COVID’s Failures Must Never be Repeated, Stakeholders Tell UN Pandemic Meeting
The UN multi-stakeholder meeting on pandemic prevention, preparedness and response.

The global response to COVID-19 failed people in developing countries, women and health workers and must never be repeated, non-state actors told a meeting hosted by the United Nations (UN) in New York on Tuesday.

The UN convened the four-hour multi-stakeholder meeting on pandemic prevention, preparedness and response (PPPR) in preparation for a High-Level Meeting (HLM) on the issue in September, which will adopt a political declaration.

Dr Joanne Liu, representing the Independent Panel for PPR, told the meeting that Ebola would not have been defeated without high-level political leadership, and the same was necessary to address future pandemics.

“We need the highest level of political attention on pandemic threats because they are overwhelming, complex and have a multi-sectoral impact,” said Liu. “A leader-led Global Health Threat Council is essential to sustain global pandemic readiness.”

Lui added that “it is certain that new pandemic threats will emerge, but full-blown pandemics are a political choice.

“This September, the UN General Assembly has the historical opportunity to choose to make COVID-19 the last pandemic of such devastation.”

Health threats council?

In a recorded message, World Health Organization (WHO) Director-General Dr Tedros Adhanom Ghebreyesus supported “the proposal for a health threats council as a forum for high-level political leadership”. 

However, he warned that such a council had to be “grounded in WHO constitutional mandate and complement and strengthen existing governance structures, including the World Health Assembly and the Standing Committee on Health Emergency Prevention, Preparedness and Response, which the WHO’s executive board established last year”. 

Otherwise “we face the risk of establishing multiple disconnected initiatives that drive further fragmentation”, he added.

But Nina Schwalbe, representing the UN University’s International Institute of Global Health, advocated for a high-level council to hold member states accountable for their commitments to PPR that was independent of the WHO.

“As has been evidenced by other sectors, including human rights, chemical weapons, climate and atomic energy, signing a treaty is not enough,” she noted. 

“Compliance requires independent monitoring. Reporting to the highest level of government, a high-level political council made up of heads of state and their representatives can drive cross-national, multisectoral accountability and monitor member states compliance with the pandemic accord,” she added.

Meanwhile, the Pandemic Action Network called for “a robust set of monitoring and accountability mechanisms in the high-level declaration, starting with a progress review within 12 months of the summit”. 

Nurses from the primary care team at the Gonçal Calvo Health Centre in Spain test for COVID-19.

Addressing inequity

“The primary manifestation of inequality was the inequitable distribution of vaccines,” said Dr Carlos Correa of the South Centre. “The COVAX mechanism failed to achieve equitable distribution of vaccines not only due to financial reasons but because the governance of the system was not multilateral in nature.”

Amnesty International noted that 28% of COVID-19 deaths were in Latin America and the Caribbean, yet it is home to only 8.4% of the world’s population.

“Our societies suffer a rampant inequality that excludes entire populations from health systems, especially women and indigenous peoples,” it noted.

The Medicines Patent Pool (MPP) said it was possible to include equitable access conditions in funding agreements to help “address questions of affordable access long before the product comes to market”. 

“This is especially important in the context of PPPR. Public, multilateral and charitable financing of r&d can be conditioned on funded entities taking sufficient measures by voluntary licencing or otherwise, to ensure that every medical technology is available and affordable to all,” said the MPP.

Meanwhile, the People’s Vaccine Alliance wants any political declaration to “enable local production to ensure a sustained supply of countermeasures”. 

“That means a commitment to sharing technology, removing intellectual property barriers, investing in r&d in the south, and investing in actual manufacturing,” said the alliance’s Mohga Kamal-Yanni.

Protecting healthworkers 

“The pandemic exacted a huge toll on the physical and mental health of health workers around the world, infecting millions and causing the deaths of more than 180,000,” said Pamela Cyriano from the International Council of Nurses.

“Excessive” burnout and the ageing of the workforce are exacerbating the already existing shortage of six million nurses, half of which are in our African nations. 

“Healthcare workers stepped up for COVID and put their lives on the line. But we have to ask, will they be there the next time,” she said, calling for the investment in fair and decent pay and in the training new nurses,” sakis Cyriano.

David Bryden, director of the Frontline Healthworkers Coalition, also pointed out that “migration of health workers, in particular nurses, from low and middle-income countries to high-income countries has increased dramatically in recent years, putting pandemic response capacity at risk in their countries of origin”.

More parliamentary involvement

Ricardo Baptista Leite, president of UNITE Parliamentarians’ Network for Global Health

Ricardo Baptista Leite, president of UNITE Parliamentarians’ Network for Global Health, urged more involvement of Members of Parliament in negotiations on a pandemic accord, currently coordinated by the WHO.

“I was in a meeting of 300 MPs recently and asked who had heard of the pandemic accord and no one put up their hand,” said Leite, pointing out that MPs pass the budgets of countries and are thus essential in securing finances for pandemic preparedness.

Leite also urged more action against the deluge of misinformation that is undermining public trust in medicines and vaccines.

Angela Kane, Senior Advisor to the Nuclear Threat Initiative.

Angela Kane, former UN Undersecretary General and Senior Advisor to the Nuclear Threat Initiative, said that there were “significant gaps” in international mechanisms to help figure out the source of biological events.

The WHO “is well positioned to assess outbreaks of natural origin, so-called spillover from animals to humans”, said Kane, adding that it is “still deciding how far it will go to assess an outbreak origin once signs begin to emerge that it may have resulted from a lab accident or deliberate bioweapons attack”. 

“This is an important decision because WHO needs to maintain the trust and openness of its member states to carry out its public health mission and engaging in security-related issues could make that difficult,” said Kane.

On the other end of the spectrum the UN Secretary-General has the authority to investigate allegations of deliberate bioweapons use –  but only when there were brought to it by member states and this had never happened.

“There is no mechanism in the UN system to assess events of unknown origin that fall between the scope of these two mandates,” said Kane. “Are we doing enough to rapidly identify cases where there’s ambiguity about a source of an outbreak?

“The challenges of discerning COVID-19 origins have highlighted the need to fill this gap for determining the origins of a disease outbreak in a form that is scientifically based.”

The multi-stakeholder meeting was one of a trio – the others dealing with tuberculosis and universal health coverage – held this week in preparation for the UN HLMs on these three issues over three consecutive days from 20-22 September.

Image Credits: Consorcio Sanitario del Maresme, Spain.

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