Call for G7 Leaders to Take Pandemic Action!

Ahead of this month’s G7 Leaders’ Summit and in the face of multiple global challenges, civil society groups (CSOs) from around the world urge G7 Leaders to take action on pandemics to both align the global response to make COVID-19 a controllable respiratory disease across all countries and step up efforts to prepare the world against the next pandemic threat. 

While the outcomes of the last Global COVID-19 Summit and G7 Ministerial Meetings showed renewed political commitment and a much needed reset to the global response, ending this pandemic still demands further action. As noted in May’s G7 Foreign, Health, and Development Ministers communiqués, the pandemic won’t be over until it is over for all. Echoing their words, nearly 40 CSOs call on G7 Leaders to invest now to end the current crisis and prevent the next, including by addressing poverty and inequality as barriers to ending pandemics and through investment in national health capacity and community systems.

Three priority actions:

  1. Fill the financing gaps to advance the delivery of COVID-19 tools still needed such as tests and treatments, increasing transparency to foster coordination and enhance value for money. 
  2. Advance new, equitable, inclusive, and innovative sources of financing for pandemic preparedness and response, including through the new Global Health Security and Pandemic Preparedness Fund.
  3. Build on the G7 Pact for Pandemic Readiness Concept Note of May 20 to drive support for a whole-of-government and whole-of-society approach to pandemic preparedness.

The CSOs also strongly urge G7 Leaders to capitalize on the opportunity at the G7 Summit to publicly endorse the Independent Panel for Pandemic Preparedness and Response’s recommendation to establish a Global Health Threats Council and commit to advancing the proposal during the upcoming United Nations General Assembly.

Read the full letter. If your organization would like to sign on, contact Hanna by June 21.

Pandemic Action Network Statement on the Second Global COVID-19 Summit

The Second Global COVID-19 Summit showed a renewed commitment to end the COVID-19 crisis and prevent the next pandemic threat. Against complacency and pandemic fatigue, leaders from over 35 countries, the private sector, philanthropy, and civil society brought forward new actions and commitments — both financial and non-financial — to meet urgent needs across the summit’s priorities of vaccinating the world, protecting the most vulnerable, and preventing future pandemics. Financial commitments totaled almost US$3.2 billion, with approximately US$2.5 billion in funding from governments, and approximately US$700 million from the private sector, foundations, and other non-government actors.

Statement from Carolyn Reynolds, Co-Founder, Pandemic Action Network

Today’s Global COVID-19 Summit was a win against complacency and has provided a much-needed shot in the arm for both the global COVID response and to begin to prepare the world for the next pandemic threat. We are pleased that the Summit has yielded important new commitments to vaccinate the world, save lives, and nearly US$1 billion to establish a new Fund for global health security and pandemic preparedness. This is a significant down payment and enables the World Bank to move forward on establishing the Fund this summer. But we must maintain the momentum beyond today and political leaders must stay in the fight. This pandemic is not over, and the world must move faster to deliver lifesaving tools and prepare for whatever variant or pandemic threat is coming next. The U.S. Congress must urgently approve additional funding for the global COVID response, and other governments and private and philanthropic partners must step up support for the response and for the Fund as soon as possible. 

Statement from Eloise Todd, Co-Founder, Pandemic Action Network

World leaders‘ commitments at the Global COVID-19 Summit today have helped give a much-needed reset to the global COVID response. But without sustained and decisive action, the world could slip into permanent inequity between those that are able to be treated and vaccinated for COVID-19 and those that are not. All eyes are on global and regional bodies to see how they can build on today’s starting shot and deliver real progress by the G7 Summit at the end of June. 

As long championed by Pandemic Action Network, equity featured prominently in both reflections on the COVID-19 pandemic and in new commitments. We welcome commitments and new investments to close the funding gap for the Access to COVID-19 Tools Accelerator (ACT-A), solve for last-mile vaccination delivery challenges, accelerate access to generic therapeutics, and diversify manufacturing and procurement of medical countermeasures to build strong and sustainable systems in every region of the world. 

Pandemic Action Network was also pleased to see political and financial support for a new Fund for Global Health Security and Pandemic Preparedness from across sectors. As we double down to end the COVID-19 pandemic, we also must look ahead and prepare both for future COVID-19 variants and emerging disease threats. Government leaders from around the world stepped up today to support a new pandemic preparedness fund and advocated for the need to include diverse voices in the design and governance of a new fund. Financial commitments from the U.S., European Commission, Germany, and the Wellcome Trust total nearly US$1 billion, and represent a significant down payment toward the US$10 billion needed annually for this Fund.

But while today’s Summit serves as a needed jolt to the global COVID-19 effort, there is still much work to do. Today’s financial commitments for response sum just over US$2 billion, and while this funding is urgently needed, it’s long overdue and far short of the current ACT-A funding gap (nearly $US15 billion). It is critical that all governments and sectors step up and prioritize significant new resources to end the global COVID crisis — including the U.S. Congress and Administration working together to transcend politics and quickly pass at least US$5 billion for the global COVID-19 response. In addition, it is critical to heed the call from many African leaders for Gavi, the Global Fund, and other vaccine purchasers to prioritize purchases from African vaccine manufacturers to ensure new facilities are sustainable. It will also be important for a diversity of donors and stakeholders to commit to the new Fund for Global Health Security and Pandemic Preparedness to ensure it is inclusive, representative, and effective. 

As we look ahead to the World Health Assembly, G7 and G20 Summits, and UN General Assembly, Pandemic Action Network will stay vigilant to make sure Summit commitments are realized and accountable, and that world leaders are collectively challenging themselves to do whatever it takes to end this crisis for everyone, everywhere.

Seizing the Moment: Global Action to End the COVID-19 Crisis and Prevent the Next Pandemic

The COVID-19 pandemic is not over. The rapid global spread of the omicron variant has transitioned the pandemic to a new phase that requires updating our strategy and priorities to ensure a more effective — and equitable — response.

We are at a pivotal moment: progress on the global response has slowed, and we risk further setbacks due to the convergence of multiple global security crises with pandemic fatigue and complacency. The post-omicron global strategy must evolve, and requires global solidarity, coordination, and commitment to address short- and long-term imperatives.

These imperatives resounded throughout our jointly convened dialogue, Global Call to Action: End the COVID-19 Crisis and Prevent the Next Pandemic, on March 29, 2022. Diverse speakers joined by over 400 participants from around the world collectively identified four priorities set in a declaration to meet global needs at this stage of the pandemic and build stronger, more resilient, and equitable systems for the future: 

  1. Accelerate equitable access to and acceptance of vaccines, diagnostics, and therapeutics, building for the future.
  2. Support country-led and community-driven goals and priorities, with global support strengthening national and regional systems and advancing equity.
  3. Build and invest now to pandemic proof the future for everyone, everywhere.
  4. Drive accountability at all levels and commit to global solidarity.

Read the joint declaration by Africa CDC, Amref Health Africa, African Population and Health Research Center, Organismo Andinode Salud, Cayetano Heredia University School of Public Health, Center for Indonesia’s Strategic Development Initiatives, COVID GAP, Pandemic Action Network, ONE Campaign, University of Ibadan College of Medicine, and WACI Health.

También disponible en español.

President von der Leyen’s Opportunity to Change the Course of the Pandemic: Turning Vaccines Doses Into Urgent Funding to Fight COVID-19

This Friday, April 8, we have our eyes set on the 2022 Advanced Market Commitment (AMC) Summit — hosted by Germany and Gavi, the Vaccine Alliance — and, in particular, on the role that the European Union (EU) plays in making it a success. The Summit aims to raise at least US$5.2 billion in urgent funds for COVAX — a key component of the Access to COVID-19 Tools Accelerator (ACT-A) that helps deliver vaccines to low- and middle-income countries (LMICs) around the globe. 

While the EU and other countries have already supported ACT-A’s life-saving work, there is still a substantial funding gap to cross the finishing line. Most of the resources pledged this Friday for COVAX will be used to ramp up vaccination in lower-income countries and cover in-country delivery and ancillary costs — such as storage, syringes, and transportation — that are currently hindering vaccination targets and risking the world’s progress against COVID-19.  

Among the different participants in this Friday’s Summit, the EU has a considerable margin to maneuver to make a significant contribution. In July 2021, the European Commission (EC) announced the EU’s commitment to donate 200 million vaccine doses to LMICs, setting aside €1.3 billion for this purpose. However, despite the welcomed act of solidarity, the EC hasn’t completed the purchase yet, creating a unique opportunity to use this money more wisely. 

Taking into account that the supply of vaccines is no longer the most pressing issue, but rather in-country logistics and distribution bottlenecks, the Commission should redirect those resources to meet COVAX’s target as well as ACT-A’s overall funding gap, currently estimated at €25 billion. The change in priority from vaccines to vaccination has been echoed by health authorities across LMICs. Africa Centres for Disease Control and Prevention Director Dr. John Nkengasong recently stated that the challenge is on delivery and even warned that “too many doses without the infrastructure or coordination to distribute them could lead to vaccines expiring”. 

The EU’s decision to turn the committed doses into a financial contribution — presently at the desk of the President of the European Commission Ursula Von der Leyen — could become a game-changer in the race to vaccinate the world. It would help drive vaccination rates up and still leave plenty of money to boost the diagnostics and therapeutics pillars of the ACT-A. Or in much simpler terms, such a reallocation of funds would ensure greater impact, while demonstrating that leaders are in tune with the changing realities on the ground.

Call to Action! Accelerating an Effective and Equitable COVID-19 Response and Pandemic-proofing the Future

We are at a pivotal moment in the COVID-19 pandemic. With only 14% of people in low-income countries vaccinated with at least one dose, progress against the disease is at risk. Equitable access to vaccines, tests, and treatments remains elusive, compromising the health of millions of people, increasing the chances of more deadly variants, and endangering recovery. Now Russia’s invasion of Ukraine has brought a new security challenge, further threatening global health and safety. The humanitarian crisis in Ukraine and looming food and energy emergencies will continue to strain economies, people, and systems — not only in Europe, but also in other regions where progress against COVID-19 is still fragile.  

The convergence of different security crises with a still-present COVID-19 emergency will only deepen global suffering unless world leaders act urgently. It is essential that G7, G20, and all leaders not retreat from COVID-19 and acknowledge that ending this pandemic remains critical to the world’s security and stability. It is the time to double down and finish this solvable crisis — before the world is faced with a more transmissible or deadly variant, or even a novel pathogen. 

Together with over 30 partners, Pandemic Action Network calls on leaders to revamp their response to the pandemic in upcoming Summits and global coordination meetings taking place in 2022 and stay the course and secure the future, by prioritizing the following actions:

  1. Accelerate equitable access to and acceptance of vaccines, diagnostics, and therapeutics
  2. Provide new, diversified funding to fill country-identified gaps in response and preparedness
  3. Build now to pandemic proof the future

Read the full call to action here

This call to action is open for sign-ons. Please email Hanna if you’d like to add your organization.

Steps Taken, a Leap Required — CEPI’s Replenishment Statement

Today, as the world reaches a grim milestone of six million official deaths from the COVID-19 pandemic and as Russia wages war in Ukraine, world leaders gathered at the Global Pandemic Preparedness Summit to address what we must do better to prevent and prepare for pandemic threats. The Summit, organized by the Coalition for Epidemic Preparedness Innovations (CEPI) and the U.K. Government, represented a critical opportunity for global leaders to prioritize pandemic preparedness and support CEPI’s groundbreaking 5-year plan to develop life-saving vaccines to help prevent a crisis of similar scale to the COVID-19 pandemic, including its 100 Days Mission to develop safe and effective vaccines in 100 days following an outbreak. 

Pledges of financial and political support were made in nearly equal measure with a total of 13 countries and 2 philanthropic donors pledging US$1.54 billion to CEPI’s US$3.5 billion five-year plan. Japan’s announcement of US$300 million made it the largest contributor, followed by the U.K. in addition to commitments from Australia, Austria, Finland, Germany, Indonesia, Italy, Japan, Mexico, New Zealand, Norway, Singapore, and the U.S. 

At least nine other countries (Brazil, Canada, Greece, Kuwait, Lithuania, Nigeria, South Korea, Spain, and Switzerland) and the European Commission expressed their support, though no specific financial contribution was mentioned. 

While this is a welcome and important first step toward a world that is better prepared for pandemic threats, it is disappointing that many governments failed to match political support with bold and meaningful financial commitments. The COVID-19 pandemic showed us that the world is ill-prepared to prevent and respond to a pandemic caused by a novel respiratory pathogen. The pandemic research and development (R&D) system as it exists does not work to address the challenges of emerging infectious diseases. As we look toward year three of COVID, we are already witnessing the familiar and costly cycle of panic and neglect around pandemics spinning into motion. CEPI’s plan to reduce vaccine development time to 100 days is one in a set of critical measures to get ahead of the cycle of panic and neglect and avoid another trillion-dollar pandemic that needlessly costs millions of lives and livelihoods. 

Eloise Todd, Pandemic Action Network’s co-founder, said:

“While today’s commitments of over US$1.5 billion to CEPI are a welcome and strong start, they are not enough. The COVID crisis showed us that the vaccine R&D system as it exists cannot meet the challenges of emerging infectious diseases before they cause severe damage, nor can it ensure all people everywhere have equitable access to the tools and technologies they need to curb a global health emergency. Leaders can avoid repeating past mistakes and build a system that is forward looking and equitable. Fully funding CEPI is an impactful way to do just that. An investment in CEPI is a fraction of the trillions lost to pandemic response and an investment that pays a multitude of dividends. We expect key global leaders to step up in the coming weeks to align their financial commitments with their political commitments, and make a fully-funded CEPI a reality.”

Pandemic Action Network and its network of over 250 partners will follow up closely on the actions of governments, philanthropies, and decision makers who have expressed their commitment to this goal, especially those key global leaders who can convene other governments, rally support, and mobilize resources. Building on the strong momentum from the Global Pandemic Preparedness Summit, concerted action from world leaders in the coming months will be crucial to fully fund CEPI and ensuring the COVID crisis leaves a legacy of pandemic preparedness.

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.

Calling on U.S. Secretary of State Blinken and Foreign Ministers to take Concrete Action on COVID-19 Response and Pandemic Preparedness

In an open letter, Pandemic Action Network and nearly 40 international partners call on U.S. Secretary of State Antony Blinken and fellow Foreign Ministers participating in the Nov. 10 Ministerial Meeting to make specific, time-bound commitments and take concrete steps to end the COVID-19 crisis and build back better from this pandemic.

With a focus on the need for a clear roadmap of concrete actions, timelines, and accountability to accelerate progress toward the global targets of vaccinating 70% of the population in every country by mid-2022, expanded delivery of other lifesaving response needs, and strengthened pandemic finance and governance, the letter specifically calls for ministers to:

  1. Divert COVID-19 vaccine production and delivery at scale with full transparency in 2021
  2. Commit to fully finance the global COVID-19 response and to prepare for future pandemic threats
  3. Ramp up and increase transparency of global supply and delivery of vaccines, tests, treatments, oxygen, PPE, and other COVID-19 tools, and strengthen supply chains and pharmacovigilance
  4. Prioritize strengthening country-level distribution and delivery capabilities in a manner that addresses current needs and future health system resilience
  5. Unlock special drawing rights (SDRs) for the global response & recovery
  6. Increase transparency and tracking from inputs to outcomes

The world cannot wait any longer for action to end this pandemic and help prevent the next one. Read the full letter.

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

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

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

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

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

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

Statement from the Pandemic Action Network on the Global COVID-19 Summit: Ending the Pandemic and Building Back Better to Prepare for the Next

Pandemic Action Network welcomes the leadership of President Biden and the United States Government in hosting today’s Global COVID-19 Summit. The purpose of today’s event was to secure commitments to take action on the Summit goals and targets. The Network thanks all of the leaders who joined and made commitments to achieve the Summit’s goals to get 70% of the population in every country vaccinated within 12 months, to step up efforts to deliver lifesaving oxygen, therapeutics, tests, and personal protective equipment to patients and health workers on the frontlines of the pandemic, and to scale up investments and strengthen the international system to ensure the world is better prepared to prevent, detect, and respond to future pandemic threats.

Among the new announcements today — that will serve as critical first steps toward the bolder, coordinated global action needed — include: The U.S. pledge to purchase and donate an additional 500 million Pfizer vaccine doses for low- and middle-income countries, bringing the total number of vaccines to be donated globally by the U.S. to 1.1 billion; the establishment of an EU-US task force to work together toward the 70% target, and EU commitment to ensure 1 in 2 doses produced in Europe will be exported to the rest of the world; U.S. commitment of  US$345 million for the global COVID-19 response; U.S. plans to provide US$1 billion to establish a new fund for global health security; and new commitments by philanthropies Skoll Foundation (US$100 million) and Pax Sapiens (US$200 million) to bolster pandemic prevention, preparedness, and response.

Pandemic Action Network co-founder Eloise Todd said:

“The success of this Summit will be judged by what happens next. We urge leaders to use every tool at their disposal to map out where every country is right now, and what finances and logistics are needed to deliver jabs in arms faster, getting us over the line to 70% vaccination coverage in each country, while ensuring access for all for lifesaving tests, treatments, oxygen and PPE along the way. Piecemeal actions are no longer enough. This crisis demands not only commitment, but a coordinated global plan and leadership. To end the COVID-19 crisis in 2022, we need to do whatever it takes — and we will hold leaders to account to make it happen.”

Pandemic Action co-founder Carolyn Reynolds said:

“Today’s Summit was a critical reset of the world’s ambition to end this pandemic for all as quickly as possible, and to start making the necessary investments now to bolster our collective defenses to prevent the next deadly and costly pandemic from happening. But we are in a race against time. There has been a collective failure to date to solve this crisis and treat pandemics as the grave threat they are to global security. We need urgent, bold, and concrete action, and we need it now. We welcome President Biden’s plan to host another summit early next year to make sure the world is on track to achieve the Summit goals and targets. We stand ready to work with all leaders to ensure that this Summit leaves a legacy to pandemic proof the world once and for all.”

In advance of today’s Summit, Pandemic Action Network brought more than 60 groups together around a common position on what’s needed to end this crisis. At today’s Summit, on behalf of our Network, we committed to two things:

1. On the COVID-19 response, we will work with our partners and with leaders to ensure the commitments made today are delivered through a global action plan to do whatever it takes to fully vaccinate 70% of the population in every country in less than 12 months — and at least 40% by the end of this year.

To get there, we must dramatically ramp up support now for vaccine donations, manufacturing, and delivery; development and deployment of testing and treatments, oxygen and PPE; and a strong frontline health workforce to reach the most vulnerable communities.

2. To build back better, we commit to help mobilize the political support and resources necessary to establish a new fund for global health security and a new Global Health Threats Council. We will convene and tap the deep expertise and capabilities in our Network across sectors to inform their design and ensure they are inclusive, accountable, and sustainably funded, commensurate with the threat.

Experts Call on World Leaders to Commit to a Global Plan of Attack on COVID at Summit

More than 60 Leading Organizations across Civil Society, Academia, Philanthropy, Health, and Social Enterprise Define a 6-Point Plan to End the Global COVID-19 Crisis

September 20, 2021, Seattle, WA – This week, hosted by the United States, world leaders will gather virtually for the Global COVID-19 Summit: Ending The Pandemic And Building Back Better. According to a group of experts convened by the Pandemic Action Network, the summit is an opportunity to kickstart a global coordinated response plan. As the pandemic persists and the gap between the vaccine haves and have nots grows larger, the Network and partners from around the world welcomes the summit and the targets defined by the Biden Administration, but warns that without specific, concrete action driven by transparent leadership and accountability, we will see millions more COVID-19 infections, deaths, and chances for virus mutations. The Framework for a Global Action Plan for COVID-19 Response, backed by 61 organizations, outlines a 6-point global plan of attack to deliver on the summit targets.

“We are 18 months into this crisis, and we still don’t have a global plan to address this global pandemic,” said Eloise Todd, co-founder of Pandemic Action Network. “This year’s UN General Assembly and the Biden Administration’s summit must be a step change to how we are tackling this crisis. We need leaders to attend this summit, commit to ensuring that 40% of the world’s population gets vaccinated by the end of the year and 70% by mid-2022. Leaders must roll up their sleeves to take the action needed, delivering all the tests, treatments, PPE, and of course vaccines to achieve this ambition. This pandemic is incubating the next one — it’s time to do whatever it takes to end the COVID crisis for everyone in 2022.”

“The staggering global inequality in vaccine access is costing lives, fracturing the world even more, and compromising global cooperation in all other critical areas such as climate change,” said Pascal Lamy. “Vaccinating the world is a solvable problem. But it will require much stronger coordinated action to correct the course and put us firmly on track to end the devastating effects of the pandemic. We’ve defined what must be done, and we now need leadership and accountability.”

Pascal Lamy is President of the Paris Peace Forum and former director-general of the WTO, and one of the 20 individuals and more than 60 organizations that have signed on to the framework, including Care, the CDC Foundation, the Future Africa Forum, Global Citizen, the International Rescue Committee, ONE, PATH, Sabin Vaccine Institute, Save the Children, the United Nations Foundation, VillageReach, and Women in Global Health as well as the Paris Peace Forum.

In order to end the COVID-19 crisis and prepare for the next, Pandemic Action Network, COVID Collaborative, multiple centers at Duke University, and more than 60 global partners are calling on world leaders to:

  1. Strengthen global leadership and accountability. Strong, sustained political leadership and accountability is needed to coordinate and galvanize the many existing multilateral and bilateral responses.
  2. Develop and implement a Global COVID-19 Response Roadmap. Leaders should develop and agree to an end-to-end, fully costed roadmap to end the acute phase of the COVID-19 pandemic, which should include specific, timebound commitments and steps.
  3. Empower a Global Task Force for Supply Chain and Manufacturing. This Task Force should be part of the global leadership framework and should expand production of vaccine inputs, vaccines, diagnostics, therapeutics, and other life-saving interventions.
  4. Accelerate sharing of vaccines and other life-saving interventions.
  5. Prioritize strengthening country-level distribution and delivery capabilities. Recognizing that country-level distribution, delivery, and demand-generation are quickly becoming the key constraints in the race between vaccines and variants.
  6. Increase multi-year financing for the pandemic response and preparedness in low- and middle-income countries. Funding must be additional and must match the scope and urgency of the COVID-19 response and close critical global gaps in pandemic preparedness.

 

“We are in a race against time. The world has the resources and the ingenuity to end the COVID-19 crisis, but we need leaders to step up to meet the moment with the urgency that it deserves,” said Gary Edson, president of the COVID Collaborative.

“This is about leadership and accountability. If the global COVID-19 response remains rudderless and fragmented, without real levers for accountability, all well-meaning commitments will have little impact,” added Krishna Udayakumar, founding director of the Duke Global Health Innovation Center.

The full framework with a 6-point action plan is available here.

About Pandemic Action Network

Pandemic Action Network drives collective action to end the COVID-19 crisis and to ensure the world is prepared for the next pandemic. The Network is a robust partnership of over 140 global multi-sector organizations aligned in a belief that every effort made in the fight against COVID-19 should leave a long-term legacy. One where humanity is better prepared to deal with outbreaks and prevent a deadly and costly pandemic from happening again. Learn more at: pandemicactionnetwork.org.

About Paris Peace Forum

For the fourth consecutive year, the Paris Peace Forum brings together the most important players in collective intelligence. Heads of state and government and CEOs of major multinationals, as well as several civil society actors, will gather for a unique hybrid edition from November 11 to 13 to advance concrete solutions to the enormous challenges posed by the COVID-19 pandemic, and to improve global governance post COVID.

About COVID Collaborative

The COVID Collaborative is a national assembly of experts, leaders and institutions in health, education, and the economy and associations representing the diversity of the country to turn the tide on the pandemic by supporting global, federal, state, and local COVID-19 response efforts. COVID Collaborative includes expertise from across Republican and Democratic administrations at the federal, state and local levels, including former FDA commissioners, CDC directors, and U.S. surgeon generals; former U.S. secretaries of Education, Homeland Security, Defense and Health and Human Services; leading public health experts and institutions that span the country; leading business groups and CEOs; groups representing historically excluded populations; major global philanthropies; and associations representing those on the frontlines of public health and education.

About Duke Global Health Innovation Center, Duke-Margolis Center for Health Policy, Duke Global Health Institute

The Duke Global Health Innovation Center, Duke-Margolis Center for Health Policy, and Duke Global Health Institute work cooperatively to synthesize research on global and public health and advance evidence-based policies that support strong public health systems at all levels of government. Work on this initiative represents the individual expertise of the researchers involved and not necessarily the views of the administration of Duke University.

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

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

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

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

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

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

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

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

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

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

G20 health Ministers’ Meeting — What Happened? What’s Next?

DESPITE PROMISING STATEMENTS OF COOPERATION, VERY LITTLE WAS AGREED UPON DURING THE G20 HEALTH MINISTERS’ MEETING AND WHAT COMES NEXT TO TURN COMMITMENTS INTO ACTION REMAINS UNCLEAR. 

In advance of the two-day gathering of Health Ministers from the Group of Twenty (G20) in Rome, Italy’s health minister Roberto Speranza, holding the G20 presidency this year, said the event was an occasion to strengthen international relations and work for fairer COVID-19 vaccine distribution.

While the G20 Health Ministers’ declaration contains encouraging messages of strong multilateral cooperation to end the pandemic and enhance timely, equitable, and global access to safe, affordable, and effective COVID-19 vaccines, therapeutics and diagnostics, very little was agreed in terms of concrete steps needed to turn these promises into a reality.

Here are some of our main take-aways:

“Pact” on achieving vaccine equity

Countries committed themselves in the so-called “Rome Pact” to providing the entire world population with access to COVID-19 vaccines. Speaking after the meeting, Italian Health Minister Speranza told journalists, “if we leave part of the world without vaccines, we risk new variants which will hurt all of us.” He promised that efforts would be strengthened bilaterally and through international platforms starting from COVAX.

We welcome the Ministers’ commitment to continue their efforts to meet the World Health Organization’s (WHO) goal to vaccinate at least 40% of the world’s population by the end of 2021 and continue to support collaborative initiatives, such as the Access to COVID-19 Tools Accelerator (ACT-A) and COVAX as well as important global research and innovation initiatives as the Coalition for Epidemic Preparedness Innovations (CEPI). We still have a long way to go — the WHO Director-General has said that while 5 billion vaccines have been administered worldwide, almost 75 percent of these doses have been administered in just 10 countries.

Most high-income countries have bought significantly more doses than needed to cover domestic vaccination needs. We need these countries to donate at least 1 billion vaccine doses as soon as possible, and 2 billion doses by the end of 2021, if this goal is to be achieved. We welcome Germany’s announcement on the sidelines of the meeting to make 100 million vaccine doses available for the international inoculation campaign before the end of the year, and call on others to swiftly follow suit.

Financing for pandemic preparedness and response

According to the Health Ministers’ declaration, proposals on sustainable financing to strengthen future pandemic preparedness and response are being drafted to be presented at the G20 Joint Finance and Health Ministers’ meeting in October. Immediate and multi-year funding commitments for the pandemic response in low- and middle-income countries (LMICs) must match the scope and urgency of the need. We must urgently establish a financing mechanism to channel and direct the additional funding required for the current pandemic response to where it is most needed, and to jumpstart funding for preparedness for emerging pandemic threats. Read more on the call for a new global financing mechanism that provides robust and sustained investments in pandemic prevention, preparedness, and response in this policy brief.

One Health approach

On a positive note, there was agreement on adopting a ‘One Health’ approach in responding to future health emergencies, i.e., recognizing that human, animal, and environmental health are interlinked and determinant of our wellbeing. According to the Ministers’ declaration, the WHO, World Organisation for Animal Health (OIE), Food and Agriculture Organization (FAO), and UN Environment Programme (UNEP) are to work on a joint work plan on ‘One Health’ to improve prevention, monitoring, detection, control, and containment of zoonotic disease outbreaks.

Vaccine education

There is an abundance of great research, information, and approaches to vaccine education, yet efforts to address vaccine hesitancy and build vaccine confidence can be fragmented and siloed. Catalyzing vaccine confidence requires action across the world by diverse stakeholders, active inclusion, and feedback loops with local implementers. Therefore we welcome the ministerial declaration’s emphasis on the need to promote vaccine confidence “by implementing the most effective, culturally appropriate, and science-based public communication and listening strategies tailored to the context of communities at the local level, to combating misinformation and disinformation, and instilling trust in public institutions and experts.”

Implications for the G20 Leaders’ Summit

The G20 Health Ministers’ meeting was one of the last G20 ministerial gatherings before the Leaders’ Summit in Rome on 30 and 31 October. We urgently need strengthened global leadership and accountability; and expect the next joint Health and Finance ministerial and the G20 Leaders’ Summit at the end of October to produce solid commitments on the following issues:

  1. Building strong political leadership for the global COVID-19 response by setting out a fully-costed Global COVID-19 Response Roadmap with specific time-bound commitments to help drive us to the end of the pandemic — full details are defined in our Framework for a Global Action Plan for COVID-19 Response;
  2. Sharing doses at scale and donating entire production slots where feasible, to accelerate global immunity, starting with the donation of excess doses as soon as possible;
  3. Delivering meaningful finance at scale to tackle the global pandemic, including looking to free up as much as possible of the IMF’s US$650B in Special Drawing Rights (SDRs) to low-income countries and to contribute to funding the global COVID-19 response.

We wholeheartedly agree with Minister Speranza when he calls the vaccine a ‘key to freedom’. But we urgently need leaders to focus on ensuring that this ‘key’ is accessible to everyone, not only those in G20 countries.

African Health Ministers’ Path Ahead — A Slow but Steady Fight Against COVID-19

By Nahashon Aluoka, Regional Advisor, East & Southern Africa, Pandemic Action 

Amidst Africa’s persistent third wave of COVID-19, the 71st session of the World Health Organization (WHO) Regional Committee for Africa gathered Ministers of Health and leaders from across the continent. The message coming from WHO’s decision-making body was clear: solidarity is required to address COVID-19 in a region that has also been under the stranglehold of more than 50 different public health emergencies in the WHO reporting period.   

In a special session on COVID-19 response, a status report on vaccine rollout and uptake was presented, and Ministers exchanged ideas on approaches to tackle the pandemic and the post-COVID-19 recovery. Vaccines and rollout were top-of-mind. There is slow but steady progress in acquisition and deployment of vaccines. So far, more than 129 million doses have been received in the continent through multiple platforms and more than 93 million doses have been administered. 

However, the response to this crisis is beleaguered with various challenges and leaders clearly laid them on the table. These include: 

  • The magnitude of the crisis requires multi-sectoral coordination at the country level. Ministers noted that the involvement of the private sector, civil society and communities could be improved. 
  • Fragile health systems are stretched and lack adequate funding to properly respond to COVID-19 let alone other health challenges.
  • In many countries, there are also challenges of non-compliance to public health measures, i.e., mask-wearing, physical distancing, and handwashing, and low levels of vaccine confidence continues to be fueled by virulent misinformation. 
  • Weak planning and inadequate resourcing for vaccine deployment. Two countries have yet to begin vaccine rollout and inconsistent supply has resulted in uneven rollouts across the continent.


Priorities Ahead
Calls for a comprehensive and costed global action plan to vaccinate the world continue, but they have yet to be heeded. 

African leaders must continue to work in solidarity starting with a focus on planning for and effectively managing vaccine delivery. So much attention is paid to vaccine procurement but similar attention must be put on ensuring that countries and communities are ready for vaccine delivery.  

Now that the vaccine pipeline from multiple sources — including COVAX and the path-breaking efforts of the Africa Vaccine Acquisition Task Team (AVATT) has increased vaccine volumes into the continent, all efforts should be made to ensure vaccines are equitably deployed and that there is zero wastage. 

With the limited availability of vaccines and the fact that vaccines don’t work alone in containing the pandemic, member states need to increase investment in creating awareness and promoting compliance to public health measures that stop the spread of COVID-19. Such campaigns must address the contextual aspects of their populations and be voiced by trusted sources on trusted channels.

Importantly, African member states must work together through the African Union to transform the current political will to develop local manufacturing capacities for vaccines, diagnostics, and therapeutics on the continent into a solid action plan. This pandemic has made it clear that the continent’s health security cannot, and should never, be anchored on global solidarity and goodwill and that Africa must define a new public health order driven by its regional and national institutions

 

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.

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Civil Society Leaders Urge Kristalina Georgieva to Do ‘Whatever It Takes’ to Vaccinate the World

Dear Kristalina Georgieva,

We are writing from a wide range of organizations to thank you for the leadership you have shown in convening a task force to implement a roadmap to vaccinate the world. We would like to call on you to bear the following principles in mind as you take that work forward:

Draw up the plan, commit to doing whatever it takes to vaccinate at least 70% of people in all countries, and get them the tests, treatments, and PPE they need alongside vaccines. A comprehensive, coordinated strategy to get to global herd immunity as soon as possible is urgently needed. Many organizations are drawing up such plans, but you are in a position to draw all of these strands together and make sure there is a one-stop-shop costing that is not limited by numbers, mandates, or politics, but focuses on setting out what it will take to end this pandemic.

Make US$50B the floor; the ceiling will be much higher: Most existing calls for funding are focused on procurement.  Yet multiple studies show that it will take billions more on to fully deliver a global response that enables countries to deliver a COVID-19 response and mitigates the impacts of COVID-19 on the most vulnerable. Your plan needs to include a comprehensive costing and analysis covering all elements of the global response. This should identify gaps in supply, procurement, as well as resources needed in-country for the delivery of vaccines, tests, and treatments – ACT-A finance, for example, does not cover rollout costs from “tarmac to arm” of its own vaccines. Ensuring the costs needed to administer vaccines and other COVID-19 tools — including to health systems and health workers, including frontline and community health workers — are also met, so that vaccines and other tools are not just available but also delivered and administered, as part of a fully-costed global plan to reach global herd immunity.

Maximize grant funding for the global response: As you have said ‘vaccine policy is economic policy’, and until countries are vaccinated to at least 70%, all other COVID-19 tools — tests, treatments, PPE, and the ability to deliver all tools — are an integral part of the strategy. We are looking at a situation in which the best investment high-income countries (HICs) could make is investing in the global response, and they should do this from their own reserves, outside of ODA budgets. We ask that you maximize grant funding for low- and middle-income countries (LMICs) within this plan and get HICs to agree to a burden-sharing model to set out fair share contributions leveraging funding streams outside of ODA budgets.

Maximize the 650B in SDRs, frontloading whatever is possible: Your team is looking at recycling options for the 650B in SDRs. Announcements so far suggest that 100B of this might be available for LMICs. We should make as much of the 650B as possible available for LMICs to both help their domestic budget situations and fund the global deployment of COVID-19 tools as well as potentially freeing up funding for climate needs as set out in the G7 communiqué. We urge you to look at ways to free up as much of the 650B for LMICs, and to maximize the amount that can be freed up in the short term to contribute to funding the global COVID-19 response. 

Bring stakeholders into the War Room: Representatives from LMICs, health ministries, health agencies, and civil society can all help advise on your work. Bring us in, we are ready to contribute. 

We would welcome the opportunity to discuss these urgent matters with you in the coming days, at your convenience — we have no time to waste. Many thanks for your attention to these issues, and we look forward to hearing from you. 

Your sincerely,

Eloise Todd
Co-founder
Pandemic Action Network

On behalf of:


PATH

 

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

G20 Finance Ministers Urged to Fill the Huge Gaps Left by the G7 on Finance and Vaccines

Dear G20 Finance Ministers,

The G7 collectively, and most countries individually, have so far failed to absorb the necessity of collective global action and investment. We cannot afford to continue with the piecemeal approach that has characterized the global response until now. We are therefore writing to you in advance of your G20 Finance Ministerial meeting so that by 9-10 July you can take actions that will: fill the gaps left by the G7 on urgent dose-sharing, increase transparency to facilitate efficient tracking and accountability in this crisis, and come up with credible financing to back the emerging plan from Kristalina Georgieva to vaccinate the world.

Firstly, on dose sharing, the G7 pledge to share 870 million doses over the next year is far from the quantity requested by the WHO and lacks solidarity given the third wave that is building momentum in many under-vaccinated regions. Dose-sharing is urgently needed, not as a long-term solution, but to plug the immediate vaccine supply gap in low- and middle-income countries (LMICs). We need G20 countries to fill COVAX’s gap for this summer. The majority of the dose-sharing announced at the G7 Summit will not be delivered till well into 2022. Therefore, we call on you not to let the meeting finish before the G20 have collectively found the doses needed to fill COVAX’s supply shortage — 275 million doses for June alone — and we are reiterating the call for 1 billion doses to be shared by the end of August 2021.

Secondly, we need bolder agreements for the medium term and absolute transparency on vaccine supply. In order to shine a light on what is going wrong in vaccine supply and create better understanding of the system, as well as sharing doses now to fill the COVAX supply gap, we also ask that you:

– plan to share at least 1 billion doses by the end of August and at least 2 billion doses by the end of the year, which must be counted as an addition to current ODA levels and global development priorities;

– clearly commit to share all of your excess doses by Q1 2022; and,

– publish a detailed month-by-month timeline to the end of 2022 of doses promised and doses actually delivered and publish the prices the G20 and COVAX have paid for doses.

We know that G7 countries alone have bought three billion more doses than they need to fully vaccinate their entire population to 70%, but the G7 pledge provided only enough doses to vaccinate 10.3% of the population in LMICs. Since we sent these letters to each of you individually, head of the WTO Ngozi Okonjo-Iweala called for the G20 to give 3bn doses when they meet – this is exactly the kind of ambition and action we need right now to get this response on track.

Thirdly, it is vital that Finance Ministers commit to backing a fully-costed, coordinated, and comprehensive Global Roadmap to Vaccinate the World covering end-to-end finance for vaccines, tests, treatments and PPE, dose donations, and tech and patent policies. Kristalina Georgieva has committed to developing a roadmap — we want to see the G20 Finance Ministers commit to financing such a roadmap. Latest estimates anticipate that it will cost at least US$50-66B simply to provide doses to vaccinate the world. We want a comprehensive plan that covers tests, treatments, PPE, and vaccines — as well as covering end-to-end delivery costs so that vaccines and other COVID-19 tools are not left on the tarmac and can be delivered. This will require innovative solutions using Special Drawing Rights (SDRs) in the medium term but also scaling grant funding now. We welcome the G7’s recent commitment to reallocate their new SDRs to the poorest and most vulnerable countries struggling to tackle COVID-19, health systems, hunger, education, and economic fallout of the pandemic. We now urge the G20 to reallocate most, if not all, of their new SDRs to vulnerable countries by the end of the year, to support health and climate in particular, and an equitable and green recovery, and ask that countries publicly share how much they will contribute to this goal.

We can no longer afford to wait to take concrete action to end COVID-19, and we hope the G20 can deliver the leadership the world needs. We are counting on you to take immediate action to fill the vaccine gap now and to fund the plan to vaccinate the world.

Vaccine policy is economic policy, and until countries are vaccinated to at least 70%, all other COVID-19 tools — tests, treatments, PPE, and the ability to deliver all tools — are an integral part of the vaccination strategy. We are counting on you to fill the dose gap, deliver the COVID-19 tools we need, and find the funding so we can stop the spread and save lives. We are counting on you and your fellow Ministers to take the urgent steps needed now to help protect us all. We would welcome the opportunity to discuss these issues with you in the coming days, at your convenience.

Many thanks for your urgent attention to these matters, and we look forward to hearing from you.

Your sincerely,


PATH
 
 

Lots of Warm Words, Barely No Action — Is the G7 Still Relevant?

By Isabelle De Lichtervelde, Senior Program Officer, Policy & Advocacy

Last week, I wrote about our hopes and asks for the G7 Leaders’ Summit. At their annual gathering, G7 leaders faced two choices: they could either decide to take the fight against COVID-19 to another level and agree on a comprehensive global plan to end the pandemic everywhere for everyone or choose to continue with the piecemeal approach that has characterized the global response until now. Distracted by domestic issues, such as Brexit, they sadly went for the latter. The G7 communiqué contains a lot of warm words such as “a collective goal of ending the pandemic in 2022” and a commitment to both “strengthen global action now to fight COVID-19, and to take further tangible steps to improve our collective defenses against future threats and to bolster global health and health security”, but very little action to turn these statements into reality.

Here are some of our main take-aways (for a line-by-line emoji-based assessment of the health and development portions of the communiqué, click here):

  • On dose sharing, with the exception of the U.S. pledge to purchase 500 million Pfizer doses, the collective level of ambition failed to meet the urgency of the moment. G7 leaders committed “to share at least 870 million doses directly over the next year” and to “make these doses available as soon as possible and aim to deliver at least half by the end of 2021 primarily channelled through COVAX towards those in greatest need”. This is far from enough. Dose-sharing is urgently needed NOW, not as a long-term solution, but to plug the significant vaccine supply gap in low- and middle-income countries (LMICs) caused by rich countries massively overbuying doses. Our ask is one billion doses by the end of August and at least two billion doses by the end of 2021. According to publicly-available data, G7 countries have bought three billion more doses than they need to fully vaccinate their entire population to 70%. On top of that, the pharma company’s own data shows that there will be 5 billion doses in circulation by the end of August and a staggering 11 billion doses by the end of the year. Yet, G7 leaders have only agreed to share 870 million doses over the next 12 months. According to a new analysis, this will provide only enough doses to vaccinate 10.3% of the population in LMICs.
  • While COVID is still raging, particularly in countries in need, the G7 didn’t make any new financial commitments to end COVID globally. ACT-A is still facing a US$18.1Bn funding gap and the latest estimates anticipate that it will cost at least US$50-66B to fully vaccinate the world — and likely much more when end-to-end delivery costs are factored in. Yet G7 leaders simply claimed pledges made in the past, without any concrete action to finance a global roadmap to end the pandemic in the coming months.
  • On a slightly more positive note, the G7 supported the extension of ACT-A and increased transparency on procurement and delivery data for both donor and recipient countries. The communiqué reads “efforts on this scale require close monitoring of progress made by ACT-A with reliable, transparent, up-to-date and clear information on procurement and delivery to both donor and recipient countries in close partnership with regional organizations. Progress should be reported to the G20 in Rome.” We need total transparency around vaccine production in order for the world to be able to get COVID-19 under control — see our transparency guidelines here. The Network will follow this important issue and continue to push for progress at the G20 meeting later this year.
  • On pandemic preparedness, the G7 outcome document is full of positive language but very little action, including around financing mechanisms for pandemic preparedness. The G7 committed to “explore options for building consensus this year, around sustainable global health and health security financing, supported by robust financial reporting, increased and defined accountability, and oversight”, — a potentially positive baby step toward having a catalytic, sustainable, and multilateral financing mechanism that is dedicated to promoting pandemic preparedness and prevention.


To quote the Network’s co-founder, Eloise Todd, “in footballing terms, the G7 had the ball in front of the net, open goal, and they skied it.” The consequence of this disappointing G7 Summit will be a prolonged pandemic, with more lives lost around the globe.

When will someone finally demonstrate the political leadership needed to end this pandemic?

Transparency Guidelines for the Global Roadmap to Vaccinate the World

As the G7 leaders gather this weekend, civil society organizations have been fighting hard for a Global Roadmap to Vaccinate the World, which calls for an end-to-end plan to vaccinate the world to at least 70%. One of the most urgent issues will be to plug the vaccine gap in the coming months – through sharing doses, providing ambitious finance, and supporting governments to make sure the plan to get to herd immunity delivers tests and treatments to citizens and jabs in arms.

On vaccines themselves, part of the gap will be filled by dose-sharing, and part by ensuring COVAX has the means to purchase enough vaccines. As the G7 rallies around Prime Minister Johnson’s ambition to raise 1bn doses, it is vital we understand the data around what has happened so far:

1. How many doses are being produced in 2021 and who owns them?
2. How much did they cost?
3. When will they come off the production line?

G7 governments are stating that the demand to share 2bn doses in 2021 will not be possible – but the data from different sources tells a different story. For example, GAVI data shows that even accounting for universal booster shots, countries with excess supply will likely have between 1.2 billion and 4 billion doses to redistribute, especially the US & EU. The Duke university project shows that the G7 will likely have in excess of 3bn spare doses in 2021 – with 1bn definitely being a minimum in reach even when making cautious estimates. On top of that the pharma company’s own data shows that there will be 5bn doses in circulation by the end of August and suggests a staggering 11bn doses by the end of the year. There are also publicly available resources on dose deliveries such as this UNICEF dashboard which provide other figures. That’s why we need the G7 leaders to adhere to the following transparency principles as an integral part of the global vaccine roadmap:

Ensure the pharmaceutical industry publishes detailed production schedules setting out the queuing system of which vaccines will be ready for which country, by when, according to realistic production schedules

Publish a detailed month-to-month timeline to the end of 2022 of expected doses that will be produced for the G7, COVAX and other countries and institutions, showing how the G7 can collectively share doses; commit to timeframes for the delivery to fill the urgent vaccine supply gap building towards providing 2bn doses by the end of 2021

Publish a tracker of doses promised and doses actually delivered (when, where, via which sharing mechanism)setting out clearly confirmed contracts vs. options

Publish the prices that doses have been bought at for COVAX, the AU and other LMICs, and set out what ‘not-for-profit’ pricing must be for future purchases for those in LMICs

In light of production data, keep the door open to sharing more doses later in the year

U.S. Global Health Experts Urge G7 Action to Vaccinate the World Quickly and Equitably

Open Letter to G7 leaders proposes five-point action plan – including sharing of at least one billion doses worldwide this year and striving to vaccinate at least 60% of every country’s population in 2022

WASHINGTON – A coalition of global health experts today called on the Group of Seven (G7) leaders to share at least 1 billion, and aim for 2 billion, vaccine doses to low- and middle-income countries by the end of this year, and more urgently help countries distribute and deliver vaccines quickly and equitably across their populations, striving to achieve at least 60%, and ideally 70%, vaccination coverage in every country in 2022.

President Biden and his G7 counterparts will meet at their annual summit on June 11-13 in the United Kingdom, and global vaccination efforts will be on their agenda.

In an Open Letter, representatives of four U.S.-based organizations – Center for Global Development, Center for Strategic & International Studies (CSIS), COVID Collaborative, and three units of Duke University – together with the endorsement of renowned global health experts – urged the G7 leaders and member states to use their vaccine expertise and manufacturing capacity to accelerate global access to vaccines while meeting domestic health needs.

The experts said that today’s global vaccine gap is a supply problem and also a massive distribution and delivery challenge. There are alarming gaps in vaccine distribution and delivery capacity across much of the world that require urgent attention and more resources. “Delivery capabilities and vaccine hesitancy, not supply, are likely to be the critical bottleneck to vaccinations in most low- and middle-income countries within the next 6 months,” the letter said.

The letter highlighted that G7 members have unique resources and capabilities, as well as a legacy of high-impact, collaborative leadership during past crises, and that the coming months are a critical period for leaders to address catastrophic outbreaks in many countries, preempt further growth of the virus elsewhere, and prevent the unchecked spread of the virus from spawning new variants that threaten everyone.

The coalition is asking the G7 leaders to adopt an action plan that includes the following initiatives:

  • Establish a G7 Vaccine Emergency Task Force, open to additional nations and organizations, to provide transparency, predictability, and accountability to the global sharing of vaccines and the vaccine marketplace. As G7 members develop excess vaccine supplies beyond what is needed for domestic use, accurate projections based on real-time country data will facilitate more effective and coordinated global vaccination distribution and prioritize countries with the most urgent need.
  • Develop and commit to a path to share at a minimum 1 billion doses, with the aim of 2 billion doses, of G7-authorized vaccines before the end of 2021, and ensure the availability of enough doses to enable broad vaccination in every country as soon as possible in 2022. As supply continues to increase quickly, the G7 and EU should approach dose-sharing with far greater urgency and intensified systematic planning to meet global needs.
  • Implement a coordinated G7 strategy to immediately increase production of high-quality, well-regulated vaccines, with the goal of further increasing access to these vaccines across the rest of the world. This includes addressing distribution bottlenecks, removing export restrictions and other barriers, and cooperating to provide essential raw materials, equipment and supplies over the next several months.
  • Accelerate development of high-quality globally distributed manufacturing capacity by bringing together public and private sector stakeholders and using voluntary licensing agreements, with a focus on Africa, Asia outside of India, and Latin America. This effort will require establishing cooperative agreements that provide access to financing through both public and private sources, including USDFC, IFC/World Bank and local private funding. The G7 should set a target to finalize at least five such public-private agreements by the end of 2021, each leading to the establishment of vaccine manufacturing capacity before the end of 2022.
  • Increase bilateral and multilateral technical and financial support to low- and middle-income countries to enhance their vaccine distribution and delivery capabilities, and address vaccine hesitancy, with three specific goals: achieve demonstrated national vaccination preparedness in each country by the end of 2021; strive for at least 60%, and ideally 70%, vaccination in every country in 2022; and avoid significant excess vaccine stockpiles ahead of pandemic control in all nations.

The health experts said the G7 members are on a path to contain the pandemic in their respective countries, and to meet the moment, must work to assure the fastest possible path to access to billions of doses of high-quality vaccines – and ensure local capacity to deliver them – complementing ongoing multinational efforts.

The signatories to the open letter include the following:

Amanda Glassman
Executive Vice President, Center for Global Development; CEO of CGD Europe; and Senior Fellow
J. Stephen Morrison
Senior Vice President and Director, Global Health Policy Center, Center for Strategic and International Studies
Gary Edson
President, COVID Collaborative
Mark McClellan
Director, Duke-Margolis Center for Health Policy, Duke University
Rachel Silverman
Policy Fellow, Center for Global Development
Katherine Bliss
Senior Fellow, Global Health Policy Center, Center for Strategic and International Studies
John Bridgeland
CEO, COVID Collaborative
Krishna Udayakumar
Director, Duke Global Health Innovation Center, Duke University
Prashant Yadav
Senior Fellow, Center for Global Development
Anna McCaffrey
Fellow, Global Health Policy Center, Center for Strategic and International Studies
Anjali Balakrishna
Program Director, COVID Collaborative
Michael Merson
Wolfgang Joklik Professor of Global Health, Duke Global Health Institute, Duke University

 

The following individuals have formally endorsed the letter:

Thomas J Bollyky, Senior Fellow, Council on Foreign Relations
William H. Frist, former US Senate Majority Leader
Helene Gayle, President and Chief Executive Officer, The Chicago Community Trust
Scott Gottlieb, Resident Fellow, American Enterprise Institute, and former Commissioner of the US Food and Drug Administration
Margaret (Peggy) Hamburg, former Commissioner of the US Food and Drug Administration, and former Foreign Secretary of the National Academy of Medicine
Amb [ret] Jimmy Kolker, former Assistant Secretary, Global Affairs, Department of Health and Human Services
Jack Leslie, Chairman, Weber Shandwick
Jennifer Nuzzo, Associate Professor, Johns Hopkins Bloomberg School of Public Health
Carolyn Reynolds, Co-Founder, Pandemic Action Network, and Senior Associate, Global Health Policy Center, CSIS

The full text of the Open Letter can be viewed here.

It’s G7 Week — Will It Deliver the Global COVID-19 Plan We Desperately Need?

By Isabelle De Lichtervelde, Senior Program Officer, Policy & Advocacy

This week, all eyes will be on the G7 leaders as they meet in Cornwall for their annual Leaders’ Summit. At the gathering, leaders of the world’s seven largest advanced economies face two choices: they can either decide to take the fight against COVID-19 to another level and agree on a comprehensive global plan to end the pandemic everywhere for everyone or choose to continue with the piecemeal approach that has characterized the global response until now, thus prolonging this crisis for those who are most vulnerable. 

G7 Health Ministers and Finance Ministers met ahead of the Summit.

  • Health and Finance Ministers expressed their commitment to fully fund the Access to COVID-19 Tools Accelerator (ACT-A), which still has a US$18.1 billion funding gap in 2021. Health Ministers are open to considering the extension of ACT-A into 2022 alongside efforts to strengthen supply chains and boost global vaccine manufacturing capacity. 
  • Finance Ministers also expressed strong support for the new Special Drawing Rights (SDR) allocation, including a reallocation to countries in need. 
  • On pandemic preparedness, while Health Ministers welcomed the upcoming special session of the World Health Assembly to consider the benefits of a pandemic treaty, Finance Ministers are looking forward to the Pandemic Preparedness Partnership’s Report to G7 Leaders and the G20 High-Level Independent Panel’s findings, and will consider their recommendations, particularly on financing mechanisms.


In parallel, progress was made regarding intellectual property rights and the impact it has on manufacturing and global supply of COVID-19 tools. The Biden Administration recently expressed its (partial) support for the World Trade Organization (WTO) COVID-19 TRIPS Waiver proposal, and the
EU presented its own proposal on patents which it is introducing to the WTO.

Ultimately, both meetings’ communiqués included positive language on the global response.  While these are all steps in the right direction, eighteen months into the pandemic, we need G7 leaders to move beyond their “think big, act small” strategy. They need to think big and act fast. As they gather for the annual G7 Leadership Summit, leaders have one job: to deliver a comprehensive, coordinated roadmap that accelerates global vaccine access and delivery of vaccinations and other COVID-19 tools for everyone. This strategy should include:

  • A comprehensive costing to show what it would take to achieve at least 70% vaccination coverage in all countries, including analysis to identify gaps in supply, procurement, and resources needed in-country for the delivery for vaccines, treatments, and tests. 
  • A burden-sharing model to set out fair share contributions and fully fund global vaccination to reach 70% coverage as soon as possible (including fully funding ACT-A.)
  • A plan to urgently address the huge vaccine supply gap in low- and middle-income countries by sharing two billion doses at the Leaders’ Summit, delivering one billion by the end of August and the second billion by the end of 2021 in coordination with COVAX.

 

As part of this global plan, G7 countries must urgently share vaccine doses with countries in need. G7 countries have bought three billion more doses than they need to fully vaccinate their entire population to 70%. The G7 U.K. Presidency should lead by example by committing to share 100 million doses as soon as possible before the Leaders’ Summit, and others should follow suit, in particular Team Europe and the United States.

G7 leaders can make a difference for the world this week and finally deliver the desperately needed plan to end this deadly pandemic. Let’s hope they deliver.

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                 

 

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

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

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

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

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

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

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

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

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

Seizing the “Chernobyl Moment”: Actioning the Independent Panel’s Report Over the Next 100 Days to Make This the Last Pandemic

Last week’s release of the report by the Independent Panel for Pandemic Preparedness and Response’s (Independent Panel): COVID-19: Make it the Last Pandemic comes at arguably one of the most complex and challenging times in the global COVID-19 crisis.

Just as many states and businesses across the U.S. quickly lifted mask-wearing restrictions in response to new guidance from the U.S. Centers for Disease Control and Prevention, and countries across the world lifted restrictions, the world continues to see record numbers of new COVID-19 cases. World Health Organization (WHO) Director-General Dr. Tedros warned of the grave emergency in India and the worsening situation in countries such as Nepal, Sri Lanka, Vietnam, Cambodia, Thailand and Egypt that are dealing with spikes in cases and hospitalizations. Nearly 18 months since the outbreak of the COVID-19 virus was first reported, the global inequities in the response are sharper than ever. Only 0.3% of COVID-19 vaccine supply is going to low-income countries, and the world still lacks the necessary life-saving supplies and systems necessary to contain, let alone end, this pandemic.

It is amidst this backdrop that the Independent Panel is sounding the alarm for world leaders to take urgent action, both to ratchet up the global COVID-19 response as well as to make the significant changes to the international system necessary to bolster global preparedness for future pandemic threats. While we think the Independent’s Panel’s recommendations could have been much more ambitious in certain areas, if enacted they would constitute a major step change in how pandemics are treated by governments as an existential global security threat.  The Independent Panel calls COVID-19 a “Chernobyl moment” for pandemic preparedness: the catastrophe that should trigger the kinds of international policies, systemic reforms, safeguards, and accountability for addressing pandemics that Chernobyl triggered for nuclear threats.

IF ENACTED. This is the key point. We have seen this story play out before — the cycle of panic and neglect characterized by a deadly disease outbreak, followed by urgent crisis response, systemic review, reports, and recommendations that leaders fail to implement. Over the next 100 days, in advance of the next UN General Assembly, we must begin to break this deadly cycle once and for all.       

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“Everything that has been accomplished by this commission is really a prelude. It’s the overture to the opera that we have not yet heard. We don’t really know yet how well these tasks will be taken up and these recommendations acted upon … It’s been shown over time that it’s not enough to lay out what the world should do. It’s going to require continued promotion, advocacy, and monitoring.”
Harvey Fineberg, President, Gordon and Betty Moore Foundation
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In April, Pandemic Action Network’s 100+ partners developed our 2021 Action Agenda to urge world leaders to take action to bolster the global COVID-19 response, hasten an end to this global crisis, and lay the groundwork for a more pandemic-proof world. Last week, we gathered global experts for an examination of the Independent Panel’s findings (view here, passcode: &DuB+G9^) and the verdict was clear: We must lay out the path and the timeline and take immediate action to carry these recommendations forward. Now, on the heels of the Independent Panel’s Report, we call on world leaders to take the following actions within the next 100 days to help end this pandemic and prevent the next.

1. Agree on the plan and secure the resources necessary for the global COVID-19 response and reach at least 70 percent vaccine coverage as quickly as possible.

While global action lags and virus variants continue to spread, the devastating human, social, and economic consequences of the pandemic will only continue to worsen and prolong our ability to reach global herd immunity and bring an end to the acute crisis.

The Independent Panel report urges countries that have bought more vaccines than they need to begin sharing doses immediately through the COVAX facility — with the goal of 1 billion doses by September and 2 billion by mid-2022. We believe we must go further and faster. We urge world leaders to apply the same ingenuity, political will, and public-private partnerships that brought us these novel vaccines in record time to speed up both the global production and the delivery of vaccines — and reach the goal of 2 billion vaccines shared through COVAX to people in low- and middle-income countries (LMICs) before the end of this calendar year.

World leaders also should adopt, rigorously cost, and fund a global vaccine roadmap to reach at least 70% vaccine coverage around the world as soon as possible. Recent cost estimates vary widely, from at least $60 billion to an estimate of $190 billion for the costs of delivery to the last mile — and the real costs are likely to be much higher. Given the lack of previous investments in preparedness, the havoc the pandemic has wreaked on already under-resourced health systems, and the continuing global shortages of oxygen, personal protective equipment, diagnostics, therapeutics and other life-saving supplies, a full costing of the global COVID-19 response is likely to be much higher. But even a doubling the higher-end estimates would still be a fraction of what governments have spent so far on response and stimulus measures or the projected $22 trillion in losses to the global economy from the pandemic over the next five years.

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“The world must step up in its ambition and its collective efforts to solve the crisis as soon as possible. It’s unfortunate that 18 months after the start of this pandemic the Panel still felt the need to call for the global roadmap to end this pandemic.”
Muhammad Pate, Global Director, Health, Nutrition, and Population, World Bank,
and Director, Global Financing Facility
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2. Build and commit the resources to launch a new and enduring multilateral financing mechanism for pandemic preparedness.  

The Independent Panel’s recommendation to create an International Pandemic Financing Facility embraces earlier calls by the Pandemic Action Network and others for a new multilateral funding mechanism to bolster pandemic preparedness. The Panel’s proposed facility would mobilize an additional US$5-10 billion annually over the next 10-15 years for pandemic preparedness and be able to disburse rapid-surge financing for response of $50-100 billion at short notice to help stop an emerging pandemic threat. Based on the experience of this pandemic, these funding targets, especially for preparedness, will likely need to increase.

World leaders should commit to launch and fund a new financing mechanism that is fit-for-purpose, based on more rigorous cost estimates of what is required to get the world better prepared, and ensure that its resources are not only additional to current global health spending but also that the preparedness funds are protected in the event of a crisis. This should not just be about business as usual or mobilizing more money for all things health: A new facility should be catalytic; incentivize countries to prioritize development, budgeting, and implementation of their national health security action plans; and hold them to account. Launching this mechanism should not wait until this pandemic is over.

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We must, we absolutely must use this window to focus on tangible actions this year. To build the tools for the future we need, for financing, surge capacity, manufacturing triggers, for oversight. We don’t want to miss this opportunity.”
Beth Cameron, Senior Director for Global Health Security and Biodefense, National Security Council, White House
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3. Elevate pandemic preparedness and response to the highest levels of political leadership, including adopting a global implementation plan and establishing a high-level oversight body with the mandate to prepare for and respond to pandemic threats.

To solve for the egregious lack of decisive leadership and clear accountability for the global COVID-19 response and for pandemic preparedness, the Independent Panel calls for world leaders to take several actions this year: establish a Global Health Threats Council made up of heads of state and government, adopt a political declaration at a Special Session of the United National General Assembly, and adopt a Pandemic Framework Convention. Taken together, these steps would ensure this agenda gets the high-level and sustained political attention and support it demands, and which has been lacking for far too long. A Global Threats Council model is not only something the world needs to prevent and prepare for future pandemics, but a model that we need now to coordinate and action key priorities to end this pandemic. World leaders should embark on those negotiations now and a high-level oversight body should be set up to steer these efforts forward. Simultaneously, world leaders should forge a robust political declaration for adoption at UNGA that will be more than words and not just a one-off event. The Special Session should set in motion a global plan to implement the full range of the Panel’s recommendations to get the world better prepared before the next pandemic strikes, and every head of state or government should lay out what they will do in support.

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“One way to get countries to do more is to have them held accountable by their citizens … Civil society needs to be brought into the decision making processes [for pandemic preparedness], to hold governments accountable for action.”
— Rosemarie Muganda, Regional Advocacy Director for Africa, PATH
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4. Create meaningful and sustained mechanisms to engage civil society as critical partners for driving system change and accountability.

The Independent Panel report underscores that COVID-19 is so much more than a public health crisis; it’s a profound socio-economic crisis, whose impacts will be felt by the poorest and most vulnerable for years, perhaps decades, to come. The longer the pandemic persists, the more the inequities in our systems are amplified and deepened.

As countries, companies, and communities emerge from the acute crisis of the pandemic, they have a responsibility to step up and help close these global gaps, and ensure that this does not happen again. Leaders, at every level — national, regional, global — should take steps to ensure that civil society organizations have a seat at the table as they build and adapt their response and preparedness plans, to ensure those plans reflect the needs of their communities, and to empower citizens to hold their political leaders to account for enacting the fundamental changes needed for a more resilient world.

Pandemic Action Network is laser-focused to seize this window to take action and we are relentless in our advocacy because we believe that we can and must pandemic-proof our present and our future. Together, our 100+ partners urge world leaders — at the G7, G20 and other global summits — to recognize that right now, they have one job: end this pandemic and ensure we are prepared for the next.

 

The First 100 Days of the Biden Presidency: A Pandemic Progress Report

Carolyn Reynolds, Co-founder & Courtney Carson, Senior Program Officer, Pandemic Action Network

The COVID-19 pandemic has overshadowed almost every aspect of President Biden’s first 100 days in office. During the transition, the Pandemic Action Network and leading global health experts called on then-President-elect Biden to take bold steps and work with Congress and with world leaders to end the pandemic as soon as possible and ensure we are better prepared for the next one.

So how has the Biden-Harris Administration done so far, and what remains to be done?

Prioritizing the threat: Right out of the gate, President Biden made a series of welcome announcements to prioritize pandemic response both at home and abroad.  

 

These early announcements included reversing the politically-motivated decision last year to initiate U.S. withdrawal from the World Health Organization (WHO). Instead the Biden-Harris Administration has leaned in to bolster the WHO and the international response to this crisis. Notably, Vice President Kamala Harris’s first conversation as VP with a global leader was with WHO Director-General Dr. Tedros.

COVID-19 response: President Biden has shown leadership by wearing a mask consistently in public, and by issuing a universal mask mandate for all federal buildings, public transportation, and transportation hubs. This cemented the science-backed recommendation that wearing a mask is a key preventative measure. In addition, his first major legislative package, the $1.9 trillion American Rescue Plan Act (ARPA), provided urgently needed relief to families, states, and communities grappling with the economic, social, and health impacts of COVID-19, and  accelerated the frontline pandemic response both at home and abroad. Despite some early challenges, the domestic vaccine rollout has accelerated in Biden’s first 100 days, with 235 million vaccines administered and 98 million people fully vaccinated as of today, according to the CDC. Despite these efforts, vaccination rates are now slowing — a worrying trend as vaccines skepticism grows across the U.S.

On the global response front, the Biden Administration has also taken some important steps, namely to commit a total of $7.5 billion to date to the Access to COVID-19 Tools Accelerator (ACT-A) partnership and its COVAX financing facility to ramp up access to vaccines and other lifesaving tools around the world. As a result, the U.S. is now the leading donor to this global solidarity effort. Highlighting its commitment to the global response, the U.S. hosted international leaders to kick off a virtual resource mobilization campaign for COVAX, urging other wealthy nations to contribute. It also announced agreements to loan vaccine doses to Canada and Mexico, and to provide relief and vaccine donations to India, including mobilizing the U.S. military to provide emergency aid in the face of the country’s growing COVID-19 crisis.  

Pandemic preparedness: U.S. leadership is also needed to strengthen systems for pandemic preparedness, at home and abroad. Pandemic Action Network continues to urge President Biden and other world leaders to lay the groundwork for a pandemic-proof America and world now — before the pandemic fades from view and political and public attention shifts to other priorities, as it has too many times before.  

Here again, the Biden-Harris Administration has laid down some important early markers. First at home: The American Jobs Plan includes a serious commitment of $30 billion to bolster prevent future pandemics and protect against a range of biological threats. This represents renewed and increased commitment to bolstering research and development, surveillance, and strategic stockpiles to ensure America is ready to respond to future disease threats. 

On the global front, President Biden is leading a push for new sustainable financing to help all countries be prepared to counter pandemic threats. Pandemic Action Network is pleased that in NSM1 and several follow-on announcements, the Biden-Harris Administration has expressed its intent to heed our call to establish an enduring international catalytic financing mechanism for preparedness, with the aim to ensure that every country has the core capacity it needs to detect, prevent, and respond to outbreaks at their source before they become deadly and costly pandemics like COVID-19. Earlier this week, Vice President Harris urged representatives at the United Nations to work together now to prepare for the next pandemic. The Administration’s initial budget proposal for FY22 released April 9 backs up these pledges with a $1 billion increase in funding for global health security. 

Looking Ahead: This progress in President Biden’s first 100 days is a welcome start. But much more must be done, and urgently — as the pandemic continues to rage around the world and as the next pandemic threat is looming. Pandemic Action Network has issued an Agenda for Action for world leaders. U.S. support will be critical to drive progress in all of these areas, but here are three where the Biden-Harris Administration can and should lead the way now:

  • Expanded global vaccine access is vital to ending this pandemic. According to the Launch and Scale Faster initiative at Duke University, the U.S. has secured at least 500 million more doses than it needs to vaccinate every American, while some of the poorest nations have yet to receive a single dose. Given U.S. success in vaccination — and the threat to the U.S. of the continued spread of COVID-19 and its variants in other parts of the globe — the Biden-Harris Administration should lead the way to immediately share more excess doses with the world through COVAX. In his first address to Congress, President Biden committed to sharing vaccines with the world once the U.S. has amassed additional supply and when all Americans have access to COVID-19 vaccine. We are there, and we will not end this pandemic if we continue to allow other countries to go unserved. And President Biden should also work with world leaders to agree on a Global COVID-19 Vaccine Roadmap to reach at least 70% global vaccine coverage as soon as possible. 
  • Mobilize additional domestic and international funding for preparedness on par with the threat. To this end, we urge the U.S. to build on its commitment to establish a global financing mechanism for pandemic preparedness with a pledge of at least $2 billion to start, and call on other G7 and G20 member countries to join the U.S. and invest in this effort toward an initial capitalization of $20 billion this year. Separately, the U.S. should also commit a multi-year pledge toward fully funding the five-year plan of action for the Coalition for Epidemic Preparedness Innovations (CEPI). CEPI is playing a critical role in accelerating global access to vaccines in this crisis, and has set a bold goal to compress the future timeline to develop new vaccines for emerging pandemic threats so that they can be quickly developed, tested, and rolled out in an emergency. This is the kind of ambition the world needs, and the U.S. must do its fair share to advance this global public good.  
  • Fix the global pandemic defense system. While new and dedicated funding for preparedness is absolutely critical, it’s not the only piece of the puzzle. The COVID-19 crisis has shown that we must strengthen our international instruments of leadership and accountability to ensure both better preparedness and more rapid response to potential pandemics. This includes strengthening our existing global mechanisms such as the WHO and International Health Regulations, but also seriously entertaining bold and new modalities and frameworks for pandemic governance, such as the proposal for a new pandemic treaty, which now has the backing of dozens of other world leaders. President Biden convened world leaders last week on climate change to push for bold solutions; pandemic threats deserve the same level of political priority.

 

The next few months will see a series of global summits and convenings, offering world leaders multiple opportunities to seize the moment and take action. Pandemic Action Network urges President Biden and his Administration to seize these opportunities, doubling down on the progress of the first 100 days and going bigger and bolder on ending this pandemic and preventing the next. While progress since January 20 has been meaningful, the costs of the U.S. and the world failing to act sooner continue to mount — and the pandemic is far from over. Now is the time for a step change in the ambition of the U.S. and global leaders to do what it will take to end this pandemic for everyone, and ensure that COVID-19 leaves a long-term legacy of a pandemic-proof world. 

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.

Call to Action! Dose Sharing for Global Vaccine Access

This week, advocates that included partners of the Pandemic Action Network sent two separate letters to U.S. President Joe Biden and U.K. Prime Minister Boris Johnson — leaders of two countries with some of the highest potential vaccination coverage in the world — urging them to share their countries’ excess doses with the rest of the globe. Donating surplus doses of COVID-19 vaccine through COVAX is the fastest way to give low- and middle-income countries (LMICs) access to sufficient amounts of COVID-19 vaccines for their populations to reach herd immunity.

Read the letter to President Biden here, and the letter to Prime Minister Johnson here.

Read Pandemic Action Network’s briefing calling on wealthy countries to share excess doses here.

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.

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.

Pandemic Action Network Statement on Outcomes of the G7 Special Summit and Munich Security Conference on the Global COVID-19 Response

Eloise Todd and Carolyn Reynolds, Co-Founders of the Pandemic Action Network, said:

The Pandemic Action Network applauds the financial pledges made today by global leaders to the Access to COVID-19 Tools Accelerator (ACT-A) and its COVAX facility, which together constitute a significant jump forward toward ACT-A’s US$38B funding target. Substantial contributions from the leaders of the US, Germany, and the European Commission helped make this leap, along with new contributions from Canada and Japan. We also welcome US President Joe Biden’s call for increased investments in global health security to address emerging pandemic and biosecurity threats.

This strong show of multilateralism, together with commitments already made by the United Kingdom’s leadership of the G7 Presidency and the Italian G20 Presidency to prioritize global health security in their forthcoming summits, gives us hope that 2021 could be the year in which we not only can turn the corner on COVID-19, but also lay the foundation for a world that will be better prepared for future pandemic threats.

To accelerate the end of this global crisis, we urge G7 leaders to heed the call of French President Emmanuel Macron to ensure healthcare workers and the most vulnerable people in the poorest countries can urgently access to COVID-19 vaccines, by sharing some of the vaccines ordered by the wealthiest countries without delay, as well as by closing the remaining financing gap for the ACT-Accelerator.

Yet even as the world is fighting this crisis, we must urgently prepare for the next one. That’s why we also are urging G7 and G20 leaders to join with President Biden in plans for “creating an enduring international catalytic financing mechanism for advancing and improving existing bilateral and multilateral approaches to global health security.” Speaker after speaker at the Munich Security Conference today talked about how the costs of inaction vastly outweigh the cost of acting in advance of future outbreaks to quash potential pandemic threats, yet preparedness has been ignored for far too long. Actions speak louder than words: Now is the time for the G7 and G20 to commit the policies, plans, and resources necessary to build a future that will protect both people and planet.

2021 could be a historic year for multilateral action to combat some of the gravest threats facing humanity. There is an opportunity for leaders to ensure equitable access to vaccines and to advance ambitious pandemic preparedness, climate, and biodiversity plans toward a better, safer, and healthier world. Our Network of more than 90 partners around the world stands ready to work with world leaders to seize this unprecedented opportunity. We simply cannot afford to fail.

Calling on Wealthy Countries to Reallocate Excess Vaccine Doses

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

An Opportunity for a Leap Forward: Reflections from the 34th African Union Summit

By Nahashon Aluoka

This year’s African Union (AU) Heads of State Summit (February 6-7, 2021) went virtual because of the COVID-19 pandemic. For some, it was refreshing to see this important meeting happen devoid of all the pomp and color that has characterized it in the past. As anticipated, the COVID-19 pandemic, the African Union Commission (AUC) elections, and AU reforms dominated the Summit. Looking at the journey of the AU, the progressive reforms, and the continental leadership and solidarity it has cultivated—albeit with some pockets of contention in responding to different crises ranging from wars and conflicts to pandemics like COVID-19—it is time for the Union to take a leap forward.

Leadership Reassurance
While some changes in the midst of a pandemic can be scarring, the decision by the new AU Chairperson, President Felix Tshisekedi of Democratic Republic of Congo (DRC) to appoint his immediate predecessor, President Cyril Ramaphosa of South Africa as the champion for the COVID-19 vaccine strategy and acquisition by AU member states is reassuring. The latter has been deeply involved and spearheaded efforts at the global level to ensure that the continent accesses the required tools for COVID-19 response, including diagnostics, therapeutics, and vaccines. It is also calming to an extent that the incumbent AU Commission Chairperson, former prime minister of Chad Moussa Faki Mahammat, who was unopposed for re-election, successfully retained his chair seat for a second and final four-year term. In a recent International Crisis Group report, Faki is highlighted for his firm focus on conflict prevention and resolution, strengthening the AU’s relations with multilateral partners, especially the UN and European Union, and his proactive leadership in coordinating Africa’s response to the pandemic.

Opportunity for a Strategic Leap Forward
Although President Felix Tshiekedi’s assumption of responsibility as the AU chair is due to the rotational nature of the role, he has an opportunity to demonstrate leadership at the national level with regard to COVID-19 response, and to help steer the continent to make a strategic leap forward in preparedness for future responses based on the stark and unpleasant lessons the continent has continued to observe with this pandemic. These include the ban on export of COVID-related tools mostly by the developed countries just after the declaration of COVID-19 as a public health emergency of international concern (PHEIC) by the World Health Organization (WHO). This action disrupted the global supply chains for life-saving tools, including diagnostics and therapeutics. Vaccine nationalism has also seen African countries being last on the queue in accessing vaccine doses despite the gallant efforts by Africa Centres for Disease Control and Prevention (ACDC), and other actors to acquire vaccine doses beyond the COVAX facility.

It is commendable that President Tshiekedi acknowledges the importance of enhancing investment in research and development (R&D) for the continent to be able to better deal with its challenges in responding to the current pandemic and future pandemics. He has a once-in-a-lifetime opportunity to lead at the national level to significantly invest in R&D and significantly shore up investment in COVID-19 response. Given DRC’s experiences with Ebola and the expertise at various levels in responding to outbreaks, leadership demands that President Tshiekedi ramp up testing for COVID-19 and lead preparation for vaccine roll-out. At the continental level, he has an opportunity to rally our leaders and specialized institutions to implement important continental strategies that would enhance the continent’s preparedness for future pandemics. These include the Pharmaceutical Manufacturing Plan for Africa (PMPA), the Health Research and Innovation Strategy for Africa (HRISA), and the Science, Technology and Innovation Strategy for Africa (STISA). These critical health frameworks are only useful if implemented.

Further, given the common understanding that political instability, wars, and conflict on the continent complicate response to pandemics—as was the case with Ebola in the DRC—it is important that the AU continues its razor-sharp focus on responding to, mitigating, and preventing conflicts even as it coordinates efforts to contain COVID-19. Wars and conflict-related disruptions will continue to jeopardize efforts to contain COVID-19 and ensure the health of citizens across the continent.

Read the official press release from the AU Heads of State Summit here.

Briefing: China in the Global COVID-19 Response ― Vaccine Development and Distribution

By Ming Geng

Ending the pandemic requires a robust, coordinated global response ― the virus does not respect borders. The longer COVID-19 is allowed to languish anywhere in the world, the more likely we will see other highly transmissible variants of the virus emerge and a continuing loop of infections, needless deaths, and lockdowns. Yet most of the world’s population still lacks a clear path to access the vaccines and other tools they need to stop this pandemic and prepare for the next one. Without concerted and swift action on all fronts, it could be years before COVID-19 vaccines are widely available in many low- and middle-income countries.

Amidst this context, the Chinese Ministry of Foreign Affairs issued the following statement, “The whole world needs to pull together in order to defeat the pandemic. China will continue to provide in a timely manner, to the best of its capability, vaccines to relevant countries, especially the developing countries, and contribute its share to building a global community of health for all. We also hope the international community will work together to promote the equitable allocation and use of vaccines globally to make sure developing countries have access to and can afford them.”

The following briefing details the current state of China’s vaccine development and distribution strategy.

Vaccine Development
Sinovac and Sinopharm are the two most advanced COVID-19 vaccine developers in China.

Sinovac Research and Development Co., Ltd, the Beijing based biopharmaceutical company is behind the CoronaVac, an inactivated COVID-19 vaccine. CoronaVac has recently been authorized for emergency use in Bolivia, Brazil, Chile, Indonesia, and Turkey. There is now an academic debate on the wide range of the efficacy rate of CoronaVac reported by different countries. The effectiveness ranges from 91.25% in Turkey to 50.4% in Brazil.

The China National Pharmaceutical Group (Sinopharm) has led the development of two inactive COVID-19 vaccines which have gone through phase III clinical trials in several countries. BBIBP-CorV is developed by Sinopharm, China National Biotec Group, and the Beijing Institute of Biological Product, and has already received emergency use authorization from China, Bahrain, and the United Arab Emirates (UAE). The other inactive vaccine candidate is developed by Sinopharm, China National Biotec Group, and the Wuhan Institute of Biological Product. This vaccine is currently undergoing phase III clinical trials in UAE, Peru, Morocco, and China. Some reports indicate that this vaccine has also been granted emergency use authorization in some countries.

According to the World Health Organization (WHO), there are currently three Chinese vaccine candidates that are undergoing phase III clinical trials, which are Ad5-nCov by CanSino, ZF2001 by Anhui Zhihui Longcom, an unnamed SARS-CoV-2 vaccine by the Chinese Academy of Medical Sciences. In addition, there are three Chinese vaccine candidates that are currently in phase II clinical trial: DelNS1-2019-nCoV-RBD-OPT1 by Wantai Biological Pharmacy, a Recombinant SARS-CoV-2 by West China Hospital, and an inactivated SARS-CoV-2 vaccine (Vero cell) by Beijing Minhai Biotechnology Co. In addition, Chinese manufacturers are also actively involved in global vaccine development cooperation. Most notably, Fosun Pharma participated in Pfizer-BioNTech COVID-19 vaccine development.

Vaccine Distribution ― Domestic Market
The current vaccination strategy in China is a two-step approach: the first step targets priority groups, and the second step covers the rest of the population. At present, the vaccination campaign covers people ages 18 to 59 with a high risk of infection and transmission, including people engaged in the handling of imported cold-chain products, people working in wet markets, medical workers, customs officers, watercraft pilots, air crews, public transport workers, and people who have to work and study abroad in high-risk countries.

According to a recent press conference held by the National Health Commission on January 13, China will expand the target population for COVID-19 vaccination to include elderly people over the age of 60. The expanded strategy is due to increasing data from clinical research on vaccines, a growing supply of vaccines, and the need to better control the outbreak.

In addition, youth ages 3 to 17 years-old may also be vaccinated as early as March 2021, according to Sinopharm. The company is submitting relevant clinical data to the National Medical Products Administration.

According to the National Health Commission, more than 10 million people have already been vaccinated as of January 13, 2021. The aim is to vaccinate another 40 million by Chinese New Year. In Beijing alone, it was reported that 1.7 million people have been vaccinated in 205 infusion sites, set up across the city.

Beyond the domestic vaccination plan, the Chinese government also will provide assistance to Chinese citizens who now live abroad in receiving vaccination, especially with Chinese-produced vaccines.

Vaccine Distribution ― International Market
As of January 15, at least 20 countries have purchased COVID-19 vaccines developed by Chinese manufacturers, including Sinovac and Sinopharm, according to Global Times calculations, with more planning to purchase Chinese vaccines, despite politicalized scrutiny by some western media over their efficacy and safety.

The following graph shows the purchase of COVID-19 vaccines produced by two main Chinese vaccine manufacturers.

 

GT_Vaccine Purchase

According to China’s Ministry of Foreign Affairs, China has already joined COVAX, the global initiative on equitable access to COVID-19 vaccines. In order to bridge the huge supply gap in developing countries, China will donate 10 million doses of vaccines to COVAX upon the request from WHO. Meanwhile, China is providing vaccine aid to Pakistan, Brunei, Nepal, the Philippines, Myanmar, Cambodia, Laos, Sri Lanka, Mongolia, Palestine, Belarus, Sierra Leone, Zimbabwe, and Equatorial Guinea, altogether 13 countries. In addition to taking an active part in COVAX, China is targeting reach to additional 38 low- and middle-income countries.

A Year into COVID-19: It’s Time to Urgently Fund the Global Response and Start Preparing the World for the Next Pandemic

By Carolyn Reynolds and Eloise Todd

January 30 marks the one-year anniversary of the World Health Organization’s declaration of COVID-19 as a global health emergency. Yet as governments around the world have scrambled to respond and protect their citizens from the fast-moving pandemic, support for the global COVID-19 response has continued to be given short shrift. If we are going to end this devastating pandemic and make sure we are better prepared for the next one, this national near-sightedness must change now. 

The frightening speed with which variant strains of COVID-19 are spreading around the globe is further proof of how highly nationalist responses to the pandemic are misguided. While it may seem intuitive for governments to first take action at home, this approach belies the fact that the virus does not respect borders. Many countries that managed to control or even stop the spread of the virus earlier are once again seeing a surge in cases. There simply is no effective domestic response without also embracing a global approach.  

That’s why at the Pandemic Action Network we have been urging support for a robust, coordinated global response as the only way to hasten the end to COVID-19 everywhere and ensure that the trillions that countries are spending to try to end this crisis also help jumpstart long-ignored investments in better global preparedness to help stop the next pandemic before it starts. 

Early announcements on the importance of global engagement on the COVID-19 response and pandemic preparedness from the new Biden Administration in the US, together with the plans from the Italian presidency of the G20 and the European Commission to host a Global Health Summit in May and a 5-point plan from the UK presidency of the G7, are important signals of support for a stronger international approach. Those opportunities, along with the forthcoming final report of the Independent Panel for Pandemic Preparedness and Response, offer an unprecedented political window of opportunity to act. But that window will likely close quickly as high-income countries get more of their populations vaccinated from COVID-19 and governments begin to shift their attention toward economic recovery and other needs that have been neglected during the pandemic. 

Our international network of more than 90 partner organizations is calling on world leaders to own and accelerate an aggressive agenda to stop the spread of COVID-19 everywhere and leave humanity better prepared for emerging pandemic threats. The imperative to act has never been greater: this deadly and costly pandemic has affected every nation, and the next one is lurking. Leaders need to get these four things done urgently in 2021 to make the world safer:

Fully fund the Access to COVID-19 Tools Accelerator (ACT-A) and COVAX Facility to   speed up global access to COVID-19 vaccines. If vaccines are distributed only to high-income countries first, recent estimates are that the world may only avoid one-third of COVID-19 related deaths. While political commitments made thus far toward the ACT-A and its COVAX Facility have been a bright spot of rhetorical solidarity, world leaders must act on those words to urgently close the ACT-A financing gap to accelerate widespread distribution, not only in vaccines, which are in the spotlight right now, but also of diagnostics and therapeutics which will be needed even more while supplies of vaccines build up. When it comes to vaccines, all countries should also commit to work through the COVAX Facility to exchange and donate their excess vaccine supplies to support other nations in need.

Ramp up investments in frontline preparedness. Recent estimates point to at least a  US$5-10 billion annual funding gap to make the world better prepared for pandemics. This amount is likely now higher given the toll of COVID-19 has inflicted on frontline health workers and already struggling health systems around the world, particularly in low- and middle-income countries. Yet this is still a small fraction of the trillions governments have spent on COVID-19 stimulus packages, vaccines, and other response measures to date. Just as the world mobilized to respond to the global AIDS crisis, this moment calls for a bold, dedicated multilateral financing mechanism to supercharge pandemic preparedness. Creating a Global Health Security Challenge Fund will support countries to close their critical health security gaps and stimulate a global “race to the top” for better preparedness. Once the ACT-A is fully funded, donor nations, private foundations, and investors should kickstart the Challenge Fund with an initial US$10 billion this year.

Bolster global research, development, and delivery of tools for emerging infectious disease threats. This crisis has shown that the world needs an at-the-ready capacity for timely delivery of the health technologies and supplies needed to combat the known and unknown diseases likely to spark the next pandemic. Leaders should secure and finance the effective Coalition for Epidemic Preparedness Innovations (CEPI) to ensure it has the resources necessary to continue to respond to COVID-19 and also to secure its future. Building on the emerging lessons from the current pandemic, CEPI has the potential to serve as a permanent global R&D coordination hub with an end-to-end approach, working closely with the World Health Organization on the global R&D Blueprint. Leaders should also help build and/or fortify a network of regional R&D, manufacturing, and supply hubs so that every continent and every nation can quickly get the tools to stop outbreaks at their source.  

Build a smarter global pandemic defense system. The WHO must be 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 and a state-of-the-art, global outbreak detection system to better predict and manage cross-border threats. European allies have laid out a 10-point WHO reform plan which, together with the forthcoming report of the Independent Panel, can provide the basis to achieve consensus on a more responsive global system. Pandemic preparedness should be at the top of the UN Security Council agenda, and the UN Secretary-General should convene heads of state in a global preparedness summit before the year’s end to secure their commitments to act – and enable their citizens to hold them to account.

Everyone deserves to hope for a swift end to the pandemic, regardless of where they live. But it will only be possible if our political leaders act globally as well as locally, knowing no country will be safe until every country is safe. Their shared goal should be even bigger: to leave a legacy of a healthier and safer world by taking the steps necessary to help prevent another deadly and costly pandemic from happening again.

World AIDS Day: It is Only By Coming Together That We Will Defeat COVID-19 and HIV/AIDS

By Isabelle de Lichtervelde

 

Each year, World AIDS Day is recognized on December 1 to commemorate those who have lost their lives to AIDS and those living with and affected by HIV. It has also been an important occasion to galvanise support for a stronger and fairer response to HIV/AIDS. As with everything else impacted by COVID-19’s devastation this year, World AIDS Day 2020 is a unique moment and opportunity.

COVID-19 has shown the world once again how health is interlinked with other critical issues, such as inequalities and economic well-being. COVID-19 has plunged the world economy into deep contraction and, like many other crises, it is hitting the poorest, most disadvantaged, and most vulnerable the hardest. The pandemic has also reminded us all that a global crisis requires a global response. 

The world has made significant progress since the late 1990s, but HIV remains a major global health crisis that has been further deepened by COVID-19. The UNAIDS annual report shows that HIV services have been worryingly disrupted due to COVID-19, particularly in low- and middle-income countries (LMICs) where health systems are more fragile. The HIV/AIDS response could be set back by 10 years or more, if COVID-19 leads to severe disruptions to HIV services, leaving many at greater risk of HIV infection and AIDS-related deaths. 

With this in mind, the theme of World AIDS Day 2020 is “Global solidarity, shared responsibility”. The world needs global solidarity and shared responsibility now to beat the epidemics of HIV and pandemic of COVID-19. 

For this to happen, here are three things that the world leaders need to do NOW.

  • Fully fund the global response against COVID-19 while protecting and increasing other life-saving health programmes. World leaders must commit to fully fund the Access to COVID-19 Tools Accelerator (ACT-A) without diverting investments from other health priorities, including HIV/AIDS. US$5.1 billion has been committed to the ACT-A to date. US$4.2 billion is still needed urgently, with another US$23.9 billion needed by the end of 2021. We must look beyond scarce development assistance budgets to fund the ACT-A. Official development assistance (ODA) is a precious resource that we must increase rather than decrease at a time of rising need in LMICs. Fully resourcing the ACT-A is not a matter of charity; it is an investment in the world’s recovery. Governments should use a portion of their domestic fiscal stimulus for the multilateral response against COVID-19, while increasing investment in other life-saving global health programmes. 
  • Invest in pandemic preparedness and prevention. Health systems must be urgently strengthened, in particular in LMICs in order to ensure all countries have the capacity to respond to COVID-19, HIV/AIDS, and other epidemics as well as prevent and be prepared for future epidemic threats. Other key pandemic preparedness and prevention priorities include accelerating global health research and development for epidemic-risk diseases and securing reliable access to personal protective equipment (PPE) and other pandemic supplies.
  • Ensure fair and equitable access to health tools globally. No-one can be left behind in accessing life-saving diagnostics, treatments, and vaccines. Errors of the past cannot be made again. Millions of people in LMICs died waiting for HIV treatment. Fully equitable access still isn’t a reality today. Due to lack of access to HIV services, 690,000 people died from HIV-related causes and 1.7 million people were newly infected last year. Fair and equitable access to all health commodities, including COVID-19 treatments, diagnostics, and future vaccines, must be urgently ensured. Global equity must be at the heart of the world’s response to COVID-19 by prioritising multilateral action over bilateral action and ensuring that distribution mechanisms and allocation frameworks are based on equitable terms. Products should be both accessible to LMICs as soon as they become available and suitable for LMIC settings.

 

COVID-19 has brought the world to its knees and has threatened decades of hard-won gains in the global HIV/AIDS response. However, this crisis is also an opportunity to do things differently and build back better. Every effort we make together in the fight against COVID-19 should leave a longer-term legacy that better prepares humanity to more effectively deal with outbreaks and pandemics, including HIV/AIDS.

Guaranteeing Equitable Access: Considerations During Vaccine Development Impacting Global Access

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

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

“Vaccines Don’t Deliver Themselves, Health Workers Do.” – Last Mile Health CEO Raj Panjabi at World Bank and IMF Annual Meeting on COVID-19

 

On October 21, 2020, Last Mile Health CEO Dr. Raj Panjabi shared the following remarks at the World Bank Group and IMF Annual Meeting event on “Investing in COVID-19 Vaccines & Primary Health Care Delivery Systems.”

This summer, I came home after testing patients in a COVID-19 clinic where I was forced to reuse the same gown all day. When I got home, I didn’t want to risk infecting my family. So I took off all my clothes before entering the front door. My children were amused, but I was worried.

And I have been even more worried for my fellow health workers around the world. Without masks, community health workers knock on doors in the poorest neighborhoods to find COVID-19 patients. Without face shields, midwives try to deliver babies in community clinics. Without gloves, nurses canoe across rivers to deliver vaccines to families in the rainforest.

We applaud frontline health workers as heroes. We respect them but don’t protect them. Over 7,000 unprotected health workers have died from COVID-19.

We pray for them but don’t pay them. Over $1 trillion of work by women in health care – many as community health workers, nurses and midwives – goes unpaid.

Yes, vaccines can save lives. Yes, vaccines can speed up economic recovery. But no, vaccines will not be a ‘magic bullet’ – because vaccines don’t deliver themselves, health workers do.

We are honored to partner with many of you to invest in paying and protecting community-based health workers. We know this isn’t just the right thing to do, it’s the smart thing to do. We know every dollar we invest in community health workers returns ten dollars to the economy through saving lives and creating jobs. During this recovery, we should ask not only how our health policies, but also economic initiatives, can seize this opportunity to protect lives and livelihoods at the same time.

When epidemics like smallpox and polio threatened to bring humanity to its knees, community-based health workers did not surrender. They went door-to-door to vaccinate billions around the world. Now, health workers are prepared to go as far as it takes to control COVID-19. The question is, are we prepared to go as far as it takes to invest in them?

 

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

By Eloise Todd

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

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

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

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

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

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

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

EU Launches Vaccine Strategy: Will It Be Global?

Today the European Commission proposed a new Vaccine Strategy for the EU. While the strategy at its core has the objective of securing the necessary volumes of a safe vaccine for EU citizens at a good price, the EC also expressed its commitment to make it accessible for all the regions of the world, in particular the most vulnerable countries who struggle to secure vaccines for their populations. This is good news and opens the door to this being a global instrument, not just one for Europeans.

At the Pandemic Action Network, we’re committed to ensuring the EU delivers a truly global, equitable response to COVID-19. The EU vaccines strategy set out by President von der Leyen this morning must expand globally. The “buyers’ group” could see richer countries negotiate additional tranches of vaccines that will cover citizens in LMICs, LICS and fragile states.

As the EC communication sets it “this is not only a European challenge, it is also a global one. All regions of the world are affected. The spread of the virus has shown that no region is safe until the virus is under control everywhere.”

COVID-19 anywhere means it is a global threat, including EU citizens, and a global strategy is the only way to sustainably eradicate the virus. We hope that EU leaders have the foresight to use this opportunity to deliver on the strong verbal commitments they have all made to ensure a truly global, equitable response.