By P. K. Balachandran

COLOMBO – An independent international panel has urged members of the United Nations to sink their differences and rivalries to put together a system which will prevent the recurrence of pandemics like COVID-19.

The ‘Independent Panel for Pandemic Preparedness and Response’ co-chaired by Helen Clark, a former Prime Minister of New Zealand, and Ellen Johnson Sirleaf, a former President of Liberia, called upon member States of the UN to request the UN Secretary-General to convene a special session of the UN General Assembly to reach agreement on the reforms needed to prevent the next outbreak of a new pathogen becoming another pandemic.

The panel sought the adoption of a “political declaration” by the Heads of State and Government committing themselves to transforming pandemic preparedness and response in line with the recommendations made in its report. It urged the setting up of a ‘Global Health Threats Council’ (GHTC) at the most senior level to secure high-level political leadership and ensure that attention to pandemic prevention, preparedness and response is sustained over time to ensure a “world without pandemics”.

The GHTC should be an “inclusive and legitimate voice of authority with the ability to utilize both accountability mechanisms and provide access to financing to ensure preparedness as well as response at the national, regional and global levels,” the panel said.

It called for a ‘Pandemic Framework Convention’ within the next six months, to be facilitated by WHO and with the clear involvement of the highest levels of government, scientific experts and civil society.

“Our message for change is clear: no more pandemics. If we fail to take this goal seriously, we will condemn the world to successive catastrophes,” the panel declared and listed the global damage done by COVID-19.

COVID-19 is still killing more than 10,000 people every day, it said noting that 148 million people had been confirmed infected and more than three million have died in 223 countries, territories and areas as at April 28, 2021. At least 17,000 health workers died from COVID-19 during the pandemic’s first year. US$ 10 trillion of output of goods and services are expected to be lost by the end of 2021, and US$ 22 trillion between 2020 and 2025.

“This is the deepest shock to the global economy since the Second World War and the largest simultaneous contraction of national economies since the Great Depression of 1930–32. 115–125 million people have been pushed into extreme poverty,” the panel observed.

Uneven access to vaccines

People living in the poorest countries are at the tail-end of the vaccine queue. High-income countries have over 200% population coverage of vaccine doses. In the poorest countries, less than 1% of people have had a single dose of vaccine.

The COVID-19 Vaccines Global Access Facility (COVAX Facility) is making progress but has been hampered by a lack of sufficient funds and by vaccine nationalism, and vaccine diplomacy. COVAX has secured 1.1 billion vaccine doses and has optioned 2.5 billion more. Before the end of April, one billion vaccine doses were administered, but overwhelmingly in high-income or upper-middle-income countries.

Therefore the panel urged high income countries with a vaccine pipeline for adequate coverage to commit to providing to the 92 low and middle income countries at least one billion vaccine doses no later than September 1, 2021 and more than two billion doses by mid-2022, to be made available through COVAX and other coordinated mechanisms.

The panel called for an all-out effort to reach the world’s population with vaccines within a year and set in place the infrastructure needed for at least five billion booster doses annually. It also suggested setting up manufacturing capacity in low- and middle-income regions so that 5.7 billion people in the world aged 16 and over are vaccinated. The panel appealed to the G7 countries to provide 60% of the US$ 19 billion in 2021 for vaccines, diagnostics, therapeutics and strengthening health systems with the remainder being mobilized from others in the G20 countries.

The panel urged increase in the production of and access to COVID-19 tests and therapeutics, including oxygen, be scaled up urgently in low- and middle income countries with the full funding of US$1.7 billion for needs in 2021 and the full utilization of the US$3.7 billion in the Global Fund’s COVID-19 Response Mechanism Phase 2 for procuring tests, strengthening laboratories and running surveillance and tests.

Strengthening WHO

The panel called for the strengthening of the independence, authority and financing of WHO. “The quality, timing and clarity of the technical advice and direction WHO provides to the world are of the utmost importance, but the way WHO is financed today has serious impacts on the quality of the organization’s performance. Its precarious financing is a major risk to the integrity and independence of its work,” the panel said.

The panel noted that the 2003 SARS pandemic propelled a decade-long negotiations to revise and broaden the International Health Regulations (IHR) to a rapid conclusion. The current regulations were adopted in 2005, setting out legally binding duties for both States and WHO in notification and information-sharing, prohibitions on unnecessary interference with international travel and trade, and cooperation for the containment of disease spread. The new IHR (2005) came into force in 2007 and imposed new requirements that must be met before the WHO Director-General could act on emergencies, rather than enabling WHO to act immediately and independently.

The Global Health Security Initiative was established in 2001 by eight States and the European Commission. The Global Health Security Action Group was its implementation and information-sharing arm.  The Global Health Security Agenda was launched by the United States in partnership with two dozen other countries in 2014 and has now grown to include seventy countries and a number of international organizations. Since the 2009 H1N1 influenza pandemic, at least 11 high-level panels and commissions have made specific recommendations in 16 reports to improve global pandemic preparedness.

However, implementation has been poor, either not all or piecemeal, the panel noted.

The panel regretted that the pandemic and other health threats have not been elevated to the same level of concern as threats of war, terrorism, nuclear disaster or global economic instability. “When steps have been explicitly recommended, they have been met with indifference by Member States, resulting in weakened implementation that has severely blunted the original intentions. Pandemics pose potential existential threats to humanity and must be elevated to the highest level,” the panel urged.

Pandemics are economic disasters

Countries do not realize that pandemics have greatly damaged economies. The total cost of the economic losses due to SARS was US$ 60 billion. The 2015 MERS outbreak in just one country, the Republic of Korea, cost US$ 2.6 billion in lost tourism revenue and US$ 1 billion in response costs.

According to Statista.com, most major economies will report a GDP loss of 4.5%. To put this number in perspective, the global GDP was estimated at around US$ 87.55 trillion in 2019 – meaning that a 4.5% drop in economic growth would amounts to almost US$ 3.94 trillion in lost economic output. To prevent an economic disaster, the 2016 Commission on a Global Health Risk Framework for the Future said that its proposed preparedness spending boost of US$ 4.5 billion.

But sadly too many national governments have lacked solid preparedness plans, core public health capacities and organized multi-sectoral coordination with a clear commitment from the highest national leadership, the panel pointed out. This plus vaccine nationalism, will cost the world dearly.

-ENCL