COVID-19: what is next for public health?

Abstract

542 www.thelancet.com Vol 395 February 22, 2020 The WHO Scientific and Technical Advisory Group for Infectious Hazards (STAG-IH), working with the WHO secretariat, reviewed available information about the outbreaks of 2019 novel coronavirus disease (COVID-19) on Feb 7, 2020, in Geneva, Switzerland, and concluded that the continuing strategy of containment for elimination should continue, and that the coming 2–3 weeks through to the end of February, 2020, will be crucial to monitor the situation of community transmission to update WHO public health recommendations if required. Genetic analysis early in the outbreak of COVID-19 in China revealed that the virus was similar to, but distinct from, severe acute respiratory syndrome coronavirus (SARS-CoV), but the closest genetic similarity was found in a coronavirus that had been COVID-19: what is next for public health? U-Report to identify how and where young people wish to be involved in advancing the goal of promoting mental health and wellbeing in their communities and wider society. Alongside scalability, a need exists for inclusive tools that allow for genuine and meaningful engagement from children in rural areas, ethnic minorities, gender and sexual minorities, those exposed to poverty and violence, and those who experience health challenges. In our work with the Lancet Commission on Global Mental Health and Sustainable Development on the My Mind Our Humanity campaign, arts-based approaches have allowed us to engage young people from a range of backgrounds, both face-to-face and online. Poetry and music have created safe spaces for sharing deeply personal experiences of mental health challenges and supporting each other. These approaches have allowed us to challenge stigma by reminding young people of our shared humanity. The potential of artsbased and digital tools to foster inclusive engagement and participation is important, and our capacity to empower young generations is dependent on our ability to harness these and other resources to understand their values and experiences. The WHO–UNICEF–Lancet Commission invites us to think holistically about children and their rights to be heard and respected, and emphasises the role of community engagement in promoting the health and development of the world’s children. Children’s participation goes far beyond formal, high-level platforms. Having a voice—or lacking one—defines every relationship and interaction children experience at home and in school, work, leisure settings, and other spaces they inhabit. Children are empowered when they feel safe and welcome at home and school; when they have someone to talk to if something is wrong; and when family, friends, and teachers hear their concerns and appreciate their ideas. Indeed, family togetherness and connection to one’s culture are crucial for health and wellbeing, according to the children consulted by the Commission, from communities across New Zealand, Lebanon, Nigeria, and Argentina. The potential of shared experiences to harness children’s health and wellbeing is enormous. By fostering a culture of connectedness and mutual respect, we meet children’s needs for self-esteem and confidence and strengthen their ability to make a difference. The WHO–UNICEF–Lancet Commission presents a candid assessment of the threats children face and the sombre implications for their future. But the Commission also presents a clear vision for making a better world, for them and with them. Too often have we seen young people sidelined while those who have the power to make a change hesitate. For too long have young people been silenced, mocked, and judged for their bold ambitions to challenge the status quo. We will not be deterred. Now and always, the voices of children will call for an inclusive, fair, and sustainable future.