'Statistics Are Vital’ is a joint campaign by the Royal Statistical Society and Significance magazine, celebrating the work of statisticians during the Covid-19 pandemic.
Significance spoke to Steve MacFeely, director of data and analytics at the World Health Organization.
‘Covid has reminded us that independent science is really important. And statistics is part of that’
Can you tell us about the nature of your role at the World Health Organization (WHO)?
I joined the WHO at the end of July [2021]. I’m not a health specialist at all, I’m a career statistician. I was the chief statistician at the United Nations Conference on Trade and Development (UNCTAD) for the last seven years, and prior to that most of my career had been at the Irish statistics office [the Central Statistics Office], where I began as a statistician and left as the deputy director general.
When I was approached by the WHO, they were setting up a new data and analytics unit. And I think there was a recognition that they wanted to reconnect or connect better with the UN [statistical] system, with the international system. They [the WHO] had a lot of good epidemiologists, a lot of good health statisticians, but maybe what they didn't have was someone who understood statistics in the broader context. If you’re looking at health from a public health perspective, say, then you really want to connect with environment, with economy, and so on.
Was this something that was brought into sharp focus by the pandemic?
This was actually coincidental. It just happens that the unit was set up more or less at the same time as Covid kicked off. It's tempting to say Covid brought all of this into sharp relief, which it did. But when Dr Tedros Adhanom Ghebreyesus was appointed [as WHO director-general in May 2017], he came with this transformation agenda, and part of that agenda was to strengthen the WHO’s place with regard to data, with regard to statistics, and internally to make sure that policies and tools that were being brought out by the WHO were supported by data.
To what extent has your work been shaped by Covid?
It has in a number of ways. Everybody is looking at the world through the prism of Covid now. Naturally, people are contacting us all the time. They want to know the extent of Covid, the impact of vaccinations, our view on new mutations, and whether we have any data on that. A lot of people are looking for additional data now to contextualise what they’re doing.
Also, I'm the co-chair of the Committee of the Chief Statisticians of the United Nations System (CCS-UN). Before I joined the WHO, CCS-UN allied with a group called the Coordination Committee of Statistical Activities, which is basically the UN system plus the wider international system – IMF, OECD, Eurostat, World Bank, and so forth – and we put together a series of reports looking at Covid from a statistical perspective. I actually led that project while I was the chief statistician at UNCTAD. Those three reports – and there'll be a fourth one coming – really caught the zeitgeist in that everybody wanted to try and explain what was happening with Covid. And what I really like about those reports is that they show the 'public health' element of health, because you could see now – maybe in a way that should have been obvious but wasn’t – that if health is in crisis, it impacts on everything, from travel to trade.
Those reports were really useful in setting out what's actually happening, and also setting out why statistics are important – because a lot of the stuff we knew, but we were actually able to quantify the extent. So, for example, the World Bank did some fascinating work on [poverty] trends, showing how extreme poverty had been falling and how that suddenly had been arrested and now millions of people were being pushed back into extreme poverty. Equally, in the WHO we are about to publish a report on universal health coverage and, without any spoilers, one of the big things we're seeing is 20 years of progress now being arrested and possibly being reversed as people are being squeezed out of universal health care coverage, either because hospitals are in crisis and can't provide cover, or because of the financial side, where people just can't afford health care because we're seeing health care [cost] inflation. It's a perfect illustration of how Covid is impacting beyond just the narrow lens of Covid itself.
How are the findings of that report series, about the wider impacts of Covid, informing your work now?
It's informed my work in the sense that one of the ambitions I have, now more than ever, is to try and develop or forge links so that we can move beyond the health silo, if I can put it that way. My impression coming into the WHO is that the health narrative is quite siloed. It’s health people talking about health. But I would like to try and broaden it out and get people to see health as part of an economic discussion, as part of an environmental discussion, as part of the social discussion; that health is a pivotal element to those discussions, and you can’t sensibly talk about the economy anymore without talking about health and well-being.
Are there positives that come of this difficult period, particularly for statistics and statisticians?
If I broaden it out beyond statisticians a bit, and maybe I'm wrong here – this is very much a personal view – but my assessment is that before Covid, science in general was under threat. We saw a lot of messy politics around the world. Multilateralism was under threat. I think Covid has reminded everybody that independent science is really important. And statistics is part of that. We've seen in so many countries that chief medical officers have become household names because, all of a sudden, people think, 'Well, look, at least I can trust this person'.
Also, what we've seen with vaccination has been incredible: it just shows what we can achieve when resources are put against something. Imagine what we could do if we brought the same money and the same can-do attitude to malaria. Or, for me, the big priority would be proper registrations of birth and death. Not only for health reasons but even as a human right, registration of birth is critical. And for a lot of countries that are trying to formalise their economies, registration is the beginning. We could get this done by 2025, or 2030, if we really wanted to – if this was set out as a priority. And then, if you get that done, you can move on to something else. It could be a rolling prioritisation.
For me, it's kind of exciting, but equally frustrating, because I suspect that won't happen. But we’ve seen evidence of what we could do if only we did it.
For an extended interview with Steve MacFeely, see the February 2022 issue of Significance magazine (significancemagazine.com).