How to beat the pandemic? Collaborate fairly and do it now
There needs to be a binding agreement among countries for an equitable use and distribution of resources
Almost two years in, and the Covid inferno still burns. Several countries are witnessing a fifth wave of high transmission. Others are recording their highest daily case numbers since the pandemic began. Low- and middle-income countries — where vaccination rates are often very low — are seeing substantial numbers of deaths.
The trends are seen both in nations with adequate doses of vaccine and in those with tight supplies. Many of the latter are in Africa, where more than 97% of the population still hasn’t been immunised. These countries cannot get the vaccine they need because supply commitments from manufacturers are not coming through as planned. They can get vaccines to their people but simply do not have enough doses to meet the need.
How did the world get here?
Insufficient preparation. Insufficient investment. Insufficient collaboration. Insufficient learning.
The answer is to learn from what has happened in the last two years and, in the months and years to come, to implement actions that are evidence-based and equitable, when and where they are needed.
Outbreaks usually start without any warning. Preparedness and readiness within countries is essential for rapid responses. These responses must be supported by robust global collaboration that can function even amid inter-governmental tensions. Health systems must be able to detect emerging pathogens and offer rapid and robust responses wherever they are needed, to prevent spread both within nations and across national borders.
Responses work best if built on collaboration, coordination and solidarity: all are essential when tackling global challenges. The Access to Covid-19 Tools (ACT) accelerator shows what can be achieved if professionals from different nations are enabled and supported to act together to develop and share vaccines, treatments and diagnostics.
So, what is preventing the authorities in low- and middle-income countries from achieving the target of 40% of their people fully-vaccinated by the end of 2021 — and 70% by the middle of 2022? High-income nations are forging ahead, offering booster doses to their people and ensuring they have plenty of vaccine stocks in reserve. They also offer donations to countries in need, but commitments are generally too haphazard to offer consistent and predictable support. Collaboration between nations is also inconsistent and not sustained. As the fires of the pandemic flare up, the quality and predictability of response are hampered by suspicion and competition.
Responses so far are suboptimal and millions of people are feeling much distress and pain. In every country it is the poorest and most vulnerable people who bear the brunt of Covid-related suffering.
We see how vital it is to learn from what has happened in the last two years and, in the months and years to come, to implement actions that are evidence-based and equitable, when and where they are needed.
Now is the time to support the farsighted efforts of many member nations of the World Health Organisation (WHO) as they work towards an international legally binding agreement for preparing better responses to disease outbreaks, epidemics and pandemics. To consider the merits of a new agreement for pandemic preparedness and response, these nations have called for a special session of the World Health Assembly, starting on November 29. The WHO director-general has highlighted that the agreement should set out high-level principles to strengthen solidarity and equity.
Such a step is vital. The pandemic is raging in many countries and needs concerted attention from decisionmakers. Now is the time to hit hard to prevent such an avoidable global tragedy occurring again. There is a growing chorus of support among countries and leaders that a legally binding agreement is essential, and the sooner the better. We, the WHO special envoys for Covid-19, ask leaders to act together, spurred on by the suffering provoked by this pandemic, to prevent a sequel before political attention lapses.
This anticipated international agreement must be principled. It should be based on people having fair access to what they need for their health, for the viability of their economies and for them to realise their human rights.
It should be a universally-binding agreement that articulates a firmly agreed upon approach to equitable use and distribution of resources. It is not only morally correct; it is also the right thing to do from a public health point of view.
We call on national leaders and the WHO to make the agreement happen and to do it effectively, rapidly and on a sound, durable financial footing. This is a once-in-a-generation opportunity to insulate the world from the next inferno of infectious disease and build forward with better mechanisms that protect all future generations.
WHO director-general’s special envoys are:
Prof Maha El Rabbat, former minister of health and population of Egypt;
Dr David Nabarro, former special adviser to the UN secretary-general on the 2030 Agenda for Sustainable Development and Climate Change;
Dr John Nkengasong, director of the African Centres for Disease Control and Prevention;
Dr Mirta Roses, former director of the WHO Region of the Americas;
Dr Palitha Abeykoon, former director, health systems development, WHO Southeast Asia regional office, senior adviser Sri Lankan ministry of health;
Prof Samba Sow, director-general of the Centre for Vaccine Development in Mali.
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