Physician and geneticist Axel Kahn, president of the National Cancer Association, is releasing a new book * in which he reviews, among other things, the health crisis and its consequences.
As a physician, what do you think of the words of the philosopher André Comte Sponville who spoke of “healthy nihilism” and “universal medicalism”?
André Comte-Sponville is deeply misunderstanding, in my opinion. He forgets the two basic ingredients of freedom: individual and collective. Freedom is doing anything that does not harm others. Taking healthy measures so as not to infect others, and this is what guarantees collective freedom. If I am contagious and do not wear a mask, then I seriously harm your individual freedom. We must take into account individual freedom, as well as the collective fear of individual freedom.
“The public good in the field of vaccine is to achieve global governance for manufacturing and distribution.”
For its part, economic liberalism has been particularly embodied by the pharmaceutical companies and the race for vaccines. Do you think a vaccine should be a public good?
The public good in the field of vaccine would have been to establish a global department for manufacturing and distribution. At the moment, there is no beginning to implement such a policy. Entrepreneurial freedom, which was very important, triumphed over the improvement of the common good.
“We cannot play the economy against health.”
Some point to the catastrophic economic consequences of this crisis, and the long-term impact on health and people’s lives. Could one have imagined another trade-off between economy and health?
For the economy to recover, viral circulation must be reduced. There is no other way. The idea that the virus should be allowed to spread to avoid an economic meltdown is absurd. When you tolerate high viral circulation, there is always an economic meltdown. Currently, the economic collapse is greater in Sweden than in Denmark or Norway. Brazil is on the verge of bankruptcy, although we wanted to preserve the economy and try to take less action. We cannot play the economy against health. Healthier numbers and fighting the virus is part of the economic recovery.
The advantage of democracy and consensus in addressing this epidemic was not clear. ”
From a political point of view, we sometimes have the impression that the least democratic countries have been the most effective in managing the crisis …
This is indeed one of the terrible consequences of this crisis. China is one of the countries that has managed the health situation better, which has emerged from it faster and has increased its economic and technological dominance. Countries that worked well, such as Singapore where is the VietnamNot great democracies either. From this point of view, the advantage of democracy and consensus in fighting this epidemic is not clear. Likewise, the European construction ideal did not come out of managing this crisis. In the end, the results are not satisfactory. It would have been better for the people to be dissidents, such as the English or Hungarians, who freed themselves from European rules.
“We were in a situation where nothing was known about this disease. Meanwhile, there are 24-hour news channels providing viewers with information about the virus.”
And science, is it also on the way to a crisis? Has this epidemic shed light on a general crisis for those who know it facing a private conspiracy?
The plot was previous and did not progress with this crisis. The situation has just crystallized. We can see this well with adhesion to graft. It is very broad: 70% of people are supportive of vaccines. The image of science and teachers in the public eye fell from a misunderstanding. We were in a situation where nothing was known about this disease. Meanwhile, there are 24-hour news channels providing viewers with information on the virus.. Since we know nothing, everyone comes up with their intuition: an epidemiologist, an infectious disease specialist, or a resuscitator. They are very different jobs. For public opinion, science speaks with one voice. In fact, everyone comes up with their own idea. This is a completely natural process in science when starting from zero knowledge. But it was very disturbing to the general public.
All in all, did the experts take up too much space? Was politics hiding behind it at times?
In France, the opposite is true today: we are witnessing the political exclusion of experts. For the most part, all of Macron’s recent decisions were made based on his political and health intuition. In a normal world, it is up to the politician to make the decisions. For this decision to be wise, it surrounds itself with a variety of experiences. But the expert is never a decision maker. A politician must enrich his knowledge in order to build his opinion. This did not really happen during this crisis: Sometimes politicians referred excessively to experience. sometimes, They have disavowed their responsibility. Some decisions should have been purely political. On the one hand, a president who considers that he no longer needs experts is a true anomaly of modern democracy …
“We are entering a world where privacy will not exist, except perhaps on a desert island.”
“For the most part, the narrow scope of privacy is a visualization of the past,” she writes. “When all health data is computerized and enriched in real time, the issue of its confidentiality becomes intractable.” Is this an inevitable deviation in health monitoring in your opinion?
Medicine will be completely transformed by artificial intelligence. What is the Lancet scandal? A private fund has stolen health data everywhere. Today in cryptography, we can produce very strong security keys. But no security key will be able to resist an attempted quantum digital hack. We are entering a world where the world of privacy no longer exists, if not perhaps on a desert island …
Do you support the permissibility of vaccination?
Traveling abroad feels natural to me, similar to old vaccination records. Even more difficult is the use of a vaccination passport to access social events. This would be discriminatory. Because people who have been vaccinated can access it while others, who have not been vaccinated, will not be able, but would like to.
“A hospital cannot be the only part of a country’s health system.”
The hospital is in poor condition. During this pandemic, we never stopped evoking it by evoking its necessary re-evaluation. But very tangibly, what does this mean?
Hospital reassessment is not sufficient. The entire health system must be reviewed. Today, 70% of people go to the emergency room because they need medical advice. Hospital emergencies cannot accommodate 70% of unplanned needs. We must strengthen the hospital, but city medicine must also be revitalized. Each person should be able to access physical contact with the human being and receive authorized medical advice. We must find a way to fix doctors by rethinking the health system as a whole. A hospital cannot be the only part of a country’s health system.
* And the Good All In All, Axel Khan, Stock, 460 p. 20.50 euros