Civil Society Support Calls for Increased Quality in Dose Donations to Africa

The Africa Working Group on Pandemic Preparedness and Response supports the Joint Statement on Dose Donations of COVID-19 Vaccines to African Countries by the Africa Centres for Disease Control and Prevention (Africa CDC), the African Vaccine Acquisition Trust (AVAT), and COVAX published on November 29, 2021.

The statement draws the attention of the international community to the quality of donations of COVID-19 vaccines to Africa, and other COVAX participating economies, particularly those supported by the Gavi COVAX Advance Market Commitment (AMC).

Read the full letter here.

Exclusion of Pandemic Financing in the Build Back Better Act Statement from the Global Health Council’s Global Health Security Roundtable Co-Chairs

“We are disheartened that, in the middle of the ongoing COVID-19 pandemic, one of the compromises made in the agreement on the Build Back Better Act was to cut out financing for future pandemic preparedness. While we welcome the needed US$1.3 billion to support expanded global vaccine production capacity and research on infectious diseases, the bill leaves out critical elements of President Biden’s American Pandemic Preparedness Plan, including the US$600 million requested to stand up a new multilateral fund to bolster global preparedness for future pandemics.

We represent dozens of organizations who have been calling for U.S. global leadership to establish such a fund to address pandemic threats. Establishing this fund is a long overdue step  toward addressing the years of chronic underinvestment that left America and the world vulnerable to COVID-19. There is strong bipartisan support for the fund from both the House and the Senate and from leading global finance and health experts, who have urged that the fund be set up swiftly and capitalized at US$10 billion per year over the next five years. While the US$600 million U.S. contribution to the fund that was included in the Biden Administration’s Pandemic Preparedness Plan represents only a fraction of the global need, it is an urgent first step toward helping prevent another devastating pandemic from happening again.

Omitting this critical funding from the bill will signal a return to complacency in the face of one of the most looming threats to our national and global security. And it will signal to other countries that President Biden’s signature initiative to establish a new fund to fight pandemics  — which he touted to world leaders at the Global COVID-19 Summit just one month ago as a key piece of his plan to Build Back Better — is not backed by any serious financial commitment or urgency from the United States. The White House and Congress should urgently agree to ensure the US$600 million for the multilateral fund is included in the Act before final passage and then urge other countries to join the U.S. and contribute their fair share.”

Partnering to Advance Health Security in the Middle East and Around the World

The global response to COVID-19 has shown that the world was ill-prepared to prevent and rapidly respond to a novel pandemic threat. Despite repeated warnings of the increasing threat of epidemics and pandemics, both public and private sector actors have failed to prioritize the forward-looking investments, systems, and structures that are necessary to ensure that life saving tools and medical countermeasures are ready to deploy to curb the spread of disease before it becomes a global health emergency.

When COVID-19 emerged in early 2020, the Kingdom of Saudi Arabia (KSA) determined that urgent and unprecedented action would be required. In response, the government mobilized emergency surge funding to kickstart research and development (R&D) of new medical countermeasures. As President of the G20 at the time, KSA in April 2020 partnered with the Coalition for Epidemic Preparedness Innovations (CEPI), investing US$150 million to help fuel the development of COVID-19 vaccines for global use. With this timely support, CEPI was able to leverage additional funding, expertise, and know-how from around the world to accelerate COVID-19 vaccine development with the aim of enabling rapid global, equitable, and affordable access to vaccines to save lives and slow the spread of the virus.

Although COVID-19 vaccines were developed in record time, most low- and middle-income countries have been left far behind their high-income country counterparts in terms of vaccine access. Without widespread global vaccination, the COVID-19 virus will continue to spread unchecked in many parts of the world, risking the emergence of new variants that can withstand existing vaccines and therapeutics while threatening to undo the progress that has been made. This underscores the urgent need to immediately ramp up the supply and delivery of COVID-19 vaccines to get more jabs in arms and reach the 70% global vaccination goal set at the Global COVID-19 Summit.

Produced by the Future Investment Initiative Institute and Pandemic Action Network, The Kingdom of Saudi Arabia: Partnering to Advance Health Security in the Middle East and Around the World calls for strategic investments in CEPI to be made by KSA and global partners to answer the call for increased, more predictable, longer-term, and sustainable funding for vaccine R&D, thus addressing variants and preparing the world for future pandemics.

Read the full report here.

Civil Society Organizations Call on G20 Leaders and Ministers to Deliver Concrete Action on Global COVID-19 Targets

Ahead of the G20 Finance and Health Ministers Meeting on Oct. 29 and the G20 Leaders’ Summit on Oct. 30-31, Pandemic Action Network and more than 20 civil society partners call upon the G20 countries to deliver specific, concrete action on key targets set out at the Global COVID-19 Summit on Sept. 22. The Global COVID-19 Summit rallied world leaders and secured commitments to ensure at least 70% of the population in all income categories in all countries are fully vaccinated by mid 2022 — and at least 40% by the end of this year.

But meeting this target will require specific, concrete action. Civil society organizations urge the G20 leaders and Ministers to agree on a plan of action in the forthcoming meetings to deliver on these targets, including commitments to:

  1. Ensure at least 70% of people in every income category in every country are fully vaccinated by sharing doses at scale, releasing production slots, and supporting non-exclusive knowledge and technology sharing measures;
  2. Increase multi-year financing for the pandemic response and preparedness in low- and middle-income countries (LMICs) to match the scale of need;
  3. Reallocate Special Drawing Rights to support the fight against the pandemic in LMICs;
  4. Strengthen global leadership and accountability.

Humanity deserves a world where every country is equipped to end the COVID-19 crisis and every country is prepared to stop infectious disease outbreaks from becoming deadly and costly pandemics. Read the full letter.

If your organization would like to endorse the letter, please contact Aminata Wurie by Tuesday, Oct. 26. 

Bridging the Innovation Gap to Prevent the Next Pandemic — Policy Brief

The world was woefully unprepared to prevent or rapidly respond to the COVID-19 pandemic. This is the result of decades of failure by national and global policymakers to address pandemics as a systemic and growing threat. A glaring weakness is that the ecosystem for pandemic preparedness research and development (R&D) — the system that is meant to develop vaccines, treatments, and other tools for known and unknown health threats — is rife with market and systems failures that prevent it from operating efficiently, effectively, and equitably.

While pandemics can affect the whole world and create large, global markets for vaccines, treatments, and other technologies, those markets have repeatedly failed to respond with the foresight and urgency needed to match the scale, scope, and unpredictability of pandemic threats. The world must urgently address the persistent market and systems failures in the global health R&D ecosystem to prepare for the next pandemic threat.

This policy brief, prepared by Pandemic Action Network, covers the market and systems failures in the pandemic preparedness R&D ecosystem and lays out the unique role that the Coalition for Epidemic Preparedness Innovations (CEPI) plays in leveraging partnerships and incentives to counter the failures as one key step in building a smarter, more effective and equitable pandemic R&D ecosystem.

Read the policy brief here and the full analysis here.

Do Whatever It Takes! Making the COVID-19 Summit a Step Change in Global Response

Pandemic Action Network is relentlessly focused on ending the COVID-19 crisis everywhere and preventing the next pandemic. We work with our global network of more than 140 partners to push governments to bridge the divide between rhetoric or piecemeal efforts and meaningful actions. When we first learned about the prospect of a global COVID-19 Response Summit — something we have been calling for over the past 18 months — we set out to define the step change in ambition that leaders would need to take after the devastatingly inadequate action taken to tackle this pandemic crisis to date.

That’s why in advance of this Summit, we worked with our partners at the COVID Collaborative and across multiple centers at Duke University to bring more than 60 organizations together around a common position on what’s needed to end this crisis. We’re pleased to see much of what we have been calling for reflected in the Summit targets, which we support. But this Summit has to set itself apart by being the starting point in a much longer journey.

It’s beyond time for an action plan, leadership, and accountability. The world is divided between the haves and the have nots like never before. Those with access to COVID-19 vaccines, and those with no access in sight. We have to change this, and at the 22 September COVID-19 Summit, leaders must pledge to do whatever it takes to fully vaccinate 70% of the population in every country in less than 12 months. We will be tracking their progress towards that commitment and the interim target of at least 40% by the end of 2021.

To get there, we must dramatically ramp up support NOW for:

  • Vaccine donations, queue swaps, manufacturing, and delivery
  • Development and deployment of testing and treatments — including oxygen — and PPE
  • A strong frontline health workforce to reach the most vulnerable communities

We make our own commitment to deliver. We will continue to help mobilize the political support and resources necessary to deliver the targets, and track progress of countries towards their goals. We will also push the private sector and philanthropic donors to play their part in delivering the funding — and the policies — to achieve global vaccination and delivery of COVID-19 tools. We will convene and tap the deep expertise and capabilities in our Network across sectors to inform their design and ensure they are inclusive, accountable, sustainably funded, and commensurate with the threat.

It’s time to shine a light on the problems in the system, and fix them, before they take more lives. We are in a race against time. The world has the resources and the ingenuity to solve these challenges.

It’s a matter of leadership and political will. We will be working to ensure that this Summit leaves a legacy to end this crisis and pandemic-proof the world once and for all.

Read and share the full Framework for a Global Action Plan for COVID-19 Response endorsed by more than 60 partners here.

Call for the EU to Immediately Use the Flexibility Instruments for the Global COVID-19 Response

COVID-19 recovery is at the top of every political agenda, with many donors — including the European Union (EU) — supporting the Access to COVID-19 Tools Accelerator (ACT-A), a global collaboration mechanism aiming to accelerate the development, production, and equitable access to COVID-19 tools. But significantly more funding is needed for ACT-A to complete its work.

The latest estimates anticipate that it may cost between $50-66 billion to fully vaccinate the world, plus additional investments needed to cover the cost of delivery in low- and middle-income countries. Meanwhile, ACT-A is still facing a $16.8 billion funding gap for 2021. Along with partners at Aidsfonds, CARE, DSW, Global Citizen, Global Health Advocates, and ONE, we call on the EU to contribute €1.3 billion more to meet their “fair share”.

To do this, the EU should turn to the budget lines designed for crises exactly like this:

  • The Emerging Challenges and Priorities Cushion (the cushion)
  • The rapid response pillar within the Neighbourhood, Development and International Cooperation Instrument (NDICI) / Global Europe instrument.

Read more here.

Addressing Market Failures: The Role of CEPI in Bridging the Innovation Gap to Prevent the Next Pandemic

The global response to COVID-19 not only shows that the world was ill-prepared to prevent and respond to a pandemic caused by a novel respiratory pathogen, but also that there are an array of system and market failures in global health research and development (R&D). Solving for these failures ― and building a ready and sustainable R&D ecosystem for pandemic preparedness ― will be critical to advancing global health security and preventing future infectious disease outbreaks from becoming the next deadly and costly pandemic.

Addressing Market Failures: The Role of CEPI in Bridging the Innovation Gap to Prevent the Next Pandemic, produced by Volta Capital, Pandemic Action Network, and the Africa Centres for Disease Control and Prevention (ACDC), examines global health R&D failures to help inform policy and funding decisions to bolster preparedness and response for emerging pandemic threats. In particular, the paper considers the unique role of CEPI in addressing some of these failures, its strengths and challenges in the COVID-19 response, and the role it can play through its new strategy to bolster future epidemic and pandemic preparedness.

Key findings of the paper include:

  • Longstanding and persistent market and systems failures in global health R&D, especially for vaccines against novel pathogens, have left the world at grave risk of deadly and costly pandemics.
  • The world cannot wait for the next pandemic to bolster investments in R&D and preparedness for emerging infectious disease threats.
  • CEPI has a key role to play in a better prepared global R&D ecosystem.

To learn more, read the full analysis Addressing Market Failures: The Role of CEPI in Bridging the Innovation Gap to Prevent the Next Pandemic and the accompanying policy brief.

Share the key messages using our social media toolkit.

Calling on World Leaders for A Global Summit to End the COVID-19 Pandemic

A global pandemic needs a global plan of attack.

A coalition of 80 global leaders and over 25 organizations across corporate, philanthropic, civil society, advocacy, academic, and health sectors is calling on world leaders attending the United Nations General Assembly to convene a global summit to ignite an urgent global action plan to end the pandemic.

This call-to-action was coordinated by the COVID Collaborative, Duke-Margolis Center for Health Policy, Duke Global Health Innovation Center, Duke Global Health Institute, and the Pandemic Action Network.

Read the full letter to world leaders here.

Framework for a Global Action Plan for COVID-19 Response

We are at an exceedingly perilous and urgent moment in the COVID-19 pandemic. As the Delta variant has demonstrated, we are fighting a virus that doesn’t respect borders and rapidly advances across continents. If the virus continues to circulate unchecked in large parts of the world, we will see not only many more millions of infections and deaths, but also new variants that could totally pierce vaccine immunity, returning the world to square one. The global COVID-19 crisis demands leadership and a global plan of attack. A coordinated, global response, the only possible successful response to the pandemic, must be grounded in equity at all levels – global, regional, national, subnational and community. An “all hands on deck” crisis response must deploy all available resources and capabilities – multilateral and bilateral, public and private sector. A robust and effective response to the current crisis is also the best foundation for health systems strengthening and future pandemic preparedness. World leaders should therefore urgently convene a “Global Pandemic Response and Vaccination Summit” and commit to urgent actions detailed in our Framework For a Global Action Plan for COVID-19 Response. Read more here.

An “all hands on deck” crisis response must deploy all available resources and capabilities – multilateral and bilateral, public and private sector. A robust and effective response to the current crisis is also the best foundation for health systems.

Calling for a New Multilateral Financing Mechanism for Global Health Security and Pandemic Preparedness

People and countries around the world continue to suffer from the devastating human, economic, and social costs of being unprepared for a deadly pandemic like COVID-19. This crisis is a call-to-action. World leaders must seize this opportunity to leave a legacy of a healthier and safer world — starting with a new global financing mechanism that provides robust and sustained investments in pandemic prevention and preparedness. At the 2021 United Nations General Assembly, world leaders should launch a 100-day action plan to establish and resource a new financing mechanism, or Fund, that can mobilize at least US$10 billion annually over the next five years to bolster global health security and pandemic preparedness. History has shown time and again that if action is not taken during a crisis, then political will dissipates once the crisis fades from view. An expedited timeline for establishing the Fund will provide a critical new tool for the ongoing COVID-19 response efforts and create continuity between the pandemic response and recovery activities while bridging to escalated and sustained efforts on pandemic preparedness.  This policy brief, prepared by contributors from the Center for Global Development, Pandemic Action Network, and Nuclear Threat Initiative, is intended to inform and guide ongoing conversations among governments and non-governmental stakeholders on the parameters and design of the new Fund and action plan. Read the policy brief here.
This policy brief, prepared by contributors from the Center for Global Development, Pandemic Action Network, and Nuclear Threat Initiative, is intended to inform and guide ongoing conversations among governments and non-governmental stakeholders on the parameters and design of the new Fund and action plan.

UN General Assembly Called Upon to Lead Global Pandemic Prevention and Preparedness

Civil society leaders urge UN General Assembly President Volkan Bozkir to use the informal plenary on July 28 to formally start the process for a UN High-Level Summit on Global Health Security and Pandemic Prevention and Preparedness during the 76th session of the General Assembly.

Your Excellency,  

On behalf of the Pandemic Action Network and our partners around the world, we welcome the announcement of an informal plenary of the General Assembly on 28 July to discuss what the world needs to do to prevent and prepare for future pandemics, informed by the findings and recommendations of the Independent Panel for Pandemic Preparedness and Response (IPPPR) and other review efforts. The devastating health, economic, and social impacts of this deadly, costly, and protracted global crisis underscore that it is well past time for the community of nations to prioritize and prepare for pandemics as the existential, catastrophic, and growing global security  threats they are. We urge you to ensure that the outcome of this plenary is a commitment to a concrete, time-bound political process for international action on pandemic prevention and preparedness. 

Specifically, we urge you to use the 28 July 2021 informal meeting to kick off a formal process and set a date during the 76th session of the General Assembly — ideally within the first six months or no later than September 2022 — for a UN High-Level Summit on Global Health Security and Pandemic Prevention and Preparedness at the Heads of State or Government level. The Summit should agree to a Political Declaration or similar, which outlines a set of concrete solutions, backed by the requisite financing, institutional, and policy reforms, and member state commitments, that will ensure an international system better prepared to detect, prevent, and respond to pandemic threats. Given the whole of society nature of  pandemics, it will be essential that the Summit fully and actively engage leaders of multilateral institutions, civil society organizations, private sector, foundations, academic, and research institutions alongside government leaders. 

The proposals from the IPPPR, the G20 High-Level Independent Panel on Financing the Global Commons for Pandemic Preparedness and Response (G20), the Global Preparedness Monitoring Board (GPMB), our Network, and others have been based on robust evidence, deep consultation, thorough analysis, and active debate before and during the COVID-19 pandemic. There is a striking convergence of recommendations around the global financing, governance, and accountability reforms that are urgently needed; what has been sorely lacking is political will to act.  

While accelerating the global COVID-19 response remains the most urgent priority, we cannot afford to wait until this pandemic is over to begin to bolster our collective defenses against emerging pandemic threats. Now is the time to lay the foundation for a resilient international system that can act quickly and equitably to prevent a health emergency of this scale from occurring in the future. Too often, political will for system change recedes as a crisis wanes. World leaders must seize this opportunity to commit to pandemic-proof the future and leave a legacy of a healthier and safer world. 

Pandemic Action Network and our partners stand ready to work with you to support this process. Thank you for your urgent attention to this matter, and we look forward to your reply.  

Sincerely, 

Carolyn Reynolds 
Co-founder
Pandemic Action Network  

On behalf of:

 

If your organization would like to sign on, please email Hanna Hwang

Calling on the European Union to Fund the Global Fight Against COVID-19

Significantly more funding is needed to accelerate the end of the COVID-19 pandemic for everyone. The Access to COVID-19 Tools Accelerator (ACT-A) is facing a US$16.9B funding gap in 2021 as of late June 2021, and latest estimates anticipate at least US$50B-55B to fully vaccinate the world.

With the European Union (EU) currenting negotiating its budget for 2022, Pandemic Action Network is joining other civil society organizations (CSOs) to call on the EC to contribute its fair share of another €1.2B for ACT-A in 2021 and more in 2022 to fully fund any future roadmaps to vaccinate the world. This funding should not be at the detriment of other global health and human development priorities but should come from other recommended budget lines.

Read the letter here. If your organization wishes to join the letter, please email Isabelle De Lichtervelde.

Why Masking Still Matters

Eighteen months into the COVID-19 pandemic, as COVID-19 variants spread and the pandemic persists around the world, there are a lot of questions about masking. When do I need to wear a mask? Where do I need to wear a mask? Is masking still needed if I’m vaccinated? In short, to protect those who are most vulnerable and to end this pandemic for everyone, masking still matters — now more than ever. Together immunization, ventilation, hand hygiene, social distancing, and mask-wearing are the best tools we have against COVID-19. No single intervention alone is sufficient to end the pandemic, but face-covering has become increasingly important as lockdowns are eased and people seek a full return to public life. By wearing a mask in public indoor and crowded places, everyone can help slow the spread of COVID-19 and save lives. Ending mask requirements too soon will unnecessarily cost many lives. Read our latest policy brief including key messaging and recommendations for governments, businesses, and individuals.

Why Smooth Vaccine Rollout And Social Proof are Key to COVID-19 Acceptance and Trust

Note: Policy recommendations to decision makers available here

Since the world began to entertain viable vaccines as a real prospect in the fight against COVID-19, we have been confronting the challenge of vaccine hesitancy and navigating what is required to address this challenge. While recent surveys show that vaccination intent has been on the rise globally, increasing hopes that the world will be able to turn the tide on the pandemic relatively soon, the dynamic nature of this pandemic shows that vaccination intent and trust correlates to vaccine access, management of vaccine rollout, and social proof.

The challenge of vaccine hesitancy to end the pandemic
Vaccine hesitancy remains a looming threat to the successful rollout of vaccines and the prospect of ending the COVID-19 pandemic globally. The “anti-vax industry” is well-financed and organized, and determined to spread doubt as to the safety and efficacy of COVID-19 vaccines. A study by Imperial College found that hesitancy around COVID-19 vaccines could lead to thousands of extra deaths. The study, from March 2021, compares current levels of hesitancy compared to the ideal level of uptake. The potential risk is particularly acute in countries like France, where vaccination intent is among the lowest. France could see 8.7 times more deaths in 2021/22 than it would under the ideal level of uptake. This compares to just 1.3 times more in the U.K., which has among the highest vaccination intent.

In many countries, one of the main reasons for vaccine hesitancy is that corners have been cut due to the speed of the clinical trials, and that unknowable long-term side effects potentially exist.

In addition, conflicting public health messages have led to increased mistrust from the public. For example, inconsistent guidance on face-coverings earlier in the pandemic has primed people to distrust proclamations about vaccine safety and efficacy. This has led to many people wanting to “wait and see” real-world proof of safety and efficacy before getting a shot. As a result, a critical element of increasing COVID-19 vaccine uptake is building vaccine confidence among this “wait and see” group, the moveable middle.

“Wait and see” approach to COVID-19 vaccines

Because of concerns on the speed of development and potential unknown side effects, a share of the population wants to “wait and see” how the COVID-19 vaccines work for other people before they get vaccinated themselves.

The share of people in this “wait and see” category has declined since vaccines have started rolling out globally.

Smooth rollout and social proof as tools to increase vaccine trust among the “wait and see”
The emerging evidence, including from the U.K. vaccine rollout, shows that social proofing through communication about widespread acceptance and a fast and uninterrupted vaccine rollout seems to increase trust in COVID-19 vaccines. The more people get vaccinated and the more people hear about others getting vaccinated, the more normal it becomes. A study by Rockefeller Foundation from March 2021 found that social proof of others getting immunized and seeing the tangible benefits that come with it might be the most determining factor in motivating people to get vaccinated.1 In their study they found that among U.S. adults who weren’t sure they’ll get the vaccine, 43% said they were waiting for more people to get vaccinated before they do so themselves. Other research found that people are more willing to get the COVID-19 vaccine when hearing about its popularity, suggesting that public health officials should communicate about the growing and widespread intention to get vaccinated among the population rather than overstating vaccine hesitancy. Finally, in a study conducted amongst 18-30 year olds in the U.K., study participants reported slightly stronger intentions to take the vaccine when they learn that 85% of others plan to take the vaccine, versus 45% of others.

The U.K. is a good example of how social proofing and a smooth rollout may help address vaccine hesitancy, particularly among the “wait and see” group. The U.K.’s rollout strategy has been to vaccinate as many people as possible from the start. Within the U.K., the Welsh rollout program has been the speediest in the world, faster than Israel. A key element of that was the decision to delay the administration of second doses in order to get a first dose in as many arms as possible, as quickly as possible. Experts believe that the speed of the U.K. rollout and the decision to delay second doses had an important impact on attitudes towards COVID-19 vaccines. Another important component of the U.K. strategy has been to proactively emphasize the widespread uptake of COVID-19 vaccines, for example social media posts such as “Join the millions already vaccinated.” With more and more people knowing or hearing about someone who had had their first vaccination, it helped build momentum as well as create social proof to build trust and convince those in the “wait and see” category to eventually get vaccinated.  

In January, 90% of people in the U.K. said that they would either probably or definitely take a COVID-19 vaccine, up 7% since December, when the rollout started. Just two months later (March 2021), the proportion of adults who said they would not be likely to get vaccinated had more than halved since December — from 14% to just 6%. Between January and March, 53% of adults shifted to a more positive attitude — either already receiving a jab or reporting that they are now more likely to do so. According to Imperial College’s Year Review of ‘COVID-19 Global Behaviours and Attitudes’, of the 29 countries surveyed for study,  the U.K. had the highest intention of vaccination among those not yet vaccinated in April 2021 (67% of those not yet vaccinated), and had the lowest share of respondents who stated they were worried about side-effects (27%).

The U.K. also had a different response to the AstraZeneca and Johnson & Johnson (J&J) blood clotting issues compared to the U.S. and many European countries.  The U.K. did not pause the use of the AstraZeneca shot, instead it simply updated its guidelines advising people with a predisposition to blood clots and those under 30 (in April) and subsequently under 40 (in May), to get an alternative shot. Research and pollings indicate that the U.K.’s ‘restrained reaction’ helped keep hesitancy low. A study found there was no change in the intentions and attitudes of the U.K. public in the aftermath of the blood clot story. A YouGov poll in April suggested this led to only a minor decrease in trust. The number who considered the drug to be unsafe ticked up only slightly, from 9% in March to 13% in April, with still 75% of Britons considering the vaccine to be very or somewhat safe. 

The impact of pauses on vaccine trust globally
After extremely rare cases of blood clots, unlike the U.K., a number of governments in the U.S. and Europe temporarily paused the roll-out of the AstraZeneca or J&J vaccines. These pauses have had a significant impact on public trust, not only in the countries where the rollout was paused, but globally. 

Despite the European Medicines Agency (EMA) safety committee’s recommendation from 11 March “that the vaccine’s benefits continue to outweigh its risks and the vaccine can continue to be administered while investigation of cases of thromboembolic events is ongoing”, at least 13 European countries paused the use of the AstraZeneca shot. Skepticism in France and Germany increased rapidly after the use of the AstraZeneca vaccine was paused over blood clot concerns in March. In a YouGov poll conducted in March, 32% of Germans said the AstraZeneca vaccine was safe, down from 42% a month before. Confusion also plagued the rollout of the AstraZeneca vaccine in European countries, further tarnishing the shot’s reputation. For example, in February when it finally started using the AstraZeneca vaccine, German health officials decided to restrict its use to people under 65. It took until March 4 for Germany to update its guidelines and recommend AstraZeneca’s use for people over 65. Just 11 days later, on March 15, Germany paused its use entirely for several days over blood clot concerns. Finally, on March 30, Germany officials tweaked their recommendations yet again, limiting its use to people over 60. In the case of France, it all started with a comment by French President Emmanuel Macron in January incorrectly describing the shot as “quasi-ineffective” for people over the age of 65. Like Germany, French officials then also did a U-turn on their age restriction guidelines in addition to pausing the vaccine use for a few days in mid-March.   

In the US, public trust in the safety of the J&J shot was down to 37% after the government paused the rollout in April, compared to 52% before the announcement. A Washington Post-ABC News poll from mid-April found significant mistrust in the J&J vaccine after health officials paused its use with fewer than 1 in 4 Americans not yet immunized willing to get the shot. The Kaiser Family Foundation COVID-19 Vaccine Monitor found that in early May less than half of Americans believed the J&J vaccine was safe, and concerns about potential side effects had increased among those not yet vaccinated, especially women. About one in five unvaccinated adults say the news caused them to change their mind about getting a COVID-19 vaccine. The Monitor also found indications that concerns about side effects from the vaccines in general had increased following the pause, particularly among women. The reputation of the AstraZeneca vaccine that has not been approved for use in the U.S. yet has also been damaged by blood clotting concerns and temporary suspension in Europe. Only 38% of Americans surveyed in April 2021 considered the AstraZeneca vaccine safe.  In contrast, trust in the Pfizer-BioNTech (Pfizer) and Moderna vaccines appeared unaffected. The Ad Council found that conservatives, in particular, increased in skepticism after the J&J pause.2

Even beyond Europe and the U.S., these short pauses and confusion around age restrictions have damaged the reputation of the AstraZeneca and J&J shots around the world, including in low-income settings where they are particularly crucial. Both the J&J and AstraZeneca vaccines that use adenovirus-vector technology have raised hopes of better global access and, in the case of the J&J shot, faster rollout. These vaccines are less expensive, more stable, and easier to distribute than their mRNA-based counterparts from Moderna and Pfizer. Because they are less expensive and easier to store than Moderna’s or Pfizer’s, and the J&J vaccine requires only one dose, these shots have been considered particularly crucial for less developed and hard-to-reach parts of the world. Yet, experts raised concerns that short suspensions in Europe and the U.S. may further hit an already fragile vaccine confidence in low-income countries and threaten to undermine vaccination campaigns in these settings. Cameroon, the Democratic Republic of Congo, Indonesia, and Thailand all suspended the AstraZeneca vaccine rollout following pauses in European countries. Concerns about rare blood clots on top of the rubbishing of COVID-19 vaccines by some African leaders and confusion over expiry dates have slowed vaccine uptake across the African continent. Health workers in countries such as Nigeria, Ivory Coast, and Malawi noticed growing fears and conspiracy theories, as well as slower demand for vaccines. Africans have expressed their reluctance to use the AstraZeneca shot when Europeans have stopped using it.  At the G7 Vaccine Confidence Summit hosted by the U.K. in June 2021, Dr John Nkengasong, Director of Africa CDC, highlighted that confidence in Africa was significantly hit by the suspension of the AstraZeneca vaccine in a number of European countries with some African ministries being reluctant to continue the rollout of the vaccine. 

Lessons learned and recommendations
The world has only started its vaccination effort against COVID-19 with millions of people around the globe, particularly in developing countries, still needing to get inoculated against the disease. Yet, lessons can start to be drawn from vaccination programs that started in early 2021.

  • All indications point to the fact that consistent messaging about the safety and efficacy of vaccines and about widespread acceptance, as well as smooth and effective rollouts that build social proof of the safety, efficacy, and benefits of COVID-19 vaccines have been key ingredients to build trust and increase vaccination intent and intake.
  • On the contrary, conflicting public messages and guidance as well as temporary suspensions of the use of certain jabs have created a breeding ground for doubt, fears, and conspiracy theories, not only in the country where they occurred but globally. As Heidi Larson, the founding director of the Vaccine Confidence Project at the London School of Hygiene & Tropical Medicine, said: “Don’t let the ambiguity drag on. Because every day just opens the space for misinformation, disinformation, anxiety, and confusion.”

As they progress in their vaccination campaign and in advance of vaccination delivery, decision-makers should take stock of these lessons learned and quickly adjust their strategy accordingly.

Decision-makers should:

  • Increase vaccine trust through a social proofing strategy. Decision-makers should put social proofing at the heart of their vaccination rollout strategy, learning from best practices in countries that have successfully deployed this approach. Such best practices may include proactively emphasizing the growing and widespread intention/acceptance to get vaccinated of others rather than overemphasizing hesitancy levels. Another way may be, where the supply and timing of the second second for two-dose vaccines is guaranteed, delaying the administration of second doses in order to get a first dose in as many arms as possible, as quickly as possible. Experts believe this can have an important impact on attitudes towards COVID-19 vaccines as more people know someone who has been vaccinated.
  • Refrain from temporarily suspending the use of shots over unconfirmed safety concerns (unless recommended by the regulator), and instead take swift decisions to prioritize certain demographics while concerns are being investigated. Total suspension, even when temporary, increases mistrust not only in the countries where the rollout was paused, but globally. For example, the temporary suspension of the use of the AstraZeneca vaccines in a number of European countries despite the EMA’s recommendation to continue to administer the vaccine led to many African countries suspending the use of the shot and increased hesitancy globally, including on the African continent where the AstraZeneca jab is particularly crucial because it is less expensive, more stable, and easier to distribute than the mRNA-based counterparts from Moderna and Pfizer.
  • Always act on scientific advice and follow the regulator recommendation before making any statement on the safety or efficacy of COVID-19 vaccines as well as before introducing any demographic restrictions. Unfounded statements and age restrictions in some European countries early in their roll-out, i.e., limiting the use of the AstraZeneca vaccine only to young people, created confusion and a fertile ground for fear and conspiracy theories. Scientific evidence should be very carefully and regularly assessed by decision-makers and their teams before making any decision or statement on the use of COVID-19 vaccines.

_____

1 The research included focus groups among people expressing concerns about getting the vaccine in March 2021 and a message testing study in February 2021
Source: Ad Council | IPSOS National survey conducted April 12-19, 2021

Call-to-Action: Global Roadmap To Vaccinate The World

There is currently no plan to get to global herd immunity, needlessly leaving the world vulnerable to case resurgence and the proliferation of variants. We are calling on leaders to agree to a Global Vaccine Roadmap to achieve global herd immunity as soon as possible (at least 70%, more if the evolving science points to the need for further coverage). This Roadmap should:

  1. Set out a comprehensive, coordinated strategy to get to global herd immunity as soon as possible.
  2. Increase and improve the global supply of all COVID tools through investment, policies, and the redistribution of excess doses.
  3. Fully cost the response, agree to a burden-sharing model, and begin to plug the gap by fully funding the Access to COVID-19 Tools Accelerator (ACT-A).

Most existing funds are mainly focused on procurement, yet multiple analyses show that it will take hundreds of billions of dollars on top of procurement financing to fully deliver a global response. If successful, ACT-A, for example, will provide vaccines for 27% of low- and middle-income (LMIC) populations in 2021 on current financing levels — but ACT-A finance does not cover rollout costs from “tarmac to arm” of its own vaccines. The situation in India also underscores the importance of oxygen and other tools that are needed before herd immunity is reached. We need a fully-funded, holistic response. We are therefore calling on leaders to:

Set out a comprehensive, coordinated strategy, as has been called for by the IMF, World Bank, WHO, and WTO, to get to global herd immunity as soon as possible, which:

  • Gives countries the support they need so that all efforts to deliver the global response are mapped, efforts are mutually-reinforced, duplication can be avoided and critical gaps can be identified and filled.
  • Delivers a comprehensive costing and analysis covering all elements of a global response to establish what is already covered and identify gaps in supply, procurement, and resources needed in-country for the delivery of vaccines, tests, and treatments.

Increase and improve the global supply of all COVID-19 tools through investment, policies and the redistribution of excess doses.

  • Scale up the production of tests, treatments, and health commodities, including oxygen, and accelerate LMIC-led research and development (R&D) through fully-funded diagnostics and therapeutics pillars.
  • Increase vaccine manufacturing through investments in regional capacity and back policies to increase knowledge sharing, remove trade-related barriers, and create tech transfer hubs.
  • Ensure vaccines are offered at an affordable price and on a not-for-profit basis.
  • Prioritize dose-sharing. G7 leaders should pledge 2 billion doses at the Leaders’ Summit, delivering 1 billion by the end of August and the second billion by the end of 2021 and as part of this delivery, ensure that 250 million additional people in low-income countries (LICs) and LMICs have actually received their doses by the end of August in parallel with national vaccine rollout plans.

Fully cost the response, agree to a burden sharing model, and begin to plug the gap by fully funding the ACT-A.

  • Agree to a burden-sharing model to set out fair share contributions and fully funding ACT-A.
  • Leverage funding opportunities by identifying new funding streams to protect official development assistance (ODA).
  • Fully fund global vaccination to reach 70% coverage, requiring at least US$50B according to IMF estimates, with more in grants needed to enable LMICs to cover the full costs of delivery.
  • Work with countries to urgently cost all delivery needs outside of ACT-A’s mandate so vaccines and other tools can be distributed and administered, including the costs of frontline and community health workers.

Three key deliverables for the G7: leadership, supply, and finance 

G7 leaders must:

1. Develop a Global Roadmap to Vaccinate the World: 

  • Develop a comprehensive, coordinated strategy that plugs gaps and shines a light on the blind spots of current efforts, including delivery of tools to low-resource settings.
  • This Global Roadmap should be kicked off at the G7 Summit and delivered with full costings and logistical, human, and financial resource needs by the end of June at the latest, when other costings will also be available to inform the roadmap.
  • There are growing calls for leaders to step up and set out the plan that is designed to bring the acute phase of the pandemic to an end and vaccinate the world. As well as the proposal from the IMF, World Bank, WHO, and WTO, the Spanish Government has set out a ‘Vaccines for All’ plan, more voices in the U.S. are calling on the Biden Administration to show leadership, and in the vacuum left by the lack of a truly global response, other organizations are stepping up to offer policy prescriptions for a global plan. The report of the Independent Panel on Pandemic Preparedness and Response also recognized the lack of global coordination and political leadership during this pandemic and called for a Global Health Threats Council to be formed.
  • The G7 must not delay in corralling leaders to deliver a Global Roadmap. The UK Presidency is well placed to work hand in glove with the G20 to deliver a comprehensive roadmap that plans to vaccinate at least 70% of people in the world and provides the support needed for every country to get the vaccine delivered and administered safely to 70% of each country’s population.


2. Increase the supply of vaccines available globally by: 

  • Prioritizing dose-sharing. The G7 should pledge 2 billion doses at the Leaders’ Summit, delivering 1 billion by the end of August and the second billion by the end of 2021 and as part of this delivery, ensure at least 250 million additional people in LICs and LMICs have actually received their doses by the end of August. Without dose-sharing, G7 countries would have enough supply to vaccinate to share over 3 billion excess doses even after vaccinating 70% of their own populations.
  • Scaling global capacity to produce COVID-19 vaccines by the end of 2021 through investments in regional capacity, backing policies to increase knowledge sharing, removing trade-related barriers, and creating tech transfer hubs.
  • Buying vaccine supply for COVAX and other mechanisms to help reach 70% coverage.


3. Fully finance the global response to COVID-19 by: 

  • Fully funding global vaccination to reach 70% coverage, requiring at least US$50B according to IMF estimates, with more in grants needed to enable LMICs to cover the full costs of delivery, on the basis of a clear burden-sharing agreement, which will:
    1. Fill the immediate ACT-A funding gap of US$19B.
    2. Commit in principle to fund the global roadmap to get to 70% global coverage on the basis of a clear burden-sharing agreement, finding new resources and protecting existing ODA.
    3. Leverage multilateral development banks (MDBs) to help finance the global roadmap.
  • Ensuring the costs needed to administer vaccines — including to health systems and health workers, including frontline and community health workers — are also met, so that vaccines are not just available but also administered, as part of a fully-costed global plan to reach global herd immunity.
  • Costing and then mobilizing the additional finance needed to deliver this plan to vaccinate the world, using all possible finance tools to raise the amounts necessary, including, but not limited to, SDRs, funds from MDBs, and new sources of funding, including innovative mechanisms and providing finance beyond government funding.

 

                           PATH                 

 

Download PDF version of this call-to-action here. Share this call-to-action with the social media toolkit here.

Call-to-Action to African Leaders: Scale Up COVID-19 Testing Now

As the world looks back on one full year of living in the COVID-19 pandemic, the response is still far from over. With only 41 million tests conducted in Africa since the start of the pandemic, and 28,030 tests conducted per million people (well below the Africa CDC-recommended optimal testing level of 75,000 tests per million people), there is an urgent need for African Union (AU) member states to scale-up testing. In spite of disruptions in the global supply chain for COVID-19 tools, including diagnostics, there has been a slow but steady increase in testing. However, the continent needs a rapid scale up of testing for better epidemiological management of the pandemic in order to keep economies open and save lives. Without sufficient testing, we are fighting the pandemic blindly.

Africa CDC and Partners Working Group on Testing, of which Pandemic Action Network is a member, has developed a letter signed by Center for Global Health Security and Diplomacy, FIND Diagnostics, PSI, Right to Health Action, and WACI Health, and three advocacy networks each composed of 100+ members (Pandemic Action Network, Global Fund Advocacy Network, and Treatment Action Group).

The call-to-action is directed to African Ministers of Health urging them to:

  • Order quality-assured antigen tests  
  • Ensure sufficient budget for procurement of antigen tests and testing this fiscal year
  • Ensure sufficient budget for procurement of lower-priced PCR tests for COVID-19 and other diseases including TB, HIV, and Hepatitis C

Read the call-to-action letter here and contact [email protected] to take part in the advocacy efforts with AU leaders.

It’s Time to Pandemic-Proof the World: A 2021 Agenda for Action

The devastating health, economic, and social impacts of the COVID-19 global health crisis show that it is well past time for world leaders to prepare for pandemics as the existential, catastrophic, and growing global security threat they are. In 2010, well before COVID-19, there were six times more zoonotic spillover events than in 1980, and the number of new outbreaks continues to grow. Persistent gaps in international pandemic preparedness and response capacities have been flagged by various expert panels in the wake of previous health emergencies, but time and again, once the crisis disappears, political attention and funding shifts to other priorities. This dereliction of duty must stop once and for all.

Despite impacting people around the globe, COVID-19 has not affected everyone equally. The pandemic has exposed and exacerbated long-standing health and socio-economic inequalities within and across countries and in marginalized and vulnerable populations, including inequalities due to gender, race, ethnicity, class, and disability. The glaring disparities in global access to lifesaving COVID-19 vaccines, therapeutics, diagnostics, and vital tools such as oxygen and personal protective equipment (PPE) underscore the inequitable global health and preparedness system. And the lack of proactive attention by leaders to address and account for these inequities has significantly undermined the global COVID-19 response.

As the Global Preparedness Monitoring Board (GPMB) made clear in its September 2020 report A World in Disorder, the world cannot afford to continue to ignore or delay preparations to bolster our collective defenses against emerging pandemic threats. As they battle the current crisis, countries and international institutions must act now to ensure the world is better prepared for the next pandemic threat, which may be lurking just around the corner. These commitments should include building and reliably funding a well-trained and well-equipped health and research workforce, more resilient frontline health systems, timely and transparent disease surveillance, and effective supply chains for vaccines, diagnostics, PPE, and other tools to enable every country to detect, prevent, and rapidly respond to outbreaks before they become deadly and costly pandemics. It is time to invest in a smarter, more responsive, and more resilient global health security architecture.

Pandemic Action Network’s 100+ partners urge world leaders to take urgent action in the following areas to bolster the global COVID-19 response, hasten an end to this global crisis, and lay the groundwork for a more pandemic-proof world.

Support an equitable global response to COVID-19

The only way to end this pandemic is to end it for everyone through a coordinated global response. Yet as world leaders navigate the second year of responding to COVID-19 and securing vaccine doses for their constituents, nationalist inequitable approaches are still pervasive. Recent data shows that the world has now procured enough COVID-19 vaccine doses to reach herd immunity globally, but while some high-income countries have secured multiple times the number of doses as there are eligible adults in their countries, only 0.2% of doses administered have been in low- and middle-incomes countries (LMICs). Although it may seem intuitive for governments to first take action at home, this approach belies the fact that the virus — and its swiftly spreading variants — do not respect borders. Many countries that managed to control or even stop the spread of the virus earlier in the pandemic are once again seeing a surge in cases. There simply is no effective domestic response without also embracing a global approach. Everyone deserves to hope for a swift end to the pandemic, regardless of where they live. But it will only be possible if political leaders act globally as well as locally, knowing no country will be safe until every country is safe.

1. Accelerate global access and delivery of COVID-19 vaccines needed to achieve at least 70% coverage in all countries and enable an equitable global response and recovery.

World leaders should:

  • Fully fund the Access to COVID-19 Tools Accelerator (ACT-A) in 2021, filling the $22.1 billion funding gap as soon as possible with countries paying their fair share for this global public good. Countries should also commit to continue to invest in research and development (R&D) as well as scale-up of proven tools to prevent, test, and treat COVID-19 and ensure that medical countermeasures are effective against all strain mutations and all variants of concern. Given the scale of resources required, countries will need to tap into fiscal stimulus funding and other financial sources beyond official development assistance (ODA).
  • Agree to a roadmap to achieve at least 70% coverage of vaccines for LMICs, with at least 30% being secured, delivered, and administered in 2021. Leaders need to agree to a fully costed plan to achieve equitable global coverage as soon as possible. The full costs of delivering and administering doses in-country should be included in this roadmap, as well as the investments in vaccine education required to increase vaccine confidence.
  • Commit to donate, free of charge, all excess COVID-19 vaccine doses to the COVAX facility in parallel to their domestic vaccination efforts and start those donations as soon as possible. Countries should immediately announce commitments to share their full surplus supply on the most ambitious timeline possible, putting plans in place to deliver on this commitment as soon as is feasible in 2021 in line with COVAX’s dose sharing principles. These donations should not count as ODA, and should be in addition to funding the ACT-A.
  • Commit to “slot swaps” as another way to give COVAX additional supply. “Slot swaps” should be undertaken whereby high-income countries reallocate some of their existing orders immediately, potentially ordering replacement vaccines to arrive farther in the future, effectively giving their earlier “slots” to COVAX to help provide vaccines for LMICs to close the current acute gap in supply.
  • Ramp up global access and delivery of rapid testing, medical oxygen, and personal protective equipment to the frontlines. Continuing shortages of PPE and medical oxygen for frontline health workers and extremely limited deployment of testing — including genetic sequencing capacity to detect variants of interest — especially in LMICs, is hampering the global COVID-19 response and is a rate limiting factor for global rollout of COVID-19 vaccines and restoration of essential health services.

Prioritize and invest in pandemic preparedness and prevention

According to the IMF, the pandemic will cost the global economy and the World Bank projects that more than 160 million people will fall into poverty by the end of 2021. Conversely, recent estimates are that as little as $10-20 billion annually can ensure the world is much better prepared to detect, prevent, and respond to the next infectious disease outbreak before it becomes another deadly and costly pandemic. To minimize human lives lost from infectious diseases and lessen the impact on countries due to economic fallout, leaders should take the actions below to be prepared for the next pandemic.

2. Establish a catalytic, sustainable multilateral financing mechanism that is dedicated to promoting pandemic preparedness and prevention.

World leaders should:

  • Pledge new investments toward a target $20 billion initial capitalization co-funded from public, private, and philanthropic sources. Priorities for this new multilateral financing mechanism — which will fill a strategic gap in the existing global health architecture — should be on supporting LMICs to develop and implement national action plans for health security and pandemic preparedness, to close their urgent health security gaps, and foster a global “race to the top” among all nations for preparedness. The catalytic nature of this mechanism will help ensure both countries and other global health initiatives prioritize coordinated, multisectoral, prevention and preparedness funding in their domestic budgets, including support for country-level programmatic and managerial capacity in health systems strengthening.
  • Align funding with target country priorities to strengthen pandemic preparedness and containment as well as promote efforts toward pandemic prevention. Programs that should be financed at scale include detecting and stopping the spread of outbreaks and ensuring compliance with the International Health Regulations (IHRs), strengthening laboratory and manufacturing capacity, bolstering and protecting a trained, compensated health workforce, building and strengthening health information systems, ensuring resilient national and regional supply chains, One Health initiatives, and stopping zoonotic spillover from causing new outbreaks through measures such as reductions in deforestation and wildlife trade.

3. Bolster financing and at-the-ready global R&D capacity and coordination to combat emerging infectious diseases and pandemic threats without undermining important funding for existing epidemics research and innovation, including poverty-related and neglected diseases.

Applying the lessons learned from COVID-19, leaders should support the development and financing of mechanisms and initiatives that coordinate and catalyze research and development for new tools, including the Coalition for Epidemic Preparedness Innovations (CEPI), Global Antibiotic Research and Development Partnership, and other not-for-profit product development partnerships (PDPs) addressing the broad range of health threats.

World leaders should:

  • Fully fund CEPI’s $3.5 billion replenishment. This funding would support the organization’s moonshot initiative of compressing vaccine development for new pandemics to 100 days, and continuing efforts to develop vaccines for known threats. It would also support CEPI’s other objectives, including preparing clinical trial networks to quickly respond to new threats, coordinating with global regulators to streamline vaccine oversight, and linking manufacturing facilities to speed up global production.
  • Support integration of R&D into the Global Health Security Agenda (GHSA) framework to include R&D capacity-building for medical countermeasures. Inclusion of metrics through a GHSA R&D taskforce will help countries assess, prioritize, and better plan for strengthening their R&D capabilities.
  • Build on the ACT-A’s response to COVID-19 to ensure a robust, end-to-end, and sustainable investment in global health R&D for pandemic preparedness, including long-term investments to strengthen global research, laboratory, and manufacturing capacities. This future readiness state should also foster more investments and partnerships with diverse research and academic institutions to both build regional R&D prior to crises and scale up support during emergencies. Investments should be made with policies that promote equitable global access to and affordability of tools like vaccines, diagnostics, and therapeutics.

4. Strengthen global and national surveillance capacities & outbreak analytics.

COVID-19 has demonstrated global gaps in early detection and data sharing around emerging threats, as well as gaps in ongoing surveillance capacities of countries, especially low-resource countries. Current emerging infectious disease surveillance and investigation is poorly allocated, with the majority of the globe’s resources not focused on areas with the most zoonotic hotspots where the next emerging deadly pathogen is likely to originate.

World leaders should:

  • Strengthen integrated national disease surveillance capacities in LMICs. Such surveillance capacities should take a One Health approach and be responsive to local needs (i.e., give results in real-time for use by clinicians and public health officials). Such capacities should not be developed in a silo for pandemic risk monitoring; rather they should provide utility for day-to-day public health programs, leverage the latest developments in digital tools to streamline operations for health workers, and accelerate data flow and analysis.
  • Strengthen mechanisms and platforms that allow for independent sharing and verification of data related to emerging health threats, complementary to and in partnership with the WHO’s role in collecting data from official sources under the IHRs. Such capacities should enable and promote more transparency and accountability in data access for all relevant stakeholders.
  • Commit to the rapid publishing and sharing of line list and pathogen genome data into shared repositories (e.g., the Global Influenza Surveillance and Response System and the International Nucleotide Sequence Database Collaboration) to ensure that data necessary to monitor variants of concern can be acted upon before they become dominant.
  • Support innovations in outbreak detection and analytics capacity nationally through emergency operations centers, regionally through academic centers of excellence, and globally through laboratory and disease surveillance networks. The ACT-A has taught the community about the importance of collaboration and rapid response, and these lessons should be applied to future tools.

5. Bolster global capacities, institutions, and systems for pandemics, health security and resilient health systems, including through reforming WHO and strengthening international frameworks for pandemic preparedness and response.

World leaders should:

  • Build consensus for, and rapidly move to implement, proposals that will strengthen the WHO as the global coordinating authority on health. Leaders should support proposals for sustainable financing of the WHO, including incremental increases in assessed contributions and more (and more flexible) voluntary financing. Such resourcing should go hand-in-hand with strengthening the WHO’s normative and technical capacities, including the Chief Scientist’s Office, the Health Emergencies Programme, and the WHO Academy, and with encouraging greater staff mobility and budget flexibility to bolster the WHO’s capacities at the country-level. In line with the Framework for Engagement with Non-State Actors (FENSA), leaders must enable more robust and transparent engagement with key stakeholders such as civil society and the private sector.
  • Strengthen the IHRs to foster more timely and accountable response to pandemic threats, including to authorize international investigations. Leaders should afford the WHO the ability to independently investigate potential and emerging threats, specify better information sharing, and better calibrate the definitions of a Public Health Emergency of International Concern (PHEIC). Metrics on equity, R&D, infection prevention control, capacity strengthening, and water, sanitation and hygiene should also be included in the IHR Monitoring and Evaluation Framework, to incentivize countries to assess, plan, prioritize, and better support sustainable and resilient health systems, and promote healthcare worker safety.
  • Support other voluntary and compulsory instruments to strengthen accountability of nation states and foster multilateral cooperation for pandemic preparedness and response. Many gains can be made by strengthening existing mechanisms and instruments, which should be prioritized alongside the proposal for a new pandemic treaty. Such instruments should promote accountability in functions including ensuring novel countermeasures are treated as global public goods; motivating faster flow of financing to address direct and collateral impacts of pandemics, including protecting frontline health workers and social protection for vulnerable populations such as refugees and those living in conflict-affected areas; reaffirming the centrality of human rights considerations in the context of a pandemic; boosting domestic R&D and manufacturing capacity; and establishing up data surveillance systems, and norms and standards around data sharing and data privacy.
  • Scale up national and global vaccine education efforts to increase vaccine confidence, distribution, and uptake. Countries should have budgets dedicated for vaccine education within health ministries, initiate public education campaigns to manage the spread of misinformation online, and build capacity for vaccine hesitancy research. Training should be prioritized for frontline healthcare workers, community leaders, and others in how to engage in difficult conversations on vaccine hesitancy.

6. Promote equity-focused initiatives and human rights protections in all aspects of pandemic preparedness, response, and recovery, including specific attention to address the intersectional and gendered effects of outbreaks.

World leaders should:

  • Commit to equitable financing to support populations most at risk for morbidity and mortality, including addressing inequities due to disparities in gender, race/ethnicity, sexual orientation, socioeconomic status, and disability.
  • Ensure commitments to human rights and equity are met, in alignment with IHR Article 3 on human rights, the United Nations Security Council Resolution 1325 for Women, Peace and Security, the UN Political Declaration for Universal Health Coverage, and the UN Sustainable Development Goals.
  • Commit to equal and diverse representation on emergency committees, including the IHR Emergency Committee and UN technical working groups, with active and meaningful participation of gender advisors and civil society groups as non-participant observers of EC meetings.
  • Ensure that all data pertinent to pandemic preparedness and response collected by the WHO and other health-focused UN bodies (as well as national governments) is published and disaggregated by sex and key socioeconomic groups.

 


 

An array of upcoming international summits — including the G20, G7, World Health Assembly, World Bank/IMF Meetings, and UN General Assembly — offer opportunities for leaders to act on this agenda. Critically, while health ministers have a key role to play, a concerted effort to end pandemics is a whole of government effort — and must be addressed at the level of heads of state. That is why the Pandemic Action Network supports the GPMB’s call for the UN Secretary-General to convene a focused UN High-Level Summit on Pandemic Preparedness and Response to mobilize increased domestic and international financing and advance efforts toward a new international framework for pandemic preparedness. Such a summit at head of state level should take up the forthcoming findings of the Independent Panel for Pandemic Preparedness and Response (the Independent Panel), the G20 High-Level Independent Panel for Financing the Global Commons (HLIP), the International Health Regulations (IHR) Review Committee, and the proposal for a new international treaty on pandemic preparedness and response.

World leaders must seize this opportunity to commit to action and leave a legacy of a healthier and safer world. We can pandemic-proof the future if world leaders act now. The world can’t afford to wait.

Calling on Wealthy Countries to Reallocate Excess Vaccine Doses

As more and more people in high-income countries become vaccinated against COVID-19, the inequitable allocation of approved vaccines across the globe is coming into stark relief. Wealthy nations have secured multiple times the amount of vaccine needed to protect their population, while low- and middle-income countries still need to get to the 20% of the population coverage offered by the COVAX Facility. Pandemic Action Network’s Funding and Access to COVID-19 Tools Working Group produced a policy brief urging high-income countries to coordinate with COVAX to donate excess COVID-19 vaccine doses to low- and middle-income countries – and to engage in ‘slot swaps’ to make sure vaccines can be delivered without delay to LICs and LMICs. As vaccines arrived in wealthy nations in December and January,  it became clear that countries without bilateral deals with pharmaceutical companies could be left behind. In light of this reality, the working group pushed COVAX to offer countries the option to reallocate excess supplies. Read the paper here. If your organization wishes to add their logo to the briefing, please email [email protected].

Recommendations for the Biden-Harris Administration – Now or Never: An Agenda for Global Action to Make America and the World Safer from Pandemic Threats

We urge President-elect Biden and the incoming Biden-Harris Administration to launch and lead an aggressive agenda for action on global health security to end the COVID-19 pandemic as quickly as possible while accelerating global preparedness for the next pandemic. The following five-point agenda for action has been prepared by a group of leading U.S. global health policy experts, including two of our Pandemic Action Network co-founders. The outlined recommendations reflect the group’s collective experience as well as the conclusions of an extensive body of research and reports from numerous expert groups over the past five years. As the pandemic has upended lives and livelihoods in every household in America and every corner of the globe, the political moment is ripe for President-elect Biden to galvanize and lead a global coalition of public and private actors around a shared commitment to help prevent a deadly and costly pandemic like COVID-19 from happening again. President-elect Biden has the opportunity to leave a longer-term legacy that will better prepare humanity to more effectively address emerging pandemic threats, and break the persistent cycle of panic and neglect once and for all. Waiting until this crisis is over or until the next one happens will be too late. It’s now or never. Read the five-point agenda white paper here: Now or Never: An Agenda for Global Action to Make America and the World Safer from Pandemic Threats

The Missing Piece of the Puzzle: Getting from Vaccine Hesitancy to Acceptance

For too long, the global health community has ignored the warning signs, assuming that anti-vaccination challenges were limited to a single geography or vaccine, and that anti-vaccination beliefs were fringe and would not impact broader uptake. In 2019, the WHO finally listed vaccine hesitancy as one of the world’s top ten global health threats. In 2020, this threat has been supercharged by the pandemic, representing a critical tipping point in the decades-long trend of vaccine distrust and hesitancy. The world must now act urgently to address this growing threat in order to end the COVID-19 pandemic and help stop future deadly outbreaks.

As multiple promising vaccine candidates come to market, there is hope that the world will soon turn a corner on defeating COVID-19. But in many countries around the world, fewer than 70% of the population plan to get themselves vaccinated—less than the threshold at which public health experts estimate herd immunity to COVID-19 to be effective. Within communities across the globe, vaccine hesitancy threatens countries’ ability to effectively stop the spread of COVID-19 and risks prolonging the outbreak further, costing more lives. The Pandemic Action Network released a policy paper with a set of recommendations for a wide range of actors, including governments, community leaders, multilateral institutions, and social media companies. This paper urges the world to address the various issues leading to vaccine hesitancy to ensure individuals can make critical decisions about their health and the health of their families and communities based on trustworthy and factual information. No one actor can address vaccine hesitancy alone. The challenge of vaccine hesitancy demands collective global action for vaccine confidence and acceptance.

Read the paper here: The missing piece of the puzzle: Getting from vaccine hesitancy to acceptance

Guaranteeing Equitable Access: Considerations During Vaccine Development Impacting Global Access

As world leaders come together to strategize how best to inoculate against, test for, and treat COVID-19 across the world, they must prioritize equity in their agendas to end this pandemic as swiftly as possible. The Pandemic Action Network’s Ending Barriers to Equitable Access Working Group has crafted a briefing with key considerations for decision-makers to ensure vaccines, therapeutics, and diagnostics reach those who need it most, when they need it most. We are all at risk until this disease is defeated internationally. We must ensure that low- and middle-income countries and vulnerable groups have equitable access to the tools needed to fight COVID-19 on every front. Read the full paper here.

Contributors to the paper include Deutsche Stiftung Weltbevölkerung (DSW), Global Citizen, Global Health Technologies Coalition (GHTC), PATH, and VillageReach. Special thank you to DSW for design support.

Pandemic Action Agenda: What World Leaders Should Do to Help Prevent the Next Pandemic

With global COVID-19 cases set to surpass 50 million and spiking across the United States and Europe, world leaders are gathering in a series of international summits to discuss what they will do to stop the pandemic. The current crisis demands urgent and united action as a global community, as no country will be safe from the virus until every country is safe.

But this pandemic didn’t have to happen, and the next one won’t wait. As they fight the current battle, leaders must also take steps NOW to bolster our global and national defenses against emerging pandemic threats before they materialize.

Synthesizing lessons of what has gone wrong in COVID-19 and in previous outbreaks and epidemics, the Pandemic Action Network’s Global Health Security Architecture Working Group has identified six priorities for international action to ensure the world is better prepared for the next pandemic. These are captured in our brief Pandemic Action Agenda paper released last month.

 

 

Pandemic Action Agenda Series

Now we’re pleased to release a series of Pandemic Action Agenda papers which expand on each of the six priority areas for action:

Pandemic Action Agenda Summary: Calling on world leaders to strengthen the global health security architecture and governance and make the world better prepared for pandemics. 

Global Health R&D: Bolstering the global research and development architecture for health security.

Outbreak Detection: Enhancing the availability and use of reliable data and early warning systems to drive more effective preparedness and response to outbreaks.

Pandemic Financing: Mobilizing sufficient funding for national pandemic preparedness and global response efforts. 

Country Capacity: Enhancing countries’ capacity to prevent and respond to outbreaks through technical assistance and improving health security infrastructure.

Pandemic Supplies: Solving supply chain bottlenecks and ramping up regional and local production and delivery to ensure health workers everywhere have access to sufficient quality personal protective equipment (PPE) and other frontline health supplies.

Metrics and Evaluation: Increasing accountability through more effective mechanisms to assess—and fill gaps in—country preparedness levels. COMING SOON

 

What You Can Do

Advocate for action. Help us deliver the Pandemic Action Agenda directly to key decision-makers in your country and international organizations, and press them to take action on these issues. Contact Naomi Komuro at [email protected] and let us know who you can reach (or we can give you ideas!). 

Spread the word. Share the #PandemicActionAgenda on your social media channels and through other communications within your networks to help build us momentum to prioritize global preparedness. Find the social toolkit here

Hold leaders to account. Sustained advocacy and communications are essential to avoid repeating the cycle of panic and neglect when it comes to deadly outbreaks. Follow up with decision-makers through emails, meetings or events, and ask them share what they are doing to respond to the Pandemic Action Agenda—and let us know what you learn to inform our ongoing advocacy efforts. 

Every effort we make in the fight against COVID-19 should leave a longer-term legacy that better prepares humanity to more effectively deal with outbreaks and pandemics and—when possible—to prevent them at the source. 

Want to learn more? Please contact Carolyn Reynolds, Co-Founder, Pandemic Action Network at [email protected]

 

Why Masks Matter

The Pandemic Action team has released a briefing on Why Masks Matter, detailing the growing evidence that wearing a mask or face covering can help slow the spread of the disease and save lives – especially when paired with handwashing, social distancing and when governments introduce effective test and trace policies. Until we have widely available treatments or a vaccine for COVID-19, it is up to every one of us to step up and do all we can to help beat this disease.

The evidence is piling up as to the effectiveness of mask-wearing. Masks are effective because they block large droplets from the wearer of the mask before they become aerosolized. New evidence also shows that mask wearing can reduce the amount of viral load that is passed on – lessening the severity of the impact of the disease on others .

Mask-wearing protects the people around you – my mask protects you and yours protects me, and there is increasing evidence masks help protect the wearer too. So, who should wear a mask, and when? We believe that to fight this pandemic as swiftly and effectively as possible, mask wearing needs to become the new normal. Here’s why:

First, people may have COVID-19 without knowing it. Studies show that people infected with COVID-19 may start to be infectious 1-3 days before the onset of their symptoms and they could even be most infectious in the 24 hours before symptoms appear. This underlines how important it is to wear a mask even when we’re feeling fine—plus some people may never show symptoms, but still have the ability to infect others.

Second, the effectiveness of universal masking could be comparable to that of a societal lockdown. Without the enormous economic, social, health and educational costs of closed workplaces, schools, and public spaces and limited geographical mobility. Mask-wearing is a complementary measure to other measures taken by governments, but right now huge decisions that are affecting everyone’s lives, education and livelihoods are being taken often before universal masking and other behaviours have been made policy and communicated widely. Modelling report cited in our brief shows that if everyone wore a mask, we could diminish the scale and the impact of COVID-19 swiftly.

Third, countries are starting to feel the benefits. An Oxford University study found that in countries where face coverings have been introduced as a national policy (often but not always alongside other measures), transmission rates fell in the subsequent days.

For all these reasons and more, we are calling for clear, comprehensive guidance on mask-wearing in public spaces. Our recommendations call for governments to make mask-wearing mandatory in public as well as properly enforce mask-wearing,  communicate the benefits of mask-wearing to the public, ensure mask supplies for healthcare and other frontline workers while also encouraging the public to wear face coverings. We also ask that they lead by example and wear a mask themselves. We call on businesses to adopt and implement mask-wearing policies and for everyone, everywhere, to don a mask when they leave their home. This simple measure can work if enough of us take collective action, wherever we are around the world.

Get involved, get your mask on, take a selfie and tag your friends to share widely. This is how we can help get this disease under control – together we can beat this if we #WearAMask, this #WorldMaskWeek and every week.

Break the Cycle of Panic and Neglect: Preventing the Next Pandemic

Time for unprecedented international cooperation say global health organizations

In the wake of the US decision to terminate the relationship with the World Health Organization (WHO), Pandemic Action Network and leading global health organizations have published a brief paper outlining some of the critical steps that the world needs to take to prevent pandemics.

The report sets out a key challenge for global leaders to work together in an unprecedented way to end COVID-19 as swiftly as possible and prepare for future pandemic threats.

The report, published jointly by the Pandemic Action Network, ONE, PATH, Nuclear Threat Initiative (NTI), Global Health Security Agenda Consortium (GHSAC), Management Sciences for Health (MSH) and Global Citizen highlights how years of ‘panic and neglect’ in the international health system has led to inadequate preparedness for pandemics in every country, resulting in the loss of hundreds of thousands of lives to COVID-19. Among the report’s recommendations is to strengthen WHO. Read the report HERE.