Pandemic reform agenda is moving, but not fast or cohesive enough

Reform on pandemic preparedness and response is underway, but to end this pandemic and prepare for the next global health threat, Heads of State and Government must come together to make faster progress.

In a six-month accountability report, the former Co-Chairs of The Independent Panel for Pandemic Preparedness and Response assess the linked areas of leadership and governance, financing, equity, a new legal instrument, and a stronger World Health Organization (WHO).

The Co-Chairs presented their findings today in a new report titled Losing Time: End this pandemic and secure the future, during a Chatham House event.  

“We are encouraged to see some movement to address the major gaps exposed in global pandemic preparedness and response. Conversations are happening in many of the right places,” said the Right Honourable Helen Clark.  “The world now needs these conversations to come together – especially at the UN General Assembly, where Heads of State and Government can declare their commitments and a pathway to a more secure world, including to a new Global Health Threats Council to provide much needed leadership and accountability.”

In May 2021, Her Excellency Ellen Johnson Sirleaf and the Right Honourable Helen Clark issued the Independent Panel’s findings following a nine-month deep-dive into the global and national response to COVID-19. They recommended immediate actions to end COVID-19 and a package of international, interlinked reform solutions intended to stop a future outbreak from becoming another devastating pandemic.  In today’s report, they summarize progress on each recommendation in a comprehensive dashboard.

Uneven and fragmented efforts 

The former Co-Chairs find uneven and sometimes fragmented efforts as the pandemic continues at pace. They note that in just the six months since tabling their plan for action at least 90 million more  people have contracted COVID and 1.65 million more people have died – and those are only the illnesses and deaths that have been recorded.

Of grave urgent concern remains vaccine inequity – which has changed very little since May 2021. Analysis shows very low full coverage in the poorest countries – in some under 1% of the population are fully vaccinated.

“Our Panel calculated that there were at least one billion doses available to redistribute to low-income countries by 1 September this year,” said Her Excellency Ellen Johnson Sirleaf. “Yet while wealthy countries have made public pledges, just a fraction of redistributed doses have actually been delivered. The idea that a poor health worker is unprotected while the healthy and wealthy receive booster doses should present a deep moral quandary. To this there is only one solution – vaccine equity.”

The former Co-Chairs say that global health cannot be left hostage to a pharmaceutical industry which buys up patents and develops them in the interest of making profits. They say that the development of a true end-to-end global public goods model remains the answer.

The report also warns that vaccine pledges can be soured by inconsistent delivery and dumping of near-expired vaccines – creating “a wasted opportunity to protect people.”

Some progress, much more to be done 

With regard to specific progress and the work remaining, the Co-Chairs point to:

Leadership and Governance 

• The UN Secretary General, António Guterres, stated to the U.S.-hosted Global COVID-19 Summit in September that “The recommendations of the Independent Panel for Pandemic Preparedness and Response must be a starting point for urgent reforms to strengthen the global health architecture.”
• Growing momentum for a UN special summit, with support from many countries and the Global Pandemic Preparedness Monitoring Board
• Statements in support of a new leader-led Global Health Threats Council, from Heads of State and Government and the G2O High-level Independent Panel on Financing the Global Commons for Pandemic Preparedness and Response (G20 HLIP)

Financing 

• The report stresses that “governance without finance lacks teeth; and finance without governance lacks accountability.” The Independent Panel recommended that the Global Health Threats Council should have the task of allocating and monitoring funding from a new financing mechanism to existing regional and global institutions which can support development of pandemic preparedness and response capacities.
• The report notes growing convergence on the need to raise new financing for pandemic preparedness (of at least US$10 billion annually), including from the G20 HLIP, and the United States and Norway proposal for a Financial Intermediary Fund.
• The report also underscores the importance of having a pool of response funding – in May the Panel recommended that up to US$ 100 billion be made available in case of pandemic threat.

Equity for vaccines, diagnostics and treatments 

• Progress includes the pledged donations of vaccine through 2022, though delivery must be planned, faster, and carried out transparently
• The announcements of new mRNA vaccine production hubs in Latin America and on the African continent
• Recent announcements about the latest oral antivirals becoming available to several dozen countries through the Medicines Patent Pool.

Strengthening WHO and a Pandemic Treaty

• On the need for better surveillance and more rapid information sharing, the Co-Chairs welcome the new pathogen sharing and digital surveillance institutes being established in Switzerland and Germany.
• The report notes the continued need for a much larger portion of WHO funds to come from assessed contributions rather than being earmarked.
• WHO Member State Working Groups are discussing the Panel’s recommendations for strengthening and more sustainably financing WHO. The World Health Assembly (WHA) Special Session this month will focus on whether to launch negotiations for new legal instruments, and reforms to WHO will be considered at the regular WHA session next May.

Purpose, urgency, results

The Co-Chairs warn however about the potential for protracted discussion at the World Health Assembly and the United Nations when the need for reforms is urgent, and ask Member States to work with purpose towards real results that will protect people.

“We urge Member States to spend less time debating commas in committees while a pandemic still rages, people are dying, and a new pandemic threat could arise anytime and anywhere,” said Helen Clark.

Overall, the report underscores that more focused and coherent work be done on a reform package with urgency. The Co-Chairs stress that the reforms required now can both contribute to ending the current pandemic and preventing another.

In their preface, the Co-Chairs write that much of the groundwork for reforms has been done and that it’s now imperative to seize the moment to make change.

“What is needed now is for countries to make a final push so that the opportunity to create a safer world does not slip through our fingers. We ask: if this pandemic representing a threat to the health and wellbeing of humanity worldwide cannot catalyse real change, what will?”