Two years ago, three months before coronavirus erupted, the Global Preparedness Monitoring Board (GPMB) issued a warning to the international community that a pandemic was only a matter of time, and that the world was not prepared. Tragically, we were proved right.
After 20 months of Covid-19, with nearly five million directly attributed deaths and economic devastation, we say again that the world is not prepared. It has neither the capacity to end the current pandemic in the near future, nor to prevent the next one.
We should not be surprised by the catastrophic failures of this pandemic. They are rooted in a long history of inequality and inaction. We should feel deep shame over the multiple tragedies that have shattered our lives. We should grieve and be angry. Because millions of deaths – many preventable – is neither normal nor acceptable.
Covid has exposed a broken world of haves and have-nots where access to vaccines, treatments and PPE depends on your ability to pay. Most glaringly, it is the imbalance of vaccines that strikes at our moral fibre and confirms that this pandemic is no longer a problem shared. Rates of vaccine distribution almost perfectly track income distribution.
The lack of global equity is due in part to the fundamental misunderstanding of global solidarity as being founded on generosity, not justice. It is also caused by longstanding systemic inequities in the global health emergency and broader international system.
Financing health emergency preparedness and response is based largely on ad hoc, bilateral and multilateral development assistance. Low- and middle-income countries are often under-represented and opportunities to engage communities and civil society are meagre, further marginalising vulnerable groups.
Covid erupted into a polarised world characterised by heightened nationalism, distrust and inequality. It has only accelerated those trends. The inadequacies start at the top. The UN general assembly, UN security council, World Health Assembly, G7 and G20 leaders among others, have little to show for their efforts other than declarations of intent.
Worse, while the key to containing the pandemic and preparing for the next is collective action, current processes to reform the health emergency ecosystem are splintered and could exacerbate the existing fragmentation.
For all the pandemic’s challenges, it has also offered an opportunity. It has given us occasion to celebrate the life-saving and inspiring role that science can play in mitigating dangerous diseases. We have seen the kindness, comfort and solidarity that people can offer one another. We have also reached a consensus that the global health emergency system needs fundamental reform.
Preparedness starts with communities and countries. Every country has the responsibility for the protection of its own population. Every country must follow through on the commitments it has made to its people. Every country can – and must – do more. But global preparedness is greater than the sum of national preparedness. It needs concerted, collective and coordinated action. At its heart must lie a new global social contract which prioritises equity, accountability, solidarity, reciprocity and inclusivity.
This is why the GPMB, in its new report, is calling for stronger political leadership and accountability to change the way the international community prepares for future health emergencies. We are calling on countries – including those from the global south – to work together with civil society, the private sector and other stakeholders, to take urgent steps to strengthen the ecosystem of pandemic preparedness and response; to negotiate an international agreement in WHO; to create a new financing instrument at the World Bank; and to develop end-to-end mechanisms to advance public goods for health emergencies and share data. And at the heart of this ecosystem, we need an empowered WHO, strengthened with resources and authority.
We also stress the importance of independent monitoring, which plays an essential role in keeping our leaders, governments and institutions accountable. Together, these actions will help to create a coherent plan for global preparedness and monitoring. As we move forward with these solutions, we must be mindful of the lessons of the past, and design for equity and interdependence.
The window of opportunity for change is fast disappearing. As life in some parts of the globe returns to a new normal, and the world’s attention is distracted elsewhere, the urgency fades.
We know what we need to do. There have been hundreds of recommendations to reform the system. We just cannot seem to do it. But do it we must. We have learned the hard way that disease knows no borders. None of us is safe until all of us are safe. We must move from words to action.
Elhadj As Sy is co-chair of the Global Preparedness Monitoring Board, an independent body working to chart a roadmap for a safer world, whose annual report can be accessed here