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The worst ravages of the Covid-19 pandemic could have been avoided had the world not “lost” a month at the start of the crisis to indecision and complacency, concludes the first major independent review of the crisis.
The Independent Panel for Pandemic Preparedness and Response (IPPPR), led by two former heads of governments and a host of international experts including former UK Foreign Secretary David Milliband, says the international health system led by the World Health Organization (WHO) is “clearly unfit” to prevent another outbreak and calls for radical reform.
“Covid-19 is the 21st century’s Chernobyl moment,” says the report. “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”.
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The 86-page report, supported by a raft of supplementary annexes, describes the WHO as being “underpowered and underfunded”. It adds that it was hamstrung by conservative international regulations which prevented it from acting “immediately and independently” with respect to China and more quickly declaring an international health emergency.
But, even once an emergency was declared by the WHO on January 30 last year, most countries failed to react – instead waiting for the virus to spread far enough for it to be properly called a pandemic.
“February  was a month of lost opportunity to avert a pandemic. Most countries chose to ‘wait and see’, rather than take firmer measures that could have contained the virus,” said Helen Clark, former Prime Minister of New Zealand and co-chair of the Panel.
“For some, it wasn’t until hospital ICU beds started to fill that more action was taken – and by then it was too late.”
The independent report was commissioned last May by the WHO at the behest of member states and calls for radical reform, including a shift towards acting early on the “precautionary principle”, rather than waiting for proof of an emerging threat.
It recommends a new Global Health Threats Council, led by heads of state rather than officials, be created to sit above WHO within the orbit of the United Nations.
The new body would be vested with legal powers – cemented via a new international Pandemic Framework Convention – to monitor and test member states pandemic plans and response and to “hold actors accountable”.
The new Convention should be signed within six months and would, among other things, “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,” say the authors.
Who member states would also have their national pandemic plans made subject to regular independent “peer review” and would be asked to stage annual pandemic simulations such as the UK’s Exercise Cygnus in 2016 – albeit with the findings independently audited.
The 13-strong IPPPR, co-chaired by Ms Clark and Ellen Johnson Sirleaf, the former President of Liberia, has spent the past eight months reviewing the evidence around how Covid-19 became a pandemic, alongside the global and national responses.
In the presentation of the report and its findings to the press, former President Sirleaf stressed the need for bold reform.
“Our message is simple and clear: the current system failed to protect us from the Covid-19 pandemic. And 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.”
The report added that the world was repeatedly warned about the potential threat of a pandemic ahead of the Covid-19 outbreak but had failed to act.
“The shelves of storage rooms in the UN and national capitals are full of reports and reviews of previous health crises,” said President Sirleaf. “Had their warnings been heeded, we would have avoided the catastrophe we are in today. This time must be different.”
The report also considers how best to end the current pandemic and calls on high income countries to commit to provide “at least a billion” vaccine doses to poorer nations by September this year in order to slow the outbreak globally.
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 transfer of vaccine technology to developing countries, it says.
“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,” it adds.
Greater investment is also seen as crucial, now and in the future.
The report calls on the G7, currently led by the UK and set to meet in Cornwall next month, to “immediately commit” to provide 60 per cent of the US$19 billion required in 2021 for vaccines, diagnostics and therapeutics to fight Covid-19.
In the longer term, the report calls for the creation of an International Pandemic Financing Facility, which would have the capacity to mobilize long term (10-15 year) contributions of approximately US$5-10 billion a year to finance ongoing readiness globally.
The idea is to build a global contingency fund so US$50-100 billion could be disbursed at short notice in the event of a new outbreak.
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”, it adds.
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