OPINION: By Helen Clark, review co-chair
In July last year, the Director General of the World Health Organisation (WHO) asked the former President of Liberia, Ellen Johnson Sirleaf, and me to be the co-chairs of a review of the international health response to Covid-19.
His request followed a World Health Assembly resolution in May 2020 asking for an impartial, comprehensive and independent evaluation of experiences gained and lessons learned from the pandemic, with recommendations on how to improve preparedness and response for the future.
A year on, it could have been hoped that the end of the pandemic was in sight. Sadly, that is not the case, as the agony reported in our daily news from India and elsewhere shows.
There were as many Covid-19 cases reported to WHO in the past two weeks as there were in the first six months of the pandemic.
, the Independent Panel for Pandemic Preparedness and Response has made recommendations not only for the medium-term changes needed to make our world safer from pandemic threats, but also for the short-term where dramatic action to curb transmission is required.
New Zealand has pursued aggressive containment of Covid-19 with results which are successful by any international comparison. To stop the pandemic phase of the disease, our panel says it is imperative that all countries urgently apply strong and proven public health measures. These will continue to be required to varying degrees, even if near universal vaccination is achieved.
But to date the vaccine rollout has been shockingly unequal. Demand far outstrips supply. Some countries like ours have ordered far more vaccines than we can use. Our panel recommends that collectively the high-income countries with an adequate vaccine pipeline for their own needs should commit to provide low- and middle-income countries with a billion doses by September 1 and two billion by mid next year.
We also urge the WHO and World Trade Organisation (WTO) to convene the major vaccine-manufacturing countries and companies now to broker fast agreement on voluntary licensing of production and the knowledge and technology transfer to make it possible. If they can't agree within three months, then a waiver of intellectual property rights under the TRIPS (Trade-Related Aspects of Intellectual Property Rights) Agreement should come into force.
A world where privileged countries can fully vaccinate and others continue to struggle with rampant transmission of Covid-19 is not a world fit for any of us to live in. Extraordinary times require extraordinary measures.
The story of Covid-19 from outbreak to pandemic is one of failures, delays and gaps – all of which are addressed in our report. We call for a Global Health Threats Council at leader level to provide ongoing political support for mobilisation of action on preparedness and response. We call on WHO to provide countries with clear bench marks and targets to meet, and to use peer reviews to assess progress.
Any country unprepared to avert a pandemic threat and respond rapidly is a threat to all other countries. Investment in the capacities required is therefore a global public good investment, and needs to be funded accordingly. Under our proposal, low-income countries would get support from a new financing facility which would itself be financed on a basis of from each according to their means and to each according to their needs. The funding would be allocated via the Global Council.
We back the negotiation of a Pandemic Framework Convention, among other things to fill gaps in existing international law and clarify responsibilities of states and international organisations. We found that the WHO response was hindered, not helped, by the current International Health Regulations. It needs the explicit authority to access disease outbreak sites rapidly, publish information without requiring a country's permission, and to act in a precautionary manner. In medieval times, an infectious pathogen travelled on foot and by donkey. Today it is on the next flight. We need our responses to occur at the same speed.
Action now needs to occur at three levels: countries must overhaul their preparedness, the WHO must be strengthened and invested in, and the UN General Assembly needs to endorse the Panel's far-reaching package of reforms. If the package as a whole is implemented, then there is a fighting chance of averting another catastrophe like Covid-19. If it isn't, then this review, like many before it, will be another missed opportunity to take the stitch in time that saves nine. Lives, health and social and economic progress are on the line. That's why transformational change at every level is needed.
• Rt Hon Helen Clark is Co-Chair of The Independent Panel for Pandemic Preparedness and Response