Even though the end is not yet in sight for the COVID pandemic, the world can end it as a global health emergency in 2022, says WHO DG at the opening of the 150th sesssion of the World Health Organization Executive Board.

While the world will be living with COVID for the foreseeable future, countries can end the acute phase of the pandemic this year, said WHO’s Director General Dr Tedros Adhanom Ghebreyesus Addressing the opening session of a week-long WHO Executive Board meeting in Geneva, the DG warned that the world will need to learn to manage the virus through a sustained and integrated approach to acute respiratory diseases –  which will also provide a platform for preparing for future pandemics.

“Learning to live with COVID cannot mean that we give this virus a free ride. It cannot mean that we accept almost 50,000 deaths a week from a preventable and treatable disease. It cannot mean that we accept an unacceptable burden on our health systems when everyday, exhausted health workers go once again to the frontline. It cannot mean that we ignore the consequences of long COVID which we don’t yet fully understand. It cannot mean that we gamble on a virus whose evolution we cannot control nor predict,” Tedros said.

He added that it is dangerous to assume that Omicron will be the last variant or that the world is in the end game for the pandemic while on the contrary, globally, the conditions are ideal for more variants to emerge.

And he appealed to WHO member states to agree on a fromulat to increase their regular, fixed payments to WHO according to a proposed 5-year scale-up plan, that would give the Agency a greater ability to plan and budget rationally, warning that, if the current funding model, dependent on voluntary contributions continues “WHO is being set up to fail.  A paradigm shift in world health that’s needed must be matched by a paradigm shift in funding.”

Germany now WHO’s largest donor – says US$ 20 billion needed for vaccines, tests and treatments in low-income countries

The WHO Director General spoke shortly after holding a joint press conference with Germany’s new Economic Cooperation and Development Minister, Svenja Schulze, where he told reporters that Germany was now WHO’s largest donor.

“As you all know, Germany has been an important friend and longstanding partner to WHO and in fact it is now WHO’s largest donor,” said Tedros Adhanom , speaking alongside Schulze who assumed her post in Germany’s new government elected late last year.

Traditionally the United States has been WHO’s largest financial backer, contributing about US$250 million a year in “voluntary contributions” alongside about about $115 million in regular “assessed contributions” – the paid by virtually all 194 member states, according to a fixed and scaled formula.  But that was outpaced by Germany, which was contributing to the tune of about $560 million a year as of the third quarter of 2021 – most of it in voluntary contrbutions.

But Germany has emerged as one of the strongest political backers of WHO over the course of the pandemic.  Last year, Germany opened a WHO Hub for Pandemic and Epidemic Intelligence in Berlin – to step up surveillance.

And it is also leading the charge for a deeper change in the Organization’s financing formulas. According to that proposal, fixed, “assessed contributions”  by WHO member states would gradually rise to 50% of WHO’s US$ 3.5 bilion-a-year budget to ensure more predicatable funding.  Germany, along with European and other African states have been pushing hard for a clear signal on the measure at this week’s EB, but that is unlikely in light of the continued resistance from several other rich and middle-income countries, including Japan, the United States, Argentina and Brazil. See related story here.

As WHO Executive Board Meets – Handful of Countries Stall Plans to Reform WHO Finance

In the pre-EB press conference, Schulze also said she’d use Germany’s new G-7 leadership role to ensure sufficient pandemic response funding was available to low-income countries in 2022 – noting that some US$ 20 billion would be needed from donors.

“We know that around $20 billion will be needed this year to supply the poorer countries with vaccines, tests, and therapeutics. The G7 will play an important role in that organization for the world. We will be pushing for the world’s bigger economies to contribute their fair share of that financing,” she said, adding that the world needs a “massively accelerated truly global vaccination campaign – along with stronger health systems overall.

But she admitted that Germany remains opposed to a proposed World Trade Organization waiver on COVID-related intellectual property, contending that voluntary licensing of available know-how is a better way to jump start more manufacturing efforts in low- and middle-income regions.

“We are convinced that patent protection encourages innovation; it led to the development of these vaccines,” she said, adding that the world, “will need further innovations in order to deal with the further variants of COVID, but also the many other diseases that we have in the world, where we will need vaccines.” 

Dangerous to assume Omicron will be the last variant or the end game

Speaking later at the EB Opening, Tedros warned that while “there are different scenarios for how the pandemic could play out…. it’s dangerous to assume Omicron will be last variant or we are in the end game. On the contrary, globally conditions are ideal for more variants to emerge.

“To change the course of the pandemic, we must change the conditions that are driving it. We recognize that everyone is tired of this pandemic,” he added.

But even if the virus becomes endemic, the world can end the pandemic in 2022 – and reduce the risks of new variants emerging with more universal COVID vaccine coverage, and the deployment of other public health measures. 

“If countries use all of these strategies and tools in a comprehensive way, we can end the acute phase of the pandemic this year,” Tedros said.

“We can end COVID-19 As a global health emergency, and we can do it this year.” 

He restated the aim of vaccinating 70% of the eligible population of every country by mid-2022 – with a focus on the most at risk groups.  COVID mortality can be reduced by enshrining strong clinical management beginning with primary health care, and equitable access to diagnostics oxygen and new oral antiviral drugs at the point of care. 

Other essential elements include the need to further increase COVID testing and genetic sequencing of virus samples globally to track the virus closely – and monitor the emergence of new variants.  Identification of new variants early on will improve countries’ ability to calibrate the use of public health and social measures when needed – as happened in South Africa with the early identification of Omicron. 

But as the world enters what is now the third year of the pandemic, a renewed focus also needs to be placed on other long-neglected health services, he emphasized.

“It [also] means restoring and sustaining essential health services. And it means learning critical lessons and defining new solutions now, not waiting until the pandemic is over. We can only do these with engaged and empowered communities,” the WHO DG said.  

Progress despite COVID

Despite the strains on global health as a result of COVID-19, the WHO DG noted that several giant strides were still recorded on several health issues in different parts of the world.

 WHO issued a historic recommendation for widespread use of the world’s first malaria vaccine, which Tedros said could save tens of thousands of young lives each year. 

“China and El Salvador were certified by WHO as malaria free last year, and the Islamic Republic of Iran recorded three consecutive years of zero in cases of malaria,” he added, noting the continued progress against elimination of what remains the world’s most deadly parasitic disease. 

He added that eight countries achieved “90-90-90” percent targets for testing, treatment access and viral suppression of HIV by the end of 2020, while a further 20 countries are close. 

Moreover, a total of 15 countries have eliminated mother-to-child transmission of HIV and/or syphilis with Botswana in 2021 becoming the first high burden country in Africa to achieve Silverchair certification on the path to elimination of mother to child transmission of HIV.

Progress was also recorded in the global fight against hepatitis, neglected tropical diseases and eradication of wild polio, he pointed out.

Health is not a byproduct of development

The WHO DG noted that the COVID-19 pandemic has shown the world that health is not merely a byproduct of development nor an outcome of prosperous societies — or a footnote of history.

“It’s the heartbeat, the foundation, the essential ingredient without which no society can flourish,” the DG said.

Considering health is dependent upon the fullest cooperation of individuals and the states, WHO DG warned that the continuing inequitable pace of development in different countries, with respect to the promotion of health and control of disease, remains a common danger for everyone.

Beyond that, he underlined that reaching “the highest attainable standard of health is one of the fundamental human rights of every human being” – echoing the vision set out in the original WHO Constitution.

Rising Tensions with Ethiopia

The DG’s speech received a positive receiption from most WHO member states – but with the notable exception of Ethiopia.

Ethiopia’s EB representative took the floor in an attack on Tedros’ his statements about the health and humanitarian situation in the countriy’s blockaded Tigray region, saying that the WHO DG was “using his office to adance his personal political interests.”

But he was cut off by EB Board Chair Patrick Amoth of Kenya who said that he was out of order since the EB had decided to set aside a  “note verbale” on the allegations, which had earlier been submitted by Ethiopia to the board. Amoth declined to disclose the full contents of the note verbale, saying it was “complicated” and fraught with legal and political implications.  

For some weeks now, @WHO has been protesting the dire humanitarian situation in #Tigray & #health blockade, with rising appeals @DrTedros, himself from #Tigray. 👉https://t.co/d0afXRfPAH
Now #Ethiopia may be retaliating – and in more formal channels than social media – #EB150. https://t.co/ERVHrqe0rL

— Health Policy Watch – Global Health News Reporting (@HealthPolicyW) January 24, 2022

There has been a rising chorus of Ethiopian government media and social media mudslinging against Tedros and other UN groups, recent accusations against the DG of misconduct.

That comes as WHO and DG Tedros protested the Ethiopian government’s months-long blockade of the rebel Tigray region – asking officials to permit entry to humanitarian aid for medicines and other basics like insulin.  In a recent press briefing, the DG noted that the current ban on the entry of international relief workers is unprecedented even in the annals of the world’s most bitter civil conflicts.

WHO Slams Ethiopia’s ‘Blockade’ on Health Relief to Tigray Region as ‘Catastrophic’ and ‘Unprecedented’ Even in Conflict Zones

The WHO stance and DG’s comments have been widely echoed by other UN and humanitarian groups, confirming the dire situation that has left hundreds of thousands of people on the verge of starvation, as well as unable to acces medical care. But the fact Tedros is Tigrayan, as well as the sole WHO candidate running for re-election to head the agency, have left him open to personal political attack, observers say.

European Union officials recently charged that the Ethiopian state-controlled media also have been circulating “Fake News” about European humanitarian aid efforts and the WHO.

At the EB in Geneva, Kenya’s Ambassador to the UN in Geneva, speaking on behalf of WHO’s African group, also gave Dr Tedros tacit backing, saying that WHO should remain focused on it’s main health mission.

“The African member states wish to underscore the importance of WHO maintaining focus on the needs of those most vulnerable through providing the required support to member states at the country level in pursuit of their national, global commitments and the SDGs,” said Dr Cleopa Mailu, who is also a former Kenyan Health Minister.

–Elaine Fletcher Ruth contributed to this story. 

Image Credits: WHO.