Multilateralism Failed Africa; Regionalism May Work Better – Africa CDC Deputy Head at European Health Forum Gastein European Health Forum Gastein 27/09/2021 • Elaine Ruth Fletcher Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to print (Opens in new window) Clockwise from left-right: Richard Hatchett, Coalition for Epidemic Preparedness Innovations, Clemens Martin Auer, President EHF-Gastein, Ahmed Ogwell Ouma, Africa CDC; Hans Kluge, Director, WHO European Region Multilateralism has “failed” to help Africa solve the COVID crisis and regional approaches to solving common problems could help the continent forge a “new public health order” said Africa Centers for Disease Control Deputy Director Ahmed Ogwell Ouma, speaking at the opening of the European Health Forum- Gastein. His statement at at the traditionally “Eurocentric” conference, palpably illustrated the way in which lack of access to COVID-19 vaccines and treatments is forcing leaders on the continent to look inward for new solutions – following the failure of international initiatives like the COVAX vaccine facility to bring adequate responses. The five-day European forum, which traditionally draws hundreds of participants from across the region to the Austrian spa town of Bad Gastein every autumn, is happening this year on an primarily virtual platform. But the conference, taking place under the slogan, “Rise Like a Phoenix” – Health at the Heart of a Resilient Future for Europe still includes the rich array of European and global health policymakers for which the forum has become known, including Stella Kyriakides, European Commissioner for Health and Food Safety, the European Medicines Agency’s Emer Cooke and WHO’s Director General Dr Tedros Adhanom Ghebreyesus. It also features a wide range of global health trend-setters, such as Michael Marmot, of University College London, who led WHO’s cutting edge work on the Social Determinants of Health a decade ago and Wellcome’s Sir Jeremy Farrar, who has been a leading voice on policy challenges around the pandemic. And there are dozens of experts presenting at, or attending, more specialised sessions covering topics ranging from brain health to marginalized groups, to a new “Oslo Medicines Initiative” which aims to foster new modes of public-private collaboration wider facilitating access to more affordable medicines. 🔔 Starting at 11:00 CET: ‘Oslo Medicines Initiative – A new vision for collaboration between the public and private sectors’ with @hans_kluge @natasha_azzmus @drsarahgarner @yann_eurordis @GiraudSylvain @kuiper_em & more! #EHFG2021 Organised by @WHO_Europe and @Legemiddelinfo pic.twitter.com/t5vuqP1CUJ — GasteinForum (@GasteinForum) September 27, 2021 New public health order should be part of ‘Pandemic Treaty’ Ahmed Ogwell Ouma, deputy director general, Africa CDC, at Gastein Forum But the kickoff sessions were a vivid reminder that Europe is not an island – and that the failures of regions like Africa to get access to critical COVID tools and treatments – are echoing in the global north and beyond. “Where we sit here at Africa CDC, indeed on the African continent, multilateralism has failed,” said Ouma, at a press briefing opening the conference’s first day, and just after WHO Regional Director Hans Kluge made a plea for European countries to share excess vaccine doses with low- and middle-income countries – in the spirit of multilateralism. “It [multilateralism] has been very successful in meeting rooms and webinars and probably some negotiating tables, but on the ground in Africa, it has failed,” retorted Ouma. “Going down the path of regionalism,” may be more effective now, Ouma remarked, “where neighbouring countries who share the same aspirations, countries who are willing to support each other during good times and bad times, can be able to come together and work towards a common good.” He said that Africa needs to aspire to a “new public health order, including four key pillars: Strengthened African health institutions at regional and country level; A stronger African health workforce; More reliable supply chains for medicines, vaccines and equipment, including more local manufacturing capacity; Global partnerships that are “respectful and action-oriented.” All of these elements should be incorporated into negotiations for a new Pandemic Treaty, or revisions in the existing WHO International Health Regulations, which current governing health emergency responses. “Is a new treaty necessary? We can discuss that if it captures these four points,” he said. “Is reviewing of the IHR necessary? Absolutely. We have seen a spectacular failure of the IHR. But we must tackle what is wrong and not just what is convenient to discuss.” Warns against regional competition Ilona Kickbusch, Founding Director of the Graduate Institute’s Global Health Centre in Geneva. At the same time, Ilona Kickbusch, founding director of the Geneva Graduate Institute’s Global Health Centre, said that regional solidarity should pave the way to more effective global cooperation. A stronger and better financed World Health Organization, and new collaborative frameworks such as a proposed ‘European Health Union’ consolidating national health agencies regionally, could help go beyond the rhetoric. “The pandemic has shown that there were at least three areas in which we cannot afford not to work together globally. That is global health, the environment, and the digital transformation,” said Kickbusch. “All three hang together to bring better health to people all around the world. “It has become clear that regional efforts are ever more important to bring countries together and to develop new initiatives,” she added. “However, regions should not compete with one another but rather work together at a multilateral level….. This is why we hope that the European-African partnership, that already exists, will be slowly strengthened through better financing and will lead to a new kind of global coalition that will be absolutely critical”. Kluge – On boosters & dose-sharing – 1.2 billion excess doses means there are enough “to do it all” The Austrian alpine setting which usually hosts hundreds of EHF-Gastein participants – this year was the setting only for a video clip and key conference organizers/ presenters. Touching on the controversial issue of COVID vaccine boosters, Kluge veered away from the line of his boss, Dr Tedros, who has repeatedly called for a booster moratorium, in order to free up more supplies to reach the global south. Instead, Kluge asserted that there should be enough vaccines to go around if they were used more efficiently – quoting United States Chief Medical Advisor Anthony Fauci who said in August that “we should do it all” – providing boosters to already-vaccinated groups in high-income countries – as well as vaccinating the world. “My principle has been, and this was the same principle as … Dr. Anthony Fauci whom I discussed this with in August, from my mission to Washington, is: “Do it all,” declared Kluge at the presser kicking off the first day’s proceedings. He pointed out that by end 2021, rich countries will have amassed an excess of 1.2 billion vaccine doses – if they don’t share them. “So the key issue is the political leadership and coordination to get them to those countries in need.” One key barrier to more efficient distribution, Kluge added out, has been that countries often prefer to share their excess doses “based on geopolitical considerations, instead of a need basis: “While I understand this, there has to be a bit of a balance.” Another obstacle, is that countries are “waiting too long to share their excess doses – too close to expiry dates, and then for the receiving countries, this is too difficult.” At the same time, he added that recent research has suggested that expiry dates may be extended under the right circumstances, noting a recent decision by Israeli authorities to extend the shelf life of Pfizer vaccines from a total of six to nine months. He also said that receiving countries need to do their part: “to do the homework to register the new products and the manufacturing sites” – although he did not elaborate as to what countries in the global south may have been slow to register new vaccines or manufacturing sites. Overall, however, the biggest problem is political leadership to unlock more massive quantities of excess doses, he stressed: “I mean, it’s nice that countries say 1 million, sharing, and 300 million sharing, but we should be sharing in terms of billions…And that’s what we need.” Image Credits: European Health Forum Gastein. Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to print (Opens in new window) Combat the infodemic in health information and support health policy reporting from the global South. 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