Personal Protective Equipment for Frontline Health Workers: An Essential Component of Pandemic Preparedness & Response

In December 2020, Pandemic Action Network’s Pandemic Action Agenda series urged world leaders to strengthen global health security architecture and governance in key areas, including pandemic supplies, to increase accountability and ensure the world is better prepared for the next pandemic and to respond to COVID-19.

This brief takes stock of progress made since December 2020 to resolve the global personal protective equipment (PPE) access crisis, aims to assess supply and demand challenges specific to community health workers, and informs recommendations for world, regional, and national leaders to build a more reliable and sustainable emergency response supply chain for the future.

Today, we have compelling evidence of the risk of leaving frontline health workers unprotected or partially protected against COVID-19, and we still lack sustainable solutions. As we look toward year three of this pandemic and beyond, world, regional, and national leaders must learn the lessons of this crisis and continue to prioritize sufficient PPE for frontline health workers — especially those who serve the most vulnerable and hardest-to-reach populations.

Read the full brief here.

No Time to Relax! Key Questions on the EU’s Plans to Speed Up Global COVID-19 Vaccination

The European Union (EU) confirmed today that they have signed an agreement with drugmakers that includes an option for the companies to deliver vaccines modified for variants within 100 days. Alongside this were the remarks made by President Ursula von der Leyen on Thursday at the closing of the European Council, where she made reference to the production of 300 million doses of vaccines per month in the EU.

All this signals a strong rollout of vaccines, support from governments, and commitments by all to get on top of this crisis. Yet, let’s not sit back and relax too soon.

Based on current reporting, the figures do not look the same when it comes to EU support to low- and lower middle-income countries (LLMICs). The data shows that the EU’s target of 250 million COVID-19 vaccine doses donations by the end of the year appears to be slipping.

And a new roadblock could be developing.

The EU recently reached an agreement to reallocate some of its 2021 budget (EUR1.3 billion to be precise) to secure another 200 million COVID-19 vaccine doses for COVAX. The European Commission has published an Action Document, laying out how it will implement this commitment. The plan would be to procure mRNA vaccines and then give them to COVAX.

We were surprised to see that the Action Document states some quite big risks to this plan — “there is a very high risk of not meeting the envisaged delivery by mid-2022, as the required duration of the procedure is 9-12 months” and “the manufacturers may not respond to an unattractive call for tender for mRNA vaccines… this will cause delays to procurement.

So we posed some questions to the European Commission to try to work out why, when we know that COVAX has options available on 200 million doses that would allow for delivery by mid-2022, they choose to purchase doses themselves — a move that could delay rollout and potentially set a dangerous precedent by hindering COVAX from playing its role as a global risk mitigation instrument to continue accelerating global access to COVID-19 vaccines.

We asked President von der Leyen the following clarification questions:

  •  What evidence does the European Commission (EC) have that the EC directly purchasing vaccines would be the speedier option in terms of delivery on the ground?
  •  What rationale is there for favouring mRNA vaccines, and even using the Omicron variant’s spread as a justification, when the science on the relative effectiveness of vaccines to fight Omicron is still being determined and given that LLMICs need a range of vaccines suitable for a range of settings?
  •  What discussions have taken place with Member States on the merits of the EC’s approach and the risks outlined in the Action Document, and do Member States agree with this decision?

We have sent these questions to President von der Leyen and are waiting for her response.

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.

Omicron is a Wake-Up Call. It is Time to Act.

The Omicron variant is not a surprise, but it should be a wake-up call. It is time to act.

In an open letter, Pandemic Action Network and more than 30 leading organizations call on world leaders to do whatever it takes to get the world vaccinated as quickly as possible and ensure every country is equipped to spot newly emerging variants, fast.

Read the full letter 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.

World Leaders: It is Time for New Global Funding to Keep the World Safer from Pandemics

By Amanda Glassman, Executive Vice President of Center for Global Development, CEO of CGD Europe, and Senior Fellow, and Carolyn Reynolds, Co-Founder, Pandemic Action Network

This past weekend, the High-Level Independent Panel on Financing the Global Commons for Pandemic Preparedness and Response delivered a stark warning in its report to the G20 Finance Ministers and Central Bank Governors meeting in Venice: With the near certainty of an even more deadly and costly pandemic than COVID-19 occurring within the next decade, the clock is ticking to ramp up investments in international preparedness. A central feature of the Panel’s recommendations: Create a Global Health Threats Fund that can provide at least US$10 billion annually to international institutions and to low- and middle-income countries (LMICs) governments, among others, to bolster the world’s capacity to prevent, detect, and rapidly respond to pandemics.

The investment case for pandemic preparedness could hardly be more compelling. At an unfathomable loss of more than 4 million lives and nearly US$20 trillion and counting, the human and economic costs of COVID-19 will be felt for a generation. And as the Panel concludes in its report, the next pandemic could be much, much worse.

In their communiqué, the G20 finance leaders “welcomed” the Panel’s report and agreed to form a task force to discuss the proposals and report out to G20 heads of state at their summit in October. Last month, G7 leaders also said they would “explore options for building consensus” around sustainable global health and health security financing.

______________

It is time to move beyond the talk and commit to an action plan
to establish and robustly finance a new Fund by the end of the year.
______________

Our message to all these leaders: It is time to move beyond the talk and commit to an action plan to establish and robustly finance a new Fund by the end of the year. This will provide a powerful engine to help LMICs and partner agencies at regional and international levels put an end to the current pandemic and lay the foundation to prepare, if not prevent, the next one.

There has been plenty of talk already. The Panel’s call for a new Fund emerged from hundreds of hours of discussions with governments and non-governmental organizations and from dozens of expert reports and analyses on what the world needs to do to be better prepared for pandemic threats, including many written well before COVID-19. It builds on the call in May by another independent panel to create an International Pandemic Financing Facility, which in turn builds on the March 2020 proposal by the Center for Global Development, the Center for Strategic and International Studies, Georgetown University and the Nuclear Threat Initiative for a Global Health Security Challenge Fund that has been championed by a wide array of partners through the Pandemic Action Network. The Global Preparedness Monitoring Board has repeatedly stressed the need for sustainable preparedness financing and the U.S. Congress has also weighed in.

We know what needs to be done. COVID-19 has shown us that pandemics are complex and sometimes unpredictable health, humanitarian, economic, and national security crises that require a multi-sectoral, whole-of-government, and global response. But we can contain or even prevent potential pandemics at their source — and thus dramatically reduce their human and economic costs — with investments in three priority global public goods where there are acute health security gaps.

  • First, we must build a strong and reliable domestic and international surveillance and data networks for early detection of emerging pathogens with pandemic potential, including zoonotic spillovers. 

 

  • Second, we should ensure that every country, regardless of income, has achieved a minimum level of pandemic readiness, including a trained frontline health workforce and infrastructure capable of effective infection prevention and control and stress-tested systems that can stop outbreaks from spreading. 

 

  • Third, we must accelerate the development, ever-ready manufacturing, global delivery, and universal access of medical countermeasures and supplies like vaccines, diagnostics, therapeutics, personal protective equipment, oxygen, and other lifesaving tools to ensure rapid responses to preclude severe shortages anywhere and avoid prolonging a pandemic everywhere. 

 

Predictable, long-term financing for the World Health Organization (WHO) is essential to help bring these three priorities together.

The need for additional financing for preparedness is most acute in the poorest countries with the weakest health systems, which have been further battered by COVID-19. Many of these countries are now experiencing a deadly third wave of this pandemic as thus far they have only been able to secure and deliver enough vaccines to cover a tiny percentage of their populations, and their medium-term economic and health financing outlook is poor. Catalytic external financing thus becomes even more important, as most of these governments will continue to have limited fiscal space for the foreseeable future and few incentives to prioritize domestic investments in pandemic preparedness over other pressing development needs. Even middle-income countries face high opportunity costs in the use of very scarce public resources and systematically underinvest in preparedness. And one country’s outbreak, if not controlled, can quickly become everyone’s pandemic.

To address these challenges, the Fund should be structured to meet five imperatives:

  • Additional, sustainable funding for prevention and preparedness. The Fund’s primary purpose must be to address the long-neglected global “crisis of preparedness” and create a robust multilateral source of financing to help LMICs and regional and global systems rapidly strengthen their frontline capacity to detect, prevent, and respond to emerging pandemic threats. This isn’t meant to be a global fund for all things health; it’s a global fund for health security to address a strategic gap in the global health architecture to prevent and prepare for emerging pandemic threats. Recent estimates of the annual costs of global preparedness from Georgetown University, McKinsey, and WHO (each using different parameters) range from US$5 billion to about US$25 billion over the next five years. Weighing the evidence, the G20 Panel thus determined that a minimum of US$10 billion in annual financing should be channeled through the new Fund, and that this must be additional to existing investments in other global health priorities. Like traditional military readiness, pandemic preparedness also requires sustained investment over time against both known and unknown threats.

 

  • Country prioritization and ownership. One of the Fund’s top priorities should be to support LMICs to develop and implement National Health Security Action Plans to meet international surveillance and preparedness standards. Funding should incentivize countries to commit a growing share of their domestic budgets for preparedness by linking new grant financing to increased domestic resources as countries’ economies and fiscal space grows (hence our original “challenge fund” concept). As a benchmark, the Panel found that LMICs will need to increase their domestic budgets for health by at least one percent of GDP on average over the next five years. The Fund should aim to leverage as much on-budget financing for surveillance, preparedness, and response as possible, enabling country government oversight and accountability structures to function.

 

  • Global burden sharing for a global public good. Pandemic preparedness is a global public good, so every country should contribute its fair share to help build a better prepared global system based on their ability to pay. Because pandemics pose a threat not only to health but also to economic and national security, governments should tap into other budgets beyond simply overseas development assistance. Following the September 11, 2001 attacks, the U.S. government enacted a special security fee for airline tickets which generated US$4 billion in 2017 alone. We need similar out-of-the-ordinary resource mobilization solutions to bolster pandemic readiness. It’s not only the public sector that should bear the cost, as every sector of society stands to benefit from a reduction in pandemic risk. The Fund should incorporate a financing model that can also mobilize philanthropy and leverage private capital (the latter for manufacturing efforts, for example). Amazon founder Jeff Bezos recently pledged US$10 billion to set up an Earth Fund to address climate challenges. Where is the corresponding pledge to tackle the global threat of pandemics (from which Amazon and many other technology firms have reaped record financial gains)?

 

  • Financing for results. The Fund should work or merge with existing international initiatives such as the Global Health Security Agenda and create incentives for country government progress towards minimum preparedness thresholds, building on empirical data and drawing from the strengthened surveillance systems that the Fund will support. These thresholds should be based on widely agreed measurement indicators and frameworks including the WHO’s Monitoring and Evaluation Framework (to include Joint External Evaluations, States Parties Annual Report information, and other data) combined with other external measures such as the Global Health Security Index. While none of these measures were adequate when it came to predicting countries’ capacity to effectively contain COVID-19, the perfect shouldn’t be the enemy of the good, and work is already underway to look at how these measures can be strengthened in the wake of COVID-19. In general, it will be important to shift from process indicators of preparedness (such as a committee or a protocol) to performance indicators (such as the proposed 7-1-7 goal or the proposal for measures of completeness, accuracy, timeliness, and openness of mortality and disease surveillance data). In those fragile and conflict-affected states where the government cannot operate effectively, the Fund should enable international agencies and local non-governmental organizations to conduct surveillance and report on results.Another key element will be to make the Fund more than just a Fund: it should become a global hub for catalytic financing, technical assistance, and best practices that will spur the domestic planning and managerial capacities, surveillance quality, and accountability necessary to drive a “global race to the top” that will elevate and sustain political support for pandemic prevention and preparedness.

 

  • Transparent and accountable governance: Given the proposed Fund’s magnitude of US$10 billion annually and the need for pooled funding for the global public good of prevention and preparedness, its governance should be overseen by a board which will determine priorities and gaps for financing in consultation with the WHO and other international agencies and have the flexibility to re-allocate if needed to respond to novel pathogens and specific circumstances. The Fund should also operate under a strong transparency and accountability framework and be informed by the knowledge and perspectives of civil society and community-based organizations and the private sector, who are vital partners in effective pandemic preparedness and response.

 

The Panel’s proposal structures the new Fund as a Financial Intermediary Fund (FIF). FIF arrangements can vary. In the lightest touch version of a FIF, the World Bank only performs the treasury functions and acts as trustee, similar to the role it plays for international funding entities like the Global Fund for AIDS, Tuberculosis and Malaria, the Green Climate Fund, and the Coalition for Epidemic Preparedness Innovations (CEPI), to name a few. Entities like the Global Environment Facility, the Global Partnership for Education, and the Climate Investment Funds are also FIFs with separate boards and procedures, but their Secretariats are hosted at World Bank headquarters and can leverage the Bank’s balance sheet and utilize its human resource and procurement processes. And other FIFs are more closely linked to the Bank’s operations and management structure, such as the Global Agricultural and Food Security Program (which sits in the Bank’s Agriculture global practice).

Of these options, the Panel proposed the creation of a new FIF modeled on the arrangements of the Global Environment Facility (GEF). The Panel reasoned that the scale of the resources required, the need for a single pool of funding that could allocate funds across governments, international agencies, and other entities, the need to work across sectors to achieve One Health goals, and the benefits of linking to World Bank, IFC or other MDB lending justified this choice. A new pandemic preparedness fund modeled on GEF would also represent a parallel to how the Bank and its member countries deal with climate change, another global public goods challenge. While there will be some transaction costs to set up the new Fund, the Panel concluded that retrofitting existing funding mechanisms would be an even more difficult and lengthy process than building an entity fit-for-purpose for pandemic preparedness. That said, financing should be deployed through existing institutions to the extent possible, and there are fund design and use options that can build into existing global and regional structures to minimize additional bureaucracy or novel procedures that would burden partners.

Some argue that mobilizing new investments for pandemic preparedness risks diverting or leaving underfunded the fight against COVID-19 or other existing infectious disease threats. This must not — and need not — happen. The world has more than enough resources to tackle these challenges simultaneously; it is a question of political will and leadership. We believe setting up a new Fund can be a triple win: For example, enhanced investments in disease surveillance and mortality registration, supply chains and delivery systems should help accelerate the COVID-19 response, deliver better results for HIV/AIDS, tuberculosis, malaria, polio, and other diseases, and get the world ready for the next deadly pathogen with pandemic potential.

COVID-19 is far from over around the world, and urgently requires a much more muscular global response with than we have seen to date. We must redouble efforts on an array of global health goals, where progress has been seriously disrupted by this pandemic. But the growing frequency of pandemics also means the world cannot afford to wait to mount the next major initiative to confront an existential crisis: the crisis of pandemic preparedness. We must be able to walk and chew gum at the same time. So it is time for world leaders to stop discussing and start acting. Set up the Fund now. Let’s end this pandemic and help prevent the next one.


Amanda Glassman is Executive Vice President of the Center for Global Development and CEO of CGD Europe, and she was co-lead of the project team for the High-Level Independent Panel on Financing the Global Commons for Pandemic Preparedness and Response. Carolyn Reynolds is co-founder of the Pandemic Action Network, a senior associate at the CSIS Global Health Policy Center and an adviser to the CGD project team. The opinions expressed in this article are those of the authors and do not necessarily reflect the views of the Panel.

Wearing A Mask Still Matters: The World Rallies to Continue Masking to Stop the Spread of COVID-19

World Mask Week (July 12-18) is a global movement to encourage continued mask-wearing to reach the end of the COVID-19 pandemic

July 12, 2021, Seattle, WA—Pandemic Action Network, the Africa Centres for Disease Control and Prevention (Africa CDC), the African Union, 3M and over 50 global, regional, and local partner organizations announced today the launch of World Mask Week 2021 (July 12-18) — a global campaign underlining a universal truth: masking in public, in combination with handwashing and physical distancing, is still one of the best ways we can protect ourselves and others against COVID-19, especially our most vulnerable community members as countries race to vaccinate their populations.

According to WHO, 2021 is already a deadlier year in the pandemic than 2020. Today, we are seeing a two-track pandemic emerge: some regions are up against the spread of variants and rising case numbers, while others with access to vaccines are lifting masking and other public health restrictions.

“Everyone who has worn a mask in public has helped slow the spread of COVID-19,” said Deputy Director of the Africa CDC, Dr. Ahmed Ogwell Ouma. “As the pandemic continues to spread and access to vaccines has been slow across much of Africa, we must fight against pandemic fatigue and continue to do what we can to keep everyone safe.”

The campaign encourages people and organizations around the world to rally behind the continued importance of wearing a mask. People will be asked to show their support by sharing a statement on social media with #WorldMaskWeek, and a picture, or video with their favorite mask, tagging others with the message of “Thanks For Masking”.

“The pandemic is not over. We should rightly recognize and encourage our progress, but we must also put our expertise to work and stay vigilant in fighting the pandemic,” said Dr. Denise Rutherford, Senior Vice President and Chief Corporate Affairs Officer, 3M. “3M and our team members will continue to do our part. We are proud to participate in World Mask Week because when you wear a mask, you are helping protect the most vulnerable. To all who are doing their part to stop the spread of COVID-19, we thank you.”

Face coverings block the spray of droplets from sneezing, coughing, talking, singing, or shouting when worn over the mouth and nose. Consistent mask-wearing can also reduce the spread of the virus among people who are infected with COVID-19, but do not have symptoms, or are unaware they have it. While a COVID-19 vaccine will prevent serious illness and death, the extent to which it keeps people from being infected and passing the virus on to others is still emerging.

“Last year, with the first World Mask Week, we sparked a global movement in 117 countries to wear masks. This year, as the pandemic persists in much of the world, we’re coming together around the message that masking still matters and to show gratitude for those who have worn a mask and continue to mask up,” said Eloise Todd, Co-Founder of the Network. “In order to end this pandemic for everyone, we must deploy all the tools available around the world to fight COVID-19 – and that includes mask-wearing.” To mark the urgency of this moment, Pandemic Action Network has released a Why Masking Still Matters policy brief including key messaging and recommendations for governments, businesses, and individuals.

Pandemic Action Network was launched in April 2020 to drive collective action to help bring an end to COVID-19 and to ensure the world is prepared for the next pandemic. Since launching, the Network has been working with influencers to promote mask-wearing, along with physical distancing and handwashing. World Mask Week provides the opportunity for global unity around a single message: Let’s keep masking — not just for ourselves, but for our families, our communities, those who are most vulnerable, and the world.

For more information about World Mask Week, please visit worldmaskweek.com.

About Pandemic Action Network
Pandemic Action Network drives collective action to bring an end to COVID-19 and to ensure the world is prepared for the next pandemic. The Network consists of more than 100 global multi-sector partners, working both publicly and behind the scenes to inform policy, mobilize public support and resources, and catalyze action in areas of acute need. Partners are aligned in a belief that every effort made in the fight against COVID-19 should leave a longer-term legacy that better prepares humanity to deal with outbreaks and help prevent another deadly and costly pandemic from happening again. Learn more at: pandemicactionnetwork.org.

About the African Union
The African Union leads Africa’s development and integration in close collaboration with African Union Member States, the regional economic communities and African citizens. The vision of the African Union is to accelerate progress towards an integrated, prosperous and inclusive Africa, at peace with itself, playing a dynamic role in the continental and global arena, effectively driven by an accountable, efficient and responsive Commission. Learn more at: au.int/en.

About the Africa Centres for Disease Control and Prevention
Africa CDC is a specialized technical institution of the African Union that strengthens the capacity and capability of Africa’s public health institutions as well as partnerships to detect and respond quickly and effectively to disease threats and outbreaks, based on data-driven interventions and programs. Learn more at: africacdc.org.

About 3M
At 3M, we apply science in collaborative ways to improve lives daily as our employees connect with customers all around the world. Learn more about 3M’s creative solutions to global challenges at: 3M.com or on Twitter @3M or @3MNews.

###

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.

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.

Our Pandemic Anniversary Wish: Let’s Pandemic-Proof the Planet

Co-founders of Pandemic Action Network: Carolyn Reynolds, David Kyne, Eloise Todd, and Gabrielle Fitzgerald

One year ago, on March 11, 2020, the World Health Organization (WHO) finally told the world what was already clear: that with 118,000 cases in over 110 countries and territories around the world, COVID-19 could be “characterized as a pandemic.” Of course, we had no idea at that time just how large and protracted this global crisis would become, with more than 117 million cases and over 2.6 million deaths worldwide and counting as of today.

It’s been a year of both horrible and amazing developments. Around the world, governments have scrambled, misinformation has flourished, advocates have rallied, scientists have mobilized, frontline healthcare, public health, essential workers have stepped up. There have been incredible stories of resilience, adaptation, and innovation by families, communities, and businesses. Yet crisis can be a great revealer, and this one has also exposed and preyed upon deep and longstanding global inequities, vulnerabilities, and broken systems.

The anniversary of this crisis should be a moment for all of us to reflect on what we have learned, and to commit to bold and urgent action.

Leaders have an historic opportunity to take actions now that will not only hasten the end of this pandemic, but will also begin to pandemic-proof the planet so that future generations never again experience the health, economic, and social devastation we have seen over the past year. 

The pandemic has affected every aspect of our lives and the solutions require leadership from all of us. We need the best and brightest not only working in science and health but also in finance, defense, technology, education, manufacturing, transport, and across every other sector of the global economy to join forces to solve this global challenge. And pandemic-proofing the planet demands that we tackle the dual threats of climate and health hand-in-hand.

We are calling on world leaders to seize this moment to commit to take action in four areas that will help pandemic-proof the planet and leave humanity healthier, safer, more resilient, and more prosperous.

Pandemic Action Network’s Pandemic-Proof Agenda

Speed up access and delivery of COVID-19 vaccines and other lifesaving tools to everyone, regardless of where they live. This starts with fully funding the Access to COVID-19 Tools (ACT) Accelerator and COVAX Facility. It also means countries which have secured more vaccine doses than they need should start donating vaccines to reach other nations in need, in parallel to their domestic vaccine rollout. Governments and industry also must join together to find the resources, and eliminate the bottlenecks, necessary to ramp up global manufacturing capacity, as part of a roadmap to get to at least 60-70% vaccine coverage in every country. With the evolving virus strain mutations, we are in a race against time to control this pandemic. But let’s also make sure these efforts do not come at the expense of other global health needs and goals.

Get serious on investing in pandemic preparedness. Donor nations, private foundations, and investors should come together to establish a sustainable global financing mechanism for pandemic preparedness, with an initial funding target of US$20 billion. Now is the time to fuel a global “pandemic-proof challenge” to ensure that every country has the plans, capacity, trained workforce, and functioning system it needs to effectively prevent, detect, and respond to outbreaks at their source before they spread and become deadly pandemics. This initiative should also incentivize countries to prioritize pandemics in their domestic budgets as a long-term security threat. Smart climate, biodiversity, and land-use policies must be a critical piece of those plans.

Bolster global research, development, and delivery of tools for emerging infectious disease threats. The COVID-19 crisis has shown that the world needs an at-the-ready capacity for timely delivery of the health technologies and supplies needed to combat both the known and unknown diseases likely to spark the next pandemic. A good start will be to support the US$3.5 billion five-year strategy of the Coalition for Epidemic Preparedness Innovations (CEPI) to achieve its moonshot goal to have a new vaccine ready within 100 days when the next novel disease outbreak happens. And we must build a seamless global network of regional R&D, manufacturing, and supply hubs and streamline regulatory processes so that every nation can quickly get the tools when they need them.

Build a smarter global pandemic defense system. Defense starts with prevention, and the UK’s five-point plan for the G7 and the COP26 meeting later this year offer the opportunity for bold action on climate which could drastically reduce the chances of pandemics occurring in the first place. But we know outbreaks will happen, and more frequently. So the WHO must be strengthened and fit-for-purpose, with reliable funding, enhanced authority to conduct early and independent outbreak investigations, and the ability to hold member states accountable for compliance with the International Health Regulations (IHRs). To help “pandemic-proof” the future, the world also needs a new international preparedness framework or pandemic treaty and a state-of-the-art, global virus surveillance and detection system to better predict and manage cross-border threats.

A year into this crisis, we are all experiencing pandemic fatigue. The rollout of new vaccines is providing hope that the end may be near, and we can get on with our lives. Yet the reality today is that for the vast majority of the world’s population, that hope remains elusive. Everyone will remain at risk until there is universal access to the vaccines and the virus is contained everywhere. Unless we speed up the global response, we could be marking the second anniversary of this pandemic next year. Furthermore, the next pandemic could be around the corner, and could be even more lethal and costlier than this one.

But it doesn’t have to be this way: we can pandemic-proof the future if world leaders heed our wish and take action now in these four areas. The world can’t afford to wait.

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.