Why We Need a ‘Rome Roadmap’ to Vaccinate the World

By Friederike Röder, Global Citizen; Eloise Todd, Pandemic Action Network; and Emily Wigens, The ONE Campaign

We need a global roadmap to vaccinate the world — and we need it now. The scenes emerging from India are a harrowing reminder that unequal distribution of vaccines puts everyone at risk. More contagious forms of the virus are already evolving, increasing the risk of a new mutation that resists current vaccines.

Global access to vaccines is the fastest way to end the pandemic, but if rich countries monopolise supply and only vaccinate themselves, twice as many people could die — and the costs could stack up to an additional US$9 trillion. As of May 2021, just 0.3% of COVID-19 vaccines had been administered in low-income countries and COVID-19 deaths in low- and lower-middle-income countries now account for 30.7% of global deaths, compared to 9.3% a month ago.

That’s why the EU and its Member States must seize the opportunity of the Global Health Summit on 21 May and the 24-25 May European Council meeting by taking the following actions: 

  • Develop a global roadmap to vaccinate the world to reach global immunity as soon as possible, raising the level of ambition and offering the political leadership needed to deliver vaccines across the world. The EU and Member States should coordinate globally so that all efforts to deliver COVID-19 vaccines are mapped, mutually reinforcing, and avoid duplication. This strategy should include a comprehensive costing to show what it would take to vaccinate 70% of the world, and should also include analysis to identify gaps in supply, procurement, and resources needed in-country for the delivery for vaccines, treatments, and tests.
  • Immediately contribute to the call for high-income countries to share 1 billion doses by September, and 2 billion by the end of the year, sharing surplus doses via, or in coordination with, COVAX. This year, EU Member States will have at least 690 million doses more than they need to vaccinate 100% of their populations, and in many EU Member States the supply of COVID-19 vaccines will soon outstrip demand. Several Member States have stepped up with commitments to share doses, other leaders should urgently follow in their footsteps. Unearmarked doses should be donated immediately, in parallel with national vaccination rollouts, or when countries have vaccinated 20% of their populations at the latest. Moving forward, the EU should avoid purchasing more doses than necessary to fully cover its own population and should make its own contracts conditional upon pharmaceuticals making deals with COVAX at not-for-profit pricing.
  • Contribute their fair share towards fully funding the current and future ACT-Accelerator funding gaps, estimated to be at least $66 billion, in 2021 and ensuring a fair distribution between the Therapeutics, Diagnostics and Vaccines Pillars, as well as the Health System Connector. The European Commission should contribute at least an additional €1.2 billion and all EU Member States should meet their fair share in financing for ACT-A. This is the best investment they can currently make. This should pave the way for the whole of the G7 to close the current funding gap of $18.5 billion by at least 60% as soon as possible.
  • Support all means necessary to increase global supply of COVID-19 tools. It is imperative that governments and industry use every tool in their toolbox to dismantle the barriers that delay truly global access to COVID-19 vaccines, tests, and medicine. The world needs a total of 11 billion vaccine doses to achieve herd immunity, but according to estimates, we’re at best at a capacity level of 8.5 billion. The EU should lead the way on building a roadmap on producing those additional vaccine doses and future boosters, using all means necessary, both in lifting IP barriers and in ensuring sufficient manufacturing capacity. This could range from the temporary waiver of COVID-19 intellectual property rights, alongside additional licensing, technology transfers, and the elimination of trade-related barriers such as export bans. In parallel, the EU should launch an initiative to increase manufacturing capacity in LICs and LMICs, helping to bring private investors on board, and support the WHO’s mRNA Tech-Transfer Hub.

European leadership should take the fight against COVID-19 to the next level by taking urgent action now, with the aim to protect every person in the world, save the maximum amount of lives, and stop the spread of dangerous variants that will harm all of us. The world is playing catch-up on an equitable response. Now is the time for a reset with a strategic plan to reach 70% globally, dose sharing immediately, and investment in purchasing vaccines and other life saving tools — as well as action to kickstart medium-term supplies through licensing, tech transfer, and investment in production capacity. All these elements are needed.

It’s time for the EU’s leaders to deliver, at the Global Health Summit and at their Summit next week.

Friederike Roder is the vice president for global advocacy at Global Citizen, Eloise Todd is the co-founder of Pandemic Action Network, and Emily Wigens is the EU director at The ONE Campaign.

There Are Reasons to Be Hopeful About Beating COVID-19. But We’re Not Done Yet.

By Friederike Röder, Global Citizen & Eloise Todd, co-founder of the Pandemic Action Network

We’re one year into the pandemic but may now be entering a new, more optimistic phase — at least from a political point of view.

The new US administration is now in place, but there is momentum elsewhere too. Until recently, many leaders had been focused largely on domestic action and on short-term fixes. But there are now signs that leaders are starting to understand that airborne COVID-19 cannot be defeated within borders, and that global solutions are needed.

Last week’s informal G7 summit saw funding for the Access to COVID-19 Tools Accelerator (ACT-A) finally ratcheting up with important new commitments pledged.

Germany was the first G7 country to meet — and even surpass — its “fair share” contribution to the ACT-Accelerator, for which Chancellor Merkel deserves huge credit. Since the ACT-A was launched in May 2020, the financial gap has been reduced by $16 billion, including through a $4.3 billion contribution pledged during last week’s G7 summit.

The European Council on Thursday concluded that “strengthening the [World Health Organization] WHO and working towards an international treaty on pandemics” is necessary to enhance multilateral cooperation, and support for funding Europe’s fair share of COVAX — a facility designed to combat vaccine nationalism and ensure low-income countries have access to COVID-19 vaccines — was underlined.

On Friday, G20 finance ministers took a step towards new Special Drawing Rights (SDRs) — an IMF asset that could help provide crucial funding for COVID-19 response and recovery (you can read all about them here).

Kristalina Georgieva has been tasked to develop a proposal – with one more heave the G20 could make a decision in the coming weeks that could change the game for the global fight against COVID. An initial one-off issuing of these SDRs would give governments the security and fiscal space to fully fund the $22 billion that’s needed for ACT-A, but would also help low-income countries go from 20% to 60% coverage in terms of vaccination coverage, help address the many impacts of COVID-19, and invest in pandemic prevention and preparedness. The G20 have requested the IMF to work out a proposal that could help achieve this.

There are further reasons to be hopeful about the global COVID-19 response, too. For example, the one-shot Johnson & Johnson vaccine, which can be kept at refrigerated temperatures, has now been approved by the US Food and Drug Administration (FDA).

This vaccine could be a game-changer, in particular for poorer countries that don’t necessarily have the infrastructure to be able to keep vaccines at very low temperatures. The Pfizer vaccine, for example, needs to be stored at below -60 degrees C, which isn’t possible without advanced cold supply chains.

What’s more, the European Commission is exploring how to boost local production capacities under licencing arrangements in Africa, a much needed initiative as we need to increase supply.

While all of the above is encouraging, it doesn’t yet add up to the scale of ambition needed to end this pandemic and prevent the next.

We need a comprehensive roadmap with government, private sector, and multilateral action towards achieving 60% vaccine coverage for the world, in line with the minimum coverage the WHO says is needed to break the chain of transmissions.

Such a roadmap will allow us to reverse engineer this objective and set ourselves a date for completion. It will need to provide solutions to quickly ensure equitable vaccine distribution across the world, increasing supply accordingly, and ensuring we have the means to prevent and prepare for any future pandemic.

Key pieces of such a roadmap are already out there.

French President Emmanuel Macron last week called for rich countries to donate 5% of their vaccine doses to low-income countries immediately, prioritizing health care workers.

Less than half a percent of the vaccine donations currently pre-purchased by the G7 (including the whole of the EU) would be enough to vaccinate all health care workers in Africa, and thereby make real progress in limiting the spread of the virus for all of us.

Vaccine nationalism is a serious obstacle in ending COVID-19 everywhere. Even if 100% of one country’s population receives the most effective vaccine, that will mean very little if a vaccine-resistant mutant develops anywhere else in the world.

While leaders, especially from the G7, have spoken frequently about taking global action for nearly a year now, in reality, current vaccine distribution is deeply unequal and needs urgent interventions to plug the gap in supply to low- and middle-income countries.

As President of the European Commission Ursula von der Leyen put it, in her foreword to Global Citizen’s white paper A Recovery Plan for the World: “A global vaccination campaign is the most effective way to drive down the virus’ capacity to evolve” and is, therefore, our only way out of the crisis. More leaders need to start accepting this reality and be courageous enough to defend it.

Such a roadmap towards global vaccination coverage also needs to include concrete steps to increase manufacturing capacity worldwide, particularly in regions, such as Africa, that currently have very little.

Building on the EU Commission’s initiative, this now requires real commitment from both governments and pharmaceutical companies to support and develop partnerships to share expertise and expand global manufacturing, with both public and private investment.

For all of this to happen, future finance needs to move faster than any virus. The setting up of ACT-A in record time is to be applauded, but in future such mechanisms need the finance on tap, ready in advance of pandemics striking for the countries that need it most.

The issuing of SDRs could not only be the financial response of scale we need to end COVID-19 and to fuel a global, sustainable recovery, but could also allow us the time needed to find the long-term financing mechanisms that will be essential in the future.

Achieving vaccine access for all, ramping up manufacturing in low- and middle-income countries, and ensuring adequate finance for pandemic prevention, preparedness, and response are all issues the G20 Global Health Summit — which will be jointly hosted by the Italian Presidency and the EU Commission in Rome in May — is well placed to tackle.

We are calling on the G20 Presidency and the European Commission to convene the world to agree on a clear road map focused on vaccine access, manufacturing, and sustainable finance to make sure we end this pandemic and prevent, and prepare for, the next.

This is the year, this is the opportunity — there is no option but to take this path.

G20 Leaders Must Turn Words Into Action on Pandemic Response and Preparedness

By Eloise Todd

The G20 Finance Ministers meeting conclusions yesterday contained some important steps forward that will provide more resources to developing countries to fight COVID-19 and mitigate the impact on already vulnerable communities. Unfortunately, the meetings did not emphasize the need to take action on key health priorities of pandemic preparedness and prevention or on financing the Access to COVID-19 Tools Accelerator (ACT-A).

There were at least some welcome concrete steps taken yesterday. Extending the Debt Service Suspension Initiative by six months, and promising to consider a further six-month extension, frees up important liquidity for indebted countries at a time when resources are scarce. Ongoing commitments to support domestic tax revenue generation and collection in developing countries also helps economies weather the storm of this pandemic.

But on health-specific investments, it was words, not action, that dominated. Pandemic preparedness appears in the outcome text, but as all too often, as the last pillar of all – almost an afterthought. Our investments in preventing future pandemics should be top of mind, rather than at the end of the list. The G20 Finance Ministers at least agree to “enhance resilience against future shocks,” including using G20 infrastructure efforts to increase the resilience of infrastructure, as well as committing to better understanding the range of risks that lead to pandemics. At the Pandemic Action Network, we would like to see the efforts to protect our countries from future waves and risks rolled out alongside – and where possible integrated with – COVID-19 response efforts. Every effort we make in the fight against COVID-19 should leave a longer-term legacy that better prepares our countries to more effectively deal with pandemic outbreaks and – where possible – prevent them at the source. Pandemic prevention and preparedness should be among the G20’s top priorities throughout this pandemic and beyond.

At a time of crisis, we also need good intentions to convert as quickly as possible into action. While the updates to the G20 Action Plan hit the right topics, we need to see moments like G20 Finance Ministerials being used as a place to write the checks, not just agree with the general principle that more money is needed. The update to Pillar 1 of the Action Plan: “Health Response – Saving Lives,” for example, states that the G20 countries are “committed to investing in an effective response to the COVID-19 pandemic to bring the spread of the virus under control and prevent further transmission” – noting that getting on top of the disease is ultimately the only way in which our economies will recover. The reference highlighting the role of the ACT-A as a way in which we can take “forward our collective action to accelerate the research, development, manufacturing and distribution of COVID-19 diagnostics, therapeutics and vaccines” is also welcome. But with the financing gap for 2020 hovering above $14B and just over two months to go until the end of the year, a meeting of the world’s most powerful Finance Ministers must lead to immediate action in the midst of a global pandemic. Not only does that gap need to be filled, but the time it takes from pledging funds to disbursement must be accelerated so that the time lag does not cost needless delays, and ultimately, lives.

As the Pandemic Action Network works with partners to encourage vaccinations and better understand vaccine hesitancy, we welcome the G20 showing a united front in “recognising the role of extensive immunization against COVID-19 as a global public good for health.” We also recognize that this important statement must be translated into action in the weeks and months ahead.

The G20 has a responsibility not only to free up liquidity, but also to direct funds from their own countries – the richest in the world with the access to the most diverse set of financial tools – toward the world’s most urgent priorities. The G20 Leaders’ Summit, then, is the opportunity for leaders to deliver more than in principle statements, and take responsibility for directing funds to the most urgent needs.

We call on leaders heading into the November Summit to convert two clear priorities into action: first, they should ratchet pandemic prevention and preparedness up the priority list; and second, they should turn their strong support for the ACT-A into much-needed funding to help fill the more than $14B funding gap. We will work alongside partners and governments to help encourage these outcomes, but decision makers need to use every opportunity they have to deliver concrete actions and funding in the weeks and months ahead. The longer they procrastinate, the longer it will take us to get a handle on COVID-19 and lives and livelihoods will be needlessly lost. Next month, leaders have to deliver – there is simply no time to delay.

A hopeful EU Speech, a Disappointing G20 Communique – And Opportunities Ahead

By Eloise Todd, Co-Founder Pandemic Action Network

Following the Global Preparedness Monitoring Board’s report launch on Monday, this week also saw the European Commission (EC) President Ursula von der Leyen give her first State of the Union speech to a masked up, socially distanced European Parliamentary chamber and the G20 Joint Finance & Health Ministers’ meeting published their conclusions. What happened?

First, President von der Leyen’s speech on 16 September. Here are five announcements that could help the fight for a better prepared world and an equitable COVID-19 response:

1. Get ready for a Global Health Summit in 2021 focusing on lessons learned from this crisis. It will be co-hosted by the EU and the Italian G20 Presidency. President von der Leyen said “we need to strengthen our crisis preparedness and management of cross-border health threats.” The fact that this issue will be a priority for the Italian Presidency of the G20 is another huge plus.

2.The EC also wants the WHO changed “by design – not by destruction” to help build “a strong World Health Organisation that can better prepare and respond to global pandemics or local outbreaks – be it Corona or Ebola.” The WHO needs this kind of constructive approach towards reform.

3. Stronger EU health agencies – and a brand new ‘BARDA’. The European Medicines Agency and the European Centre for Disease Prevention and Control (ECDC) will both be strengthened, and a brand new European agency will be created too – a Biomedical Advanced Research and Development Agency (BARDA) – to build Europe’s pandemic preparedness capacity and respond to cross- border threats and emergencies (from nature or terrorism).

4. No to vaccine nationalism, yes to vaccine cooperation, said the President loudly and clearly: “safe vaccines are available not only for those who can afford it – but for everyone who needs it.” The EU will have to walk the walk on this in its own vaccine dealings. The COVAX Facility was also mentioned, along with the €400mn the Commission pledged just last week – and the President surely knows that the EC will need to do more in the coming months to help close the Access to COVID-19 Tools Accelerator (ACT-A)’s $38bn funding gap.

5. Last but definitely not least, the President carefully raised “the question of health competences” – suggesting that during its upcoming review of the EU’s Treaty basis, the Conference on the Future of Europe examine the powers the EU has on health policy in times of crisis. If the EU leads such a reform, it could open up Europe’s ability to act as a unit across the Union and possibly multilaterally in times of crisis.

Second, on 17 September was the G20 Ministerial outcome, which by contrast majored on warm words and not in concrete commitments. We are disappointed with the outcome, and have laid out three key points that need to be converted from abstract notions to clear directives in time for the G20 Leaders’ Summit in November:

The Multilateral Development Banks (MDBs) were called upon to “swiftly consider ways to strengthen the financial support for countries’ access to COVID-19 tools.” The urgency of this support cannot be overstated; there is a $38bn funding gap in the ACT-A – $15bn of which must be found this year and the remaining secured by the end of the first quarter of 2021. Help from the MDBs is much needed – and the same kind of innovation by multilateral institutions that has helped countries deal with the impact of COVID-19 at home needs to be deployed to ensure an equitable crisis response.

Pandemic preparedness needs to shift from words to action. The communique included the Ministers “taking note” of developments, “looking forward” to the work of the Independent Panel for Pandemic Preparedness and Response (which will not release its report until next May), and many other noncommittal statements. For inspiration as to concrete policies to pursue, they should read my colleague Carolyn Reynolds (Pandemic Action Network Co-Founder) and the Center for Strategic and International Studies’s J. Stephen Morrison’s piece on what the IPPR should do on pandemic preparedness.

There is still time for the G20 to make a difference. Ministers are updating the G20 Action Plan which will be presented at the G20 Finance Ministers and Central Bank Governors’ meeting in October 2020, and then to the Leaders’ Summit itself in November. At the Pandemic Action Network we will be coordinating with our brilliant partners to ensure the Action Plan prioritizes strong and necessary measures to prevent and prepare our world for future outbreaks.

Leaders across the world need to move with urgency and speed to deliver concrete actions to make sure we end COVID-19 equitably and swiftly across the world, and take the actions needed on preparedness and prevention to make sure this can never happen again. If your organization wants to join the fight, please get in touch today. We have no time to lose.

 

What Happened? Global Citizen and European Commission’s Global Goal: Unite for Our Future

For anyone that missed Saturday’s Global Goal: Unite for our Future, here’s what happened. 

First, sitting down to a pledging summit, you don’t necessarily expect to be entertained, educated and inspired. Saturday’s Summit managed all three–and that was before the concert event started. The two hours were dedicated to short, sharp panel discussions between the video clips of leaders giving pledges as well as featuring some partners. The Summit highlighted the role of the real heroes of this pandemic – the health care workers, the scientists, the front line workers, the researchers working hard to keep us safe, treat COVID-19 patients and find cures for and vaccines against this killer disease. Highlights included Miley Cyrus teaming up with Erna Solberg and some moving conversations about the Black Lives Matter protests across the world. Connections were made about the disproportionate suffering of Black people and other minorities in the pandemic as well as through racism. These racial justice segments deeply enriched the Summit and were very rooted in the moment.

But what did the Summit concretely achieve? Two key things: finance for international aspects of the COVID-19 fight and strong political support for making sure this pandemic is ended globally. On finance, the event raised an astonishing $6.9bn in grants and loans to fight COVID-19. Host Ursula von der Leyen got the afternoon off to an incredible start by announcing a €4.9bn loan from the European Investment Bank for the global recovery. 

Other notable contributions included a €383m pledge from Angela Merkel and smaller contributions from a wide range of countries. Global Citizen helpfully published more details after the Summit. Much of the funding raised will go to the Action for COVID Tools Accelerator, with other funds to the World Food Programme, UNFPA and others to combat the impacts the disease is having on many poor communities. Much-welcomed pledges to the WHO were made by Belgium, Qatar, Sweden and others. Increasing multi-donor support for WHO will be more important than ever to fill the financing gap looming with the recent US announcement of its intent to terminate relations with WHO.

The Pandemic Action Network and others have been calling on the European Commission to work with the EIB to extend much-needed liquidity for the global response. Just as countries (and regional blocs like the EU) have borrowed huge amounts to help their own economies recover, we need the same level of ambition for the global recovery and this is a great start.

Thanks to Global Citizen’s policing of the pledges, every announcement referred to new money (a few leaders included references to money pledged before in their video submissions, but they didn’t count in the total) – a huge leap forward in transparency that will help all of us better track funding and disbursements and save precious time. 

Second, the breadth and depth of global solidarity was on full display. Leader after leader pledged money, but also strong commitments to working together across the world to end this pandemic. President von der Leyen set the tone by calling Saturday a ‘stress test for solidarity’. Jacinda Ardern ended her piece with ‘we are all in this together’ and leaders from France, Canada, Belgium, Spain, Norway, Singapore, Switzerland and the US ambassador to the UN all called for this crisis to be resolved multilaterally. It was also great to hear Johnson & Johnson commit to producing a COVID-19 vaccine on a not-for-profit basis.

The model for Saturday’s Summit changed the way we will do business during this time of COVID, this time of increased poverty, and amid the racial justice protests that have spread across the world to stand up for equality. When President von der Leyen closed the Summit with “we are in this for the long haul, and we will use all of our convening power for the common good” there are many of us that welcome that statement and we will hold her to it! The collective leadership shown on Saturday is needed for the long haul. Now we need to plan how to raise the rest of the emergency funds the world needs as well as the investments needed to make sure this never happens again. We simply cannot afford not to.

A Down Payment on the Future

May 05, 2020
By Eloise Todd, Co-Founder of Pandemic Action Network

A Down Payment on the Future

The impressive 4 May online pledging conference organised by the European Union had two clear goals: first, to show global solidarity and cooperation against the backdrop of a world fragmented by politics, inequality and a fractured response to COVID-19; and second, to raise US$8bn for the development of diagnostics, therapeutics, and vaccines to accelerate the end of the pandemic.

On the first objective, the event was a resounding success: the resolve to work together was deep and global – albeit with the notable absence of the United States. Although participants skewed European, leaders from Australia, Canada, China, Israel, Japan, Kuwait, Oman, South Africa and the UAE were among those who joined to make this a global moment, and their unity of purpose was palpable. One after the other, leaders spoke with passion about the need to leave no one behind and to make sure a COVID-19 vaccine is a global public good, no matter where it’s produced. The across-the-board commitment to the speedy and equitable distribution of a new vaccine rang loud and clear. The private sector and Foundations were present and pledging too, and global health institutions also took the floor. The words of Richard Hatchett from CEPI were simple, honest and moving: “the work will not be easy, it will not be cheap, and we cannot be certain of our success; but by combining our skills, expertise and resources, we will find a way to defeat this disease.”

On the fundraising objective, was the event successful? Maybe. But for us as advocates, our hard work has already started – we’re digging into the numbers to ascertain which of those funds were genuinely new, and which fall inside of the parameters of the US$8bn target. This accountability work is vital: unless we set a clear baseline for what was announced, we will not be able to either understand where the remaining gaps are, or be able to set much needed (and more ambitious) goals for the future, nor will we be able to properly track and assess the impact of those investments. Transparency and accountability must be embedded in development aid, particularly in times of crisis. During the Ebola epidemic in 2014, many donors simply rebadged money that was already earmarked for Ebola-struck countries, and disbursements were difficult to track. Redeployment of funds can sometimes be a sensible policy decision – but it can also mean existing development programmes being starved of resources with serious knock-on effects for the most vulnerable populations.

While fully funding the R&D agenda is critical to defeating COVID-19, we also know that what was raised yesterday – even if we really did hit US$8bn – is only a fraction of what will be needed for a truly global response and recovery – even more will be needed on vaccine development, manufacturing and distribution alone. Furthermore, it’s vital that the world keeps its collective eye both on the short- and longer-term needs. A key goal of our new Pandemic Action Network is to ensure that the world makes the necessary investments not only to stop this pandemic, but also to help prevent the next one. That’s why we are calling on all donors to make sure the 4 May is seen as just the downpayment and beginning of a truly global process, and not a one-off moment that fizzles out. The rhetoric of many leaders and the promise of future pledging moments were promising, but as always, data and actions will speak the loudest.

We salute the European Commission for its leadership and all of the leaders who stepped up and pledged their support at this critical moment. President von der Leyen hinted there might be a next time, and that she would engage more partners. With our growing list of partners, the Pandemic Action Network is ready to accept that challenge. We urge a two-pronged approach: let’s get full transparency around the full tally of what’s been raised so far and embed those principles for the longer term, and let’s make sure that future pledges help close the global gaps in the overall COVID-19 response and make sure that every country is better prepared to prevent future pandemics. It’s time for us to reimagine the scale of the approach we need to take to protect the world from future crises – and we stand ready to work with partners to help establish, and achieve, that goal. A downpayment on our future has been made. Now we need the #UnitedAgainstCoronavirus coalition to dig even deeper commensurate with this current – and future – global challenge.

www.pandemicactionnetwork.org @PandemicAction