“More mental health to the portfolio of the SNS”

María Neira, director of Public Health and the Environment of the WHO.

The World Health Organization (WHO) has set two clear strategies in its roadmap for the short and medium term: improving the air quality and the impulse of the attention to the mental problems. They are two of the legs of the table that its director of Public Health and the Environment, Maria Neira, It has set itself the goal of disseminating information on all its international visits. On a brief stopover in Spain, passing between Sweden and Rwanda, The health spokesperson has granted an interview to Medical Writing where he has reviewed these keys to the future.

María Neira (WHO): “Investment in mental health is always positive.”

The endocrinologist doctor originally from Lto Felguera (Asturias) has presented the main recommendations that the institution has sent to all countries, including Spain, to lift the mental health stigma and investment needs in this field. While he has made a tooth and nail defense of the measures to contain the contamination, with which he has presented himself to the 55th Separate Congress of Pamplona.

What opinion does the WHO have of a congress of the magnitudes of Separ?

The fact that they are specialists in respiratory diseases at this critical time when we are promoting so much the importance of air quality gives me great satisfaction. I am an endocrinologist and yesterday I told you that I am delighted that the respiratory specialists have taken me into account to work with them.

We greatly need the support of respiratory specialists because not only do we have to cure patients with these ailments, but we have to go to the causes of these ailments and many have to do with such tremendous air pollution.

Separ has warned that the post-covid era is going to increase its activity by 60%. Is it necessary to invest more in Pneumology in Spain?

Pulmonology during the pandemic has played a fundamental, critical role. The entire medical profession has suffered greatly but they have surely always been on the front lines. Now in the post-Covid we have to reflect, continue giving all the strength to the pulmonologists, to the specialists in thoracic surgery, but also to think more and more that their voice is necessary in strategies to reduce air pollution.

The director of Public Health and the Environment of the WHO, María Neira, in an interview with Medical Writing.

We need more and more to hear the voice of doctors who have a lot of credibility in society, who have won great battles in the past, such as when we have fought for access to drinking water. It was fundamental in medicine. If you wanted to be healthy, you had to have access to clean water. Today one of our important battles has to be air quality.

We have pulmonologists, we want to create collaboration networks and I am sure that from Separ it will be important for us all to make ourselves heard and in our cities we can breathe cleaner air. And in this way, effectively, all the linked pathologies, from asthma to chronic obstructive respiratory diseases, will have another treatment that is not only curative, but also preventive.

What concerns are there currently with variants like BA.4 or BA.5?

I think that the concern that we can have is that at any moment, any respiratory transmission virus is there. But it will continue to be there with more probability if we do not take these preventive measures. If we don’t start to stop destroying the ecosystems that are the ones that somehow with that aggressive deforestation, that pollution, that use of fossil fuels, that traffic in the cities generate so much toxicity.

Indeed, the pandemic has shown that the medical profession, health in general, is essential. Investing in having the best conditions for health professionals to work is never a lost investment. It is always valid, winner. In any circumstance of crisis, post-crisis or crisis preparation, the best investment is in health and education. There is no country that is at the top of development that has not had these conditions.

In Spain, the pulmonologists have played a role and therefore it is valued socially, it is financially protected and it is reinforced where necessary and creating the best conditions for it to carry out its best work.

The WHO is studying the particular situation in Spain regarding the supply of anti-tuberculosis drugs. What is the outlook for the coming months?

All the investigation is still going on. The day before we came here we finished one. All these networks of experts, all this knowledge that has been generated in the last two years, in general, also work outside of the crisis. It has been so intense in these last two years, so creative, with so much scientific production that it has been the most stimulating part.

More and more studies will come out, more scientific publications and from there we will get results. Now we have to see what happens with post-Covid, what it means, what importance it has from an epidemiological point of view and how we are going to confront this situation.

Also, the day before yesterday we launched a report on the impact on mental health. Mental health is another of the great blocks that all professions are going to have to have a more open mind, generated by everything we have experienced in recent years. The conditions of our lifestyle are leading us in that direction.

Has the WHO given any specific instructions to Spain or to the group of member countries to face the paradigm shift in mental health?

The recommendations are above all to consider it in any strategy, in any health policy. Sometimes, we focus on the healing part, the physical ailment, and we do not take into account the problem of the mental health part. There is another recommendation regarding the possible stigma that may exist in some countries. We have to lift it and demystify the problem of illnesses related to mental health.

More professionals must be trained, more and more Services Portfolio must be incorporated with respect to mental health and it must be considered a complete part of how we normally define health. Not just a state of absence of disease, but a complete state of physical and mental health and well-being. Hopefully society moves in this direction

Is more investment in mental health necessary in Spain?

I would say that in Spain it is necessary as in all countries. If you are going to ask someone from the WHO if more investment is necessary, the answer is always going to be yes. Investment in health, not only in curing illness, is never a bad investment. It is always a very good investment. You’re not going to find anyone in the WHO who’s going to say no.

In all countries, and especially in those that still do not have access to universal and free health coverage, our call is for action to be taken. Nothing destroys the economy of a country and the social fabric more than these inequalities generated by people, a high percentage in some even rich countries, who do not have access to universal health coverage.

How does the WHO assess the deployment of the UCRI in Spain? Is it an exportable model to other countries? Is it a necessary investment?

At a national level, we obviously work with the health authorities, but to assess a specific model we would need a very specific study, to buy it at a European level. There are many different initiatives in Europe. Now will be the time to confront them, to see them and to extrapolate which ones are going to be the most useful, always with a public health perspective.

In the WHO we work a lot not only on the extremely curative part, but above all on the balance of how that balance of investments makes the whole system work. That requires not only a hyper-specialized ad hoc investment, but a complete review of how the entire health system that is in place can be improved. With companies like Separ, there are many issues that can be discussed, that can be promoted and that will result in very positive proposals for the health system if they are listened to and implemented.

María Neira answers the questions of Redacción Médica en Pamplona.

Although it may contain statements, data or notes from health institutions or professionals, the information contained in Medical Writing is edited and prepared by journalists. We recommend the reader that any questions related to health be consulted with a health professional.

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