While the Delta variant of COVID-19 drives new waves of infection and lockdowns, high-income nations are announcing plans for vaccine booster shots as lower income countries struggle to get the bare minimum to protect their people. Meanwhile, recent news from South Africa illustrates the continued potential for the emergence of more variants that could threaten us all.

It’s clearer than ever that our initial inability to contain this virus was just the start. COVID-19 has exposed how woefully unprepared the world is to manage and fund an agile, sustained, well-coordinated and equitable global pandemic response that leaves no one behind.

A new report from the G20 High Level Independent Panel on Financing the Global Commons for Pandemic Preparedness and Response makes clear that we do not lack the capacity and resources needed to mitigate pandemic risks, nor do we lack the scientific know-how or finances to respond more effectively than we have to COVID-19.

To put it bluntly: we can and must do better.

As the Director-General of WHO Tedros Adhanom Ghebreyesus pointed out to G20 Health Ministers this past weekend, in addition to urgently scaling up investments in vaccine equity and the public health response for the current crisis, a truly global effort is needed – now – to strengthen and scale existing systems that will sustainably support pandemic preparedness and response efforts into the future. When the next outbreak strikes, we must be prepared as one global community.
 

Invest in global disease surveillance and cooperation

Sharing epidemiological and genomic data in a timely and equitable manner is critical to managing health outbreaks, and as such there is a demonstrated need for a global body capable of doing so. National initiatives such as the US Centers for Disease Control and Prevention Center for Forecasting and Outbreak Analytics are a welcome start, but we must also build upon the promise of what we already have. A global framework similar to the WHO-led Pandemic Influenza Preparedness (PIP) Framework would be helpful to reach across borders and cut through political barriers around global infectious disease surveillance.

First and foremost, WHO’s authority and financing must be strengthened, and countries should support its formation of a transparent Hub for Pandemic & Epidemic Intelligence. These efforts can be bolstered by the establishment of a Global Health Treats Council led by Heads of State and Government, convened through the United Nations General Assembly, as recommended by the Independent Panel for Pandemic Preparedness and Response (IPPPR).

Strengthen national systems for health and invest in social protections

All 193 Member States of the United Nations committed to universal health coverage by 2030 when they signed the Sustainable Development Goals in 2015. Countries must invest in and strengthen their national health systems so that all people have quality health services, including effective diagnostics, medicines and vaccines.

As COVID-19 has so tragically shown, the lives and livelihoods of people depend upon more than just effective public health. Inequality, poverty and discrimination drive disease, which then further impacts and exacerbates those very inequalities.  

The Sustainable Development Goals Report 2021 found that hundreds of millions of people were pushed back into extreme poverty and chronic hunger in 2020, representing the first rise in the global extreme poverty rate in more than 20 years. Meanwhile, the most recent Global AIDS Update found that in sub-Saharan Africa, which is home to two-thirds of all people living with HIV, less than three percent had been given at least one COVID-19 vaccine dose by July 2021, as key populations and marginalized groups struggle to get adequate HIV prevention and treatment services.

Countries must invest in strengthening social protection and health systems to limit both the immediate health impacts of the virus and the equally deadly ripple effects of pandemics – this includes investments that address the range of social, economic and environmental determinants of health. UNDP has found that temporary basic income (TBI) can help protect vulnerable populations from the worst effects of health crises and would cost most low-income countries far less than one percent of their GDP per month.

Act to reduce inequities

All of these actions must be underpinned by a commitment to reducing inequities within and across countries. Preparedness for a select few will not be enough to protect the world against future crises.

In June, G7 countries pledged a substantial amount of COVID-19 vaccine donations to the COVAX Facility, but only a fraction of those doses have been delivered. What’s more, according to analysis from UNDP, WHO and University of Oxford’s Global Dashboard for Vaccine Equity, low-income countries would have to increase their healthcare spending between 30-60 percent to cover the cost of vaccinating 70 percent of their populations against COVID-19, compared to just 0.8 percent for high-income countries.

High-income countries must act on their pledges to share doses through the COVAX Facility and help urgently fill a US$7.7 billion gap to fund the ACT-Accelerator’s work to end the pandemic. Now is the time to heed WHO’s call to share doses, share know-how and waive IP protections for COVID-19 vaccines and therapeutics.

Additionally, long-term investments in digital solutions and community-based primary health care represent important steps toward ensuring that all people can access the services they need. UNDP is working with countries to help design and establish these types of systems. In Bhutan UNDP has helped develop a digital system for the country’s national COVID-19 vaccination programme. In Libya, UNDP, in partnership with the Ministry of Health, the Government of Japan and a private sector start-up company, Speetar, launched the country’s first telemedicine initiative, an app that connects Libyans with physicians in diaspora communities who speak their language. The app also reduces the burden of travel and mobility for people suffering from chronic diseases.

Pandemic preparedness goes well beyond country-specific disease surveillance and temporary public health countermeasures. It is a constant investment in the local, national and global systems needed to educate, protect and prepare communities against a range of health threats such as the climate crisis and rising antimicrobial resistance, which are already impacting the health and development of vulnerable populations around the world. These layered crises are exacerbated by rising inequalities and threaten reversals in human development if we don’t act now. Inclusive, urgent and unified long-term investments in preparedness that leverage cutting edge technologies and innovation will allow countries to build forward better by creating more equitable and resilient systems that can help get us back on track to meeting our global goals and securing a safe and healthy future for all.