Monday August 15, 2022

High time

November 29, 2021

For G20 countries, to have and to hoard life-saving vaccines and deny them to the poorest countries, is morally indefensible. To allow tens of millions of doses to go to waste is an act of medical and social vandalism that may never be forgotten or forgiven. An urgent, ongoing, month-by-month delivery plan and airlifting of vaccines, coordinated by the G20 countries, is now needed to put the unused capacity to use where vaccines are most needed.

But the vaccine inequities show why more fundamental changes are needed in the international architecture of health decision-making. Of course, few international organisations have been given the freedom and independence to make binding decisions that national governments are obliged to follow. The discretion available to the Appeal Court of the World Trade Organization and to the International Criminal Court, whose decisions are final, are areas where an international organisation can overrule nation-states and because of that, they are under assault from a coalition of anti-internationalists.

While there is a global health treaty focused on reducing the demand and supply of tobacco, and a 2011 agreement to ensure the WHO can commandeer supplies of flu vaccine when needed, the binding worldwide agreement that has been called for to enable world health authorities to do more to prevent, detect, prepare for and control a pandemic still eludes us.

The special World Health Assembly summit offers us a unique opportunity to address these gaps by serving as a launchpad for a process that will urgently develop a legally binding international agreement under the auspices of the WHO Constitution. They can build on important reports – the G20 report of Larry Summers, Tharman Shanmugaratnam, Ngozi Okonjo-Iweala, the Mario Monti report to the European region of the WHO and, the recommendations of the WHO review led by former Liberian President, Ellen Johnson Sirleaf and former New Zealand Prime Minister Helen Clark.

First, our global health leaders must have more authority to develop and upgrade health surveillance. Second, we need to build on the pioneering work of ACT-A and COVAX to ensure equitable manufacturing and distribution of PPE, tests, treatments and vaccines so that all countries can detect, respond, treat and protect against current and future pandemics. Third, we need a global pandemic preparedness board.

But all this will work only if we devise a sustainable financing mechanism to address the glaring global inequalities in health provisions across the world. Too often, in times of global crises – even those where we face life and death decisions – we are reduced to passing round the begging bowl or convening ‘pledging’ conferences in a way that is more reminiscent of organising a whip-round at a charity fundraiser.

Excerpted: ‘It is high time we start preparing for future pandemics’