He had preferred, in recent months, to stay away from any debate or controversy.
While the very first vaccinations against Covid 19 are announced this Sunday in France, the former Minister of Health and co-founder of Médecins du Monde and Médecins sans Frontières Bernard Kouchner exclusively gives us his perspective on the health crisis.
Without excluding anything, from the communication hiccups of the public authorities to the vaccination strategy, including the question of consent and the situation of poor countries in the face of the pandemic.
In March, you approved the government's strategy, which was then very criticized on the management of masks, for example.
What is your position today?
BERNARD KOUCHNER.
I misunderstood myself.
I wanted at the time not to add one more voice to the discrepancies of the moment.
There may of course be differences of point of view but I have learned, during my various visits to the Ministry of Health, that a public health decision must be applied and for it to be, it must be established. a real relationship of trust between doctors, pharmacists, nurses and the French.
Unfortunately, that was not the case at the time, especially since we knew very little about the virus.
Talking indiscriminately led to obvious and unnecessary anxieties.
What do you mean ?
Contradictory opinions must be heard but I believe that the multiplicity of interventions on the news channels was very damaging.
It was enough for someone to pass by so that they could lend him a white coat on a TV set and give his point of view, sometimes with unfounded arguments.
The role of social networks, since the revolt of the yellow vests, has also been very harmful.
The enemy was no longer the virus but the government.
It was the scientific committee and the health officials that had to be heard and in my opinion, to establish this essential confidence, not to address France in general but to families and in particular to their officials who are very often women.
They are the ones who decide and tell their children what is right and wrong to do.
The way public authorities communicate has been questionable, not very focused and not “human” enough.
This cacophony has a name: it's called infodemia.
That is to say, too much information, leading to doubt.
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Why accept to speak again today?
Because the vaccines are there!
They are the first serious attack against a virus that has changed our habits.
Finally a great hope for this anguished country.
So yes, the first vaccinations on this Sunday are a bit symbolic because we just don't have a lot of vaccines available yet.
But they will allow the medical profession to talk to patients, to explain that all this is not magic, nor dangerous, that nothing is hidden.
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Can we trust these vaccines produced very quickly?
Yes, the manufacturing process has been sped up, but it is absolutely complete.
It is a wonderful achievement of science.
No checks were overlooked.
Each laboratory has conducted tests on thousands of people, and the results have been checked more than usual, by the laboratories themselves first, then by the European agency and the national medicines agencies.
No serious incidents have been reported except one mild case at Pfizer.
Of course, you have to watch out for side effects, especially allergies, but every drug has its risks, of course.
This vaccine, for the moment, causes only a few small pains at the level of the injection.
Nothing abnormal, but let's not relax the attention.
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Are you going to get vaccinated?
Of course, but later as soon as I can.
I had Covid disease, which I barely felt, other than the smells going away.
I have antibodies, but for how long?
We also don't know how long the vaccine lasts, it's true, but that's no reason not to!
Pasteur's country would make a fool of itself if it refused vaccination.
You are a little over 80 years old and are primarily concerned.
Do you know when will you be personally vaccinated?
Do not worry: I will get vaccinated but without upsetting the hierarchies.
We must first let the operations be done in nursing homes and nursing homes.
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Who should play a role in allowing the poorest countries to have access to vaccines: WHO, Europe, France, NGOs?
Everyone, not France alone.
There is a WHO mechanism called Covax which will allow, in Africa, 54 countries for the moment, to have a distribution and even financial advantages to allow many countries to have access to it.
Yes, distribution networks will have more difficulty in structuring themselves in Africa but, fortunately, there will be less to do because, contrary to what we feared at the beginning of the year, the pandemic is not as widespread in Africa as it is. 'in Europe.
The instructions are respected there as well as possible, there is no laxity, and the experience of the four African countries which have been severely affected by the Ebola virus has served as a lesson.
We thought in Europe that we would not be affected by the viruses and we ignored the Ebola alert.
We were wrong.
Have the nursing staff been sufficiently supported?
No, we thought that by removing beds, we would spend less money.
We finally understood that this was not a good calculation and that we needed these beds.
In passing, I salute, hats off and heart at half mast, the caregivers who have done their hard work really well.
But when we look at our health system, which was one of the best, and see the response that has been given to the Covid, I think we have to review our system based on centralized decisions.
Germany, with its decentralized side, is visibly better organized.
And let this crisis serve as a lesson to us: much more money is needed for health.
But it's not about having a maternity hospital at the foot of every building.
You just have to find the right balance and that's what, politically, is the most difficult.
Shouldn't being Minister of Health be easy at the moment?
I find that Olivier Véran is doing quite well.
It's even a good surprise.
It's not easy because we would like to take everyone by the hand, but we are 67 million French people.
So sometimes we find ourselves a bit helpless and lonely.
This crisis has forced us to grope a little.
But if we look at the figures, France should not be ashamed of its neighbors: Spain, Italy, Belgium, Switzerland, even Germany.
There are pro and anti-vaccines, pro and anti-containment, pro and anti-Raoult.
Who can we believe when even the doctors do not agree with each other?
The doctors who disagreed shouldn't have said it so loudly.
And then you know, sometimes doctors are just as inconsistent as the rest of them.
We've had a few chloroquine gurus who haven't done any good.
We had some regional competition which didn't help either.
And then we continue to not pay enough attention when it comes to public health.
That is to say ?
This crisis has shown that we are still far behind when it comes to prevention, which has long been the poor relation of medicine.
We didn't want to talk about it.
We found that too political.
It was necessary to heal, heal, heal: it was nobler.
How do you see the year 2021 after this completely crazy year 2020?
I won't risk making the slightest prognosis.
When this virus first appeared, no one knew anything.
Even today, there are quasi-police investigations to find out where the first alert came from.
It is believed to be in a mine in China, with bats.
But we did not know how this virus behaved and we do not know more about its future today.
Will it replace the flu or not?
Stay for years?
It is not impossible.
Will we be able to slow down or even eliminate these massive contaminations with the vaccine?
I hope so, but I don't think the virus will go away completely quickly.
But deep down, nobody knows anything about it and we continue to discover things every day.
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Has there been good health coordination between countries at European level?
There is very effective research in Europe, but unfortunately we never wanted to create the Europe of health.
There were too many competing interests.
And therefore, we are still floating when we should all be together, conduct research operations with each other, which means pooling budgets.
This is essential.
But above all, we must not confront each other because it makes the virus laugh!
What scares a lot of people too is to sink into a masked social habit ...
Remember how people laughed at the beginning of the mask.
Let's be clear: we blindfolded ourselves by telling ourselves that we were at the cutting edge of research and that we did not need masks.
Well we were, as usual, a little pretentious.
Me too.
Hiding was actually the only way to protect yourself a little.
And it was a big mistake not to recognize that we didn't have enough masks.
This is the only big miscommunication.
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What mistake should we not make regarding vaccines?
I repeat.
General practitioners, pharmacists and town nurses must be put back on the front line.
They must be the backbone of vaccination.
They must strive to convince.
We should be able to vaccinate everyone, but it will not be easy because if the patient refuses, he will not be vaccinated, as prescribed by the law on patients' rights.
However, those who will not be vaccinated will be in danger and obviously potentially carriers of the virus.
And can therefore contaminate in turn.
How many French people are in doubt today?
I hope that we will explain to them that the vaccine is safe, with a very small share of risk like all vaccines.
But take the situation in nursing homes where, when the virus appears, there are potentially 15 to 20% of deaths!
So what do we do?
We let them die or we try to convince them to be vaccinated.
If there is no "person of confidence" as allowed by this "law of the sick" or of family to whom one can ask his opinion, I believe that it is for the doctor to choose, in fine.
Let us never forget that the greatest progress has been and always will be the equality of each and everyone in terms of care.