1. Introduction
1. Following a proposal by the
five political groups, the Parliamentary Assembly decided on 24 January 2022
to hold a debate under urgent procedure on “Beating Covid-19 with
public health measures”. I was appointed rapporteur on the same
day.
2. This urgent debate is being held in the context of the rapid
evolvement of the Covid-19 pandemic, which is causing much suffering
as the virus continues to spread at the regional and global levels.
The pandemic and the consequent measures imposed by member States
in order to contain the spread of the virus invites a lot of ethical,
legal, and practical considerations, as was pointed out by our colleague
Ms Jennifer De Temmerman in her report on Covid-19 vaccines. As
the pandemic evolves, there is a need to continuously review the
public health measures put in place in our member States with parliamentary
oversight so as to ensure that they are always relevant, proportional
and effective, in a way which is human rights compliant.
3. The pandemic has been afforded a lot of attention at the Assembly.
In its
Resolution 2329
(2020) “Lessons for the future from an effective and rights-based
response to the Covid-19 pandemic”, the world was advised that in
order to avoid a disastrous outcome in terms of lives lost and the
burden of disease, and equally disastrous knock-on effects on the
economy and human rights, we need to act fast to contain outbreaks,
using tried, tested and effective measures, implemented in a rights-compliant
way. Moreover,
Resolution
2361 (2021) “Covid-19 vaccines: ethical, legal and practical considerations”,
underlines the importance of equitable allocation of Covid-19 vaccines
globally and within member States, and provides practical recommendations on
ensuring high vaccine uptake in a way which is human rights compliant.
In December 2021, the Committee on Social Affairs, Health and Sustainable
Development adopted a declaration expressing deep concern over the
pandemic situation in Europe and worldwide.
![(3)
<a href='https://assembly.coe.int/LifeRay/SOC/Pdf/DocsAndDecs/2021/AS-SOC-2021-54-EN.pdf'>Declaration</a> adopted by the Committee on Social Affairs, Health and
Sustainable Development on 1 December 2021: The Covid-19 situation:
“No-one is safe until everyone is safe”.](/nw/images/icon_footnoteCall.png)
4. In light of the worrying development of the pandemic situation
across the world, the urgent debate proposal asks the Assembly to
urgently examine necessary measures to ensure global equitable distribution of
vaccines, sufficient uptake in member States, including the question
of mandatory vaccinations, building up stronger health systems to
tackle the crisis and stronger commitment to addressing the socio-economic
issues that have arisen due to the pandemic.
2. Fighting new waves and variants
5. By 19 January 2022, more than
332 million confirmed cases of Covid-19, including more than 5.5 million deaths,
had been reported to the World Health Organization (WHO). These
figures are alarming, in particular since they are bound to be a
large under-estimate in many parts of the world. Currently, the
European and the Americas regions of WHO are recording the most
cases, as the fast-growing Omicron variant displaces the previously
dominant Delta variant – nearly 9 million cases and over 21 000
deaths were recorded in the last 7 days in the European region alone.
6. The Omicron variant arrived at a time when much of Europe
was already in the grip of a wave of the highly contagious, and
severe disease-causing Delta variant. The vigilance and openness
of the South African and Botswanan scientists and public health
officials enabled the WHO to act quickly.
![(4)
<a href='https://theconversation.com/omicron-why-the-who-designated-it-a-variant-of-concern-172727'>https://theconversation.com/omicron-why-the-who-designated-it-a-variant-of-concern-172727.</a>](/nw/images/icon_footnoteCall.png)
On 26 November 2021, less than two
weeks after the first reported cases of the Omicron variant, it
was designated a variant of concern by WHO due to the unprecedented
number of spike mutations which implied even higher contagiousness, as well
as a possible immune escape from both vaccines and prior infection.
This prompted many member States to take new restrictive measures
in order to stem the spread of the virus, but some do not seem to
have not taken the warnings seriously enough.
7. The Director General of WHO, Dr Tedros Adhanom Ghebreyesus,
has warned world leaders that the pandemic was nowhere near over.
At a press conference on 19 January 2022, he pointed out that the
Omicron variant had led to 18 million new infections across the
world in the prior week alone. European countries are now facing
record new case numbers, with France reporting over half a million
new daily cases on Monday, 17 January 2022, and Germany surpassing
100 000 new infections in 24 hours for the first time since the
start of the pandemic the following day. The United Kingdom has
been suffering from very high infection rates of hundreds of thousands
of infections a week for weeks.
8. Experts have warned that although the Omicron variant may
prove to be less severe on average, it is misleading to say that
it is a mild disease.
![(5)
<a href='https://www.euro.who.int/en/health-topics/health-emergencies/pages/news/news/2022/01/the-omicron-variant-sorting-fact-from-myth'>www.euro.who.int/en/health-topics/health-emergencies/pages/news/news/2022/01/the-omicron-variant-sorting-fact-from-myth.</a>](/nw/images/icon_footnoteCall.png)
It is still causing hospitalisation
and deaths, and even the less severe cases are inundating health
facilities. The risk of developing long Covid, which affects even
young people without underlying conditions, is another reason why
it is dangerous to ease down on restrictions and let transmission
get out of control.
9. According to the WHO Technical Advisory Group on Covid-19
Vaccine Composition, a vaccination strategy based on repeated booster
doses of the original vaccine composition is unlikely to be appropriate
or sustainable. Instead, they call for the development of new vaccines
that not only protect people who contract the virus against becoming
seriously ill, but also have high impact on prevention of infection
and transmission (providing “sterilising immunity”).
![(6)
<a href='https://www.who.int/news/item/11-01-2022-interim-statement-on-covid-19-vaccines-in-the-context-of-the-circulation-of-the-omicron-sars-cov-2-variant-from-the-who-technical-advisory-group-on-covid-19-vaccine-composition'>www.who.int/news/item/11-01-2022-interim-statement-on-covid-19-vaccines-in-the-context-of-the-circulation-of-the-omicron-sars-cov-2-variant-from-the-who-technical-advisory-group-on-covid-19-vaccine-composition.</a>](/nw/images/icon_footnoteCall.png)
10. As WHO has pointed out, “the situation is very different from
region to region, country to country, province to province and town
to town.... Getting vaccinated, maintaining physical distancing,
cleaning hands, avoiding crowded and closed spaces, and wearing
a mask are “anti-lockdown measures”: they can prevent the spread
of disease without having to shut down large parts of society. However,
the inequitable distribution of the tools which assist in mitigating
transmission or save lives – including diagnostics, oxygen, personal protective
equipment and vaccines – is driving a two-track pandemic. This inequity
will prolong the acute stage of this pandemic for years when it
could be over in a matter of months. If this virus is circulating
anywhere, it’s a threat everywhere”
![(7)
38th Regulatory
update, 12 September 2021, <a href='https://www.who.int/teams/regulation-prequalification/covid-19'>www.who.int/teams/regulation-prequalification/covid-19.</a>](/nw/images/icon_footnoteCall.png)
. WHO has developed guidance with
considerations for implementing and adjusting public health and
social measures in the context of Covid-19, which our member States
should follow.
![(8)
<a href='https://www.who.int/publications/i/item/considerations-in-adjusting-public-health-and-social-measures-in-the-context-of-covid-19-interim-guidance'>Considerations
for implementing and adjusting public health and social measures
in the context of COVID-19.</a>](/nw/images/icon_footnoteCall.png)
11. The message from
Resolution
2329 (2020) “Lessons for the future from an effective and rights-based response
to the Covid-19 pandemic” was to go in fast and hard in order to
contain transmission so that we could possibly avoid stricter lockdowns
at a later stage. We must continue with low-level protective measures
such as wearing FFP2 masks, ensuring proper ventilation of indoor
spaces (such as schools and workplaces), exercising physical distancing,
teleworking whenever possible, encouraging outdoor serving at bars
and restaurants, and frequent handwashing in order to stop the spread
of the virus and buy ourselves more time in order to save lives,
prevent people from getting seriously ill and save our economies.
Such measures may also have the effect of preventing the necessity
for harder lockdowns at a later stage when the virus could be even more
dangerously out of control.
12. At the beginning of the pandemic, coronavirus transmission
was not well understood, and personal protective equipment, in particular
effective masks, such as FFP2/N95/K95 respirators without valves,
was in short supply. While cloth masks and surgical masks are still
better than no masks at all, such masks provide practically no protection
to their wearers from infection, due to the extreme contagiousness
via aerosol in particular of the newer variants such as Delta and
Omicron (the latter of which can infect people at 3 meters physical
distance still and can remain airborne for 3 hours). Mandating the
use of FFP2-masks, as has been done for example in Austria and several
German states, in risky situations, such as on public transport,
in crowded spaces inside and outside, and in schools (in particular,
secondary schools), is an effective and comparatively low-cost measure
of infection control.
13. There are worries that even in Europe, mandating the use of
such masks could lead to inequities. However, developing production
capacity, distribution and considering mandating the use of high-quality masks
(progressively moving to masks of FFP2 standard if possible) would
nevertheless be useful measures, as would providing such masks free
of charge for vulnerable groups if possible (and ensuring that they
are affordable for the rest of the population).
14. Although vaccines lower the risks of falling seriously ill
and reduces transmission, there is still a chance that one may get
infected. Thus, testing systems should still be in place, and encouraged,
in our member States. In November, Germany reintroduced free testing
as a measure to hit the brakes on a new wave of infections. More
member States should follow this line, ensuring that testing is
free and easily accessible to everyone in order to cut down on transmission
chains. Persons in Germany who have not yet taken their booster
shot will need to have a negative test result in addition to two
vaccine doses in order to access non-essential businesses such as
restaurants and bars.
![(9)
<a href='https://www.integrationsbeauftragte.de/ib-de/staatsministerin/corona/what-do-you-currently-need-to-know-about-corona-englisch--1876282'>www.integrationsbeauftragte.de/ib-de/staatsministerin/corona/what-do-you-currently-need-to-know-about-corona-englisch--1876282.</a>](/nw/images/icon_footnoteCall.png)
15. Recalling the declaration adopted by our committee on 1 December
2021, member States should mutually recognise all anti-Covid vaccines
developed and authorised for use in Council of Europe member States,
as well as all WHO-authorised vaccines, for the purpose of not discriminating
against the millions of persons who have received their vaccine
doses abroad. Member States should also collaborate on a technical solution
on how to recognise proof of Covid-19 infection abroad.
16. Governments should take concrete measures based on scientific
evidence to stop the spread of the virus instead of hiding behind
travel bans that are not recommended by the WHO and have proven
to have little efficacy. Many have rightly criticised the travel
bans imposed over the Omicron variant. The travel bans targeted
only African countries, several of which had not detected the Omicron
variant, although the variant was already present in other continents,
including in Europe. The WHO Director General expressed deep concern
that these countries were being penalised by others for doing the
right thing and sharing information. Moreover, Ms Maria Van Kerkhove,
technical lead on Covid-19 at WHO, added that the travel bans had
other serious implications, including limiting the ability of South
African researchers to ship virus samples out of the country.
![(10)
<a href='https://edition.cnn.com/2021/12/04/africa/africa-travel-ban-omicron-variant-intl-cmd/index.html'>https://edition.cnn.com/2021/12/04/africa/africa-travel-ban-omicron-variant-intl-cmd/index.html.</a>](/nw/images/icon_footnoteCall.png)
17. On 1 December 2021, the World Health Assembly established
an intergovernmental body to draft and negotiate a convention, agreement
or other international instrument under the Constitution of the
World Health Organization.
![(11)
<a href='https://www.who.int/news/item/01-12-2021-world-health-assembly-agrees-to-launch-process-to-develop-historic-global-accord-on-pandemic-prevention-preparedness-and-response'>www.who.int/news/item/01-12-2021-world-health-assembly-agrees-to-launch-process-to-develop-historic-global-accord-on-pandemic-prevention-preparedness-and-response.</a>](/nw/images/icon_footnoteCall.png)
The Council of Europe member States
should support the development of such a global accord. This would
help build preparedness and resilience to pandemics and other global
health emergencies, support prevention, detection, and responses
to outbreaks with pandemic potential, ensure equitable access to
pandemic countermeasures, and support global co-ordinating through
a stronger WHO.
![(12)
<a href='https://apps.who.int/gb/COVID-19/pdf_files/2021/18_03/Item2.pdf'>A
Potential Framework Convention for Pandemic Preparedness and Response.</a>](/nw/images/icon_footnoteCall.png)
3. Urgent
need for global equitable distribution of Covid-19 vaccines
18. The committee has on several
occasions warned that “no-one is safe until everyone is safe” and
the emergence of new variants is further proof of this. Already
in the early stages of the vaccine rollout, a year ago, our colleague
Jennifer De Temmerman underlined in her report that if we allow
the virus to mutate, by allowing “pockets” of the virus to remain
in circulation in certain parts of the world, we might blunt the
world’s most effective instrument against the pandemic so far –
and have to go back to square one all over again.
19. Global equitable distribution of vaccines and transfer of
technology is vital in order to protect public health and to overcome
the social and economic crisis sparked by the pandemic. Despite
longstanding calls from the WHO, public health experts and scientists,
as well as
Resolution
2369 (2021) “Covid-19 vaccines: ethical, legal and practical considerations”,
member States have not done nearly enough to ensure global equitable
access to Covid-19 vaccines.
20. The COVAX initiative, which won the 2021 Council of Europe
North-South Prize, was launched in 2020 in order to ensure global
equitable allocation of Covid-19 vaccines with the goal of delivering
2 billion doses to low- and middle-income countries by the end of
2021. Regrettably, it did not manage to deliver even half of the doses
last year. Only on 13 January 2022, it surpassed 1 billion doses.
While according to a WHO press release, 36 of the WHO member States
have vaccinated less than 10% of their population, and 88 member States
less than 40%, high income countries, including many of the Council
of Europe member States, began vaccinating healthy individuals with
booster shots already in the second half of 2021.
21. COVAX’s mission was compromised by hoarding and stockpiling
by rich countries, as well as catastrophic outbreaks leading to
borders and thus supply chains being closed down. Moreover, a lack
of sharing of licenses, technology and know-how by pharmaceutical
companies meant manufacturing capacity went unused.
![(13)
<a href='https://news.un.org/en/story/2022/01/1109852'>https://news.un.org/en/story/2022/01/1109852.</a>](/nw/images/icon_footnoteCall.png)
This lack of global equitable allocation
of Covid-19 vaccines has already resulted in a setback of the United
Nations Sustainable Development Goals.
22. Member States must thus redouble their efforts for equitable
and speedy delivery of Covid-19 vaccines on a global level together
with the necessary technology transfer and building up local production
capacity.
![(14)
<a href='https://theconversation.com/omicron-why-the-who-designated-it-a-variant-of-concern-172727'>https://theconversation.com/omicron-why-the-who-designated-it-a-variant-of-concern-172727.</a>](/nw/images/icon_footnoteCall.png)
It should be our top priority to
ensure that vulnerable groups
![(15)
There
is a risk of low immunogenicity of Covid-19 vaccines among immunocompromised
people, particularly in solid organ transplant recipients and patients
with malignant hemopathies: <a href='https://www.pasteur.fr/en/press-area/press-documents/covid-19-systematic-review-clinical-and-immunological-efficacy-vaccines-immunocompromised-people'>www.pasteur.fr/en/press-area/press-documents/covid-19-systematic-review-clinical-and-immunological-efficacy-vaccines-immunocompromised-people.</a>](/nw/images/icon_footnoteCall.png)
and healthcare workers everywhere
have access to vaccines in order to stop the virus from circulating
and to avoid more deaths and disease, and further damaging of our
economies. This includes,
inter alia,
that member States must refrain from contributing to market conditions
that substantially disadvantage countries with less economic power.
At the international and multilateral level, we need a stronger
commitment to finding a global response including through support
of a Agreement on Trade-Related Aspects of Intellectual Property
Rights (TRIPS) waiver
![(16)
The
World Trade Organization Agreement on Trade Related Aspects of Intellectual
Property Rights.](/nw/images/icon_footnoteCall.png)
and technology transfer so that
no one is left behind.
4. Measures
to ensure higher vaccination rates and the question of mandatory
vaccinations
23. Insufficient vaccination rates
within many countries, including in the Council of Europe member
States, is another contributing factor to the continued spread of
the virus and the consequent strain on our health systems. Vaccine
hesitancy, fuelled by disinformation, misinformation and distrust
in government, is making it more difficult to obtain progress in
vaccination rates.
24. As many European countries are struggling to obtain higher
vaccination rates, some have imposed vaccine mandates or other measures
to exclude the unvaccinated from being able to take fully part in
society, reviving the debate around individual autonomy on the one
hand, and the need to protect public health and the most vulnerable
in our societies on the other hand, as provided for in Article 12
of the International Covenant on Economic, Social and Cultural Rights
(ICESCR) and Article 11 of the European Social Charter (STE No.
53).
25. In the case of Solomakhin v. Ukraine,
the European Court of Human Rights (the Court) held that mandatory
vaccination is an interference with the right to integrity enshrined
in Article 8 of the European Convention on Human Rights. Nevertheless,
it concluded that such interference may be justified if considered a
“necessity to control the spreading of infectious diseases” (paragraph
36).
26. In April 2021, the Court delivered a judgement in the case
of Vavřička and Others v the Czech Republic, in
which the Grand Chamber provided a more detailed discussion of the
implications of the European Convention on Human Rights (STE No.
5) on mandatory vaccination in the context of childhood vaccines. The Court
found that the Czech policy of fining parents who refused to let
their children get vaccinated and excluding these children from
preschool was compatible with the European Convention on Human Rights. The Court
noted that States have a positive obligation to protect the health
and life of their residents, including those particularly vulnerable
to certain diseases and those who cannot have specific vaccines
for medical reasons (paragraph 282). Low vaccination rates increase
risk of outbreaks of serious diseases which may severely impact
individuals’ health and society in general.
27. Whether or not mandatory vaccination and/or the use of vaccine
passes are a necessary public health measure and human rights compliant,
will depend on the context and scientific evidence, but the State
enjoys a large margin of appreciation.
![(17)
<a href='https://gchumanrights.org/preparedness/article-on/is-mandatory-vaccination-against-covid-19-justifiable-under-the-european-convention-on-human-rights.html'>https://gchumanrights.org/preparedness/article-on/is-mandatory-vaccination-against-covid-19-justifiable-under-the-european-convention-on-human-rights.html.</a>](/nw/images/icon_footnoteCall.png)
There are valid reasons for mandating
vaccination for specific groups, such as health care workers or
others who are in contact with vulnerable groups, or indeed, those
more vulnerable themselves.
![(18)
For
example, Greece has introduced vaccination mandates for those 60
and older, and Italy for those over 50 – with fines for those who
do not comply.](/nw/images/icon_footnoteCall.png)
Austria has just become the first
country to mandate Covid-19 vaccination for almost everyone 18 and
over, beginning 1 February 2022, with routine checks of vaccination
status to begin in mid-March 2022, with fines up to 600 Euros.
28. Mr Robb Butler, the Executive Director of WHO Europe, expressed
in November 2021 that a conversation about mandatory vaccination
is a healthy debate to have.
![(19)
<a href='https://news.sky.com/story/covid-19-who-warns-of-half-a-million-more-virus-related-deaths-by-spring-across-europe-12477120'>https://news.sky.com/story/covid-19-who-warns-of-half-a-million-more-virus-related-deaths-by-spring-across-europe-12477120.</a>](/nw/images/icon_footnoteCall.png)
At a critical time when our societies are
trying to overcome new waves of the pandemic, governments must balance
individual rights with their obligation to protect public health
and safeguard the right to health of vulnerable individuals in society
who are at increased risk because others choose not to get vaccinated.
I believe there are less restrictive ways of ensuring higher vaccination
rates as I will elaborate on below, but I agree with WHO that the
time has come to have a debate on this – one that is necessary to
have in open and democratic societies.
29. In a study published in
Nature,
the introduction of the health pass in France (
passe sanitaire) was found to have
increased levels of vaccination. That is good news for public health
in terms of reducing serious illness and death, as well as the burden
on the health system. However, the study noted that the increased
uptake was achieved to a less extent amongst the most vulnerable
groups. Moreover, it did not reduce vaccine hesitancy itself, showing
the importance of outreach to underserved communities and the potential
limits of mandatory vaccination policies. In fact, the study suggested
that having hesitant or reluctant persons getting vaccinated for
the wrong reasons may have negative consequences which can reinforce
mistrust of institutions and of the healthcare system.
![(20)
<a href='https://www.nature.com/articles/s41591-021-01661-7'>www.nature.com/articles/s41591-021-01661-7.</a>](/nw/images/icon_footnoteCall.png)
30. The use of Covid passes or certificates was subject to a report
by my colleague, Mr Damien Cottier, entitled “Covid passes or certificates:
protection of fundamental rights and legal implications”. Ms Carmen Leyte
wrote an opinion to the report on behalf of our committee, underlining
that “Covid passes” should only be used to exempt their holders
from restrictions intended to prevent the spread of the SARS-CoV-2
virus when there is clear and well-established scientific evidence
that proof of vaccination, past infection or negative test results
are effective tools of infection control, namely lower the risk
of transmission of the SARS-CoV-2 virus to an acceptable level from
a public health point of view.
31. From previous expert hearings we have learned that groups
and movements against vaccination are unfortunately better at reaching
the undecided. Vaccine mandates and polarising vocabulary to describe persons
who for various reasons are not vaccinated may therefore be counterproductive
and contribute to a further divide in our societies. In a historical
context, such regulations have sometimes been associated with systemic
government oppression of marginalised groups. Taking this into account,
outreach programmes and sustained efforts to motivate those who
are hesitant should be the cornerstone of Covid-19 vaccine policies.
32. It has been the view of the Assembly that vaccine hesitancy
should be tackled first and foremost through democratic and awareness
raising measures. More could have been done, and can still be done,
in order to persuade more people to get vaccinated, but it requires
investment, time and effort from governments and public health authorities.
Resolution 2369 (2021) provides member States with practical recommendations
to consider in order to ensure high vaccine uptake, based on frameworks
and studies developed by WHO and other public health experts.
33. These include strengthening health literacy, engagement with
non-governmental organisations, trusted persons within communities
and other local efforts when developing and implementing tailored
strategies to support vaccine uptake (which can be particularly
helpful when trying to reach out to marginalised communities and
groups that have historically been subject to systemic discrimination
and oppression from governments) and being open and transparent
in communication. In particular, it is important to communicate
the benefits of vaccination, that they have undergone rigorous testing
and have proven to be safe and effective at preventing severe illness,
hospitalisation and death from Covid-19. Studies also indicate that
vaccination reduces the risk of developing long Covid. Vaccines
are thus one of the most effective ways to protect ourselves, our
families and society as a whole against the virus.
5. Building
stronger health systems
34. The pandemic has laid bare
the inequities in our health systems, including in mental health,
and lack of sufficient funding, resulting,
inter
alia, in overworked and underpaid health care staff and
insufficient hospital beds. In the WHO Europe region, staff shortages
were the overriding problem for hard-pressed health services. In
our member States, there are big differences in the number of intensive
care beds relative to population. At the beginning of the pandemic,
Germany had 28.2 hospital beds per 100 000 inhabitants and Austria
had 21.8, while the European average was only 14.1.
![(21)
<a href='https://www.ft.com/content/43ba23b5-7dc3-435d-9d6a-201dbc038451'>www.ft.com/content/43ba23b5-7dc3-435d-9d6a-201dbc038451.</a>](/nw/images/icon_footnoteCall.png)
35. The first waves of the pandemic should have been a wake-up
call for governments that this must be urgently addressed, but so
far little has been done. Chronic under-investment and mismanagement
means workforce shortages are constraining intensive care provision.
![(22)
<a href='https://www.ft.com/content/43ba23b5-7dc3-435d-9d6a-201dbc038451'>www.ft.com/content/43ba23b5-7dc3-435d-9d6a-201dbc038451.</a>](/nw/images/icon_footnoteCall.png)
Moreover, there is an urgent need
to make mental health care services affordable (ideally free for
children and adolescents) and accessible for everyone. With waiting
lists hitting all-time highs due to the pandemic, governments should
also consider low threshold offers such as short-term therapy for
mild or moderate mental health problems and disorders. The promotion of
good health and wellbeing should be included in school curriculums.
36. Thus, member States must urgently allocate the necessary funding
in order to build up stronger health systems. This includes combatting
not just the pandemic and its devastating effects on the global
economy, but also the pre-existing fault-lines and inequalities,
including in access to healthcare, which the pandemic has exposed,
and embrace the One Health approach.
37. Before the pandemic hit, the world was taking positive steps
with regard to Universal Health Coverage in order to deliver health
for all by 2030. The pandemic fundamentally disrupted our health
systems, societies and economies, and has thus eroded the development
gains over the past 25 years.
![(23)
<a href='https://www.who.int/news-room/feature-stories/detail/responding-to-covid-19-and-building-stronger-health-systems-for-universal-health-coverage'>www.who.int/news-room/feature-stories/detail/responding-to-covid-19-and-building-stronger-health-systems-for-universal-health-coverage.</a>](/nw/images/icon_footnoteCall.png)
Member States should therefore follow
WHO advice and take this crucial opportunity to reset the very foundations
of health systems: from governance to financing, strengthening access
to medicines, vaccines and health services, building up the health
workforce, to strengthening the capacities of all countries to prevent
and respond to health emergencies.
![(24)
Ibid.](/nw/images/icon_footnoteCall.png)
The
Assembly should consider working on this issue, as well.
38. We have no time to lose. The nature of the pandemic implies
that we have to act now.
Resolution
2329 (2020) “Lessons for the future from an effective and rights-based
response to the Covid-19 pandemic” and the report of the Pan European
Commission on Health and Sustainable Development “Drawing light
on the pandemic: a new strategy for health and sustainable development”
provides member States with further guidance in this matter.
6. Commitment
to addressing the socio-economic issues that have arisen due to
the pandemic
39. Health is a fundamental human
right indispensable for the exercise of other human rights. Protecting public
health is not only about avoiding infection in society. The pandemic
and the stringent measures imposed to avoid transmission in society
have had devastating effects on other rights and freedoms, and member
States must show stronger commitment to address this.
40. The pandemic has taken a great toll on human lives. But it
is far more than a health crisis as it affects societies and economies
at their core with the increase of poverty and inequalities both
within member States and globally, thus also resulting in a setback
for the achievement of the UN Sustainable Development Goals. Once
again, working people, parents, children, women, vulnerable persons
and marginalised individuals are disproportionately affected.
41. The Covid-19 pandemic knows no borders and does not discriminate,
but our efforts to prevent and contain it do.
![(25)
<a href='https://www.un.org/en/coronavirus/stronger-health-systems-and-universal-health-coverage-must-be-priority'>www.un.org/en/coronavirus/stronger-health-systems-and-universal-health-coverage-must-be-priority.</a>](/nw/images/icon_footnoteCall.png)
While the world’s 10 richest men
have more than doubled their collective fortune from March 2020,
the income of the other 99% has fallen. The pandemic has hit the
poorest and most vulnerable in our societies the hardest, with lower
incomes for the world’s poorest contributing to the death of 21 000
persons each day.
![(26)
<a href='https://www.oxfam.org/en/press-releases/ten-richest-men-double-their-fortunes-pandemic-while-incomes-99-percent-humanity'>www.oxfam.org/en/press-releases/ten-richest-men-double-their-fortunes-pandemic-while-incomes-99-percent-humanity.</a>](/nw/images/icon_footnoteCall.png)
42. The world is now facing the biggest economic recession in
eight decades. But these inter-generational impacts are not due
to Covid-19 alone. Rather, they are the result of long-term fragilities,
inequalities and injustices that have been exposed by the pandemic.
![(27)
<a href='https://www.un.org/en/coronavirus/stronger-health-systems-and-universal-health-coverage-must-be-priority'>www.un.org/en/coronavirus/stronger-health-systems-and-universal-health-coverage-must-be-priority.</a>](/nw/images/icon_footnoteCall.png)
When implementing policies to recover
from the crisis sparked by this pandemic, we must take this opportunity
to build back better, greener and fairer, as underlined in the report
on “Overcoming the socio-economic crisis sparked by the Covid-19
pandemic” by our colleague Mr Andrej Hunko.
43. Council of Europe member States should commit to stronger
mitigating measures, such as paying for sufficiently high sick leave
payments to persons infected by the virus, persons who need to quarantine
at home due to being contact cases, or parents who have to look
after children who cannot go to school because they are sick or
contact cases. As a minimum, this should apply to those who are
vaccinated (without discriminating against persons who for medical
reasons cannot be vaccinated).
44. While there has been a lot of talk about not discriminating
against persons who do not wish to take the vaccine, discrimination
of persons who are vulnerable to the virus has fallen in the shadow
of this. A disproportionate number of persons in intensive care
units in hospitals are now healthy, unvaccinated individuals. The
unvaccinated thus pose a serious threat to our public health systems
and our economies, as they are more likely to be infected, and to
be infectious themselves for longer (putting more vulnerable individuals
at risk), and more likely to fall seriously sick. We must show solidarity
with health care workers and protect the most vulnerable persons
in our societies.
45. Many have experienced disruption in education due to the pandemic.
School and university closures have a high negative socioeconomic
impact for children and adolescents, and disproportionally affect
the most vulnerable and marginalised within our communities. The
resulting disruptions exacerbate already existing disparities within
the education system but also in other aspects of life.
![(28)
<a href='https://en.unesco.org/covid19/educationresponse/consequences'>https://en.unesco.org/covid19/educationresponse/consequences.</a>](/nw/images/icon_footnoteCall.png)
Thus, member States should follow the
message from WHO, UNESCO and UNICEF that if and when restrictions
are imposed to decrease transmission and control, schools should
be the last places to close down and the first to reopen with appropriate
infection prevention measures.
![(29)
<a href='https://www.euro.who.int/en/media-centre/sections/press-releases/2021/whoeurope-keep-schools-open-this-winter-but-with-precautions-in-place'>www.euro.who.int/en/media-centre/sections/press-releases/2021/whoeurope-keep-schools-open-this-winter-but-with-precautions-in-place.</a>](/nw/images/icon_footnoteCall.png)
7. Transparency
and assessment of public health measures to ensure compliance with
human rights
46. As public health measures interfere
with some of our most fundamental rights, it is of utmost importance that
governments and decision makers are transparent and open on the
reasons for imposing restrictive measures. Parliaments, the judiciary,
and, when appropriate, external experts, should be able to assess
and review the measures so as to ensure that they fulfil a legitimate
aim and that they are proportionate. Moreover, continued assessments
are needed to ensure that measures are not in place for longer than
necessary, but also to consider other measures that may be more
appropriate.
47. The Secretary General of the Council of Europe has issued
a toolkit for governments on respecting human rights, democracy
and the rule of law during the Covid-19 crisis.
![(30)
<a href='https://www.coe.int/en/web/congress/covid-19-toolkits'>www.coe.int/en/web/congress/covid-19-toolkits.</a>](/nw/images/icon_footnoteCall.png)
Member States should make use of this
toolkit in order to ensure that measures taken during this crisis
remain proportional to the threat posed by the spread of the virus
and are limited in time.
48. Member States must by all means avoid politicising the pandemic
and instead ensure that measures are well founded in scientific
evidence and follow the recommendations made by WHO and other public
health experts.
49. I would like to stress that as parliamentarians and decision
makers we have a particular responsibility to lead by example. Bad
judgements, even though they may be in accordance with the sanitary
rules put in place, may undermine trust and create the impression
that there is another set of rules which apply to the “elite”. Such behaviour
is particularly upsetting for those who have lost their loved ones,
fallen seriously ill themselves, or have been impacted by the pandemic
in other ways, such as having lost their jobs or been isolated from
their friends and family for long periods of time.
8. Conclusions
50. It is urgent that all countries
learn the lessons of the pandemic so far, starting with the implementation of
the necessary public measures to get the pandemic under control.
Sky-high infection rates cannot be tolerated anywhere, since every
infection gives the virus a new chance to mutate, and thus become
more infectious, virulent, and/or immune-escaping – creating a seemingly
never-ending cycle of waves of disease. These cycles push decision-makers
into making stark choices between “living with the virus” and the
large burden of disease and death the virus brings, and taking harsh
public health measures to protect health systems from collapse,
and the disruption to our economies, our education systems and our
societies these measures bring.
51. As has been pointed out at several junctures of the pandemic,
“no-one is safe until everyone is safe”. The Assembly thus recommends
that governments and parliaments in Council of Europe member States
and worldwide make the necessary paradigm shift to beating Covid-19
with public health measures in a human-rights compliant way, once
and for all, with regard to:
- bringing
down infection rates;
- ensuring global equitable distribution of vaccines and
treatments;
- sufficient vaccine uptake;
- addressing “long Covid”;
- building stronger health systems nationally, at European
level, and globally;
- and addressing the socio-economic issues that have arisen
due to the pandemic.
52. The Covid-19 pandemic is not over, nor is it likely to be
the last pandemic of its kind. It is paramount to avoid the politicisation
of pandemics – and of public health measures to contain them. To
mitigate the impact of future coronavirus variants and of other
health threats which may soon emerge, the world needs to urgently establish
and strengthen pathogen monitoring and surveillance systems. The
divides between countries and within societies need to be bridged,
with politicians leading by example, so that Covid-19 can be beaten
once and for all, and future threats can be faced in a more unified
manner, with more solidarity.