(ANSA) - UDINE, 02 GEN - The  "Roadmap for health in the Western Balkans (2021 - 2025)"  was jointly endorsed by WHO Europe, Central European Initiative, and CEI Western Balkans countries on December 3 in Budva (Montenegro). The involved countries will commit to "a series of actions to improve health systems and efficiency standards, inspired by the principles of cooperation and solidarity." Ansa's interview with Dr. Hans Henri P. Kluge, WHO/Europe Regional Director, puts forth an analysis of the document and discloses the situation in the Western Balkans.

Director, can you explain the main objectives of this document? "The Western Balkans Roadmap for Health & Wellbeing aims to bridge the health gaps between the Western Balkans and the European Union. As Regional Director, I will fully support this region to increase life expectancy and health literacy, decrease child and maternal mortality, expand access to universal health coverage, and train health workers, using health to enhance stability and ensure prosperity for the region's people. In addition, the Roadmap aims to focus on and invest in whole, technically-sound projects that have the potential to address the critical points in the subsubregion's health systems." The meeting held in Trieste on 22 and 23 November and promoted by the Central European Initiative (CEI) and WHO Europe was a stage in the Roadmap. So what kind of help do the Western Balkans countries need the most in the health sector right now? "Amid the dramatic economic downturn, the Covid-19 pandemic has cast a spotlight on the need for greater investment in health across the Western Balkans. The pandemic has placed an excessive burden on health systems in the subregion, magnifying some longstanding deficits in several areas. Drawing shared lessons from the dire impacts of the pandemic, the Western Balkans have highlighted, among others, the need to strengthen the following key areas moving forward: investment in primary healthcare and essential services to better sustain periods of crisis; health and social protection of marginalized and vulnerable groups; governance and administration mechanisms across health and social systems; digital technologies that can help to improve efficiency and accountability as well as improve the interface between people and health services." How is the WHO working on regional and sub-regional cooperation to contain the damage of this situation?  "Subregional cooperation is a building block of multilateralism and shared prosperity that leaves no one behind. The persistent health gap exacerbated by the pandemic requires urgent, sustained, and decisive action by the Western Balkans and partners. Solidarity and unity are needed to responsibly build robust health and public health systems that are resilient and ready to face future challenges. The Roadmap will deliver the core health priorities that countries across Europe and Central have agreed to in the European Programme of Work 2020-2025, United Action for Better Health. We are looking to strengthen the leadership of health authorities in the subregion and ultimately to leave no one behind." In some Balkan and Eastern European countries, the infection spreads, and health structures are put to the test. So what are the most urgent measures to be taken?  "My advice to Europeans is to get vaccinated because we are not yet out of the woods, and people should not let their guard down just yet. I urge the Balkans people to get vaccinated as soon as possible and with a full series of doses. The sub-region has lower than average vaccine uptake rates. With the Delta variant still dominant in the region and Omicron spreading fast, it is vital to protect communities from severe disease. It's crucial to vaccinate the population, administer third or additional doses if immunity is waning, double the rate of mask-wearing in crowded indoor spaces, apply new clinical therapeutic protocols.

New antivirals are coming into the market, which could be a game-changer in treating Covid-19. But prevention is better than cure, and we should try to avoid getting infected in the first place. And then international solidarity. No one is safe until everyone is safe, and we must support each other, share vaccine doses, share knowledge and data, and use all the tools at our disposal to put pressure on the virus. The rich world, particularly the G7 and G20, needs to play a bigger, more coordinated role." Do you think that the vaccine should be given every year, as is done for other diseases?  Will the WHO urge pharmaceutical companies to adapt future vaccines to the new variants? "This is very difficult to predict because we are in unchartered territory. Every day, we learn more about the SARS-CoV-2 virus and how current vaccines respond to different variants. We will have to wait and see how immunity holds up after three doses. We know that immunity begins to wane roughly six months after receiving a second dose. Covid-19 is here to stay, and it will likely become an endemic virus, much like the seasonal flu. In this scenario, vulnerable populations will be offered a Covid-19 vaccine every year in the run-up to winter. Pharmaceutical companies are ready to adapt current vaccines to new variants as needed, and it is indeed a miracle of modern science that they can quickly tweak the vaccines and begin manufacturing updated vaccines." In Germany, however, where the number of vaccinated people is much higher, and the health service is better and more widespread, infection is rampant. Why?  "Infection rates in the European Region are the highest ever, and we face a rocky road ahead. There is a range of factors for this: the highly transmissible Delta variant is dominant in the region; there are still millions of people in our area who are unvaccinated and susceptible to SARS-CoV-2.; we're mixing more and because of the colder weather and spending more time gathering indoors; use of tactics known to curb the spread of the virus, such as wearing masks in indoor, confined, and crowded spaces or keeping a safe distance, remains patchy. But we have the tools to help control this pandemic, it is not a matter of chance but choice, and it is up to all of us, politicians, and citizens, to play our part".

What is the most important lesson learned to take into account during this fourth wave?  "It is too late to prevent the fourth wave in Europe, and we missed that opportunity. Right now, all our efforts must be to reduce infections. We need to increase vaccine uptake, not just to save lives but to keep our health systems from buckling under the pressure. But in the medium- to long term, we need to take a different approach to this pandemic. The virus is always one step ahead of us, and we need to catch up and get ahead of the virus. Of course, we should do everything in our power to avoid infection in the first place. There are many lessons to learn, but the overarching takeaway must be that we cannot tackle this pandemic and any future health emergency alone. That's why it's so important that we remain open to dialogue with all stakeholders at local, national, regional, and global levels, championing multilateralism and using science and evidence to inform our decisions. But ultimately, everything will fail if there is no political will. Without it, no amount of science can prevent the next big health emergency." (ANSA).