, tsarin kiwon lafiyar jama'a na sama zai rasa sassauci don biyan bukatun gida da yanki. Canja wurin tallafi daga cututtuka mafi girma, da masu kawo ci gaban tattalin arziki, suna da a da tasiri kai tsaye akan mace-mace a wadannan kasashe, musamman ga yara.
Rahoton na WHO da Bankin Duniya ya bayyana cewa dole ne a gina ginshiƙan gine-ginen PPR na duniya bisa 'tushen ka'idojin daidaito, haɗa kai da haɗin kai.' Kamar yadda annoba mai tsanani ke faruwa ƙasa da sau ɗaya a kowace tsara, ƙarin kashe kuɗi akan PPR a cikin LMICs a fili ya saba wa waɗannan ƙa'idodi na asali yayin da suke karkatar da ƙarancin albarkatu daga wuraren buƙatun yanki, don magance abubuwan da ake ganin fifikon kiwon lafiya na masu hannu da shuni.
Kamar yadda aka nuna ta barnar da martanin COVID-19 ya haifar, a cikin kasashe masu tasowa da masu karamin karfi, illar karkatar da albarkatu daga wuraren da ake bukata na iya zama na duniya baki daya. A rashin magance irin wannan 'kudin dama', shawarwarin WHO, Bankin Duniya, da sauran abokan hulɗa na PPR ba za su iya dogara da lafiyar jama'a ba; kuma ba su zama tushen fa'idar al'umma gaba ɗaya ba.
Abu daya ya tabbata. Wadanda za su samu daga wannan fadada balaguron balaguron balaguro zai kasance wadanda suka samu daga martani ga COVID-19.
Jirgin balaguron balaguron balaguro - bin kuɗin
Sabon asusun Bankin Duniya na fuskantar barazanar dagula matsalolin da ake da su a cikin tsarin kiwon lafiyar jama'a na duniya da kuma kara yin illa ga 'yancin cin gashin kai na WHO; ko da yake an bayyana cewa WHO za ta kasance ta tsakiya 'dabarun rawa;' za a yi amfani da kudaden ta bankin duniya. Ainihin, ta hanyar kuɗi tana yin watsi da matakan lissafi a WHO, inda za a iya tayar da tambayoyi na ƙimar dangi cikin sauƙi.
Tsarin da aka tsara na FIF zai ba da hanya ga kungiyoyi masu dangantaka mai karfi ga masana'antun harhada magunguna da sauran masana'antun kere kere, irin su CEPI da Gavi, don samun tasiri mafi girma a kan PPR na duniya, musamman idan an nada su '' ƙungiyoyi masu aiwatarwa '' - makamai masu aiki waɗanda za su gudanar da shirin aiki na FIF a cikin ƙasa, yanki da duniya.
Kodayake ƙungiyoyin farko da za su fara aiwatar da shirin na FIF sune hukumomin Majalisar Ɗinkin Duniya, bankunan raya ƙasashe da yawa da kuma IMF, tuni aka fara shirye-shiryen ba wa waɗannan cibiyoyin kiwon lafiya na ƙasa da ƙasa izini. Wataƙila za a iya karkatar da hannun jari ga hanyoyin samar da fasahar kere kere, kamar sa ido kan cututtuka da haɓaka alluran rigakafi, a farashin wasu, mafi mahimmanci, ayyukan kiwon lafiyar jama'a.
Kare lafiyar jama'a maimakon dukiya ta sirri
Idan da gaske duniya tana son magance raunin tsarin da COVID-19 ya fallasa, dole ne ta fara fahimtar cewa wannan jirgin ƙasa mai ɗorewa ba sabon abu bane; Tushen rugujewar al'umma- da tushen lafiyar jama'a na duniya sun fara tun kafin COVID-19.
Ba za a iya jayayya ba cewa COVID-19 ya tabbatar da cewa yana da riba tsabar kudi saniya ga masu kera alluran rigakafi da masana'antar biotech. Samfurin haɗin gwiwar jama'a da masu zaman kansu wanda yanzu ya mamaye lafiyar duniya ya ba da damar isar da albarkatu masu yawa zuwa cikin aljihun manyan kamfanoni, ta hanyar shirye-shiryen da suke tasiri kai tsaye, ko ma gudanar da su. CEPI ' 100 days Mission' don samar da 'aminci da inganci' rigakafin cutar 'barazanar hoto' a cikin kwanaki 100 - don 'ba wa duniya damar yaƙi na ɗaukar barkewar nan gaba kafin ta zama annoba ta duniya' - izini ne ga kamfanonin harhada magunguna don dacewa da kuɗin jama'a akan sikelin da ba a taɓa gani ba, bisa la'akari da nasu kima na haɗari.
Za a tabbatar da cikar annabcin 'yawan yawaitar annoba' ta hanyar turawa don ƙarin sa ido kan cututtuka - yanki mai fifiko ga FIF. Ga rahoton Bankin Duniya-WHO:
'COVID-19 ya ba da haske game da buƙatar haɗa tsarin sa ido da faɗakarwa a cikin hanyar sadarwa na yanki da duniya don gano abubuwan da suka faru na watsawa na zoonotic, ƙara ƙararrawa da wuri don ba da damar saurin amsawar lafiyar jama'a, da haɓaka haɓaka hanyoyin magance magunguna.'
Kamar yawancin iƙirarin da ake yi game da COVID-19, wannan da'awar ba ta da tushe na shaida - tushen COVID-19 ya kasance mai cike da cece-kuce kuma bayanan WHO sun nuna cewa annoba ba sabon abu bane, ko menene asalinsu. Babu wani daga cikin 'maganin rigakafin' da aka nuna don rage yaduwar COVID-19, wanda yanzu ya zama annoba a duniya.
Ƙara yawan sa ido a dabi'a zai iya gano ƙarin 'masu haɗari masu haɗari,' kamar yadda bambance-bambancen ƙwayoyin cuta ke tasowa a yanayi. Saboda haka, duniya tana fuskantar wasan neman da ba zai ƙare ba kuma za ku samu, tare da ribar da ba ta ƙarewa ga masana'antu. A da sau ɗaya a kowane zamani, wannan masana'antar za ta mai da 'cututtuka' wani yanki na yau da kullun na rayuwa, inda aka ba da umarnin rigakafin kashe gobara ga kowace sabuwar cuta ko bambance-bambancen da ke zuwa.
A ƙarshe, wannan sabon asusun bala'in cutar zai taimaka wajen haɗa ƙasashe masu ƙanƙanta da matsakaitan masu shiga tsakani a cikin ci gaban ayyukan bukatu na duniya. Babban tsarin kula da lafiyar jama'a ba zai yi wani abu ba don magance ainihin bukatun kiwon lafiya na mutane a waɗannan ƙasashe. Idan aka bar jirgin kasa na balaguro ya ci gaba da girma, matalauta za su kara yin talauci, kuma mutane za su mutu da yawansu daga kamuwa da cututtukan da za a iya magance su. Masu arziki za su ci gaba da samun riba, yayin da suke haifar da rashin lafiya a cikin ƙananan ƙasashe - talauci.
Emma McArthur gudummawa ga wannan labarin.
-
David Bell, Babban Masanin Kimiyya a Cibiyar Brownstone, likitan lafiyar jama'a ne kuma mai ba da shawara kan ilimin halittu a cikin lafiyar duniya. David tsohon jami'in kiwon lafiya ne kuma masanin kimiyya a Hukumar Lafiya ta Duniya (WHO), Shugaban Shirin Malaria da cututtukan zazzabi a Gidauniyar Innovative New Diagnostics (FIND) a Geneva, Switzerland, kuma Daraktan Fasahar Kiwon Lafiya ta Duniya a Asusun Kula da Lafiya na Duniya na Intellectual Ventures a Bellevue, WA, Amurka.
Duba dukkan posts
