Humanity was caught off guard by the Covid-19 pandemic, even though we had effectively been warned by smaller-scale outbreaks for decades. Given the strong odds that we will face another pandemic sooner or later, the international community is rightly engaged in discussions about how to do better next time.
Last month, a United Nations High-Level Meeting on Pandemic Prevention, Preparedness, and Response produced a “political declaration” that was hailed as a landmark. The 14-page draft acknowledged that, as Carolyn Reynolds, co-founder of the Pandemic Action Network, has put it, PPPR “is so much more than a national health issue; it is a national and global security and economic issue. Like climate change, pandemics are a global systemic risk and existential threat to humanity, and we need to treat them as such.”
But isn’t this just stating the obvious? While some have hailed the agreement as “historic,” it was accompanied by no firm commitments from governments.
We already know what it will take to do better next time. After Covid-19 spread globally, millions of people in poor countries died for lack of access to medicines that were being hoarded in rich countries. We needed waivers on all intellectual property (IP) related to the pandemic pathogen – including vaccines, tests, personal protective equipment, and therapeutics – as well as commitments from everyone to share their technology and provide all the funds necessary to help poorer countries.
Yet during the Covid crisis, we saw even the most powerful advocates of international governance, namely the US, show little compunction about breaking rules and norms that were seen to conflict with their own immediate interests.
We know that big pharmaceutical companies stooped so low as to charge some developing countries more than they charged developed countries. Some also insisted that the bulk of their products be exported to Europe from the emerging markets where they were being manufactured, even though those countries’ own citizens were desperate for medicines. Worse, while developing-country governments were under strict contractual obligations, the companies themselves were spared from even the minimal requirement to deliver the supplies they had promised in a timely fashion.
Any rational approach must start with the acknowledgment that controlling pandemics is in everyone’s interest. Given rich, powerful countries’ apparent inability to keep their commitments during a crisis, the reasonable solution is to ensure capacity to produce pandemic products everywhere, and to eliminate foreseeable impediments to countries doing so. That means agreeing to a strong IP waiver, and establishing stiff penalties for any drug company that wrongly interferes in another company’s use of the specified IP, including in cases where production is being exported to third countries in the developing world.
To stay ahead of future threats, some of the relevant technology should be transferred now, and governments and companies must commit to facilitate any additional transfers that future pathogens might make necessary. Governments should have the tools and legal authority to force or induce firms within their jurisdictions to share such technology, and developing countries should have the right to sue if that does not happen.
To stay ahead of future threats, we should mobilise the necessary funds now and establish clear rules for delivering them.
Since controlling any future pathogen will require data, we need all countries to commit to data sharing. But during the Covid-19 crisis, South Africa was effectively punished when it identified a new variant of the virus: other countries responded by imposing travel restrictions against it, even though it was unclear where the variant had originated, or whether it was more prevalent elsewhere.
Countries should have incentives for openness; ensuring access to technologies and emergency funding is essential to this objective.
With Covid-19, we prioritised pharmaceutical companies’ profits over the lives and well-being of people in developing countries. It was immoral, shameful, and counterproductive.
We must set the stage for a more just, inclusive, and rational response next time. Faced with that urgent task, last month’s UN meetings fell far short of what is needed. – Project Syndicate