![]() Thus, the first, rather obvious lesson was that we need to strengthen health systems and invest in traditionally neglected areas, such as community health and primary care. The immediate priority was often to prevent the health systems-in which governments had failed to invest-from collapsing under the pressure. And even if they acted decisively-which few did-they often looked in vain for clarity from their scientific advisers, who were themselves trying to make sense of the rapidly expanding, but variable quality evidence. Political leaders struggled to know what to do, or how seriously to take the threat. Even when they had developed and tested plans they had failed to learn the necessary lessons. ![]() ![]() Yet governments had failed to invest in preparedness. The pandemic was not just predictable, it was predicted by many commentators. The starting point is a diagnosis of what went wrong. The report and an accompanying evidence review have now been published. For the past year we have been working with the Pan European Commission on Health and Sustainable Development, endorsed by the Regional Director of WHO Europe, Hans Kluge, and chaired by Mario Monti, a former Italian prime minister and European Commissioner. So, as we look to the future, it is time to ask what needs to change. But, there is now some light coming through the darkness as we realise the benefits of a greater understanding of how this airborne virus is transmitted, a growing number of vaccines and treatments, and improved models of care. A generation of children has missed out on education and social contact at critical periods in their development. Businesses built up over decades have gone under. As we write, reported deaths have exceeded 4.5 million worldwide, with the true total value perhaps several times higher. The covid-19 pandemic has been a massive international shock to global health, to the world economy, and to the geopolitical order.
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