Covid-19 presents an unprecedented health crisis for the world that requires unprecedented responses. Many rich countries have announced huge bail-out and stimulus packages to keep their economies afloat. But as the pandemic now unfolds in Africa, South Asia and Latin America, the global community needs to step up its solidarity with the most vulnerable communities and consider which instruments are best suited to address this global emergency. Now is the time to invest in the health of the poorest people around the world through global mechanisms that serve us all and in which all countries contribute according to their ability.
As the Sars-Cov-2 pandemic has been ravaging through East Asia, Europe and North America, no one has been left unconcerned about their health, their jobs and the impact on their countries. But gradually it is becoming clear that an even more devastating epidemic is unfolding in the poorest regions of our globe, where people and governments are facing unsurmountable challenges to put in place effective prevention measures, and where there is virtually no access to sufficient protective gear, diagnostic facilities and intensive care for the seriously ill. We are also beginning to hear about infections in the densely populated Gaza strip and in overcrowded refugee camps in Syria, Greece and elsewhere in the region. Of all the people who need international support, refugees and migrants are clearly among the most vulnerable.
Never before in recent history has there been a simultaneous threat to the entire global community. The Sars-CoV-2 virus is attacking all of us, no matter where we live in the world, rich or poor. But stating that the virus is affecting all of us does not mean that we will all be affected in the same way. It is already clear that countries are currently competing for the same limited resources, be it protective masks, diagnostic tests or respirators. It is not hard to imagine who will win this competition without any global regulation and pooled funding.
Huge resources are required to protect our health and our economies but also needed are global mechanisms to serve all of us, mechanisms in which all countries contribute according to their ability and all benefit according to their needs. We must shift away from thinking of such investments as “foreign aid” and rather imagine them as “global public investment” – that is in our common interest as one humanity. We have to change the way we think about international cooperation. The world is confronted with a common enemy – Sars-Cov-2 – and we will need the brilliant ideas, inventions and resources of all to overcome this together.
The global investments are required to develop as fast as possible a vaccine and appropriate therapies while responding to the immediate urgency of producing and distributing the volume of protective equipment, diagnostic tests, and treatment options needed at scale in all affected countries in the coming weeks and months.
But very importantly, we have to prepare now to support resource constrained countries in rebuilding their economies and health systems in the immediate aftermath of this pandemic so that they will have more resilient and sustainable primary health care systems, making them better prepared for the next waves of viral pandemics that are definitely going to come.
Fortunately, we do have examples of global solidarity that have worked well. The world responded to the previous viral pandemic of HIV with the creation of The Global Fund to Fight AIDS, TB and Malaria (“the Global Fund”). It was established as an instrument of global solidarity making sure that anybody suffering from these devastating infectious diseases costing millions of lives every year would have access to the same level of prevention, care and treatment regardless where they lived and how rich or poor their communities were. It was putting the principle of health as a human right into practice.
We need the same spirit today, of global solidarity and the fundamental belief in the right of every human being to protect themselves from untimely suffering and death.
Another example of a pooled funding mechanism that has made a huge difference in preventing diseases at an enormous scale and saving millions of lives is GAVI (the Vaccine Alliance). But what is required today will be at an even larger scale than the combined efforts over the last two decades.
Here are the options. The World Health Organization has the mandate, authority and expertise to lead the global response to Covid-19. WHO’s Strategic Preparedness and Response Plan and future efforts for an improved pandemic preparedness mechanism needs to be appropriately funded. WHO’s newly established Covid-19 solidarity response fund deserves full support. With the Coalition for Epidemic Preparedness Innovation (CEPI) and with the Foundation for Innovative New Diagnostics (FIND) we have international partnerships that can accelerate the urgently required research into a Sars-Cov-2 vaccine and access to diagnostic tests in countries and regions that need them most. The international community needs to invest into these vital initiatives without any further delay.
But in addition to the immediate response we need global investments on a completely different scale for the longer-term task of having health systems in all countries able to withstand future waves of viral pandemics and other threats. Only specialized multilateral funding mechanisms can mobilize and pool funds from both public and private donors and make sure that these funds are disbursed with speed yet in a transparent and accountable manner. Experience with the AIDS, TB and malaria response has shown that these funding mechanisms need broad involvement of governments, the private sector, and civil society.
The Ethiopian Prime Minister and Nobel Peace laureate Abiy Ahmed has rightly called for an extraordinary effort to address the crisis in the most vulnerable nations, suggesting the G20 should launch a Global Health Fund. Creating such a fund would obviously take some time and add to the already complex global health architecture. The global community should instead ask the existing instruments such as the Global Fund, the Global Financing Facility and GAVI to take on this additional mandate to mobilize and channel the required resources to where they are needed most as a matter of urgency. The Global Fund and GAVI have been collaborating closely on a Health Systems Strengthening funding opportunity for eligible countries for many years that could now be extended to include specific Covid-19 related interventions.
There is a growing sense that the world is at a turning point. Even when we will see the infection rates and mortality from the first wave of COVID-19 coming down, the world will not be the same again. Hopefully our global community will have experienced and internalized that solidarity in our neighborhoods and in our global community is more important than ever. The world needs nothing less.