COVID-19 was a “preventable disaster” that became a pandemic due a lack “global political leadership,” according to a report issued this week by a 13-member independent panel of experts appointed by Dr. Tedros Adhanom Ghebreyesus, the director general of the World Health Organization (WHO).
According to a press release issued on May 12, Ghebreyesus appointed the Independent Panel for Pandemic Preparedness and Response (IPPPR) “in response to a World Health Assembly resolution calling for an independent, impartial, and comprehensive review of experiences gained and lessons to be learned from the current pandemic. The review was also asked to provide recommendations to improve capacity for global pandemic prevention, preparedness, and response.”
Former Liberian President Ellen Johnson Sirleaf, a Nobel Peace Laureate and Africa’s first democratically elected female head of state, and Helen Clark, the former prime minister of New Zealand, co-chaired the panel.
“Our message is simple and clear: the current system failed to protect us from the COVID-19 pandemic”, said Johnson Sirleaf while introducing the findings of the high level panel’s 8-month probe into the global response to the pandemic. “If we do not act to change it now, it will not protect us from the next pandemic threat, which could happen at any time.”
Accompanied by “a range of background papers which include the authoritative chronology of what happened,” the panel’s report entitled, “COVID-19: Make it the Last Pandemic” (PDF), is “the culmination of multiple literature reviews, original research, discussions with experts in roundtables and in-depth interviews, and dialogue with those working on the front-line, with women and youth in town hall-style meetings. It also received online contributions to its work.”
The panel published its findings and recommendations this week following an eight-month review of the global response to COVID-19 during the first year of the pandemic. After spending “the past eight months rigorously reviewing the evidence on how a disease outbreak became a pandemic, and on global and national responses,” the panel found that COVID-19 was “a preventable disaster” that instantly became a pandemic as a direct result of an absence of “global political leadership”. It found “gaps and failings,” as well as “weal links,” at “every critical juncture of preparedness” and response by countries around the world.
Stressing the urgent need for “bold reform” in the current global response to COVID-19, Johnson Sirleaf said:
The shelves of storage rooms in the UN and national capitals are full of reports and reviews of previous health crises. Had their warnings been heeded, we would have avoided the catastrophe we are in today. This time must be different.
Given the scale of devastation from this pandemic and its continuing impact on people across the globe, the Panel resolved to document fully what happened and why, and to make bold recommendations for change. The tools are available to put an end to the severe illnesses, deaths, and socio-economic damage caused by COVID-19. Leaders have no choice but to act and stop this happening again.
According to the summary (PDF) of the panel’s report:
“COVID-19 remains a global disaster. Worse, it was a preventable disaster. That is why the recommendations of the Independent Panel for Pandemic Preparedness and Response are urgent and vital. The world needs a new international system for pandemic preparedness and response, and it needs one fast, to stop future infectious disease outbreaks from becoming catastrophic pandemics.
“The Independent Panel has found weak links at every point in the chain of preparedness and response. Preparation was inconsistent and underfunded. The alert system was too slow — and too meek. The World Health Organization was under-powered. The response has exacerbated inequalities. Global political leadership was absent.
“Now, a priority is to end illness and deaths from COVID-19. Current national waves of transmission are causing the same human traumas as those witnessed last year — especially tragic when we know that public health measures could prevent them. Vaccine distribution is blatantly unjust and not strategic. Vaccine variants are emerging as SARS-CoV-2 spreads, and ever new ones are possible. The burden on people and nations is intolerable. That is why the Panel calls for essential short-term measures.
“But the world cannot afford to focus only on COVID-19. It must learn from this crisis, and plan for the next one. Otherwise, precious time and momentum will be lost. That is why our recommendations focus on the future. COVID-19 has been a terrible wake-up call. So now the world needs to wake up, and commit to clear targets, additional resources, new measures and strong leadership to prepare for the future.
We have been warned.”
The report “demonstrates that the current system – at both national and international levels – was not adequate to protect people from COVID-19. The time it took from the reporting of a cluster of cases of pneumonia of unknown origin in mid-late December 2019 to a Public Health Emergency of International Concern being declared was too long. February 2020 was also a lost month when many more countries could have taken steps to contain the spread of SARS-CoV-2 and forestall the global health, social, and economic catastrophe that continues its grip. The Panel finds that the system as it stands now is clearly unfit to prevent another novel and highly infectious pathogen, which could emerge at any time, from developing into a pandemic.”
What came after the “lost month”? COVID-19 “vaccine nationalism”. COVID-19 vaccine hoarding. And burgeoning COVID-19 vaccine “apartheid”.
COVID-19 vaccine apartheid
The “COVID-19: Make it the Last Pandemic” analysis makes no specific reference to Canada’s contribution to the lack of political leadership on the global COVID-19 pandemic. And yet, it’s impossible to ignore Canada’s contribution to COVID-19 turning from “preventable disaster” one that is now often associated with apartheid.
The global distribution of life-saving COVID-19 vaccines has the characteristics of the racist system of apartheid as it was implemented in South Africa. Apartheid deliberately prioritized the economic interests, hopes, dreams and survival of the minority white population. Apartheid deliberately deprived Black Africans, the majority and indigenous to South Africa, of access to land, economic opportunities, decent housing, healthcare, basic human rights, essential freedoms, and basic human dignity.
In an opinion piece published in STAT in March, Jonathan Shaffer, a co-founder of Right to Health Action and Ph.D. candidate in sociology at Boston University, wrote:
Vaccine apartheid is an apt description of the injustice built into the current and persistent inequalities in vaccine access. The map of current Covid-19 vaccine access overlays neatly onto much older maps of colonial conquest.
On March 11, 2020, the WHO declared COVID-19 a pandemic. Dr. Ghebreyesus, the WHO director general, labelled the deadly new coronavirus “an enemy against humanity”.
Meanwhile, a paper published by the Lancet in May 2020, warned about the “real” spectre of rich countries using their deep pockets to monopolize the global supply of future COVID-19 vaccines. Also in May 2020, Jane Halton, a former WHO board member and the Australian chairperson of the Coalition for Epidemic Preparedness Innovations, warned that the development of an effective and safe COVID-19 vaccine could trigger a form of “vaccine nationalism” – a situation where “one country looks after itself first” and prioritizes its citizens’ survival “at the expense of the rest of the world”.
Canada and several rich countries with white majorities joined the COVAX facility, formally called COVID-19 Vaccines Global Access, when it was created in early 2020. Co-led by the WHO, Coalition for Epidemic Preparedness Innovations (CEPI), and Gavi, the Vaccine Alliance, COVAX publicly recognizes the fact that poor countries in Africa, Asia, South America and other parts of the world won’t be able to strike bilateral vaccination supply deals with major COVID-19 vaccine manufacturers. COVAX is “the global initiative to ensure rapid and equitable access to COVID-19 vaccines for all countries, regardless of income level,” according to the WHO. COVAX aims “to accelerate the development and manufacture of COVID-19 vaccines, and to guarantee fair and equitable access for every country in the world.”
It’s reasonable to assume that, by bringing their countries to the COVAX initiative, the leaders of Canada and other Western, white-majority countries expressed a kinship with Black Africans and the BIPOC (Black people, Indigenous people, People of Color) majorities of Africa, Latin America and low-income countries of the Global South.
The creation of effective and safe COVID-19 vaccines changed everything.
In the last 5 months of 2020, even before the vaccines had been approved, Canada, the US and other rich countries with white majorities hoarded most of the COVID-19 vaccines. They signed 44 bilateral COVID-19 vaccine supply deals with pharmaceutical companies developing COVID-19 vaccines, leaving dozens of developing countries with BIPOC majorities with next to nothing.
An editorial piece published by The Lancet on December 18, 2020, stated that “the EU, the UK, the USA, and Canada have already made deals with manufacturers to buy more than 50% of the doses expected to be available in 2021, despite these countries representing only 14% of the global population.” At the beginning of 2021, these countries signed 12 more bilateral deals with COVID-19 vaccine developers, according to the WHO.
By December 2020, Canada had grabbed a staggering 362 million doses of the different COVID-19 vaccines that had been developed through bilateral supply deals with pharmaceutical companies. At the time, that was enough COVID-19 vaccine doses to vaccinate each one of Canada 38 million people at least 9.6 times over. Still, that was not enough. Canada is also grabbing hundreds of millions of vaccines doses through the COVAX facility. As I write, Canada has hoarded enough vaccines to give each person here, myself included, 10 COVID-19 vaccine shots.
In March, Nobel laureates Joseph Stiglitz and Michael Spence decried “the ugliness of vaccine and other aspects of pandemic nationalism” in an interim paper entitled, “The Pandemic and the Economic Crisis“. The paper noted that Canada was one of the rich, white-dominated countries that “have ordered vaccine shots for more than ten times their current population” in violation of the “ethos of COVAX” and the global alliance’s main objective of facilitating “access to vaccines for all”.
Last month, former British prime minister Gordon Brown added his voice the growing global criticism of the injustice of COVID-19 vaccine apartheid. According to Brown:
Immunising the west but only a fraction of the developing world is already fueling allegations of ‘vaccine apartheid’ and will leave Covid-19 spreading, mutating and threatening the lives and livelihoods of us all for years to come.
Earlier this month, Pope Francis announced his support of of “universal access to the vaccine and the temporary suspension of intellectual property rights” for COVID-19 vaccines, according to The Guardian. The Argentinian pontiff condemned the “virus of individualism” that “makes us indifferent to the suffering of others”. Pope Francis said:
A variant of this virus is closed nationalism, which prevents, for example, an internationalism of vaccines. Another variant is when we put the laws of the market or intellectual property above the laws of love and the health of humanity.
COVID-19 burden unevenly shared
The IPPPR probe found that “the burden” of the global COVID-19 pandemic “is being unevenly shared. It has had devastating social and financial consequences for those already disadvantaged. Up to 125 million more people are estimated to have been pushed into extreme poverty, while 72 million more primary school-age children are now at risk of being unable to read or understand a simple text because of school closures. Women have borne a disproportionate burden. Gender-based violence is at record levels, and child marriages have increased. In addition, the world lost US$7 trillion in GDP in 2020 – more than the 2019 GDP of the entire African continent (US$6.7 trillion). The pandemic has caused the deepest shock to the global economy since World War II.”
The world reached unprecedented scientific milestone of developing safe and effective COVID-19 vaccines within 16 months of the identification of SARS-CoV-2, the virus that causes COVID-19, according to the international journal Nature. The entire continent of Africa, the world’s second-largest and second-most populous continent, had received only 2% of one billion vaccine doses administered worldwide as of the end of April.
As per the Nature article:
As of 27 April, 1.06 billion doses had been given to 570 million people, which means that about 7.3% of the world’s population of 7.79 billion have received at least one dose… About three-quarters of all doses have gone to just ten nations. China and the United States alone account for nearly half of all the doses given out, but just 2% have gone to the entire continent of Africa.
At present, only 0.3% of vaccine supply is going to low-income countries. Trickle down vaccination is not an effective strategy for fighting a deadly respiratory virus.
As of the end of May, the global death toll from COVID-19 topped more than 3,535,000 deaths and global cases topped 170 million, data compiled by Johns Hopkins University shows.
Meanwhile, the world reached unprecedented scientific milestone of developing safe and effective COVID-19 vaccines within 16 months of the identification of SARS-CoV-2, the virus that causes COVID-19, according to the international journal Nature.
And yet, as of the end of April, the entire continent of Africa, the world’s second-largest and second-most populous continent, had received only 2% of one billion vaccine doses administered worldwide.
As of May 30, 2021, The New York Times‘ COVID-19 Vaccinations Tracker reported:
More than 1.84 billion vaccine doses have been administered worldwide, equal to 24 doses for every 100 people. There is already a stark gap between vaccination programs in different countries, with some yet to report a single dose… There is also a striking divide between continents. Africa has the slowest vaccination rate of any continent, with some countries yet to start mass vaccination campaigns… Less wealthy countries are relying on a vaccine-sharing arrangement called Covax, which aims to provide two billion doses by the end of the year. 85 percent of shots that have gone into arms worldwide have been administered in high- and upper-middle-income countries. Only 0.3 percent of doses have been administered in low-income countries.
The tracker showed that only 146,645 COVID-19 doses or 0.8 per 100 people, had been administered in Zambia, an impoverished, Black-majority African country from whose half-guarded economy Canada extracts tens of millions of dollars every year through largely unaccountable extractive businesses. By comparison, Canada had administered 22, 810, 709 COVID-19 doses or 61 per 100 people.
The Our World in Data project at the University of Oxford in the UK confirms these numerous other vaccine apartheid-related disparities in the current global distribution of life-saving COVID-19 vaccines.
In the African nations of Chad, Burkina Faso, Burundi, Eritrea, and Tanzania, there were “simply no vaccines at all” as of May 9, 2021, The Associated Press reported, adding:
Not even for the doctors and nurses like her, who care for COVID-19 patients in Chad, one of the least-developed nations in the world where about one third of the country is engulfed by the Sahara desert.
“I find it unfair and unjust, and it is something that saddens me,” the 33-year-old infectious diseases doctor says. “I don’t even have that choice. The first vaccine that comes along that has authorization, I will take it.”
While wealthier nations have stockpiled vaccines for their citizens, many poorer countries are still scrambling to secure doses. A few, like Chad, have yet to receive any.
The World Health Organization says nearly a dozen countries — many of them in Africa — are still waiting to get vaccines. Those last in line on the continent along with Chad are Burkina Faso, Burundi, Eritrea and Tanzania.
As per Axios, “Across Africa, an average of 397,000 doses is being administered per day. At that rate, it would take 11 years for 60% of the continent’s population to be fully vaccinated (1% have one dose).”
In his WHO member state address, Ghebreyesus, the WHO Director General, lamented the fact that while life-saving COVID-19 vaccines were “reducing severe disease and death in countries that are fortunate enough to have them in sufficient quantities,” the “shocking global disparity in access to vaccines remains one of the biggest risks to ending the pandemic. High- and upper-middle income countries have received 83% of the world’s vaccines while, low- and lower-middle countries have received just 17% of the world’s vaccines… How quickly we end the pandemic, and how many sisters and brothers we lose along the way, depends on how quickly and how fairly we vaccinate a significant proportion of the global population, and how consistently we all follow proven public health measures.”
Calling the Independent Panel for Pandemic Preparedness and Response’s recommendations “urgent and vital,” the summary (PDF) of the panel’s report stated that “COVID-19 remains a global disaster… The world needs a new international system for pandemic preparedness and response, and it needs one fast, to stop future infectious disease outbreaks from becoming catastrophic pandemics.”
The Independent Panel for Pandemic Preparedness and Response expert panel is calling on the global community “to end the COVID-19 pandemic by immediately implementing a series of bold recommendations to redistribute, fund, and increase the availability of and manufacturing capacity for vaccines, and to apply proven public health measures urgently and consistently in every country. The Panel is also recommending that national governments and the international community immediately adopt a package of reforms to transform the global pandemic preparedness and response system and prevent a future pandemic….”
Addressing the media on May 14, Ghebreyesus, the WHO Director General, warned that the second year of COVID-19 could “be far more deadlier than the first”. He added:
COVID-19 has already cost more than 3.3 million lives and we’re on track for the second year of this pandemic to be far more deadly than the first.
The Independent Panel for Pandemic Preparedness and Response expert panel has made a number of important recommendations that, if adopted by especially rich western countries that have hoarded COVID-19 vaccines, could halt the spread of the virus around the world. These include:
- High income countries with a vaccine pipeline for adequate coverage should, alongside their scale up, commit to provide to the 92 low and middle-income countries in the COVAX Gavi Advance Market Commitment with at least one billion vaccine doses by September 2021.
- Major vaccine-producing countries and manufacturers should convene, under the joint auspices of the WHO and the World Trade Organization (WTO) to agree to voluntary licensing and technology transfer. If actions on this don’t occur within three months, a waiver of intellectual property rights under the Agreement on Trade-Related Aspects of Intellectual Property Rights should come into force immediately.
- The G7 should immediately commit to provide 60% of the US$19 billion required for the Access to COVID-19 Tools Accelerator (ACT-A) in 2021 for vaccines, diagnostics, therapeutics, and strengthening of health systems, and a burden-sharing formula should be adopted to fund such global public goods on an ongoing basis.
Every country should apply proven public health measures at the scale required to curb the pandemic. Leadership from heads of state and government to achieve this is crucial.
The world must also urgently prepare to prevent a future outbreak from becoming a pandemic. To this end, the Independent Panel calls for the engagement of heads of state and government to lead on efforts to transform the existing system. The Panel calls for a series of bold and forward-looking reforms, including:
- Establishing a Global Health Threats Council that will maintain political commitment to pandemic preparedness and response and hold actors accountable, including through peer recognition and scrutiny. Countries should also adopt a Pandemic Framework Convention within the next six months.
- Establish a new global system for surveillance based on full transparency. This system would provide the WHO with the authority to publish information about outbreaks with pandemic potential on an immediate basis without needing to seek approval and to dispatch experts to investigate at the shortest possible notice.
- Invest in national preparedness now as it will be too late when the next crisis hits. All governments should review their preparedness plans and allocate the necessary funds and people required to be prepared for another health crisis.
- Transform the current ACT-A into a truly global platform aimed at delivering global public goods including vaccines, diagnostics, therapeutics, and supplies that can be distributed swiftly and equitably worldwide – shifting from a market model to one aimed at delivering global public goods.
- Focus and strengthen the authority and financing of the WHO, including by developing a new funding model to end earmarked funds and to increase Member State fees.
- Create an International Pandemic Financing Facility, which would have the capacity to mobilize long term (10-15 year) contributions of approximately US$5-10B per year to finance ongoing readiness. It would also be ready to disburse from US$50-100B at short notice by front-loading future commitments in the event of a pandemic declaration. The Global Health Threats Council would allocate and monitor the funding to institutions which have the capacity to support the development of preparedness and response capacities.
- Heads of state and government should at a global summit adopt a political declaration under the auspices of the UN General Assembly to commit to these transformative reforms.
The Panel’s report also shared recommendations for individual countries, including that heads of state and government should appoint national pandemic coordinators who are accountable to them, and who have a mandate to drive whole-of-government coordination for pandemic preparedness and response.
Read the main Independent Panel for Pandemic Preparedness and Response expert panel’s report, “COVID-19: Make it the Last Pandemic,” (PDF).
Read the findings and recommendations (PDF) of Independent Panel for Pandemic Preparedness and Response expert panel’s report.