Dr Tedros Adhanom Ghebreyesus, WHO Director General, giving his closing remarks at the 74th World Health Assembly.

The 74th World Health Assembly (WHA) closed on Monday with appeals for vaccine equity, more resources for the World Health Organization (WHO) and support for a “pandemic treaty” to combat future pathogens.

WHO Director General Dr Tedros Adhanom Ghebreyesus devoted much of his concluding speech to the global body’s dearth of finances and the importance of the proposed pandemic treaty to put more teeth into international health rules around outbreak responses. Member states agreed at the WHA session that the proposed treaty would be discussed in detail at a special WHA session at the end of November.

Despite member countries’ praise for the global body’s support, Tedros said bluntly:  “We cannot pay people with praise”, adding that many of their experts were on short contracts as the WHO struggled to maintain its current level of pandemic response.

“The message that a strong WHO needs to be properly financed has been amplified by all the expert reviews that reported to this Assembly,” said Tedros, adding that the WHO Working Group on Sustainable Finance was charting a way forward to address this.

“The one recommendation that I believe will do the most to strengthen both WHO and global health security is the recommendation for a treaty on pandemic preparedness and response,” said Tedros. “That could also improve the relationship between member states, and foster cooperation.”

For Tedros, such a treaty would be a “a generational commitment that outlives budgetary cycles, election cycles and media cycles”.

Pathogens have More Power than WHO – And Globe has a “Temperature”

The current pandemic had been characterised by a lack of sharing and a lack of global accountability, he added.

“At present, pathogens have greater power than WHO. They are emerging more frequently in a planet out of balance. They exploit our interconnectedness and expose our inequities and divisions,” Tedros stressed.

“A treaty would foster improved sharing, trust and accountability, and provide the solid foundation on which to build other mechanisms for global health security,” said Tedros, including research and innovation, early warning, stockpiling and production of pandemic supplies – and equitable access to vaccines, tests and treatments.

Referring to a visit Saturday to WHO by a group of health and climate activists DoctorsXR   the WHO Director General also noted how the climate crisis has become interwoven with the pandemic as another risk to humanity whose signals need to be heeded now. 

“Our human health is very much similar to Planet health,” he noted,  “As you know, in human health, 37 ℃ is healthy. If you add 2 degrees, which is 39 ℃, you’re sick. If you add another 2 ℃, then you are at 41, and in  danger. And then if you add more and it’s 37 ℃ plus 5℃, that’s too late. 

“And for the planet it’s the same thing.  So we need to take care of ourselves and our planet. And the recommendations they have made are: 1)  focus on preventive rather than curative care; 2) promote a more sober and equitable medicine; 3) develop environmentally-friendly healthy structures, and 4) focus on community based care and support.

“Five, respect the natural environment; 6) organize information and education, and 7)  involve the population and patients in strategic decisions. And in all that leadership is key and this is a message to you which they asked me to pass to all member states.”

Debates over TRIPS Waiver, Virus Origins Investigation and Pandemic Treaty End in Whispers  

The WHA had the longest agenda in its history, and adopted over 30 resolutions, including new initiatives to promote local production of medicines; prevent and reduce non-communicable diseases;  expand access to services for the treatment of diabetes, disabilities and eye care.

It also considered reports from three different bodies – the Independent Oversight and Advisory Committee (IAOC), the Independent Panel for Pandemic Preparedness and Response (IPPR), and the International Health Regulations Review Committee (IHRC) – which revealed the WHO weaknesses in dealing COVID-19 and how to address these.

Despite the roaring debates that occurred on the Assembly’s margins, member states clearly sought to end the packed 8-day long meeting on a note of accord – if not exactly consensus. 

Disagreements over an IP waiver to spur vaccine protection or the future direction of the WHO-led investigation into the SARS-CoV-2 origins did not break out again onto the plenary floor, as could have occurred in the closing hours of the assembly.  

Rather, member states seemed happy to let the IP waiver debate move back to its natural arena in the World Trade Organization forum, which is set to meet on the issue once more next Monday – although chances for progress remain dim in light of continued European opposition.  

A key resolution of this WHA, “Strengthening WHO Preparedness for and Response to Health Emergencies, received final approval on Monday without objections – even though scientific critics and member states had complained that the already nuanced text touching on the investigation into the SARS-CoV2 origins had been weakened further during the course of negotiations. 

A terse statement by one of the leading critics of the investigation so far, the United States, seemed to throw the ball back into the court of Dr Tedros once more.  

“We call for a timely, transparent, evidence-based, and expert-led Phase 2 study, including in the People’s Republic of China,” said the US statement.

“It is critical that China provides independent experts full access to complete, original data and samples relevant to understanding the source of the virus and the early stages of the pandemic. We appreciate the WHO’s stated commitment to move forward with Phase 2 of the COVID-19 origins study, and look forward to an update from Director General Tedros.”

But President Joe Biden was not taking any chances either.  As the WHA session was in full swing, Biden announced the launch of a US investigation into one key element of the controversy –  whether the virus more likely first infected humans via contact with the pathogen in a wild animal or food-borne source – or via a biosafety accident at the Wuhan Virology Institute, that was studying bat-borne coronaviruses at the time the Wuhan outbreak first began.  

Member States Describe Pandemic Challenges and Successes 

Malaysian Prime Minister Tan Sri Muhyiddin Yassin

Instead of touching on those sensitive nerves, leaders of member states addressing the closing plenary talked about the struggles that they still faced to contain the pandemic – as well as the qualified successes that some countries had seen. 

Malaysian Prime Minister Tan Sri Muhyiddin Yassin said his country was experiencing another surge in infections – but it had only secured 6% of the 53 million vaccines it needed to protect its citizens.

“Vaccine equity is still a major issue and we cannot win this war against the virus unless everyone has equal and rapid access to vaccines,” said Yassin, expressing his country’s support for the proposed TRIPS waiver of intellectual property on COVID-19 related products.

Argentina’s President Alberto Fernández said that his country was “going through very, very difficult times… the worst time of the pandemic”.

“We’ve got, say, a dozen countries who can produce vaccines and have managed not only to produce but to purchase about 90% of them. Everyone else has had to go searching for the vaccines in order to try and get sufficient quantities to vaccinate our people. Solidarity there has been fairly non-existent,” he said.

Fernández described the ongoing economic blockade of Cuba and Venezuela during the pandemic as “obscene”, and called for it to be lifted alongside the lifting of patents on vaccines. Cuba is reportedly in advanced stages of R&D into an indigenous COVID-19 vaccine which could be relevant for its Latin American neighbours unable to readily access sufficient supplies from the big producers in US, Europe, India, China or Rusia. 

Bhutan’s Success Mitigated by Vaccine Scarcity 

Bhutan’s Prime Minister, Lotay Tshering

On a brighter side, Azerbaijan President Iham Aliyer said that the country had vaccinated two million people – 20% of its population – mostly using the Sinovac vaccine, and would be removing most pandemic restrictions by 1 June. 

Buthan’s Prime Minister, Lotay Tshering, talked about how the tiny country had been able to vaccine 90% of its population thanks to AstraZeneca vaccines donated by India – and that had, in turn, kept the pandemic at bay.

But he expressed doubts about “how long” the reprieve would last, if Bhutan is unable to get people their second doses because of the huge surge seen in Indian cases since. 

Afghanistan President Mohammed Ashraf Gani was meanwhile critical of “UN agencies” which had neither been able to deliver the oxygen they had promised nor “offer us timely policy advice”.

In contrast, he said, “India showed us exceptional solidarity by giving us 650,000 vaccine doses” which had enabled the country, currently in its third wave, to vaccinate its most vulnerable people.

  • Elaine Ruth Fletcher contributed to this story.

 

 

Image Credits: WHO.

Polio workers protest against WHO retrenchments.

ISLAMABAD – Despite the 18-month COVID-19 pandemic, Pakistan and Afghanistan have observed a sharp decline in polio cases which the health authorities attribute to their effective back-to-back anti-polio drives.

Officials leading the polio eradication programme believe that the decline occurred due to uninterrupted polio vaccination campaigns, improved security and the polio field teams’ accessibility to the population in high-risk areas.

However, despite a remarkable decline in poliovirus cases, officials believe that ‘vaccine refusal and hesitancy’ by parents remains a bigger challenge than COVID in completely eradicating the virus.

Pakistan and Afghanistan, both members of the World Health Organization’s (WHO) Eastern Mediterranean Region, are the only two countries in the world still fighting to eradicate wild polio virus as a cause of the crippling disease.    

In August 2020, Nigeria achieved zero wild poliovirus cases, leaving Africa to be certified by WHO as a free of the wild poliovirus. 

However, some 16 countries in Africa are still experiencing periodic outbreaks of vaccine-derived polio cases (cVDPV2). While rare, vaccine-derived polioviruses cases can occur when the weakened live virus in the oral polio vaccine passes among under-immunized populations and, over time, changes to a form that can cause acute disease.  If a population is adequately immunized with polio vaccines, it will be protected from both wild polio and circulating vaccine-derived polioviruses.

A WHO report on the global battle to eradicate polio was the subject of a wide-ranging discussion Saturday at the World Health Assembly – with WHO and other member states commending Pakistan and Afghanistan and Africa on the progress seen – while also highlighting the uphill battle still faced to completely eradicate both wild and vaccine-derived forms of the disease. Member states also called upon WHO to remain committed to polio eradication – including building the capacity of national health teams to gradually take over the roles of the WHO-supported Global Polio Eradication initiative.

“We are accountable to children,” said WHO Polio Director Aidan O’Leary, in describing the challenges still faced to eradicate the last remaining cases of wild poliovirus – along with tackling vaccine derived cases that continue to circulate not only in Africa and Asia, but other regions as well.

‘Last Mile’ in Pakistan ? 

On both sides of the shared 2,640 kilometer border, Pakistan and Afghanistan are focused on both forms of the virus – working alongside about dozen international health and donor agencies.

Speaking to Health Policy Watch ahead of the WHA, key Pakistani health officials expressed hope that the wild poliovirus could soon be eradicated altogether in that country.

“This is our last mile and hopefully we will achieve zero cases in 2022,” said National Coordinator Dr. Shehzad Baig.  He told  Health Policy Watch that the last three anti-polio campaigns had been very effective reaching 90 to 95% of targets in  eradicating the virus from the country – and if that track record can be maintained then the eradication target can be met.

He said that the silver lining of the COVID-19 pandemic’s lockdown rules meant that children had been easier to reach: “Mostly children in high-risk areas remained at home and were accessible to polio teams for vaccination,” said Baig.

Stability in Pakistan’s security situation since last year also contributed to effective anti-polio drives, he said adding: “Since November, there was no security challenge for 286,000 field polio workers accessing areas for polio drives in security risk regions,” he said.

A WHO report submitted to the World Health Assembly (WHA) on Saturday, stated that WPV transmission is ongoing in traditional reservoirs in the northern corridor (Peshawar/Khyber), Karachi and the southern corridor (Quetta block, Balochistan), with expansion of virus to previously polio-free areas (Punjab and Sindh), and detection of virus across the country.

It also said that circulating vaccine-derived poliovirus type 2 continues to spread geographically, notably in Khyber Pakhtunkhwa, with ongoing breakthrough transmission complicated by a large nationwide accumulation of populations susceptible to type 2 poliovirus. 

Afghanistan also Sees Progress – But Poor Reporting May be Factor 

In Afghanistan, reports of polio virus cases were also on the decline this year as compared to 2020 – although surveillance remains an issue, particularly in areas where the reach of the central government is weak, officials cautioned.

Just one wild polio virus case has been reported so far in Afghanistan so far in 2021, as compared to 56 in 2020, according to the Independent Monitoring Board, an international body monitoring the performance of the polio programs by the countrie. And only 38 cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) had been reported in Afghanistan, in contrast to 308 cases in 2020. 

In the wake of three WPV cases in November 2020, some 54 cross-border teams and 288 permanent transit teams (PTTs) were deployed across Afghanistan, the IMB said. The teams vaccinated 79,489 adults and 538,674 children.  Wild Polio Virus type 1 is endemic to the southern and eastern regions of Afghanistan, but  WPV, along with more vaccine derived cases, can encroach previously polio-free areas in the north and west of the country in the absence of containment vaccine campaigns. And those had been suspended in the first six months of the pandemic.    

In Pakistan, cases so far in 2021 have declined even more dramatically.  According to the official data of Pakistan Polio Eradication Program (PPEP), the country saw 84 Wild Polio Virus (WPV) cases and 83 circulating vaccine-derived poliovirus type 2 (cVDPV2) virus cases in 2020 (the IMB says the number of vaccine derived cases in 2020 was even higher – 135). 

This year, there has been just one WPV case reported so far, and no cVDPV2 cases.

Speaking at the WHA, the Afghan representative said, however, that still 3.5 million children are missing from the country’s vaccination campaigns. Afghanistan also urged the global community for more financial support to expand the immunization campaigns in the security risk areas.

Setbacks at Start of Pandemic Followed by Renewed Vaccine Drives  

In both countries, campaigns were initially suspended for the first six months of the year.  For instance in Pakistan,  after the first surge of COVID-19 pandemic, the country’s polio programme had to suspend its scheduled April National Immunization Drive (NID) –  which meant that around 40 million children missed the polio drops.

That followed on interruptions in vaccine drives in 2019, as well, after attacks on polio teams occurred in the country’s southern and western regions.  As a result, around 250,000 children missed the polio drops as a result leading to 134 polio cases reported in 2019.

However, after the decline of the first COVID-19 wave, Pakistan’s polio programme, led by Dr Rana Muhammad Safdar, then National Coordinator on Polio Program now the Director General of Pakistan’s Health Ministry, rebounded. It conducted two national and three sub-national anti-polio drives between July and December  2020 to cover the immunity gaps. Then, in 2021 the country conducted another national drive to vaccine 40 million children with polio drops.

Impact of CIA’s Fake Polio Campaign

Pakistani efforts to eliminate polio were seriously undermined a decade ago when the US Central Investigation Agency (CIA) conducted a widely-criticized fake polio campaign as part of its intelligence gathering operations on the whereabouts of Osama Bin Laden in Abottabad; the al-Qaeda leader was finally ambushed and killed by US troops in his compound on 2 May 2011.

Following the disclosure of the CIA mission, the Taliban also launched an intense anti-vaccine propaganda campaign on both sides of the Pakistani-Afghan border. Polio teams were attacked in both countries by the militants, and several field workers were killed.

It is likely that these factors eroded parental confidence in vaccines and health workers and declines in vaccination rates. 

Cross Border Transmission and Vaccine Hesitancy    

To this day, parental refusal remains a bigger challenge in both Afghanistan and Pakistan than cross border transmission of the virus, said Baig.

He said that the ratio of parents’ refusal from polio drops fluctuates between 2% and 5% in different areas of Pakistan.

Meanwhile, Dr Faisal Sult, the Special Assistant to the Prime Minister (SAPM) on health, warned, however, that “we have been close before and lowered our guard and polio surged back, so rather than congratulate ourselves on efforts to date, we need to double our efforts and drive harder than ever if we are to truly protect Pakistan’s, and the world’s children from this devastating disease.”

He also stressed the need for a coordinated whole of government approach encompassing nutrition, primary health care and water and sanitation.

Risk of Resurgence

Despite the sharp decline in the polio cases in Pakistan, polio officer Anil Kumar from Sindh province believes that the risk of resurgence remains as dedicated polio vaccine teams are gradually reduced or reassigned – in Pakistan as well as worldwide.

Kumar criticized the recent WHO moves to abolish around 850 posts of national polio officers – even while the virus lingers in the country.

The cutbacks have come as part of a gradual WHO move to phase out its huge and costly ground support for the polio elimination programme – with an eye to the day when the world reaches polio eradication.

However, the strategy has been controversial among countries which have relied heavily upon the polio teams to conduc other vaccine drives too. And indeed, over the past several years, WHO has shifted gradually from talking about outright staff cuts to a more gradual integation of WHO-supported polio teams with other national immunization efforts – as part of developing stronger national immunization capacity.

In the wake of COVID, which saw national polio teams also supporting COVID  testing, tracking and containment followed by a groundswell of needs for vaccine teams generally, that approach has been validated.

But even so, countries like Pakistan say that the reality on the ground doesn’t always match the rhetoric in Geneva.

In Sindh province, one key at-risk region, the Deputy Commissioner (DC) of the Umerkot district wrote a letter to the WHO team lead in the province appealing for the retention of its lost polio officers.

In March 2021, polio workers staged a protest outside WHO’s Pakistan country office, demanding a restoration of the 850 cancelled posts. But the head of WHO’s Pakistan country office, Dr Palitha Mahipala, turned down their demand.

Warned Kumar, “some of the posts have been abolished in high-risk areas where there is still a chance of resurgence of the virus.” 

 

 

 

 

Image Credits: Pakistan Polio Eradication Program.

US delegate Colin Mclff urged bold action.

The World Health Assembly (WHA) passed a resolution on preventing violence against women and girls at Monday’s plenary – but only after heated discussion on Saturday resulted in a watered-down version with no reference to “sexuality education”. 

However, during the plenary session after the resolution had been adopted, Argentina’s representative, María Jimena Schiaffino, expressed disappointment on behalf of over 30 countries at the compromise that had been adopted “in order to not break consensus on voting on technical issues”.

“We have remained disappointed that similarly the long-standing practice of this association was not employed by objecting member states,” added Schiaffino. 

Comprehensive Sexuality Education ‘Agreed On’ in UN

“We want to take this opportunity today to again reiterate our support for comprehensive sexuality education for children to realise their health, well-being and to learn how to build relationships. For real communication, self-protection and risk-reduction skills are a fundamental part of efforts to prevent, recognise or respond to violence against children,” she said.

She added that “the term comprehensive sexuality education is based on already agreed consensus language use in other UN fora” and that the WHA  needs discussions to evolve its language to support “this evidence-based standard for the benefit of all children everywhere”.

The resolution is aimed at strengthening the health sector’s capacity to prevent and respond to violence against children. Every year around a billion children are affected by physical, sexual or emotional violence. 

During Saturday’s committee meeting on the draft resolution, US delegate Colin Mclff called for member states to “be bold” in order to “move forward with our shared goal of ending violence against children”, emphasizing that “sexuality education” would allow for a pathway to tolerance leading to “acceptance, inclusivity and empowerment”.

Countries like New Zealand also drew attention to the intersectionality of violence against children with their race, gender and other identities. 

Heated discussion over language

However, a number of countries including Kenya, Syria, Egypt, Bahrain and Iran disagreed with the language of the draft resolution, particularly with the inclusion of the term “sexuality education” over “sex education” for children. 

The push for bold language that would recognise multiple gender identities came from co-sponsor countries including the United States, Canada, the European Union, Oman and Paraguay, among others.  

Eventually, in an effort to pass the resolution with consensus, Monaco, Australia and Japan suggested a compromise that would drop the contentious paragraph:

“To provide accessible gender-sensitive, free from gender stereotypes, evidence-based and appropriate to age and evolving capacities sexuality education to children, and with appropriate direction and guidance from parents and legal guardians, with the best interests of the child as their basic concern to empower and enable them to realize their health well-being and dignity, build communication, self-protection and risk reduction skills, as a fundamental part of the efforts to prevent, recognize and respond to violence against children”

While countries agreed to the compromise, F Mamdouhi of Iran said his country disassociates itself from the parts of the resolution “that may imply in any manner whatsoever, recognition, protection, or promotion of those behaviours that are unethical under its legal system, or socio-cultural norms or which may contradict its world, and religious values accordingly.”

There were also discussions on protecting children from the growing challenge of online bullying.

Resolution on violence against women

The resolution also included suggestions to take a multi-sectoral approach to interpersonal violence as well as that in particular against women and children. While both boys and girls are at equal risk of physical and emotional abuse and neglect, girls are at a greater risk of sexual abuse. 

There was consensus on considering violence against women an issue of public health concern. 

The WHO will support their member states to train their frontline healthcare workers to respond better to violence against women and girls. Around 60 countries have already adopted or used WHO guidelines to inform their national protocols. 

While there was consensus on the need to prevent violence against women, Zimbabwe reminded the Assembly that violence against boys and men must not be ignored. 

“It is important to take particular attention not to sideline the boy child who also suffers from sexual violence in all forms of violence, including physical, inside of the ruling,” said J Chimedza of Zimbabwe. 

Image Credits: WHO.

Women-led sectors and nations have been at the forefront of the COVID-19 response – despite only a quarter of global leaders being women, speakers at a World Health Assembly side-event noted on Friday. 

“Women have been delivering good health pre-pandemic – and during the pandemic,” said Dr Farah Shroff, head of the Maternal and Infant Health (MIH) Canada, which co-sponsored the event with the Geneva Graduate Institute’s Global Health Center.

Calling women’s leadership during the pandemic “a game-changing moment for women at the helm,” Shroff said a “big difference” in COVID-19 response effectiveness was found in two groups: countries with female leadership and countries that prioritize the well-being of society, as opposed to more individualistic or business-oriented leadership. 

“[They] have really been the unsung heroes and ‘she-roes’ of this pandemic; 2021 is the tipping point for female leaders.”

Female Leaders Acted Sooner 

Marcia Castro, chair of the Department of Global Health and Population at the Harvard TH Chan School of Public Health

Women-led countries have flattened curves, implemented efficient vaccine rollouts and taken effective economic measures, she said. Research shows that these leaders were quicker to respond to the crisis, increasing public health spending, closing borders and enforcing mandatory stay-at-home orders.  

“Countries that have had some of the best responses are led by women,” Harvard University Professor Marcia Castro agreed. “Although women are still the minority in leading countries, we need to take that as an example — and carefully look at the differences in leadership, particularly when we face a major public health emergency.”  

Rwanda is noted for leading the world in women’s leadership – 67% of parliamentarians are female –  but its public health progress is just as noteworthy. Despite low resources (per-capita GDP is US $820), Rwanda has a vaccination rate of 90%.

Ninety-three percent of girls ages 12 to 22 are vaccinated against the human papilloma virus (HPV) to prevent cervical cancer, said Agnes Binagwaho, Vice Chancellor of Rwanda’s University of Global Health Equity. 

“Even during the time of COVID today, where primary health care resources are pulled out of health care systems to respond and be prepared for COVID-19, [Rwanda] has kept that line of primary care and family planning,” she said. “Despite the huge gender discrimination women are facing, we are making the difference.” 

Agnes Binagwaho, Vice-Chancellor of the University of Global Health Equity, Rwanda

Satya Lakshmi, director of India’s National Institute of Naturopathy, spoke about the unsung heroes of the pandemic, from doctors to community health workers, including Accredited Social Health Activists (ASHAs), local women trained as health educators and promoters with health ministry funding. 

Lakshmi also said collective self-help groups helped Kerala’s women by spurring local production and exchange of goods during lockdowns. 

Leadership Lessons For Future Pandemics

Speakers emphasized that compassionate leaders governing on behalf of society as a whole made a difference in the current pandemic, and they asked that these qualities not be forgotten in future crises.

“We know there’s going to be other pandemics – not just viral pandemics, but a whole variety of other pandemics that have been brewing and stewing for a long time,” said Shroff. Giving racism, neo-colonialism, violence against women, and other issues as examples.

She said leaders must “not go back to business as usual. … This COVID moment can catalyse a kinder, gentler world where we prioritise science, we prioritise human health, and we can collaborate with each other across borders.”

Image Credits: Graduate Institute Geneva.

Indonesia’s Health Minister, Budi Gunadi Sadikin

Indonesia could manufacture 550 million COVID-19 vaccine doses a year if pharmaceutical companies were prepared to share the know-how, Health Minister Budi Gunadi Sadikin told a World Health Organization event Friday.

Sadikin was addressing the first anniversary of the WHO’s COVID-19 Technology Access Pool (C-TAP), set up to encourage countries and manufacturers of COVID-19 products to voluntarily share knowledge, intellectual property and data to facilitate the rapid expansion of manufacturing.

C-TAP has failed to live up to expectations largely because large pharmaceutical companies have been unwilling to join it, preferring to pursue lucrative bilateral deals with wealthy countries instead.

“We’re holding the door open for pharmaceutical companies that have become household names, although too few households have benefited from the lifesaving tools they have developed,” Director-General Dr Tedros Adhanom Ghebreyesus said.

“They control the [intellectual property] that can save lives today, end this pandemic soon, and prevent future epidemics from spiralling out of control and undermining health economies and national security.”

Vaccines with Halal Certificates

Sadikin said Indonesia is the largest vaccine manufacturer in Southeast Asia, and has the capacity to “upscale our vaccine productions to meet regional and global demand”. What it lacks, he said, is the know-how and technology needed to make some COVID-19 vaccines, particularly mRNA vaccines.

“Currently, we have six manufacturers with a production capacity of 550 million doses per annum,” said Sadikin. In addition, he said, the Indonesian vaccines would come with halal certificates, which are crucial in some vaccination programmes. 

Abdul Muktadir, Managing Director of Incepta Pharmaceuticals in Bangladesh, said his company was also ready to produce vaccines if know-how and technology were shared.

“We have seen some statements like ‘Low- and middle-income countries do not have the ability to acquire the technology and deliver quality products,’ ” he said. Yet he pointed out that the vast majority of the world’s medicines are made by generic companies, particularly in Southeast Asia.

Bilateral Deals Trump Multilateral Sharing

Costa Rican President Carlos Alvarado Quesada

Costa Rican President Carlos Alvarado Quesada said that C-TAP – which his country has championed – was intended to foster multilateral sharing of information. But instead, he said, the world contends with “overcoming the challenges generated by bilateral negotiations and property rights”.

WHO expects more countries and manufacturers will join C-TAP, and is currently in talks with two vaccine manufacturers and five therapeutics companies, said Mariangela Simao, WHO Assistant Director-General for Access to Medicines.

Spain’s Foreign Affairs Minister Arancha González Laya also announced at the event that her country had decided to join the 42 current C-TAP members, and said she hopes this will help to boost global vaccine production.

Jesús Marco, vice-president of the Spanish National Research Council (CSIC), elaborated on this hope, saying that his country would share CSIC technologies and was considering licensing its vaccine candidates on a “non-exclusive basis”.

Untapped Vaccine Manufacturing Potential 

“We succeeded in developing vaccines at an unusual speed, but we failed to share COVID-19-related technology and knowledge and to speed up their production,” said Belgian Minister of Development Cooperation Meryame Kitir. “According to UNICEF, only 43% of the world production capacity for approved vaccines is used.”

Referring to the capacity in Indonesia and Bangladesh, WHO Chief Scientist Soumya Swaminathan said that the two countries have the “capacity, interest, and willingness to ramp up production”. 

“There’s really a call for those who have the know-how and the capacity to come and collaborate with us at the Manufacturing Task Force and through C-TAP,” she said.

Meanwhile, Health Access International (HAI) said that the “high expectations of C-TAP to halt the global catastrophe as it unfolds have not been realised”. 

“This is largely down to the refusal of the pharmaceutical industry to engage, preferring instead to protect short-term profits over global public health,” said HAI, which also blamed countries for lack of will to make C-TAP work.

“The need for an effective and functioning C-TAP remains as strong today as it did last year, as evidenced by the insufficient manufacturing capacity of patent holders to deliver on signed contracts and the difficulties endured by the COVAX facility to secure enough vaccine doses for LMICs,” the HAI statement said. 

“There is still a time and place for C-TAP within the global response to COVID-19, and that time is now. WHO should lead the efforts to secure the implementation of a game-changing mechanisms – if we can just agree that status quo is no longer acceptable.”

Image Credits: AstraZeneca.

The US reaffirmed its support for COVID-19 vaccine intellectual property waivers Friday as World Health Assembly delegates and experts discussed how to promote local production of medicines in low- and middle-income countries (LMIC).

US delegate A Lipstein Fristedt,

An Ethiopia-led resolution to stimulate local production of medicines and health technologies has the support of WHO’s African Region, the European Union, the United States, China, Brazil and other nations.

“The United States believes strongly in intellectual property protections, but in service of ending this pandemic supports the waiver of those protections for COVID-19 vaccines,” said US delegate A Lipstein Fristedt, US FDA deputy commissioner for policy, legislation and international affairs.

The Trade-Related Aspects of Intellectual Property Rights (TRIPS) Council set an informal meeting Monday (31 May) to discuss an Indian and South African proposal for an IP waiver on COVID-19 products. 

The council’s power balance shifted in the weeks since the US voiced support for a vaccine-related waiver, although the European Union is trying to broker a “third way” rather than a waiver.

Price Transparency

Ethiopia’s Alegnta Gebreyesus Guntie

The resolution urges member states to take into account “the rights and obligations” listed in the TRIPS Agreement, including those affirmed by the Doha Declaration: “to promote access to medicines and other health technologies for all”.

The resolution calls for “transparency of prices and economic data along the value chain of medicines, including locally produced medicines, and other health technologies” to address the non-disclosure agreements between countries and pharmaceutical companies that contribute to higher prices. 

“The COVID-19 pandemic has revealed the vulnerabilities of many low- and middle-income countries, most of them African countries with no or low local production capacities, exacerbating their challenges of inadequate access to the most-needed vaccines, medicines, diagnostics and other health technologies,” Alegnta Gebreyesus Guntie, Ethiopia’s representative, said on behalf of 47 WHO Africa Region countries.

She explained: “The draft resolution strengthens local production and know-how, promotes technology transfer and innovation, considers the TRIPS agreements and intellectual property rights in the context of local production, and strengthens the mandate for the WHO to work with continental bodies such as Africa Union, to provide member states with support to build capacity for local production.”.

Meanwhile, Kenya’s Dr W Kariuki said acute shortage of COVID-19 vaccines “is contrary to public health goals, as it erodes public trust, breeds vaccine hesitancy and prolongs the acute phase of the pandemic”. 

The resolution, which has the support of over 100 countries, is likely to be adopted by this year’s WHA.

Meanwhile, WHO’s Africa Region revealed this week that the continent only has enough vaccines to cover 1% of the population. African countries that received AstraZeneca vaccines from COVAX now urgently need 20 million additional doses to give those who have had one dose their second vaccination, but India’s Serum Institute has stopped supplying COVAX with vaccines.

 

.

 

Health experts have called on global leaders to tackle environmental issues affecting health and health systems.

A paradigm shift towards health systems and societies that emphasize health promotion, disease prevention and environmental protection could prevent and reduce 50% of the global disease burden worldwide, experts at an informal session on the margins of the 74th World Health Assembly  said on Thursday.

The COVID-19 pandemic has highlighted the inextricable relationships between environments and health while revealing health systems’ weaknesses, according to WHO director-general  Dr Tedros Adhanom Ghebreyesus at the event, Safe Societies and Environments for Health: The Path to Build Forward Better, Healthier and Greener.   

World leaders should hold a “Nature Summit” that would focus heads of state more squarely on delicate relationships between health, climaste and environment – and the “planetary” crisis facing ecosystems, said Inger Andersen, executive director of the United Nations Environment Programme (UNEP), in an apperance at the WHO forum. 

“There’s evidence that the more we fragment nature, the more we encroach into nature, the more we push biodiversity stress, by encroaching and destroying, then the greater likelihood of human pathogens developing out of contact with wildlife and wild diseases,“ said Andersen. 

Maria Neira, WHO director, Environment, Climate Change and Health shared Andersen’s sentiments: “We need to stop this war we are having with nature. We need to recover our relationship as it is the only way towards a safer world that is green and healthy.”

Maria Neira, WHO director, Environment, Climate Change and Health

The events coincided with a landmark decision by a court in the Netherlands, against the multinational fossil fuel giant Royal Dutch Shell – which was cheered by WHO climate and health advocates such as Neira.

The court in The Hague ordered Shell to reduce it’s CO2 emissions by 45% within the next 10 years in its response to a legal suit by Friends of the Earth Netherlands (Milieudefensie) together with 17,000 co-plaintiffs and six other organizations.  The ruling has far-reaching consequences for the rest of the fossil fuel industry worldwide – opening up the possibility of liability claims and suits in other countries against fossil fuel companies for the damage that they are wreaking on the health of the planet and its people.

WHO’s Green Manifesto

In May 2019, the 72nd WHA adopted a Global Strategy on Health, Environment and Climate Change. The WHO strategy aims to “provide a vision and way forward on how the world and its health community need to respond to environmental health risks and challenges up to 2030, and to ensure safe, enabling and equitable environments for health by transforming our way of living, working, producing, consuming and governing.”

The pandemic provides a unique opportunity to rebuild health systems while also tackling environmental issues affecting health, said Tedros at the session, while also lamenting the lack of sufficient investment today. . 

For instance, global health budgets allocate only 3% to addressing preventable causes of disease and to promoting and enabling healthier environments and lifestyle choices. Increased investment could reduce global disease burdens by half, Tedros said, and this would greatly benefit individuals, families, communities and nations.

That is despite the fact that  “preparation is not just better than cure — it’s cheaper”, he said. 

In fact, an investment of $US 1 per person per year in more disease prevention and health promotion could save 8.2 million lives and US$ 350 billion by 2023, Tedros said in his opening WHA remarks on Monday.

On Thursday he again emphasised the need for more investment. “For every dollar invested in basic sanitation, there is a return of $5.50 in terms of reduced waterborne disease … which is still one of the largest killers of children.”

“Safer air, food and roads, better nutrition, and reduced injuries and violence will save lives. But we’ll also save money by preventing health care costs and [by] contributing to employment, productivity, and inclusive economic growth. Healthy populations are also more resilient populations.”

WHO Director-General  Dr Tedros Adhanom Ghebreyesus

In May 2020, after the COVID pandemic laid bare the underlying vulnerabilities of global health, social and environmental systems, WHO issued a Green Manifesto for healthy and green recovery with several 80 action points for so-called “building back better.”

The manifesto also lists opportunities for actions to enhance the WHO global strategy, which is likewise embedded in WHO’s 2019-2023 workplan – encouraging more cross-sectoral actions on unhealthy urban environments, lifestyles, poor diets and unsustainable food systems – areas where the worst risks often hit hardest on the poor – exacerbating existing social inequalities. 

A Healthy Planet Makes Healthier People

That has been all the more vividly illustrated during the COVID pandemic, in which access to clean water and sanitation, clean air, and decent urban housing conditions have all been understood as critical to reducing disease risks and disease transmission. 

UNEP Director Andersen said the argument for climate action is at an “historic crossroads” due to the COVID-19 pandemic.

Pandemic-related policies thus need to also address climate, biodiversity, nature and pollution, because otherwise “We would just be in a systematic loop … We have been taking nature for granted.”

Although the world has for far too long assumed that climates and environments would remain stable, she said, “A healthy planet is a precondition for healthy lives.”

Referring to research pointing to vast potential losses of genetically diverse animal and plant species over the coming years, Andersen also called for more research into food systems. “Why does this affect us? Because nature is a finely-tuned ecosystem where each relies on the other. And that is what produces the food, the water, the air” that humankind relies upon for life and livelihoods.

Education to Promote Environmental Awareness

Along with high-level efforts like a summit, education also is a critical tool to raise environmental awareness and contribute to improved health, according to  Desmond Appiah, resilience and sustainability advisor in the city of Accra, Ghana. 

Appiah said there is a need to work across sectors and with communities from the ground up to address water, waste, sanitation and air pollution issues critical in developing and building healthy cities. For example, he said the city government and its partners in a WHO and UNEP co-sponsored “Urban Health Initiative,” visits local churches, faith-based organisations to educate them on  air pollution’s health impacts as well as contributing factors, from waste-burning to motor traffic and the dearth of walkable green spaces.  In line with those efforts, Accra in 2018 was also the first city in Africa to join the BreatheLife initiative, dedicated to building awareness and more local action around linked, health, environment and climate.   

In two decades of work on World Bank digital health initiatives, global health policy specialist Akiko Maeda found many fell short of their promises. She suggested these underperforming digital health initiatives focused too much on delivering hardware — but they failed to provide means to ensure stable electricity supplies, and similarly failed to provide adequate human resources to manage data, or to design initiatives that the most vulnerable groups could benefit from.

Akiko Maeda, health economist with over 30 years of experience in international development in over 40 countries

“It’s not just the infrastructure and the hardware, but how we design the software that goes with it,” Maeda said Thursday. She spoke at a World Health Assembly side event co-hosted by the Geneva Graduate Institute’s Global Health Centre, the Lancet & Financial Times Commission, and Digital Square, which is supported by USAID and the Bill and Melinda Gates Foundation. 

“Digital infrastructure is more than just a bunch of cables and devices,” said data literacy consultant Gulsen Guler, who is also co-chair of My Data Global, a civil advocacy group promoting equitable digital societies – adding that the stakes are high:

“Digital technologies can determine what the future of a child will look like…or even more, they can determine between life and death.”

Digital Health Saves Resources to Reach Universal Health Coverage 

Roger Kamba, Special Advisor to the Democratic Republic of the Congo (DRC), called digital technologies crucial in low-income countries. He said these tools can help countries reach universal health coverage and that digital health can help to meet Sustainable Development Goals. 

“Digital health is not an option, but rather a necessary step towards universal health coverage,” Kamba said. “I remain personally convinced that there can be no universal health coverage without a substantial contribution from digital health.”

However, he said that for that to happen, governments must prioritize digital transformation through a multi-sectoral approach that goes beyond the health ministry. 

In 2019, the DRC adopted its digital technology strategic plan, Kamba said. Implemented by a newly-created ministry, the plan engages all sectors, including health. “All governments need to take a systems approach to digital transformation. It’s not just the health ministry that needs to be working on health care anymore.”

An Epidemiological Nerve Centre – The Emergency Operations Centre

Kamba said existing digital health initiatives, notably the nation’s Emergency Operations Centre (EOC), have proven useful in quickly containing infectious disease outbreaks like Ebola. Set up two years ago by PATH, USAID, and the Bill and Melinda Gates Foundation in collaboration with the DRC Centers for Disease Control, the EOC acts as the country’s epidemiological nerve centre to coordinate efforts to prevent, detect, and rapidly respond to public health emergencies. 

“The center uses tools such as digital mapping, Geographic Information System (GIS) mapping, and mobile health technologies to produce layers of information that help reveal  patterns that enabled more effective interventions during the Ebola epidemic,” he said.

“Actionable surveillance data and digital epidemic maps made the response faster and more focused, and was the first time that response data was digitized and centralized”. Recently the EOC expanded its scope to investigate regional and local malaria trends; it also facilitates disease control strategies using advanced data analyses. 

Kamba warned that digital health initiatives depend on reliable and affordable electricity, which can be a challenge in low-income countries: “We’re talking here about the potential of digital solutions to help us overcome long standing infrastructure challenges in sub-Saharan Africa … Investments in digital health in DRC must be coupled with energy solutions at the national level.”

“These [digital] infrastructures are also faced with a fundamental financing gap,” said Ilona Kickbusch, Geneva Graduate Institute Global Health Centre co-founder and co-chair of the new Lancet & Financial Times Commission on Governing Health Futures 2030. “To really have sustainable financing that’s also reflected in the budgets of countries is a truly, truly big challenge.” 

Ilona Kickbusch, Geneva Graduate Institute Global Health Centre co-founder and co-chair of the new Lancet & Financial Times Commission on Governing Health Futures 2030.

Digital Health in Burkina Faso Improves Care Quality

Meanwhile in Burkina Faso, Swiss NGO Terre des Hommes (Tdh) has worked for over a decade with the Ministry of Health to develop Ieda – a digital job aid tool that enhances the clinical diagnosis of childhood diseases and improves health workers’ performance using artificial intelligence (AI) algorithms.

Ieda already is available in 80% of health-care facilities in the country and has helped with a whopping 10 million digital consultations. This generates savings of US$1.6 million every year, Tdh health programmes research head Riccardo Lampariello said. “Digital health solutions at scale bring financial savings for the authorities, of course after the initial national investment, of $1.6 million every year. Hence the importance of investing in digital health.”

Lampariello stressed that the bulk of digital health expenditure is not on infrastructure but on human resources required to build necessary technical and regulatory capacity. He noted that governments need to run local data centers, extract and analyze data, update software and fix data platforms when they crash.

Riccardo Lampariello, head of Tdh’s health programmes

“Digital health is human resource-intensive, and we should equally invest in infrastructure — which is not only tablets and solar power panels, it is also data centers, for example — and in human resources, including local authorities, including the government, the MOH, in technical skills … and also look to teach them the governance skills to regulate labor use.”

Thanks to this already-existing digital health infrastructure, when the coronavirus hit it took only a few weeks for Burkina Faso’s Ministry of Health to deploy digital tools to support training, awareness-raising and triage, and to reach vulnerable groups in remote and unsafe areas, Lampariello said.

But he warned that the digital health landscape is still fragmented in low-income countries, challenged by duplication, a lack of interoperability and waste of precious devices and electricity.

“Even before COVID, it wasn’t rare to pay a visit to a health-care facility in a very poor country, open a cupboard and find two or three tablets or smartphones [for] dealing with different platforms and databases. In a context of limited resources, this represents a lot of wasted tools,” Lampariello said. “And not to mention, for example, the additional unnecessary e-waste and energy consumption related to that.”

Speakers Ask For Well-Designed & Equitable Digital Health Initiatives

Digital health initiatives are likely to be more impactful if they designed to be equitable, added panelists on Thursday. In Japan, for example, vaccine uptake in older age groups was hampered by the country’s response plan failing to consider that booking vaccine appointments online can be a struggle for older people. “It’s a design issue, and it’s not a complex issue, but it was not adequately designed for the elderly, so there’s a huge problem going on right now in Japan,” said Maeda.

Ann Aerts, Head, Novartis Foundation

“Every solution, digital- or AI-driven, has to be human-centered,” said Novartis Foundation head Ann Aerts. “And that’s quite obvious, although it’s not always the case. The best way is to use a human-centered design with input from the people who will have to use a solution, and by thinking up-front how the solution will be integrated in the processes of the health workforce, or the workflow.”

According to a World Bank study, successful digital health initiatives tend to share characteristics like strong leadership and regulatory systems, substantial financial commitments to digitize health systems, and national frameworks to facilitate data flows between systems, added Aerts. 

Disability services should be incorporated into primary health care programmes at the community level, states a resolution adopted at the 74th WHA.

A new resolution adopted on Thursday by the 74th World Health Assembly aims to scale up access to services and treatment for people living with disabilities – using a more “gender-sensitive and inclusive” approach.

The resolution co-sponsored by Israel and Australia,  calls upon member states to ensure that disability services are incorporated into primary health care programmes at the community level – and that conversely disabled people also have full access to health services.

It also calls for special attention to be paid to the “unique vulnerabilities of those who may be living in care and congregated living settings in times of public health emergencies such as COVID-19, and for special protection against infections in particular for at-risk groups,” including more education for health care workers. 

And, the resolution calls upon WHO to etch out a global research agenda on disabilities, as well as to develop, by the end of 2022, a global report on disabilities, updating estimates on the numbers of disabled people worldwide, from a decade old World Report on Disability (2011).

Countries Said Community-based Interventions Are Key 

Israeli diplomat Nitzan Arny speaks about the resolution on persons with disability led by Israel.

One in seven persons worldwide experience some form of disability. The numbers are increasing due to factors such as ageing populations and widespread chronic health conditions. 

Many countries highlighted the roles community-based interventions can play in improving access – in reactions that warmly supported the initiative overall. 

The resolution broadly calls for collection of reliable data that allow for disaggregation by disability. It also advocates equal access to effective health services, protection during health emergencies, and access to cross-sectoral public health interventions. 

Persons with disabilities face inequality in social, economic, health and political spheres and are more likely to live in poverty than those without disabilities. They are also more likely to have risk factors for noncommunicable diseases and less likely to have access to essential health services.  

“Nothing about us without us’ is not just a catchphrase. Meaningfully involving persons with disabilities in decision-making processes is a precondition for ensuring disability inclusion,” said Israel’s delegate to the WHA,  Nitzan Arny, in presenting the initiative. 

Australia, the resolution’s co-sponsor said: “We recognize the importance of promoting disability inclusion in the health sector to ensure persons with a disability enjoy the highest sustainable highest attainable standard of health, including access to quality disability inclusive health services, information and education across their lifetimes.”

Israel, Australia, the United States, European Union, Kenya, Botswana, the United Kingdom, Japan, Mexico and a dozen other countries co-sponsored the resolution.

Meanwhile, the resolution gives new impetus for action, particularly in light of the fact that WHO’s current Global Disability Action Plan 2014–2021 is set to expire this year. 

New Zealand, however, said it supports extending the Global Disability Action Plan because “This would demonstrate continued international commitment to this goal, and provide guidance for how this can be achieved.” 

 

COVID’s Impacts on Persons With Disabilities 

The pandemic has harmed people with disabilities in various ways, yet few member states collect data that are disaggregated by disability.  

Women and girls living with disabilities face particular challenges. “Women, young women and girls who are disabled have a high risk of being marginalized and seriously discriminated against. That reduces their economic and social status, it increases the risk of sexual violence and sexist attitudes against and towards them and [of] limited access to justice,” Canada said. “These challenges have only increased during the COVID-19 pandemic, and disabled women and girls continue to fight for their rights for equality and for changes to the system.” 

The resolution highlighted the role of community health workers in advancing equitable access of persons with disabilities to safe, quality, accessible and inclusive health services.

Stress on Community-Based Rehabilitation

Among the stakeholders invited to collaborate under the resolution are organisations of persons with disabilities, private sector companies, scholars and teachers. 

“Community-based rehabilitation is a strategy to improve access to the services to persons living disabilities in middle-and low-income countries through the optimal use of local resources,” said Colombia. 

 Civil society organisations have welcomed the resolution. “We welcome that the resolution calls on governments to actively involve people living with disabilities in decision-making and programme design. This will ensure that health systems and responses to health emergencies can better deliver on the needs of the people most affected,” said Nina Renshaw of the NCD Alliance. “As we’ve seen in other fields of global health, such as HIV and TB, meaningful inclusion of lived experience is absolutely fundamental to catalyse overdue progress.”

Image Credits: PicPedia.

Mr Ma Bin, Consultant at the Health Emergency Response Office, China’s National Health Commission, read the statement for China at the session

China told the World Health Assembly on Wednesday it will continue to support developing countries’ access to affordable COVID-19 vaccines – but it stopped short of any commitment to supplying its recently-approved Sinopharm vaccine to the WHO co-sponsored Global COVAX vaccine facility. 

WHO officials had said they hoped China would join the COVAX facility, following WHO’s decision to grant the Chinese Sinopharm vaccine an Emergency Use Listing.  COVAX has been badly strapped for doses to send to over 100 low- and middle-income countries after its major supplier, the Serum Institute of India, announced it would have to redirect all of its vaccines to domestic needs following India’s huge COVID surge.  

But China’s WHA delegate said that the country had honored its commitment to provide vaccines as a global public good by providing bilateral vaccine assistance to more than 80 countries, along with exports to 43 more nations – for a total of 300 million vaccine doses. 

“China believes that promoting equitable distribution of and access to COVID-19 vaccines worldwide is crucial to the current pandemic prevention and control,” the delegate said. On the private market, the Sinopharm vaccine is the most expensive in the world – outstripping the cost of the highest-performing mRNA vaccines produced by Pfizer and Moderna.  

 

The Chinese representative also avoided taking a clear position on the proposed Pandemic Treaty. A draft agreement on taking at least the first steps towards a treaty was reached earlier this week among WHA delegates. The proposal – by 26 entities including the European Union, USA, UK and key countries from each WHO region – appeared to be gathering more momentum from other countries as well. 

However, China supports “the concept of building a One Health Surveillance System as well as a whole-of-government and whole-of-society response approach,” the Chinese delegate, Mr Ma Bin, stated. 

In a wide-ranging discussion at the Assembly’s morning sessions, most countries’s statements also stressed the pandemic’s damage to their societies and economies. 

“The emergence of new variants of the virus has overwhelmed the already overburdened health system,” said Ethiopia’s delegate, saying the pandemic had also resented unprecedented social challenges and put enormous strains on economies. 

Strategies to engage communities and communicate effectively with the public are pillars of the Ehiopian response aimed to reduce disease transmission, she said. The COVAX Initiative has meanwhile supported the vaccination of 1.7 million Ethiopian’s at high risk, she added. 

“However, due to the current global situation, our vaccination campaign is seriously challenged, severely hampering our response and management of the spread of COVID-19. This reality is being experienced by many developing countries,” she said. 

Her comments sidestepped any reference to the pandemic or wider health issues faced by Ethiopians in the country’s war-ravaged Tigray region, where UN officials have warned that famine now looms.  

vaccine
Hiwot Solomon, Director, Disease Prevention and Control, Ethiopia’s Ministry of Health: “The emergence of new variants of the virus has overwhelmed the already overburdened health system.”

Sudan’s representative, meanwhile, said that while the pandemic has shaken all health systems, it has widened health service delivery inequities particularly in Low and/or Middle Income Countries (LMICs).

“While Sudan is committed to playing its role in the global efforts for control and prevention of public health emergencies of international concern, challenges remain,” Sudan’s representative said. “This is observed in the difficulties to regularly evaluate legislation, regulations, and policies to facilitate full implementation as well as capacity for infection prevention and control.”

Sudan called for WHO technical support to establish public health laboratories in difficult spaces and to support LMICs with consumable supplies. Sudan said its particular needs include food safety surveillance systems and a poison control center.

COVID – One Among Many Outbreaks Africa Faces 

Dr Matshidiso Moeti, WHO Regional Director for Africa.

WHO Regional Office Director for Africa Dr Matshidiso Moeti described COVID-19 as just one among a number of outbreaks African countries face. She noted the region has endured humanitarian crises as well as outbreaks of Ebola, measles, yellow fever and other diseases.

Still, she said, African governments “have pushed to sustain hard-won health gains and to minimize the pandemic’s impact, and are taking actions to prevent and treat other diseases.”

The pandemic highlights the need to invest in preparedness and the importance of equity in order to protect the vulnerable, Moeti said. “Much needs to be done immediately and in significant quantities to make the difference.”

‘Last Pandemic’ Report Approved

The WHA morning session also formally accepted the report of the Independent Panel for Pandemic Preparedness and Response. This panel was created to provide evidence and historical context to ensure that countries and global institutions, specifically the WHO, will be able to address future pandemic threats.

See also: Sweeping Report on COVID Pandemic: Broken Global Emergency Alert System, Hesitant WHO & Patch Country Response 

Former Liberian President Ellen Johnson Sirleaf, who co-chaired the panel, repeated to the Assembly once more her mantra that actions need to be taken now – so that COVID-19 may be the last pandemic of its kind.

Ellen Johnson Sirleaf: “We identified shortcomings at all stages of the response at both the national and international levels.”

“We identified shortcomings at all stages of the response at both the national and international levels. We also identified successes, and we recognize the hard work and sacrifices made – especially by health workers across the world,” Sirleaf said.

The panel’s goal wasn’t to apportion blame, she said, but to identify the pandemic’s lessons “so that the world can move forward to end the current pandemic and make it the last”.

Former Prime Minister Helen Clark of New Zealand, the Independent Panel’s other co-chair, said that fully acting on these findings can address the current pandemic as well as prevent future outbreaks from becoming pandemics.

‘Two-tiered World’ of Vaccinated and Unvaccinated

Helen Clark, co-chair of the WHO’s Independent Panel for Pandemic Preparedness and Response (IPPR), and former Prime Minister of New Zealand.

As virus deaths continue in the thousands daily, she said, vaccines that provide hope also show development of a two-tier world of the vaccinated and unvaccinated. 

“Immediate action therefore is needed on vaccines,” Clark said. The panel has recommended that high income countries share their existing vaccine doses on a much more massive scale – to free up at least 1 billion doses by September for lower-income member states.  

“At the same time, we urge removing the barriers to manufacturing scale-up by sharing intellectual property and transferring knowledge and technology, and by fully funding the Access to COVID-19 Tools Accelerator (ACT-A),” Clark said. 

She was referring to the WHO co-sponsored initiative that includes COVAX as well as funding for medicines rollout and strengthening health systems. It remains US$ 18.5 billion short of funds needed for 2021, according to senior WHO adviser Bruce Aylward, speaking at the WHA Tuesday. 

Said Clark: “The return on investment would be enormous – both for people’s health and for economies.”

Image Credits: Paul Adepoju , Paul Adepoju.