The WHO should be overhauled and given more authority to investigate global disease threats, according to a review of the international COVID-19 response, which found that a multitude of failures, gaps and delays allowed the coronavirus to mushroom into a pandemic.
While stopping short of assigning blame to any particular factor, the report released on Wednesday by an independent panel cochaired by former New Zealand prime minister Helen Clark linked the severity of the global outbreak to deficiencies across governments, the WHO and other multilateral organizations, and regulations that guide official actions.
The panel also called for an agreement to waive vaccine patents, limit terms for WHO leaders, create an oversight body and create a legally binding treaty to bolster the prevention and response to future pandemics.
The international system remains unfit to avoid another disease from spiraling into one matching COVID-19, which threatens to cost the world economy US$22 trillion by 2025, the panel said.
“The situation we find ourselves in today could have been prevented,” former Liberian president Ellen Johnson Sirleaf, the panel’s other cochair, told reporters on Monday. “This was partly due to a failure to learn from the past.”
In the first weeks of the COVID-19 pandemic, the WHO could have warned countries to assume that SARS-CoV-2 was spreading among people, said the panel, which was established at the request of the WHA, the WHO’s decisionmaking body, a year ago.
HAMPERED BY POLITICS
The WHO also could have declared much earlier that the outbreak in Wuhan, China, was a public health emergency of international concern — the highest level of global alert. This could have been done by at least Jan. 22 last year, Clark said.
The role of the WHO and its director-general have been contentious from the early days of the pandemic, as governments sought to understand how the virus emerged and spread unchecked.
The UN agency came under blistering criticism from former US president Donald Trump, who claimed that the WHO had coddled China, allowing the government in Beijing to conceal the origin of the virus. Trump threatened to withhold funding from the organization.
The WHO was hindered by its regulations, which are not conducive to taking a precautionary approach, Clark said.
The “slow and deliberate pace” with which information is treated under the International Health Regulations and the alert system used were out of step with a fast-moving respiratory pathogen and the swift availability of information through digital tools and social media, the panel found.
The WHO should have the power to investigate outbreaks speedily, with guaranteed rights of access and with the ability to publish information without waiting for a member state’s approval, Clark said.
“Sensitivities about sovereignty cannot delay alerting the world to the threat of a new pathogen with pandemic potential,” she told Monday’s media briefing.
WARNINGS UNHEEDED
The elevation of the COVID-19 threat to the WHO’s highest level of alert on Jan. 30 failed to trigger an urgent, coordinated, worldwide response, the panel found.
It called for disease surveillance and alert systems to be overhauled to function at “near-instantaneous speed” to detect and verify signals of potential outbreaks.
Most countries failed to heed the warning, choosing to “wait and see,” rather than taking firmer measures that could have contained the virus, Clark said.
She added that February was “a month of lost opportunity.”
“For some, it wasn’t until hospital [intensive care unit] beds started to fill that more action was taken, and by then it was too late,” she said. “There were also countries which devalued science, denied the severity of COVID-19, delayed responding and sowed distrust among their citizens, with deadly consequences.”
Although missed opportunities and failure to act characterized much of the early response to the virus, the panel found areas in which early action was taken to good effect: the rapid containment of the virus by some countries, including Taiwan, New Zealand, South Korea and Vietnam, and the unprecedented speed at which the virus genome was sequenced and vaccines were developed.
“Science delivered when the world needed it most, and the world benefited wherever there was open sharing of data and knowledge,” Johnson Sirleaf said.
The Harvard-educated former banker said the WHO and the WTO should help broker an agreement among major vaccine-producing countries and manufacturers on voluntary licensing and transferring vaccine technology to third parties.
RESPONDING TO A CRISIS
“If actions do not 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,” Johnson Sirleaf said.
While manufacturing needs to be scaled up urgently, the panel called on wealthy countries with adequate vaccine coverage to commit to providing at least 1 billion doses no later than Sept. 1 to 92 countries that lack adequate supplies.
The panel also called for a number of reforms, one being the creation of a Global Health Threats Council that maintains political commitment to pandemic preparedness and holds actors accountable for their responses.
Also proposed is a Pandemic Framework Convention to address gaps in international regulations, and to clarify responsibilities between states and international organizations. Strengthening of the authority and financing of the WHO, and creating funds of up to US$100 billion to disperse in the event of a crisis were also recommended. A single, seven-year term for the WHO director-general is favored by the panel.
“COVID-19 is the 21st century’s Chernobyl moment — not because a disease outbreak is like a nuclear accident, but because it has shown so clearly the gravity of the threat to our health and well-being,” the report said. “It has caused a crisis so deep and wide that presidents, prime ministers and heads of international and regional bodies must now urgently accept their responsibility to transform the way in which the world prepares for and responds to global health threats.”
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