Three Years of the COVID-19 Pandemic: ‘A Failure of Multilateralism and Solidarity’
Covid-19 pandemic
Thousands of small white flags stand sentinel outside the Washington D.C. Armory in October 2020, each representing an American who died from COVID-19.

Three years after the World Health Organization’s (WHO) declaration of the COVID-19 pandemic, the era of hourly headlines updating death and case counts has come to a merciful end. But the virus is still killing around 1,000 people worldwide every day, and it isn’t going anywhere. 

As of 7 March, WHO has confirmed over 750 million cases of COVID-19 and 6.8 million deaths – widely viewed as a considerable underestimate by experts. 

The world’s choice to move on from the pandemic is reflected in the increasingly sparse data on case, test and death counts that once underpinned the breathless news cycle at the height of COVID-19’s assault. 

Last week, Johns Hopkins University announced it was shutting down its global COVID-19 tracker due to the lack of data. The interactive map had been a trusted source for journalists, academics, researchers and policy makers since it launched shortly after the virus began its escape from China. 

Yet WHO has said it is not ready to declare an end to the pandemic, and some experts worry that the virus could mount a counter-attack. COVID-19’s continued circulation provides it with ample opportunities to mutate and become more transmissible by learning to sidestep immune responses. 

“Whatever the virus is doing today, it’s still working on finding another winning path,” Dr Eric Topol, head of Scripps Research Translational Institute told the Associated Press.

With public trust in global health institutions in free fall and deep global divisions permeating the COVID-19 landscape, Topol fears the world is not prepared for a more infectious variant to emerge.

“I wish we united against the enemy — the virus — instead of against each other,” he said.

‘Never Again’

Former United Nations (UN) Secretary General Ban-Ki Moon, Nobel laureate Joseph Stiglitz, and current Timor-Leste President and Nobel Peace Prize winner Jose-Manuel Ramos Horta joined nearly 200 global figures in signing an open letter calling on world leaders to “never again” allow pharmaceutical companies to choose profits over saving lives. 

The letter, published on the third anniversary of the WHO’s pandemic declaration on 11 March, pinned millions of preventable deaths on the “private monopolies” created by vaccine patents and the pharmaceutical industry’s “desire to make extraordinary profits” over “the needs of humanity”.

“Instead of rolling out vaccines, tests, and treatments based on need, pharmaceutical companies maximized their profits by selling doses first to the richest countries with the deepest pockets,” the letter said. “Billions of people in low and middle-income countries, including frontline workers and the clinically vulnerable, were sent to the back of the line.”

Equitable sharing of vaccines globally could have saved an estimated 1.3 million lives in the first year of vaccine availability – one every 24 seconds – according to an analysis published in Nature based on modeling by The Lancet. 

Helen Clark, former Prime Minister of New Zealand and co-chair of the Independent Panel for Pandemic Preparedness and Response established by WHO, said the vast public funding backing the science that contributed to the vaccines meant they should have be treated as global common goods. 

“Nationalism and profiteering around vaccines resulted in catastrophic moral and public health failure which denied equitable access to all,” she said. “We need to fix the glaring gaps in pandemic preparedness and response today, so that people in all countries can be protected when a pandemic threat emerges.”

IP-related suffering

A United States delivery of 655,200 COVID-19 vaccine doses through COVAX to Ethiopia on September 23, 2021.

The letter also noted that this is not the first time intellectual property claims by pharmaceutical companies over life saving medicines have caused unnecessary suffering.

“In the AIDS pandemic, pharmaceutical monopolies have resulted in an appalling number of unnecessary deaths – and it has been the same story with COVID-19,” said Winnie Byanyima, Executive Director of UNAIDS. “But governments still have not learned that lesson. Unless they break the monopolies that prevent people from accessing medical products, humanity will sleepwalk unprepared into the next pandemic.”

The pharmaceutical industry, meanwhile, points the finger at vaccine nationalism displayed by governments. Industry groups also highlight the scientific achievements of the COVID-19 vaccine race, which brought safe vaccines to market in record time and catalyzed hundreds of promising medical trials based on mRNA technology. 

“The pharmaceutical industry has been advocating for equitable vaccine distribution to vulnerable populations in low-income countries since 2021, and has worked as a key partner in COVAX,” Thomas Cueni, Director General of the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) told Health Policy Watch in an email. 

It must be recalled that after [the] initial fast roll-out of COVAX vaccines, which saw Ghana receive the first batch of vaccines less than three months after the first distribution in Europe, India – which was the principal source of licenced vaccine supply – shut its borders for almost seven months, and it took far too long for high income countries to step up and start dose sharing,” he said. 

The United States and European Union were also slow to share their vaccine supplies as they struggled to get their domestic outbreaks under control, resulting in millions of doses sitting in warehouses as poorer countries begged for them to be shared. 

In its 2022 annual report, the UN World Intellectual Property Organization (WIPO) estimated the social benefit of COVID-19 vaccines – a calculation of lives saved, health costs avoided, and value of saving economies from mitigation measures like lockdowns – at $70.5 trillion, 887 times pharmaceutical revenues of $130.5 billion. 

Vaccines have saved tens of millions of lives globally since the onset of the pandemic, according to the Lancet’s Infectious Diseases Journal. But unequal access in low-income countries has limited their impact, highlighting the need for global vaccine equity.

“Singling out intellectual property as the cause of lack of access also diverts attention from focusing on key hurdles such as weak health systems, supply chain challenges, vaccine nationalism, and gross misinformation, all of which significantly contributed to slow vaccine uptake,” Cueni said. “Governments must engage to create a social contract that enhances equity in future pandemic responses.” 

Negotiating a pandemic accord 

WHO Director-General Dr Tedros Adhanom Ghebreyesus has called on countries to not repeat the mistakes of COVID-19 in negotiating a new pandemic accord.

WHO member states are currently negotiating an accord to guide the global response to the future pandemics, including equitable access to medicines such as vaccines, but progress has been slow

The latest negotiations on the zero draft of the global pandemic accord were dominated by concerns over equity and financing, echoing the now familiar battle lines that have defined international climate adaptation and biodiversity negotiations. 

WHO Director-General Dr Tedros Adhanom Ghebreyesus, who has stated he hopes to preside over the initial approval of a WHO pandemic accord in 2024, when a final draft is due to be presented to the World Health Assembly, appealed to member states in his opening remarks to “not repeat the same mistakes” of the COVID-19 pandemic. 

He repeated that message on Monday in a ceremony at the University of Michigan, Ann Arbor, where he received a global public health award, saying that the importance of global cooperation is among the three lessons of the pandemic – along with the importance of health and science:

“Instead of a coherent and cohesive global response, the pandemic has been marked by a chaotic patchwork of responses. This is because of narrow nationalism,” Tedros said. “We can only face shared threats with a shared response, based on a shared commitment to solidarity and equity.”

Rooted in equity and human rights

Echoing that, Ban-Ki Moon said the pandemic accord must be “rooted in equity and human rights,” and place “the needs of humanity above the commercial interests of a handful of companies” in a comment accompanying the People’s Vaccine Alliance open letter.

“The great tragedy of the COVID-19 pandemic has been the failure of multilateralism and the absence of solidarity between the Global North and the Global South,” Ban-Ki Moon said in his statement accompanying the open letter. “We need a return to genuine cooperation between nations in our preparation and response to global threats.”

But negotiations are still in their early stages, and it is too early to judge whether they will be successful. 

The US, Japan and India have expressed opposition to the current accord draft’s stipulation that 5% of GDP be designated for pandemic preparedness, with India calling the provision “overly prescriptive”.  

Western Pacific countries, inscluding small island states that are already facing the earliest consequences of climate change, meanwhile, have requested that “specific recommendations in recognition of the impacts of climate change” be considered. 

A confluence of crises  

Former United Nations Secretary General Ban-Ki Moon called the global response to COVID-19 a “failure of multilateralism and an absence of solidarity.”

It is hard to keep count of the generational crises that have hit the world since WHO declared the COVID-19 pandemic. 

Estimates of lives lost in Russia’s invasion of Ukraine number well over 200,000, with hundreds of thousands more injured, and millions displaced. The largest earthquake since Fukushima shook Turkey and Syria, claiming 50,000 lives and counting. 

The visceral images of the devastation wrought by these catastrophes empower their death counts with shock value, but also put into perspective the numbness with which the 1,000 daily global deaths from COVID-19 are met three years into the pandemic. 

This confluence of crises over the past three years has created a perfect storm where the eye of the hurricane looms over the livelihoods of the world’s most vulnerable.

The virus as a test run for other challenges…

In a 2022 analysis by Nature, researchers found that up to 667 million people were living in extreme poverty – nearly 100 million more than before the pandemic and Russia’s invasion of Ukraine. 

The virus showed that a threat anywhere could be a threat everywhere – a trait shared with the overlapping crises of climate change, conflict, economic inequality, migration and global health.  And if the pandemic was the test run, it has shown the world is not up to the challenge of meeting any of these challenges.  

Climate change declared its arrival as a regular part of the day-to-day lives of billions around the world as floods submerged over a third of Pakistan last August, and drought-related hunger gripped the Horn of Africa this year with increasing severity.  Meanwhile, the world’s efforts to curb global warming to 1.5 degrees continue to fall far short

Russia’s invasion of Ukraine sent shockwaves through the world’s fertilizer and energy markets, further exacerbating a global food crisis that had already reached historic heights. 

Over 345 million people will face food insecurity in 2023 – over double pre-pandemic levels, with 200 million more people struggling to feed themselves and their families than in 2020, the World Food Programme said. Another 900,000 worldwide are facing famine, 10 times more than five years ago. 

Meanwhile, the past decade has seen the top 1% capture around half of all new wealth created since 2020, worth $42 trillion, according to a January 2023 report by Oxfam published on the opening day of the World Economic Forum in Davos, Switzerland. 

“While ordinary people are making daily sacrifices on essentials like food, the super-rich have outdone even their wildest dreams,” Gabriela Bucher, Executive Director of Oxfam International said. “Forty years of tax cuts for the super-rich have shown that a rising tide doesn’t lift all ships – just the superyachts.”

The legacy of the pandemic is not yet fully written. But as it stands, it is a story of inequality. 

Image Credits: Ron Cogswell, US State Department, World Bank.

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