Speaking at a global summit in Feburary, WHO Director-General Tedros Adhanom Ghebreyesus said: “History teaches us that the next pandemic is a matter of when, not if.”
He is right. That is why it is vital that the world’s governments successfully conclude their work of negotiating an accord on pandemic prevention, preparedness and response. Negotiators were not able to meet the latest deadline for an agreement. They need more time, but they must also be mindful that time is running out.
We believe that an accord can be agreed that protects the world, if governments internalize the lessons of the AIDS and COVID-19 pandemics. But some are proving slow to recognize this.
Illustration: Mountain People
The draft pandemic accord opens with a bold and inspiring statement endorsing solidarity, equity and human rights. These principles underpin effective prevention and response, and early proposed versions of the accord included binding commitments from governments to put them into practice. However, the negotiations have generated pressure to water down several of these commitments, to the extent that some proposed versions would not guarantee that the response to the next pandemic would be any stronger than the response to COVID-19.
So far, the negotiations have been marked by a divide between the Global North and the Global South — the same divide that impeded the COVID-19 response. Low and middle-income countries point out the need for binding commitments to ensure that medical technologies are produced and distributed widely next time. However, they have faced opposition on this point from some wealthy countries, even though it is in everyone’s interest to ensure equitable and universal access to the products — from diagnostic tools to vaccines — needed to beat pandemics.
Health products need not be scarce: geographically diversified production can help ensure ample supply. But, too often, after governments have poured public funding into the pursuit of lifesaving medical breakthroughs, they have handed exclusive rights over the resulting vaccines and treatments to private pharmaceutical companies.
The inevitable result is that doses are provided only to countries that can afford to pay high prices for them, leaving poorer countries struggling to secure vaccines, tests and treatments in a timely manner. This deadly scarcity is not a bug in the system; it is a defining feature of private monopolies.
World leaders were slow to recognize this during the AIDS pandemic. In the late 1990s and early 2000s, 12 million Africans died from AIDS while waiting for life-saving medicines that were widely available to people in the Global North. Then the Global South started producing more affordable generic medicines, and the cost of treatment plummeted from more than US$10,000 per patient per year to below US$100.
Now, three-quarters of people living with HIV are getting the treatment they need to live long and full lives. If universal access to AIDS treatment is guaranteed, the world can eliminate AIDS as a public health threat by 2030. Beyond saving millions of lives, this would bolster global stability, health security and economic growth, with high-income countries also benefiting.
One would have expected these hard-won lessons to shape the COVID-19 response. They did not. Instead, pharmaceutical companies were given vaccine monopolies, so doses were delivered to wealthy countries first, leaving poorer countries unable to secure supplies — with tragic results. A more equitable COVID-19 vaccine rollout could have saved 1.3 million lives in the first year alone. This does not include the massive indirect losses of life and health caused by the redirection of health resources toward COVID-19 cases.
Beyond the high human costs have been severe economic repercussions. According to one estimate, vaccine inequity cost the global economy US$2.3 trillion. Ultimately, countries in the Global North have been playing a negative-sum game: The increased profits for a few pharmaceutical companies — and a few billionaire pharmaceutical barons — are dwarfed by the losses for everyone else.
The pillars of effective pandemic prevention, preparedness and response are well-known: relevant knowledge and technology must be shared openly, and vaccines, tests and treatments must be produced widely. To this end, sufficient funding needs to be provided at the national and international levels, and intellectual-property barriers that prevent safe, capable manufacturers from joining the pandemic response must be removed.
Voluntary action is not enough. The US and the EU have recognized this and implemented selective measures to mandate the sharing of technology and know-how. The pandemic accord needs to take this further, with binding commitments for all countries to share relevant resources and knowledge openly during a pandemic. Without such commitments, the world would not be able to achieve the accord’s objectives.
We cannot rely on the goodwill of pharmaceutical companies to ensure that global health is prioritized over profiteering. During the COVID-19 crisis, intense public pressure drove BioNTech and Moderna to pledge to launch operations in Africa. It was a minor concession from companies that, along with Pfizer, made US$1,000 per second by supplying vaccines to rich countries first.
However, even that proved to be too much for them: Now that the news cycle has moved on, BioNTech has massively scaled back its plans for African production, and Moderna has shelved its plans entirely. The lesson is clear: Governments can ensure access to health products only by mandating it.
Having lived through two deadly pandemics — in which we, like so many others, watched friends and family suffer and die — it is unbearable to imagine a repeat of such devastation. The pandemic accord offers hope for a better, more equitable way forward. To succeed, leaders must match their lofty rhetoric with iron-clad guarantees that the response to the next pandemic would reflect what we learned from the last one.
Winnie Byanyima is executive director of UNAIDS and undersecretary-general of the UN. Joseph E. Stiglitz, a former chief economist at the World Bank and former chair of the US President’s Council of Economic Advisers, is a professor at Columbia University and a Nobel laureate in economics.
Copyright: Project Syndicate
The return of US president-elect Donald Trump to the White House has injected a new wave of anxiety across the Taiwan Strait. For Taiwan, an island whose very survival depends on the delicate and strategic support from the US, Trump’s election victory raises a cascade of questions and fears about what lies ahead. His approach to international relations — grounded in transactional and unpredictable policies — poses unique risks to Taiwan’s stability, economic prosperity and geopolitical standing. Trump’s first term left a complicated legacy in the region. On the one hand, his administration ramped up arms sales to Taiwan and sanctioned
The US election result will significantly impact its foreign policy with global implications. As tensions escalate in the Taiwan Strait and conflicts elsewhere draw attention away from the western Pacific, Taiwan was closely monitoring the election, as many believe that whoever won would confront an increasingly assertive China, especially with speculation over a potential escalation in or around 2027. A second Donald Trump presidency naturally raises questions concerning the future of US policy toward China and Taiwan, with Trump displaying mixed signals as to his position on the cross-strait conflict. US foreign policy would also depend on Trump’s Cabinet and
The Taiwanese have proven to be resilient in the face of disasters and they have resisted continuing attempts to subordinate Taiwan to the People’s Republic of China (PRC). Nonetheless, the Taiwanese can and should do more to become even more resilient and to be better prepared for resistance should the Chinese Communist Party (CCP) try to annex Taiwan. President William Lai (賴清德) argues that the Taiwanese should determine their own fate. This position continues the Democratic Progressive Party’s (DPP) tradition of opposing the CCP’s annexation of Taiwan. Lai challenges the CCP’s narrative by stating that Taiwan is not subordinate to the
Republican candidate and former US president Donald Trump is to be the 47th president of the US after beating his Democratic rival, US Vice President Kamala Harris, in the election on Tuesday. Trump’s thumping victory — winning 295 Electoral College votes against Harris’ 226 as of press time last night, along with the Republicans winning control of the US Senate and possibly the House of Representatives — is a remarkable political comeback from his 2020 defeat to US President Joe Biden, and means Trump has a strong political mandate to implement his agenda. What does Trump’s victory mean for Taiwan, Asia, deterrence
RSS