Statement — INB Public Hearings for a New International Instrument on Pandemic Preparedness & Response

In December 2021, the World Health Assembly (WHA) established an intergovernmental negotiating body (INB) to draft and negotiate an international instrument — supported by the World Health Organization (WHO) — to “strengthen pandemic prevention, preparedness and response.” In the decision establishing the INB, the WHA also requested the WHO to hold public hearings to inform its work and deliberations.

The first round of those public hearings took place April 12-13, 2022. In response to it, the Africa CSOs Working Group on Pandemic Preparedness and Response, convened by Pandemic Action Network and PATH, submitted the following substantive elements for inclusion in the new instrument:

  • Recognize and protect the role of regional institutions and initiatives in responding to pandemics and epidemics as central in coordination, procurement, and distribution of medical products and tools, and technical support to respective member states. Such regional institutions should work in a coherent manner with global institutions.
  • Establish and protect a global pandemic preparedness fund that involves countries across regions in its design, governance, and financing, with all countries contributing to such a fund, based on their ability to contribute. The fund should support health systems strengthening in geographies with weak health systems and should have a strong accountability mechanism.
  • Elevate and prioritize leadership for future pandemics through, for example, a Global Health Threats Council, with meaningful leadership and representation from low- and middle-income countries. This body’s role will be to map out a strategic response that works for both public and private players in the health space.
  • Prioritize and finance a globally networked surveillance and early-warning system with incentives for countries to share data on and sequence new variants and pathogens.
  • Guarantee equity in access to lifesaving tools: declaring such tools as public goods and; instituting a waiver of intellectual property rights along with immediate hands-on technology transfer for all medical products and tools during a pandemic to ensure the maximum number of lives are saved, prioritizing the most vulnerable communities.

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.

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

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

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

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

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

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

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

Support an equitable global response to COVID-19

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

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

World leaders should:

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

Prioritize and invest in pandemic preparedness and prevention

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

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

World leaders should:

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

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

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

World leaders should:

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

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

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

World leaders should:

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

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

World leaders should:

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

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

World leaders should:

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

 


 

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

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

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

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

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

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

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

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

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

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

Pandemic Action Network’s Pandemic-Proof Agenda

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

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

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

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

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

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

Multilateralism Matters: Why the U.S. Should Stay in the WHO

By Carolyn Reynolds, Co-Founder, Pandemic Action Network

*This blog is adapted from an article published in CQ Researcher, September 2020

As the world marks United Nations Day on October 24 – in the midst of a pandemic with no end in sight ― it’s a good moment to reflect on how much the United States benefits from the UN, and in particular its membership in the World Health Organization (WHO). U.S. membership in the WHO is on the ballot in the presidential election, with the current Administration’s decision to initiate withdrawal of the U.S. from the WHO. On the other side, Democratic nominee Joe Biden has said that if he were to be elected President he would reverse the decision on day one in office.

The choice is clear: the WHO serves U.S. interests in several ways, and never more so than now.

First, as the COVID-19 pandemic has shown, infectious disease outbreaks anywhere in the world can quickly put American lives and livelihoods at risk. Until a vaccine exists and is widely and equitably delivered around the world, no country will be safe from COVID-19. Ending the pandemic requires a united global effort, in which the WHO plays an indispensable role. Countries worldwide rely on the WHO’s expertise to lead the global response to the pandemic, from providing technical guidance on proven interventions to coordinating international efforts to accelerate research, development, and universal access to a COVID-19 vaccine and to therapeutics. The WHO-coordinated Access to COVID-19 Tools Accelerator (ACT-A) and Solidarity Trial are unprecedented global efforts that will increase the likelihood of ending the pandemic faster.

Second, the WHO has led global efforts to combat a host of other infectious disease threats. The eradication in 1980 of smallpox, which killed an estimated 300 million people during the 20th century, is one of the agency’s greatest achievements. With sustained WHO leadership, the world is now extremely close to eradicating polio, down to just 176 cases worldwide in 2019.  U.S. political and economic support has been vital to this effort, and withdrawal could stall efforts to end this debilitating scourge. International efforts to fight influenza, HIV/AIDS, malaria, measles, and tuberculosis also depend on the WHO for support.

Third, the WHO provides the backbone for the world’s infectious disease early warning system.  Working closely with experts from the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Agency for International Development (USAID), the WHO helps governments assess their pandemic preparedness gaps and mobilize early detection and response efforts. U.S. withdrawal will hobble that capacity and leave a major hole in the common global defense against growing pandemic threats.

Both the WHO and the United States have lessons to learn from this pandemic. While the WHO’s emergency response capacity has improved considerably in recent years, all agree it can be strengthened. An independent panel has been established to review the global COVID-19 response and what governments, the WHO, and the international system could do differently to improve their preparedness and response. But scapegoating the WHO for COVID-19 is a political distraction. The agency, which lacks the ability to compel member states to act, is only as effective as its members – particularly its most powerful member and largest donor – will allow.

Leaving the WHO will further erode U.S. influence on the global stage. It would be ill-advised at any time, but to do so as the world grapples with the mounting health and economic toll of the COVID-19 pandemic is unfathomable. Only global solidarity and a coordinated, multilateral approach will bring us safely out of this war against a deadly virus that knows no borders.

America needs the WHO, and the WHO needs America. The U.S. should not only stay in, it should also step up its support ― to end this pandemic and help prevent the next one.

GPMB to World Leaders: Now Will You Listen?

By Carolyn Reynolds, Co-Founder Pandemic Action Network

 

We warned you, but you did not listen.  That’s the overarching message of the new report from the Global Preparedness Monitoring Board (GPMB) entitled A World in Disorder.  In their inaugural report one year ago, the GPMB warned of the risk of a high impact, respiratory pathogen that could quickly spread around the globe.  Now in their latest report with a starker cover and a sterner title and narrative―much like parents admonishing their delinquent teenagers―the current and former global health elders that make up the GPMB are wagging their fingers and telling world leaders: you’re out of chances.

This year’s report echoes many of the main messages from last year’s (and from many other expert commissions in recent years), including: national political leadership is paramount; investing in preparedness is not only about saving lives, it’s about protecting economies; the impact―and hence the solutions―of pandemic preparedness go well beyond the health sector, and require a One Health approach; and no one in the world is safe until everyone is safe.

Four recommendations in the report that are particularly welcome:

The UN Secretary General should convene a UN Summit on Global Health Security with heads of state, the WHO Director General, and heads of the International Financial Institutions to forge a new international preparedness and response framework.

Create a new sustainable financing mechanism for global health security that incentivizes nations to prioritize preparedness and recognizes it as a global common good that should not be at the mercy of political and economic cycles.  This echoes the call of many of our Network partners for a Global Health Security Challenge Fund.

Amend the International Health Regulations (IHRs) to improve access to information and increase member state accountability beyond the scope of the current IHRs.  This will be politically fraught but unavoidable to drive the change necessary.

Finance global health R&D as a public good by building on the unprecedented international scientific collaboration around COVID-19 to create a sustainable, coordinated global R&D financing and delivery mechanism to facilitate rapid R&D for epidemic-risk and novel diseases and ensure that every country has an affordable and reliable pathway to secure vaccines, therapeutics, diagnostics, and other medical countermeasures for health emergencies when they need them.

Unfortunately (although not surprisingly), the request for a high-level summit was stripped from the omnibus COVID-19 resolution passed by this year’s UN General Assembly, a casualty of the highly polarized geopolitical environment. But advocates should not be deterred.  Such a summit to prioritize pandemics as a grave global security threat, secure high-level political commitments, and drive a new international consensus and accountability is the right call to action.  The Pandemic Action Network and our partners will be pressing world leaders to convene this summit before the end of 2021―this should happen as soon as possible after the Independent Panel on Preparedness and Response delivers its report to the World Health Assembly next May.  To ensure this results in meaningful change by governments and international institutions, the planning should get underway now.

Does this year’s GPMB report have a better chance than its predecessor to convince policymakers to act?  I am cautiously optimistic, for two reasons. First, its warning is no longer hypothetical. The COVID-19 pandemic is still unfolding before our eyes, with no end yet in sight, and it looks likely to get worse before it gets better as we see resurgences around the globe and flu season gets underway.  If there was ever a time that political leaders may be open to do something, this should be it.

Second, we now have a global advocacy effort focused on preparedness to take up these calls for action and hold national and global leaders to account.  GPMB co-chair As Sy, the former Secretary-General of the International Federation of the Red Cross and Red Crescent Societies, said we need “a global movement of solidarity” committed to inclusion, partnership and compassion to make the world safer from pandemics.  The Pandemic Action Network is dedicated to growing this movement: In a few short months we have brought together more than 40 organizations with global reach to drive collective action to end this pandemic and help prevent the next one.  And we are just getting started.

At the GPMB report launch, WHO Director-General Tedros Adhanom Ghebreyesus said, “If we do not learn these lessons now and take the steps necessary, when will we? This will not be the last pandemic or global health emergency.  Every day we stand by and do nothing is another day we come closer to the next disaster.  We don’t know what it will be, but we know it will come―and we must prepare.  When it comes to preparedness, our biggest obstacle is ourselves.”

The warnings are crystal clear. So, will leaders listen this time and do what is required to prepare for the next pandemic? The Pandemic Action Network is here to make sure they do.  Join us!

The Wrong Decision for America and the World

July 14, 2020
By Carolyn Reynolds, Co-Founder, Pandemic Action Network

The wrong decision for America and the world

Last week, the Administration took the first formal step to initiate the US withdrawal from the World Health Organization (WHO). This decision will have huge negative consequences for America and the world – never more so than in the middle of a global pandemic.

Under the terms of the 1948 joint resolution of Congress authorizing membership in the WHO, there are two conditions for a US withdrawal: a one-year notice – on which the clock is now ticking – and full payment of outstanding US financial obligations, or assessed contributions, which currently total $203 million – $120 million for Fiscal Year 2020 and $83 million unpaid from Fiscal Year 2019.

More than ever, America needs the WHO, and the WHO needs America – its largest donor and most powerful member. Here is a brief look at how membership in the WHO serves America’s interests:

First, the pandemic has laid bare how infectious disease outbreaks anywhere in the world can quickly spread and put American lives and livelihoods at risk. Until there is a vaccine, no country will be safe. Ending the pandemic requires a united global effort, in which WHO plays an indispensable role. From providing technical guidance on proven public health interventions to coordinating international efforts to accelerate research, development and universal access to a COVID vaccine and therapeutics, countries around the world trust WHO and rely on its expertise to lead the COVID-19 response. The WHO-coordinated Action for Covid Tools Accelerator (ACT-A) and Solidarity Trial are unprecedented global efforts that will increase the likelihood of ending the pandemic faster.

Second, WHO has led global efforts to combat a host of other infectious disease threats. The eradication of smallpox in 1980, which killed an estimated 300 million people in the 20th century, is one of WHO’s greatest achievements. With sustained WHO leadership, the world is now extremely close to eradicating polio, down to just 176 cases worldwide in 2019. US political support and funding has been vital to this effort, and withdrawal could stall efforts to end this debilitating scourge to humanity. International efforts to fight influenza, HIV/AIDS, malaria, measles, and tuberculosis all depend heavily on the WHO – with US cooperation and funding – for support.

Third, WHO provides the backbone for the world’s infectious disease early warning system. Working closely with experts from the US Centers for Disease Control and the Agency for International Development, and through the Joint External Evaluations and oversight of the technical support, WHO helps governments assess their preparedness gaps and mobilize early detection and response efforts. US withdrawal will hobble WHO’s capacity and leave a major hole in our common global defense to pandemic threats, which are on the rise.

As of this writing, several Members of Congress (not enough!) had spoken up against the decision, among them retiring Senator Lamar Alexander (R-TN):

“Certainly there needs to be a good, hard look at mistakes the World Health Organization might have made in connection with coronavirus, but the time to do that is after the crisis has been dealt with, not in the middle of it. Withdrawing U.S. membership could, among other things, interfere with clinical trials that are essential to the development of vaccines, which citizens of the United States as well as others in the world need. And withdrawing could make it harder to work with other countries to stop viruses before they get to the United States. If the administration has specific recommendations for reforms of the WHO, it should submit those recommendations to Congress, and we can work together to make those happen.”

Both WHO and the US have many lessons to learn from this pandemic. WHO’s emergency response capacity has improved considerably in recent years, but there’s widespread consensus that additional reforms are needed. In May, WHO member states approved a resolution to conduct an impartial, independent and comprehensive review, and WHO Director-General Tedros announced that Former Liberian President and Former New Zealand Prime Minister Helen Clark will co-chair the panel. Among the many issues they will need to examine is WHO’s funding model and its limited ability to compel member states to act, including review of the International Health Regulations. The reality is that WHO is only as effective as its members allow it to be – and particularly its largest donor.

The health and security case for US membership and support for WHO is clear – and leaving WHO or trying to set up an alternative body will only serve to further erode US influence on the global stage. The decision to withdraw could be revoked at any time before the one-year deadline; presumptive Democratic nominee Joe Biden has said that if he were to become President he would reverse the decision on day one. But this should never be a partisan issue.  The US should stay in and use its might to ensure a stronger WHO – to end this pandemic and help prevent the next one.

Pandemic Action Network’s Support for WHO Statement

Pandemic Action Network believes that the world needs a strong World Health Organization both to stop this pandemic and to help ensure every country is better prepared to manage future pandemic threats.  No country is safe from pandemics until every country is safe.  The world is in the midst of the biggest public health crisis in a generation, and global solidarity and collaboration is needed more than ever. US involvement is needed to support and strengthen the World Health Organization to help tackle future pandemics.

The health and safety of Americans – and people around the world – depend on it.  We hope that all countries, including the US, will soon be able to unite to tackle this crisis and prevent future pandemics, and to strengthen and improve the WHO to the benefit of us all.