PANDEMIC, plandemic, scamdemic . . . there are a number of variants in the referencing of the period also known as the covid era which began six years ago, in March 2020. There is, however, another term coming to the fore – syndemic.
The word is a blend of synergy and epidemics, defined as the evaluation of how social and health conditions arise, how they interact, and what drivers may produce their interactions. It was coined by American medical anthropologist Merrill Singer in the 1990s to describe the intertwined crises of substance abuse, violence and Aids.
I have written previously for TCW about the unique partnership between Public Health Wales and the World Health Organization, and it just so happens that the WHO has re-designated Public Health Wales’s Policy and International Health Directorate as a WHO Collaborating Centre on Investment for Health and Well-being. Apparently, this ‘reaffirms Wales’s position as a global leader in shaping policies, strategies and investments with health, wellbeing and equity at the heart’.
It’s an eyebrow-raising affirmation, given that the Institute for Fiscal Studies (IFS) has just published a rather damning report on public services, including health, in Wales. Its executive summary opens with the statement that ‘public services play an important role in households’ wellbeing and their residents’ life chances’.
Yet according to this document the WHO Collaborating Centre has established and is strengthening Wales’s role as a ‘global influencer’ and ‘live innovation site for health equity and prosperity for all’. It also describes Covid-19 as a ‘syndemic’. A quick internet search for a definition directed me to this publication co-authored by professors from the London School of Hygiene and Tropical Medicine and Imperial College London. The institutions between them host multiple WHO collaborating centres. Two examples of these are the WHO Collaborating Centre for Infectious Disease Modelling at Imperial (remember Neil Ferguson?) and the WHO Collaborating Centre on Climate Change, Health and Sustainable Development at the London School of Hygiene and Tropical Medicine.
I daresay we will be hearing much from the WHO Collaborating Centre for Environmental Risks and Health in the near future. This was established just a couple of months ago and ‘contributes expertise on air pollution and environmental health risk’. Wales is the first UK country to have passed an Environment (Air Quality and Soundscapes) (Wales) Act in 2024.
The press release about the renewal of the Public Health Wales collaboration is a typical word salad which contains phrases such as ‘reducing inequities’, ‘applying novel investment and social value tools’ and ‘building a healthier, fairer and more sustainable future for all, leaving no one behind’. Of course, the latter slogan about leaving no one behind was the central slogan of the UN Sustainable Development Goals in 2015.
Despite the eight-year collaboration seemingly initiated to improve health, according to the IFS study NHS waiting times in Wales are higher than pre-pandemic and comparable measures are higher than in either England or Scotland. The Welsh NHS has more funding and staff than pre-pandemic but hospital activity has not increased proportionally. Accident and emergency waiting times have worsened during the last two years. The International Health Co-ordination Centre (IHCC) collaboration is clearly not about improving the health and wellbeing of the people of Wales.
However, if we read the following quote from Dr Gillian Richardson, Deputy Chief Medical Officer for vaccines who oversaw the collaboration project which began in 2018, we have a better insight into what it is really all about.
She said: ‘We live in an interconnected world where local health threats rapidly become global, and global threats have local impact, as we have seen with the coronavirus pandemic, climate change, food and water security and essential medical and other supply chains. In 2017 Public Health Wales made a commitment to become an organisation which is nationally focused and globally responsible through a ten-year International Health Strategy.’
There has even been a resource co-produced with Oxfam Cymru (Wales) and the Wales Centre for International Affairs which is an expansion of this commitment, in order to develop NHS Wales professionals as ‘global citizens’. This featured staff training ‘deep dives’ into climate change and sustainability, rights-based health, peace and conflict and globalisation and interdependence.
I asked ChatGPT what the specific purpose of the IHCC in Wales is and it told me that it is to build and promote global partnerships, promote global citizenship and ‘responsible’ health systems. It is akin to the Wales and Africa scheme which gives individuals from the public, business and third sectors in Wales ‘the opportunity to work on projects designed to both enhance their leadership skills and deliver a developmental outcome for their hosts’. The Wales and Africa Health Links Network merged in 2024 with the Tropical Health Education Trust to become the Global Health Partnerships Cymru. Its website openly states that its purpose is ‘to support health partnerships between Wales and Africa to contribute to the UN Development Goals’. No doubt there are ample opportunities for staff jollies or ‘international learning opportunities’ featured here, despite the apparent climate ‘catastrophe’.
Therefore, if you or a family member is a citizen of Wales, waiting for a hip operation or an appointment with a cardiologist, please be patient. Your government may be disastrously failing its population’s health and wellbeing, but rest assured that change will come. Once enough global research has been fulfilled, tools have been developed and inequalities have been reduced (along with the numbers of hospitals in Wales) everything will be hunky dory.
Or should that be Jackanory?
