The COVID-19 Action Fund for Africa Was Supposed to Be a Short-Term Solution: A Year Later, the Need is Still There

BY GABRIELLE FITZGERALD, CEO AND FOUNDER OF PANORAMA & CO-FOUNDER OF PANDEMIC ACTION NETWORK

Over the past year, the COVID-19 Action Fund for Africa distributed 81.6 million units of personal protective equipment (PPE) to almost 500,000 community health workers in 18 countries in sub-Saharan Africa.

The COVID-19 Action Fund for Africa is a radically collaborative initiative that was co-founded by Pandemic Action NetworkCommunity Health Impact CoalitionDirect ReliefCommunity Health Acceleration Partnership, and VillageReach.

“All regions are at risk, but none more so than Africa.” — WHO Director General Tedros

I previously wrote about some of the strategies­­ that have been vital to the success of this initiative: we formed a loose partnership, we moved fast and there were no organizational or individual egos. As a result, between August and December 2020, CAF-Africa was the fifth largest procurement mechanism of PPE in the world.

Where are we today?

Today, we are eighteen months into the global pandemic. Last week, the World Health Organization’s Director General Tedros said, “All regions are at risk, but none more so than Africa.” And Dr Matshidiso Moeti, the organization’s lead for Africa warned: “Be under no illusions, Africa’s third wave is absolutely not over . . . Many countries are still at peak risk and Africa’s third wave surged up faster and higher than ever before.”

Sadly, the stop-gap measure we put into place a year ago is still needed, and major systemic challenges remain:

  • There is still limited visibility into PPE needs at the country and global levels.
  • There is no single regional body that quantifies cross-country PPE needs, tracks pipeline, and aggregates needs and gaps.
  •  The PPE market remains fragmented.

In order to create sustainable solutions, we believe it’s critical to:

  • Invest in strengthening the procurement options available to support countries to meet their PPE and other supply needs, during the pandemic and beyond; and
  • Continue to explore models to pool the philanthropic dollars going to medicines and supplies for health workers.

This post originally appeared on Medium

Why Masking Up Matters More Than Ever

By Gabrielle Fitzgerald, CEO and Founder of Panorama & Co-Founder of Pandemic Action Network

In May, the U.S. Centers for Disease Control (CDC) told vaccinated Americans they could take off their masks. Many public health officials and advocates, including the Pandemic Action Network, questioned this shift, especially as so many Americans remained unvaccinated. In response, Anne Hoen, an epidemiologist at Dartmouth College, said, “Wearing masks should probably be one of the last things we stop doing.” This statement has stuck with me. To protect the most vulnerable, the unvaccinated and actually stop the spread of COVID-19, we need to deploy all our tools until the end.

And when it comes to wearing a mask, the science is clear: masking in public can provide another layer of protection and help prevent the virus from spreading to others who aren’t protected, regardless of vaccination status.

Now two months after the CDC guidance shift, we are seeing accelerated spread of the COVID-19 Delta variant. In the U.S., every state is reporting increasing COVID-19 cases, thus demonstrating that relying on the honor system and local guidance alone is insufficient.

“Vaccines do not equal the end of the pandemic,” my Pandemic Action Network co-founder Eloise Todd shared with Forbes. “With vaccines and other precautions like face masks, we moved so close to normal. Why would we now move away from these measures?”

I agree. More than ever, it’s important that we stay focused on what can keep us all safe.

This month the Pandemic Action Network once again catalyzed our network of 130+ partners to ignite a global movement around the importance of continued masking.

With #ThanksForMasking selfies from leaders from Dr. Matshidiso Moeti, to Smita Sabharwal, WHO Director General Dr. Tedros, and Dr. Tom Frieden and key messages shared by organizations like UNICEF, Africa CDC, and 3M, this year’s World Mask Week campaign reached 250M+ people and was shared in 171 countries, or nearly 90% of countries around the world.

(Side note, if you’re interested in partnering with us to reach communities in the other 25 countries we didn’t reach, like Burkina Faso, Cyprus, and Chad, we’d love to talk!)

World Mask Week 2021 came at an absolutely critical time in the COVID-19 pandemic. Many countries, like the U.S., with access to vaccines were in the process of opening up, dropping mask-wearing guidance, and ignoring the fact that the pandemic is very much not over for the majority of people around the world. In fact, countries like Bangladesh, Indonesia, India, and many others in Africa and Latin America, are suffering some of their worst peaks of this pandemic yet. And, they are not alone, the more contagious Delta variant is sparking COVID-19 spikes around the globe, including countries with relatively high vaccination rates, such as the U.S. and the United Kingdom.

But sadly, we have moved away from consistent mask-wearing and World Mask Week was a reminder that not only should we continue to mask up, but we need clear and consistent masking guidance at the national level in order to stop the spread of COVID-19.

While World Mask Week turned up the volume of this key call-to-action, there is urgent work to be done to ensure masking up is fundamental to our collective COVID-19 response. The fact is not lost on us that World Mask Week concluded the day before the U.K. celebrated “freedom day.” And, here in the U.S., Los Angeles Country reinstated an indoor masking order amidst an alarming rise in coronavirus cases.

Dr. Anthony Fauci, White House chief medical adviser, recently disclosed that U.S. health officials are actively considering a revision to the mask guidance. However, as of this article’s publish date, the Center for Disease Control has not updated their guidance for full vaccinated individuals. As we shared in a policy brief this month, masking still matters, and governments, businesses, and individuals all have a role to play in normalizing mask-wearing to protect those who are most vulnerable and to end this pandemic for everyone.

That’s why we’re so thankful for all of our partners who participated in World Mask Week this year and helped amplify our collective #ThanksForMasking call-to-action. And, we will continue to rally around this issue and not mask the truth when it comes to the importance of the simple and effective act of mask-wearing.

#ThanksForMasking and continue to mask up until we end this pandemic for everyone.

Two Ways to Take Action for India Now

Gabrielle Fitzgerald, Co-founder, Pandemic Action Network

This weekend’s sunshine and blue skies had what seemed like the entire population of Seattle outside enjoying the early summer weather.  Everywhere you went, people were enjoying the sunshine—it almost felt like COVID-19 was a bad dream that we’d finally woken up from.

But, we know that isn’t true… The past weeks have marked the highest number of COVID-19 cases the world has recorded to date. Since the beginning of this pandemic, COVID-19 has exposed and amplified our inequities. Now, as the U.S. has accelerated vaccination (even for youth) and has preemptively given Americans the chance to take off their masks and enjoy summer, the pandemic rages around the world.

Most notably, India is in the grips of a terrible and all-too-real nightmare. India currently has the highest daily number of COVID-19 cases and deaths of any country in the world. Official totals from India’s health ministry report 24.6 million total COVID-19 cases and 274,000 deaths. Daily case counts range between 350,000 to 400,000, with most experts believing these numbers are significantly underplaying the extent of the disease.

Dr. Ashish Jha of Brown University, believes deaths caused by COVID-19 in India could be closer to 25,000 to 50,000 per day, and new infections happening each day in India could be between two million and five million.

So, while we should celebrate our progress here in the U.S. and hug our loved ones, we must understand that we are not out of the woods. With variants and the nature of COVID-19 waves, we must understand that only together can we truly end this pandemic for everyone. Now is the time to support the needs of India and other countries who are facing dire consequences from the disease, while also advocating for equitable distribution of COVID-19 vaccines and access to life-saving supplies.

On Friday, WHO Director General Tedros spoke of his bittersweet feeling as he received his COVID-19 vaccine.  While he celebrated the “triumph of science,” he lamented the fact that only 0.03% of the vaccine supply is going to low- and middle-income countries (LMICs). A New York Times vaccine tracker shows that many countries are yet to administer a single dose of the vaccine.

Meanwhile, access to basic medical supplies like oxygen remains challenging in many countries, as documented by the COVID Oxygen Needs Tracker. According to Dr. Marc Biot, MSF Director of Operations, “Oxygen is the single most important medicine for severe and critical COVID-19 patients. Yet oxygen supply is often insufficient because infrastructure has been neglected in lower- and middle-income countries for decades.” The crisis in India, now spreading to Nepal and other nearby countries, highlights that oxygen is the most critical medicine for people with severe COVID-19 and 18 months into the pandemic, oxygen supply is under-resourced and LMICs are often the last in line.

Stories in the media and from colleagues in India provide devastating details on the crushing burden faced by hospitals and health care providers, as well as stories of entire families being lost to COVID-19 in a matter of days.

While we have seen donations from governments, businesses, and philanthropies to respond to the humanitarian crises in India, they don’t seem to meet the scale of the problem.  And the breadth of these challenges can make it seem as if there is little an individual can do to help, but individuals and organizations can make a difference in this unprecedented situation.

Here are two ways to take action for India now:

Dasra was established more than 20 years ago to channel funds from philanthropists to small non-governmental organizations across the country. Over this time, they have built the capacity of more than 1,000 organizations to provide services to their communities. With the COVID-19 crisis, they set up the #BacktheFrontLine COVID Emergency Fund to provide immediate resources to 50 of their trusted, high-impact partners who work in local communities providing a range of services to respond to the emergency.

Oxygen for India is a new initiative created by Dr. Ramanan Laxminarayan of the Center for Disease Dynamics, Economics & Policy. A long-time health researcher currently based in Delhi, Ramanan quickly mobilized a large network of partners to provide reusable oxygen cylinders and 3,000 oxygen concentrators for hospitals in Delhi and Kolkata. This volunteer-led program has utilized local knowledge and relationships with global connections to procure 40,000 oxygen cylinders.  When an emergency hits, a catalytic coalition made up of individuals and organizations who jump in to help can sometimes move quicker than large, established organizations with complex procurement processes and bureaucracies.

These are two of the many organizations who desperately need funding, and both organizations can receive tax deductible donations from U.S. citizens.

While we in the U.S. are reconnecting with family and friends we haven’t seen in a year, please take a moment to think of the desperate need of so many families in India and other countries around the world.

And for those who are celebrating the end of COVID-19 in the U.S., India should be a cautionary tale.  Less than six weeks before the surge of new coronavirus infections, government officials said India was at “the endgame” of the pandemic.  At that time, India had 11,000 cases per day, and an average of about 100 deaths.  Here in the U.S., we still have almost 800 deaths per day.

We are still fighting this pandemic. In today’s interconnected world, COVID-19 anywhere is COVID-19 everywhere.

 

UN Dialogue on Pandemic Preparedness and Response — Five Principles for Financing Future Preparedness

Gabrielle Fitzgerald, Co-founder, Pandemic Action Network 

It was an honor to have the opportunity to speak today at a meeting with UN ambassadors and global health leaders convened by the U.S. Ambassador to the United Nations, Linda Thomas-Greenfield, together with UN Representatives of Norway, Argentina, and South Africa, on how to strengthen the pandemic preparedness and response architecture

In preparing for today, I went back and reviewed many of the papers and recommendations that were prepared in response to the West Africa Ebola outbreak, many of which I took part in. In looking at these papers, written just five or six years ago, two things stood out:

First, the vast majority of the financing discussions were focused on how to ensure there were adequate funding mechanisms for responding to disease outbreaks, and very little on how to prepare.

Second, I saw that one paper begot another commission which begot another paper, into a seemingly endless cycle, with minimal action. 

To be fair, there were some important changes following the West Africa outbreak: The Coalition for Epidemic Preparedness Innovations, or CEPI, was created — a critically important organization that helps accelerate the development of new vaccines for emerging infectious diseases with pandemic potential. The World Health Organization’s Health Emergencies Programme was strengthened, and a Contingency Fund for Emergencies was capitalized. But the more far-reaching, systemic issues were not addressed, because there was no political will at the time to carry recommendations of that nature forward — and the world once again turned its attention elsewhere.

Pandemic Action Network was founded to make sure this doesn’t happen again. Our mission is to build political support for a rapid end to the COVID-19 pandemic and to ensure long-term pandemic preparedness. We are now a network of more than 100 organizations and growing, representing a range of stakeholders from across sectors and geographies, that have come together to build and sustain that political will. To that end, our Network has set out a bold, but achievable, agenda for action by world leaders in 2021.

In today’s session, I stressed that there is a political window of opportunity that exists now that shouldn’t be missed. As the COVID-19 pandemic rages on, it might be tempting to say that all our energies should be focused on responding to this disease. The urgency is great, but we must raise our level of ambition and act on both fronts. With pandemic threats now emerging on the order of at least once every decade, world leaders cannot wait until COVID-19 is behind us to take action on ensuring countries are prepared for the next pandemic. 

As global leaders consider options for how to ensure there is a sufficient, predictable, and sustainable funding model to support pandemic preparedness, I encouraged the group to take into account five principles:

Act with urgency — COVID-19 has shown us that a pandemic has massive economic, social, and security implications. The funding mechanism should be developed quickly, and governed, resourced, and structured to drive rapid investments and results.

Focus on preparedness — The funding mechanism must be focused specifically on accelerating and sustaining preparedness for the looming threat of epidemics and pandemics.

Promote head of state leadership and country ownership — COVID-19 makes clear that pandemics are not only a health threat, they are also a grave economic and security threat. We need to ensure that every head of state treats pandemic preparedness as a top priority and leads their country in developing and implementing a whole-of-government national action plan to close their preparedness gaps and maintain readiness for the next pandemic threat.

Ensure additionality — Funding for better preparedness requires substantial new and targeted investments, commensurate with the global threat and national needs, but these funds must not come at the expense of other existing global health priorities and investments.

Bolster accountability — The funding mechanism must drive accountability for progress against widely agreed health security measures, including the International Health Regulations (IHRs) and joint external evaluation (JEEs), and must have a diverse and independent global governance structure that includes civil society and the private sector.  

In the spirit of urgency, I encouraged the UN member states represented at the meeting to not let “perfect be the enemy of the good.” We cannot afford to wait to have every detail figured out before we move forward on creating and beginning to implement a new financing mechanism to support preparedness.

A Year Into COVID-19 – The Costs of Being Unprepared

Gabrielle Fitzgerald, Co-founder

 

The day life changed

The day everything changed for me was February 29, 2020. It was a Saturday. I’d spent the morning having coffee with an old friend, buying Girl Scout cookies from the daughter of another.

I’d just flown back to Seattle after two weeks of personal and business travel had brought me through five airports on three continents. During the trip, I tracked the wildly different ways countries were monitoring travelers for what was then known as novel coronavirus. While I was thinking a lot about this new outbreak from a work perspective — having advocated for the past few years on outbreak preparedness, and also having Panorama team members deployed to Geneva to support the World Health Organization (WHO) surge their communications response — coronavirus still felt like a far-off threat.

As I walked home from the coffee shop, I checked my phone and learned that the first U.S. death from coronavirus had been announced, at a hospital just outside of Seattle. And that a nursing home, just three miles from my daughters’ school, had identified their first two cases.

The next few days, in every aspect, I felt life cleaving into Before and After. I went to church, where Before and After wrestled for dominance: The traditional handshake greeting was ruled out, but the sacramental wine was still offered via a shared chalice. I went out to dinner, knowing it would be the last time for quite a while.

On Monday, we received an email from my children’s school announcing that the school would be closing at the end of the day for the next six weeks. Most parents were shocked and thought this was a radical step to take after just a few deaths, but to this day, I praise the fast-thinking leaders who understood the risks at hand and took decisive action as the first school in the nation to close. As the week went on, I canceled a business trip and announced we would be closing our office for “at least a month.” I shared information with friends to encourage them to take this seriously and explain what our new world of social distancing meant. Then, on March 11, the WHO officially declared COVID-19 a pandemic.

A year into this pandemic, what have we learned? And what can we do to ensure we never have a year like this again? If we don’t draw lessons from this experience, then we’re doomed to repeat it.

Predictable problem

I had spent a year working on the West Africa Ebola outbreak in 2014-2015. That experience left me passionate about the need to do all we could to prevent large-scale outbreaks in the future.

For anyone who pays attention to disease outbreaks, it was common knowledge that the world was likely to face a major pandemic “in our lifetime.” However, in my mind, that lifetime was always in the distant future, and always in another part of the world.

Just 10 weeks before an unusual disease outbreak was reported in China, I participated in a simulation exercise designed to raise awareness about the potential damage a worldwide pandemic could have. This session certainly drove home the massive risk to global corporations, supply chains, and the travel industry. But what it didn’t capture was the pain of saying good-bye to loved ones by phone, the boarded-up restaurants, and the monotony of pandemic life.

Having just marked the anniversary of the day everything changed for me, and on the eve of the anniversary of the WHO’s pandemic declaration, I’m reflecting on what we could have seen coming and what we can learn from the shocks and losses we’ve experienced.

What isn’t surprising. . .

Leadership and fact-based communications are essential — Decisive political action and clear, fact-based communication are indispensable during crisis. We have seen way too many examples of leadership being abdicated and non-science-based messaging on COVID-19, which have led us to the point that we are now in year two of this pandemic.

Increased inequity — Outbreaks always hit vulnerable populations hardest. We have certainly seen this here in the U.S., but it is a global problem too. Early in the pandemic, we created the Pandemic Action Network to accelerate the response to COVID-19 and advocate for future pandemic preparedness. One of the major initiatives we are advocating on behalf of is the Access to COVID-19 Tools Accelerator (ACT-A), which was created to ensure equitable access to vaccines, drugs, and diagnostics to all countries of the world, not just those who can pay the highest prices.

Investment in research and development pays off — Back when I worked in the Clinton administration, the budget for the National Institutes for Health was doubled, seeding much of the research that allows us to have a vaccine today. If scientists hadn’t been picking away at spike proteins “just in case,” I shudder to imagine where we’d be today. And next time there is an outbreak, we won’t be as lucky unless we invest and plan ahead now.

What did surprise me. . .

Leadership (part 2) — I had no idea how disengaged and downright antagonistic the U.S. federal government would be. Withdrawing from the WHO? Leaving every state to make their own plans? I’m still shocked by these moves, and we’re still suffering because of them. The importance of strong national leadership and clear, consistent messaging simply can’t be understated. Pandemics are universal — that’s the “pan” part of the word. You can’t fight them locally. It takes national and global coordination.

Speed of vaccine development — This was a good surprise. A huge and heroic win. And a record-breaking timeline that far exceeded the best hopes of many. The fastest a vaccine had previously been developed was four years. The fact that the COVID-19 vaccine was being distributed within a year of the virus being sequenced is just short of a modern miracle and is a direct result of investment in research and development.

Progress toward equitable vaccine distribution — While there is still an extremely long road ahead to ensure that everyone in the world has access to a COVID-19 vaccine, it was good to see vaccines arriving in Ghana, Cote d’Ivoire and quite a few other African countries this week. Thanks to the ACT-A, this came only 11 weeks after the first vaccine was given in the U.K. In the past, the average gap between wealthy and low-income countries receiving vaccine supply was closer to 11 years. There are many, many more doses that need to be delivered to low- and middle-income countries, but at least the wait has been in weeks, not years.

The ongoing gap in health workers accessing PPE — While this problem has been mostly resolved here at home, it remains a challenge in many parts of the world. In many countries, there is no local manufacturing and there isn’t enough PPE to protect the community health workers who serve hundreds of millions of patients who don’t have access to a medical clinic or hospital. In response to this challenge, the Pandemic Action Network worked with other partners to create the COVID-19 Action Fund for Africa, which brings together global manufacturers and shippers with African health systems. To date, the fund has delivered nearly 86 million pieces of PPE to nearly 500,000 community health workers in 18 countries. But this is a stopgap measure, and we need to ensure that health workers like these around the world have ready access to critical supplies, so we don’t have to play catch-up in the future.

Personal loss and disruption — The pandemic simulation I mentioned above discussed projected costs in GDP and other common macro measures. Living through a pandemic puts you in touch with other costs — all the micro-level changes and personal losses. The disruption to education caused massive ripples I hadn’t thought about, from childcare to mental health. Now, with my teenagers spending a whole year at home during the most socially dynamic stage of their lives, I think about it every day. Then there’s the millions of mothers who have been driven out of the workforce because of the lack of childcare. The holiday gatherings that didn’t happen. I had no idea how much, and in how many ways, a year like this would hurt.

So what have we learned?

The last 12 months have taught us so much. About the need to be prepared. The vast and also personal cost of being unprepared. The things we have to do better.

We must put these lessons to use. National and global leaders must act now to prepare for the future. The Pandemic Action Network has identified six priorities for international action, including better means of detecting outbreaks, more research into infectious diseases, more secure supply chains for pandemic-fighting materials, and greater investment and accountability in health security. That’s how we beat the next pandemic.

After this year, the world can’t afford excuses. We’ve all seen the ways our systems break down or reveal that they’re broken and unfair to begin with. We’ve all felt the ways our lives suffer. None of us wants to experience another year like this.

Spread CHEER, Not COVID

by Gabrielle Fitzgerald, Co-Founder Pandemic Action Network

The holiday season is here. The next few weeks are a time that we would normally hold festive get-togethers with loved ones – Hannukah, Christmas, New Year’s. While every family has unique traditions that make their celebrations special, what binds them in common is gathering, eating, and spending time together.

In 2020, holiday traditions, like almost everything else this year, need to adapt. With COVID cases rising in every single state, it is vital that we put tradition aside for this season and find new ways to celebrate.

The concept of holiday “cheer” is defined by dictionary.com as something that gives joy, gladness, or comfort. And it’s commemorated in carols as different as “Carol of the Bells” (written by a Ukranian composer in 1914) to “Christmas Wrapping” (the modern classic by The Waitresses in 1981).

But this year, there’s a new definition of “cheer” as a way to protect yourself and your loved ones from COVID. In order to “spread cheer, not COVID” everyone should keep in mind these rules for a CHEER-ful holiday.

#SpreadCHEER not COVID this holiday season with these five tips: 

  • Cover your face. Wear a mask to protect you and those around you, especially if you are indoors.
  • Handwash often. Wash with soap and water for at least 20 seconds, especially after removing your mask. Use hand sanitizer as a back-up.
  • Explore virtual activities. Get creative with online game nights, meals, movie watching or gift exchanges with friends or families.
  • Enjoy outside. If you must meet up with people you don’t live with, go outdoors. Even then, keep distance and masked!
  • Remember we are in this together. Until COVID-19 is gone, we must do our part to keep ourselves and our communities safe.

 

Pandemic Action Network partners helping lead the charge to #SpreadCHEER not COVID this season include the Federation of American Scientists, iHeartMedia, Facebook, National Foundation for Infectious Diseases (NFID) and dozens of other national and global organizations that make up the Network. iHeartMedia, for example, is supplying 30-second radio PSAs with the Spread CHEER message to its 800 radio stations around the United States. 

#SpreadCHEER not COVID focuses on tips and stories about creative ways people are celebrating the holidays while staying COVID-safe.

Let’s all work together to have a CHEERful holiday season this year so that we can get back to our traditional cheer next year!