The world is still struggling to combat COVID-19, and the reforms needed to ensure global readiness for the next novel pathogen are not proceeding fast enough. Unless that changes, the current pandemic surely will not be the last.
AUCKLAND – With countries still muddling through waves of highly transmissible variants of the coronavirus that causes COVID-19, it is clearly premature to declare the pandemic over. Somewhere in the world, another dangerous pathogen – perhaps currently living in a bat or forming in a pig’s gut – could make the jump to humans, spread, and thrive. Many human diseases originate through such “spillovers.” In the worst cases, as with COVID-19, these organisms become serious health threats and put the whole world at risk.
If such a nightmare happened again today, would we be ready? Could the World Health Organization immediately act on a credible report of a threat and warn all countries effectively? If the new pathogen could spread almost undetected, would the global system race to coordinate a high-level response and ensure that everyone had access to the information, medical supplies, and money needed to limit the damage? Would every country have a plan to minimize the strain on health systems, schools, businesses, and livelihoods?
The short answer to all these questions is no. At the current pace of change, global readiness to manage a new pandemic threat is years away. We should be very worried about that, and also about the lack of high-level leadership to end the COVID-19 emergency.
True, there has been some progress. In May 2021, the Independent Panel for Pandemic Preparedness and Response (IPPPR), which I co-chaired with former Liberian President Ellen Johnson Sirleaf, outlined the gaps that led to the COVID-19 pandemic and recommended a package of reforms we believed would end the crisis and prevent future infectious-disease outbreaks from becoming so devastating. Other review bodies made similar types of recommendations to address serious deficiencies.
Besides the lack of coordinated leadership, the problems include woefully insufficient funding for pandemic preparedness; a marketplace for personal protective equipment, vaccines, and other essential supplies that favors the wealthy; cracks and gray zones in the international legal regime; and a WHO that lacks the resources and authority to do the job expected of it.
To the credit of the WHO and its member states, serious efforts are underway to respond to the recommendations of a range of reviews. But the effort, spread across different working groups and bodies, is slow and at times uncoordinated. It is unclear whether anyone has a vision for putting the pieces together into an effective system that extends beyond the confines of the health sector (as the IPPPR believes it must).
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One WHO committee has recommended changes to the International Health Regulations that would clarify responsibilities, the WHO’s authority, and timing for action. But these proposals may not be addressed until next year. Another workstream includes a historic effort to negotiate a new international legal instrument for tackling pandemics. That is commendable, but the work is scheduled for completion in two years, and may take longer. In yet another group, countries are deciding whether they should provide the WHO with the sustainable, predictable base funding it needs to conduct its work.
As of this writing, there are strong signals that the World Bank will host a new Financial Intermediary Fund for pandemic preparedness and response. One lesson from the past two years that the fund’s architects should not forget is that pandemic threats must be approached on the basis of solidarity. To be inclusive and effective, the fund should mobilize new financing from all countries, based on what each can afford to pay. Low-income and lower-middle-income economies should benefit most, with funds fairly allocated to meet preparedness targets.
But current funding is still insufficient to protect people from the worst of COVID-19. In mid-April, the Access to COVID-19 Tools Accelerator was still $10-15 billion short. In particular, there was virtually no new money for diagnostic tests and treatments, depriving people in lower-income countries of tools recommended and available in the rich world.
The COVID-19 pandemic has taught these countries the painful lesson that they cannot rely on wealthier economies to put equity at the heart of the response to a global crisis. As a result, African leaders are championing a more self-sufficient continent that can better protect its people. This includes establishing a cross-continental health workforce strategy, the African Vaccine Acquisition Trust, and new hubs where COVID-19 mRNA vaccines can be produced.
It is crucial to ensure that low- and middle-income countries can secure the licenses and transfers of knowledge and technology they need to produce not only COVID-19 vaccines, but also the other supplies required to tackle the current crisis, other high-priority health threats, and future pandemic risks. Health workers, the elderly, and other at-risk groups should not have to wait for the outcome of protracted trade talks in Geneva to access the protection they need to survive.
Meanwhile, the COVID-19 pandemic continues. Vaccine coverage in many countries remains far too low, governments are eliminating mask mandates, and, despite large numbers of infections in some places, many people just want to move on and discount the ongoing threat of COVID-19 altogether.
The problem is that we don’t know what will happen next. Leaders must be prepared for a range of COVID-19 scenarios, including the possibility of a new, deadly variant of the virus that spreads rapidly. But one of the most frustrating – and confounding – aspects of the pandemic has been the dearth of top-level global leadership to mobilize the plans, funds, and political will required to blunt COVID-19. Despite more than 6.2 million recorded deaths, heads of state and government have not yet come together under the auspices of the United Nations to tackle the largest economic, health, and social crisis in living memory comprehensively.
Members of the IPPPR continue to pursue a recommendation to establish a body of heads of state and government to oversee the evolving architecture for pandemic preparedness and response. Without that, there is little to bind the different reform efforts, from finance to legal instruments and beyond.
The world is not finished with COVID-19, and the reforms needed to prepare us for the next novel pathogen are not proceeding fast enough. Unless that changes, the current pandemic surely will not be the last.
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AUCKLAND – With countries still muddling through waves of highly transmissible variants of the coronavirus that causes COVID-19, it is clearly premature to declare the pandemic over. Somewhere in the world, another dangerous pathogen – perhaps currently living in a bat or forming in a pig’s gut – could make the jump to humans, spread, and thrive. Many human diseases originate through such “spillovers.” In the worst cases, as with COVID-19, these organisms become serious health threats and put the whole world at risk.
If such a nightmare happened again today, would we be ready? Could the World Health Organization immediately act on a credible report of a threat and warn all countries effectively? If the new pathogen could spread almost undetected, would the global system race to coordinate a high-level response and ensure that everyone had access to the information, medical supplies, and money needed to limit the damage? Would every country have a plan to minimize the strain on health systems, schools, businesses, and livelihoods?
The short answer to all these questions is no. At the current pace of change, global readiness to manage a new pandemic threat is years away. We should be very worried about that, and also about the lack of high-level leadership to end the COVID-19 emergency.
True, there has been some progress. In May 2021, the Independent Panel for Pandemic Preparedness and Response (IPPPR), which I co-chaired with former Liberian President Ellen Johnson Sirleaf, outlined the gaps that led to the COVID-19 pandemic and recommended a package of reforms we believed would end the crisis and prevent future infectious-disease outbreaks from becoming so devastating. Other review bodies made similar types of recommendations to address serious deficiencies.
Besides the lack of coordinated leadership, the problems include woefully insufficient funding for pandemic preparedness; a marketplace for personal protective equipment, vaccines, and other essential supplies that favors the wealthy; cracks and gray zones in the international legal regime; and a WHO that lacks the resources and authority to do the job expected of it.
To the credit of the WHO and its member states, serious efforts are underway to respond to the recommendations of a range of reviews. But the effort, spread across different working groups and bodies, is slow and at times uncoordinated. It is unclear whether anyone has a vision for putting the pieces together into an effective system that extends beyond the confines of the health sector (as the IPPPR believes it must).
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Don’t miss our next event, taking place at the AI Action Summit in Paris. Register now, and watch live on February 10 as leading thinkers consider what effective AI governance demands.
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One WHO committee has recommended changes to the International Health Regulations that would clarify responsibilities, the WHO’s authority, and timing for action. But these proposals may not be addressed until next year. Another workstream includes a historic effort to negotiate a new international legal instrument for tackling pandemics. That is commendable, but the work is scheduled for completion in two years, and may take longer. In yet another group, countries are deciding whether they should provide the WHO with the sustainable, predictable base funding it needs to conduct its work.
As of this writing, there are strong signals that the World Bank will host a new Financial Intermediary Fund for pandemic preparedness and response. One lesson from the past two years that the fund’s architects should not forget is that pandemic threats must be approached on the basis of solidarity. To be inclusive and effective, the fund should mobilize new financing from all countries, based on what each can afford to pay. Low-income and lower-middle-income economies should benefit most, with funds fairly allocated to meet preparedness targets.
But current funding is still insufficient to protect people from the worst of COVID-19. In mid-April, the Access to COVID-19 Tools Accelerator was still $10-15 billion short. In particular, there was virtually no new money for diagnostic tests and treatments, depriving people in lower-income countries of tools recommended and available in the rich world.
The COVID-19 pandemic has taught these countries the painful lesson that they cannot rely on wealthier economies to put equity at the heart of the response to a global crisis. As a result, African leaders are championing a more self-sufficient continent that can better protect its people. This includes establishing a cross-continental health workforce strategy, the African Vaccine Acquisition Trust, and new hubs where COVID-19 mRNA vaccines can be produced.
It is crucial to ensure that low- and middle-income countries can secure the licenses and transfers of knowledge and technology they need to produce not only COVID-19 vaccines, but also the other supplies required to tackle the current crisis, other high-priority health threats, and future pandemic risks. Health workers, the elderly, and other at-risk groups should not have to wait for the outcome of protracted trade talks in Geneva to access the protection they need to survive.
Meanwhile, the COVID-19 pandemic continues. Vaccine coverage in many countries remains far too low, governments are eliminating mask mandates, and, despite large numbers of infections in some places, many people just want to move on and discount the ongoing threat of COVID-19 altogether.
The problem is that we don’t know what will happen next. Leaders must be prepared for a range of COVID-19 scenarios, including the possibility of a new, deadly variant of the virus that spreads rapidly. But one of the most frustrating – and confounding – aspects of the pandemic has been the dearth of top-level global leadership to mobilize the plans, funds, and political will required to blunt COVID-19. Despite more than 6.2 million recorded deaths, heads of state and government have not yet come together under the auspices of the United Nations to tackle the largest economic, health, and social crisis in living memory comprehensively.
Members of the IPPPR continue to pursue a recommendation to establish a body of heads of state and government to oversee the evolving architecture for pandemic preparedness and response. Without that, there is little to bind the different reform efforts, from finance to legal instruments and beyond.
The world is not finished with COVID-19, and the reforms needed to prepare us for the next novel pathogen are not proceeding fast enough. Unless that changes, the current pandemic surely will not be the last.