Madrid
– As H5N1 avian influenza surges in mammal populations and
causes new human infections, and mpox is leading to deaths
of children, the former Co-Chairs of The Independent Panel
for Pandemic Preparedness and Response warn that leaders
have not done nearly enough to prepare for pandemic threats,
leaving some eight billion people vulnerable.
“In
2024, for everyone who survived COVID-19, a pandemic is a
lived experience and not a theoretical threat,” said Her
Excellency Ellen Johnson Sirleaf. “Instead of taking
action to prepare for the next major outbreak, leaders have
turned away from pandemic preparedness. This is a gamble
with our futures.”
President Sirleaf has noted with
alarm the number of child deaths occurring as a result of a
more dangerous strain of mpox, a dearth of diagnostic
testing, and the fact that while vaccines exist, they are
not yet available where children are dying.
In their
new report, No Time to Gamble: Leaders Must Unite to Prevent
Pandemics, the former Co-Chairs take stock of progress
against the package of recommendations The Independent Panel
made to the World Health Assembly in May 2021 following its
eight-month review of the response to COVID-19.
“We
were clear in 2021 at the height of COVID-19, that leaders
needed to act urgently to make transformative change to the
international system, so that there would be a new approach
to funding, new ways of managing equitable access to
products like vaccines and tests, and a new Framework
Convention to complement the rules for outbreaks and
pandemics,” said the Right Honourable Helen Clark at an
event to release the report hosted by Club de
Madrid.
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“Instead, the funds now available pale in
comparison to the needs, and high-income countries are
holding on too tightly to traditional charity-based
approaches to equity. The pandemic agreement is vital and
must succeed but has yet to be agreed. In short, if there
were a pandemic threat today – such as if H5N1 began to
spread from person to person – the world would likely again
be overwhelmed.”
Some cause for hope
The
report also points to progress. The 77th World Health
Assembly agreement to amend the International Health
Regulations (IHR) can result in faster information-sharing
from countries and from WHO, more transparent processes in
deciding a public health emergency of international concern,
and a definition of a pandemic emergency, which was not
codified before.
Other progress includes WHO Member
States’ decision in 2023 to increase the proportion of
unearmarked funding to WHO’s base budget, giving the
organization more independence in allocation of
funds.
However, the Co-Chairs also warn that WHO may
be spending too much on the operational side of health
emergencies including on delivery of supplies, when it
should focus attention on excellence in normative and
technical support. Given the attention both emergencies and
technical excellence require, the report suggests WHO Member
States consider whether WHO should be split into two
entities so that emergency operations do not overwhelm the
normative work.
Are countries prepared?
The
Co-Chairs also underscore that it’s impossible to know if
countries are prepared for a pandemic, based on the current
assessment tools and metrics. The report shows that while
voluntary self- assessments reached a record high in 2023,
the infrequency of joint external evaluations, lack of
visibility on national plans, and limitations on the types
of information being collected provide only a patchwork
picture of country preparedness.
Address these seven
areas to help change the future, starting now
The
report lays out several steps that must be taken to
implement The Independent Panel’s package of
recommendations and make the world safer from pandemic
threats. Governments, international financial institutions,
international and regional organizations and WHO should
consider the following as priorities:
Pandemic
rules:
In July, WHO Member States must set new ways
of working to make progress on the pandemic agreement. New
modalities must include inclusion of independent experts and
civil society. The pandemic agreement should be adopted by
December 2024.
Member States and WHO should
immediately abide by the amended International Health
Regulations and prepare for their coming into force by June
2025.
Multisectoral Leadership: In September at the
time of the UN General Assembly
A new Champions Group
to Prevent Pandemics, comprised of former and current
leaders, should be established.
At the Summit of the
Future in September, the UNGA must adopt a new Emergency
Platform for complex global shocks as part of the Pact for
the Future. The platform should expand to include emergency
preparedness.
Accountability: In October, the Global
Preparedness Monitoring Board should be made fully
independent and de-linked from WHO, or a new independent PPR
monitoring board, similar to the IPCC, should be
established. The pandemic agreement must include an
implementation and compliance mechanism.
Finance: The
Pandemic Fund should have a successful pledging round of
non-ODA funds in advance of the November G20. The G20 should
lay plans to convert The Pandemic Fund into a preparedness
and surge mechanism based on a global public investment
model.
Equitable Medical Countermeasures: At the G20
this year and next, Brazil, South Africa and other
middle-income countries should indicate the need to move
away from a charitable model for medical countermeasures
access and towards one of regional resilience, knowledge
generation, and technology sharing to stop outbreaks,
managing countermeasures as part of the global
commons.
An independent and more authoritative
WHO:
At the November G20, Member States must meet
milestones for WHO’s investment round and repledge their
commitment to unearmarked funding.
The January 2025
Executive Board should initiate a one-term approach for the
Director-General and Regional Directors, and WHO must work
to depoliticize senior appointments.
Country
preparedness: Countries must ensure they have updated
pandemic plans based on WHO benchmarks. WHO must update
assessment tools in line with the amended IHR and wider
whole-of-government and society approaches; and should begin
to publish clear annual assessments of country
preparedness.
The report underscores that there is
about a fifty per cent chance that the world could face
another pandemic threat on the same scale as COVID-19 in the
next 25 years, making it even more important to invest in
preparedness now.
“There were lessons to be learned
from Ebola in West Africa,” said Ellen Johnson Sirleaf.
“Just five years later, having not applied those lessons,
there were lessons to be learned again from COVID-19. There
is no need to keep learning. Instead of gambling, leaders
can make practical decisions and apply those lessons. Why
would they make any other
choice?”
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