Expert opinion on Corona consequences: production of medicaments to be shifted back to the EU
University of Bayreuth, Press release No. 040/2020, 20 March 2020
One of the most renowned doctors and medical ethicists in Germany, Prof. Dr. mult. Eckhard Nagel, chair of Healthcare Management & Health Sciences and director of the institute of Healthcare Management & Health Sciences at the University of Bayreuth, sees the coronavirus crisis as an opportunity to strengthen cohesion in society. He considers the health system to be robust enough, but urges for the production of medicaments to be shifted back to the EU, and for this process to be given political impetus.
Is dependence on medicine imports dangerous?
In the last two years, problems with the supply of medicaments have been on the rise even in Europe, which by the beginning of 2020 had already led to considerable supply difficulties for over 300 products. Many areas of medical care have been affected, especially involving antibiotics, antidepressants, and generally in the area of non-patented drugs. So even before the coronavirus crisis, there already was discussion on whether outsourcing the production of important basic goods might not pose risks. Just what such risks mean is becoming very clear at this moment. It is therefore a matter of urgency to return, like in the past, to comprehensive self-sufficiency with regard to the supply of essential basic goods, and I would certainly think of this in a European context. There is also the question of how the State can ensure that these products are regularly available.
What do you recommend?
Pharmaceutical manufacturers have completely relied on suppliers in Asia for the production of drugs and basic materials. This must be reversed. In the future, there must also be a basic supply for the production of medical goods such as protective masks or other consumables, in the European region. The current coronavirus crisis shows how necessary that is. Due to bottlenecks, the question arises: facemasks only for hospital staff, vaccines only for certain people?
What would be justifiable?
When it comes to the question of protective suits and materials for dealing with sick patients being primarily concentrated where they are needed, we are not primarily dealing with the disadvantaging of any other social group.Rather, it is about the sensible use of scarce resources. This is not an issue specific to one crisis situation, but should be done in principle. A problem only arises where people go into panic because of the prevalence of general insecurity. These fears must be countered with public education and reassurance, but not with the senseless consumption of resources - as is the case with panic buying, for example.
And what is the situation with medicaments or vaccines?
Supplying the population with essential medicaments or vaccines is another issue. Here the general principles of human rights apply, which include a general ban on discrimination. The foundations of the medical treatment contract are aligned to these principles, and in this respect, the goal is to provide adequate care for all patients in need. If a situation arises, however, in which the means for treatment are only available for a certain group, then so-called prioritization criteria are needed to determine which persons, for example, will benefit most from a vaccination (e.g. older patients or those who are likely to suffer complications if they become ill). In this regard, it would be conceivable, with a vaccine, that initially only those people would be vaccinated who have a particular risk of falling ill or possibly dying. Nevertheless, the overriding goal remains that as many people as possible in the population should be vaccinated in order to ultimately achieve immunity for the entire population and thus prevent the further spread of the disease in the long term.
Curfews to contain infection - has our hospital infrastructure already reached its limits?
Hospital infrastructure in Germany is robust and currently not overburdened. However, one of the peculiarities of an epidemic is that a large number of patients all fall ill at once, and require acute care. If we are talking about tens of thousands of patients who have to be treated as inpatients, then of course that cannot all take place at once. In this respect, the call for social distancing is an extremely important, indeed a central measure, in order to keep the number of people infected at the same time as low as possible.
Are politicians responding properly, or should they have reacted faster and more strictly?
I myself have been busy with questions on the novel corona virus since 27 December. Many of the assumptions I made in January or February this year, although they were always based on the latest findings, have proven misleading. It turns out that the developments and patterns of this infection can only be learned bit by bit, and that decisions have to be adjusted accordingly again and again.For the Federal Government this means as many restrictions as necessary, but also as much freedom as possible. Apart from border controls in Germany and in the EU area, which in my view were inadequate from mid-January until the beginning of last week, there have been no glaring failures.
Are you concerned about cohesion in our society?
In principle, no. I even believe that this situation of concern about coronavirus will tend to strengthen cohesion within our society at a variety of levels. What is important here is that the spread of solidarity among people must be faster than the spread of the virus. I have experienced this in many places, and yet I know that there are dubious individuals who will try to exploit this problematic situation for dishonest purposes. As an example, I need only mention emerging nationalism.It would be tragic if those who want to divide people, states, and continents were to outdo those who rightly hold on to the insight that such a crisis can only be overcome through strong social cooperation. That is one concern. But I am convinced that the good, that solidarity, will prevail.
Univ.-Prof. Dr. Dr. med. habil. Dr. phil. Dr. theol. h. c. Eckhard Nagel
Chair of Healthcare Management & Health Sciences at the University of Bayreuth
Phone: +49 (0) 921/ 55-4801
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University of Bayreuth
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