Despite the important steps that countries have taken to respond to the Covid-19 pandemic, all, regardless of their income level, remain visibly unprepared to respond to the epidemic and pandemic threats among them, also Albania. This was the message conveyed by the latest report of the Global Health Index for 2021.

Albania ranked 59th out of 195 which was the total of countries taken into analysis. But which aspects of health insurance taken separately have improved or deteriorated compared to 2019 when this index was last published?

What is presented with deterioration is detection or detection, which has a decrease of points by 5.4. In this category - oversight, access to data and transparency - are where steps have been taken, while case-based investigations have steadily deteriorated. The epidemiological workforce and laboratory supply chains have remained unchanged.

The answer is the third indicator that makes up the index and has marked a value of 38.1, down by 5.4, ranking us in 79th place in the world just for this indicator. The biggest decline has been in the subcomponent of access to communication infrastructure and restrictions on travel and trade. The emergency preparedness and the plan to respond to it were improving.

The only indicator where Albania has improved is that of health, which is related to the necessary infrastructure, ie the number of clinics and hospitals, as well as the available medical staff. The latter are better than in 2019, but the biggest difference is made by the sub-component of the supply chain in the health system and employees in the field of health.

Another indicator taken in the analysis is the one for the rates where there is a decrease of points by 2.9 in relation to 2019 and international commitments and financing.

The last is the risk indicator, with a decrease of 3.1 points of the index compared to 2019 and the indicator that ranks our country worse, if assessed separately. Albania ranks 121st among 195 countries only for this indicator and what is seen as problematic is the risk of security and politics, socio-economic resilience, environmental risks and public health weaknesses.

Interview with Erion Dasho, doctor and health expert:

The Global Health Safety Index presents Albania with a deterioration in the level of response to health emergencies. Health expert, Erion Dasho, says that public health, for years has not been a priority for the Albanian government, has been left in the hands of amateurs, has not been properly invested in the right directions. He points out as a problem the infrastructure of hospitals, as well as the lack of human resources.

According to this Index, prepared by the Johns Hopkins Center for Health Safety in 2021, Albania is ranked 59th out of 195 countries taken in the analysis. The element that has had the most deterioration, according to the report, has been the ability to detect health situations. Do you see this shortcoming real in the Albanian context?

I think that, in reality, we have significant shortcomings when it comes to identifying situations and this was seen during the management of the pandemic situation. We had two sides: either ignorance of the situation or another interpretation, when throughout the pandemic, Albanians were told that we were one of the countries that controlled Covid best, while subjective data, ie those coming from patients, spoke of home returned to hospitals, for a problematic situation in the autumn and winter period.

Also, when the estimated mortality data came out, it turned out that Albania had 16 thousand deaths from Covid. I think that this indicator really shows that Albania is unable to verify what is happening on the ground, or is a deliberate concealment.

Another element considered problematic, according to the report, is the weakness of public health. What do you think could be further improved in the face of an ongoing global pandemic?

Public health, for years, has not been a priority for the Albanian government, it has been left in the hands of amateurs, it has not been properly invested in the right directions. For example, students who have completed their studies in public health are unemployed.

And in our health institutions you often find people without relevant education, coming from areas that are not directly related to health. This indicator is enough to show that the priority has not been public health, so we are in this situation which is highlighted by the report in question.

The only indicator where Albania has improved is the one related to the necessary infrastructure - for the number of clinics and hospitals, as well as the available medical staff. Do you see this indicator real?

In terms of clinics, we need to distinguish hospitals from health centers. In recent years there has been a good health initiative to renovate health centers, a program which is called 300 centers. In my opinion, this has been a fair investment, because health centers need little investment, to turn into a health institution that is suitable to provide medical care.

Until a few years ago, there were health centers where the roof was leaking, or other degradation of infrastructure depreciation, which was resolved. But I do not know how much this was accompanied by the replacement of medical equipment, which is one of the important inputs of health care. Regarding hospitals, I think that the infrastructure of public hospitals in Albania is completely depreciated and inadequate to provide modern health care.

All hospitals are still of the Soviet model, with depreciated buildings not connected by bridges within the same hospital. In all modern hospitals, there is underground infrastructure, where hospital support services are concentrated, such as laboratories, radiology, etc., or non-clinical support services such as management, information technology, laundry, kitchen, etc., which is lacking as a model in Albania. .

For many years I have recommended that a gradual replacement / adjustment plan be needed to replace a regional hospital every two or three years. This will make Albania, within a 15-year period, replace this depreciated hospital structure. As for human resources, I do not know where they saw the optimism in this report, as Albania is the last country in Europe in terms of number of doctors per capita.

If Germany has 6-7 doctors per 1000 inhabitants, Albania has 1.2. Now they claim that it has increased, but I think that the figure is not correct, as the deregistrations of the doctors who left before have not been done.

(Source: Monitor)