In this turbulent world, it’s tempting to move on and forget the difficult days of COVID-19. Although the impact of the COVID pandemic is far-reaching, and for many, ongoing, as priorities shift, people are thinking less about the last pandemic or the possibility of another one. We risk falling into yet another cycle of panic and neglect. 

In episode 6 of Not If, But When, we ask, what are the challenges for the public health experts trying to apply the lessons of the last pandemic, and working to strengthen the global systems for preventing future ones?

We speak to Catherine Smallwood, former WHO Regional Office for Europe’s Senior Emergency Officer and Programme Manager (Emergency Operations), about the systems in place that guide health emergency preparedness and response.

We hear from Mike Ryan, Executive Director of WHO's Health Emergencies Programme, about why, despite increasing and overlapping emergencies, he’s optimistic that the world will find ways to work together to combat global threats.

In tropical and subtropical countries, the virus causing dengue is spiking. Close to an historic high of over 6 million cases and more than 7,000 dengue-related deaths were reported in over 80 countries and territories in 2023. Most places in Europe remain too cool to favour the mosquito or the virus, but imported dengue cases have been rising in the European region and the impact of climate change appears to be shifting the picture. 

To find out more about dengue and the family of viruses it belongs to, called arboviruses, Alice Allan speaks to Marc-Alain Widdowson, high threat pathogens technical lead at the WHO Regional Office for Europe and medical entomologist Luca Facchinelli. To learn more about Italy’s work on dengue prevention and communication, she speaks to Flavia Riccardo, an epidemiologist in the Infectious Disease Department of the Italian National Institute of Health, and her colleague from the Institute’s press office, Pier David Malloni. 

The first of the three influenza pandemics that occurred in the 20th century is estimated to have killed over 50 million people.  Based on scientific advances, what do we know about the 1918-20 pandemic? What lessons does it teach about preventing pandemics and containing outbreaks when they do occur?

• Richard Pebody, director clinical and emerging infections of the UKs health security agency, explores the deadly 1918-20 pandemic. 
• Thorsten Wolff, head of the Division for Influenza and other Respiratory Viruses, talks us through the scientific discoveries that helped to explain the virus that caused the 1918-20 pandemic, and the ongoing work of the National Influenza centre in Berlin. 
• Nicola Lewis, Director of the Worldwide Centre for Influenza at the Francis Crick Institute, UK, explains their work to monitor seasonal flu and pick up changes in flu strains that could have pandemic potential.

The 2022 mpox outbreak has taught public health authorities a lot about the value of working with communities on important areas like testing, vaccination, and risk communication. Lessons that can be applied to other disease outbreaks.

Mpox is back in the news; there are sporadic clusters of cases in our region, and, in Central and West Africa, two strains of the virus continue to cause suffering and death. 

In this episode, we speak to Rosamund Lewis, Emergency Manager & Technical Lead for the global mpox response at WHO Headquarters, about the current situation. Cristiana Salvi, who leads the Risk Communication and Community Engagement unit for WHO regional Office for Europe explains the importance of community insights in the mpox response. We also hear from epidemiologist Mateo Prochaska Nunez on the combination of factors that brought the outbreak under control and the measures needed to keep the virus in check.

In this episode, we are putting a special focus on the H5N1 bird flu. We explore the ongoing efforts to prepare for future pandemics by speaking with experts like Peter Sousa Hoejskov, who explains the constant risk of zoonotic diseases jumping from animals to humans, and Maria van Kerkhove, who emphasizes the importance of global surveillance and preparedness in the face of potential influenza pandemics. The discussion sheds light on how close human-animal interactions, even in regions like Europe, keep the threat of these diseases ever-present.

The insightful contributions from leading scientists provide a comprehensive understanding of why we must remain vigilant and proactive. Tune in to Health in Europe with host Alice Allan to discover what’s being done to protect us all from the  next pandemic - not if but when.

(Interviews for this podcast were recorded in early May 2024)

We turn our attention to the world of nursing through the compelling lens of Stefanie Fernandes and Francisco Ferraz. Francisco, a passionate third-year nursing student from Portugal, brings us into the heart of his journey—navigating the intricate balance of emotional connections and the systemic challenges within healthcare. From his night shifts in the pediatric intensive care unit to the poignant stories that shape his vocation, Francisco's experiences offer a raw and insightful look at the realities of nursing. 

This episode not only highlights the indispensable role of nurses but also underscores the urgent need for systemic reforms to better support these healthcare heroes. 

Join us as we dive into the essence of what it means to care, to endure, and to strive for change in a profession that is both profoundly rewarding and undeniably demanding.

Find out more about nursing: https://www.who.int/europe/health-topics/nursing

What are we doing to prepare for the next pandemic?

We go behind the scenes at WHO and some of the European region’s major public health institutions to understand what the most likely causes of future pandemics could be and what strategies are in place to avert them. We talk to the experts applying the lessons of previous pandemics and focus in on the systems in place to spot threats and reduce their impact.  We speak to the legion of public health experts getting on with the not very glamorous, but incredibly important work of emergency preparedness— experts in surveillance, genomic sequencing, epidemiology and more. The people who are containing outbreaks and laying the groundwork to mitigate the effects of pandemics, not if, but when they occur.

With Dr Maria van Kerkhove on Disease X, Dr Gail Carson on pandemic preparedness and Roland Driece on the Pandemic Accord.

Find out more about the Pandemic prevention, preparedness and response accord: Pandemic prevention, preparedness and response accord (who.int)

This week marks the 50th anniversary of the WHO's Expanded Programme on Immunization,  now known as the Essential Programme on Immunization, or EPI. This initiative has been a driving force behind the quest for fair access to life-saving vaccines for every child, irrespective of their geographical or socioeconomic circumstances.  

Over the past half-century, EPI has played a crucial role in shaping our battle against preventable diseases. But this is not a self-congratulatory episode, celebrating EPI’s triumphs. We will also examine the persistent challenges of inequitable vaccine access, growing skepticism towards immunization, and the future of global health collaboration. We are going to dissect successes, confront the hurdles, and question what's next for this vital global health programme.

Find out more: 50th anniversary of the Expanded Programme on Immunization (EPI) (who.int)

There is an alarming resurgence of measles. In the WHO European Region, a startling uptick has been observed, with now over 50,000 cases reported across 41 Member States during 2023. This is a staggering increase from the 941 cases recorded throughout 2022, marking a more than fiftyfold escalation. 

Measles is a highly contagious virus. It can spread rapidly through breathing, coughing, or sneezing by an infected individual. The consequences of this disease can be severe, often leading to serious complications and, tragically, even fatalities.

In addition to the suffering caused by measles, containing outbreaks is costly and detracts from other health care services.  Of course, an illness which can last two weeks or more also impacts families directly.

In a Region in which 33 countries are considered to have eliminated measles what are the reasons behind this surge in measles cases and what strategies are we exploring for curbing the spread of this virus. Joining us for discussion is Robb Butler, the Director of Communicable Diseases, Environment and Health at the World Health Organization Regional Office for Europe.

Find out more: https://www.who.int/health-topics/measles

In the latest 'Health in Europe' podcast, we explore Jack Kavanagh's transformation from a sports enthusiast to a disability rights advocate following a spinal cord injury. 

WHO talks with Jack for a deep dive into creating inclusive health systems. This episode goes beyond Jack's personal journey, addressing the societal need for health systems that cater to all, highlighting inclusivity, equity, and diverse needs. 

Find out more about Health and Disabilities on the WHO/Europe website: https://www.who.int/europe/health-topics/disability 

We explore the transformative synergy of art and health, and how art can positively help tackle noncommunicable diseases (NCDs) – from cardiovascular diseases to cancer. Join us as we discuss the healing potential of art interventions with experts from WHO/Europe's Special Initiative on NCDs and Innovation and Behavioural and Cultural insights units. Read more in the new WHO/Europe report “Learning from the arts” here: The power of healing: new WHO report shows how arts can help beat noncommunicable diseases