We Must Rectify Profound Failure of Global System that Covid Exposed
We Must Rectify Profound Failure of Global System that Covid Exposed
TIME and again throughout history, perpetrators of injustice have absolved themselves and justified miserliness and inaction by blaming the victim. Amid allegations of African culpability for the Omicron outbreak and the complaints from the Global North about vaccine hesitancy and low take-up in the Global South, 2021 saw this shameful story being told anew.
But the Omicron variant is not Africa’s fault. Responsibility starts with the governments of wealthy nations who stockpiled hundreds of millions of vaccines and who, even when warned about the failure to vaccinate more vulnerable parts of the world, did too little as the virus mutated.
It is not Africa’s wariness about vaccines that is the decisive problem. It is a lack of African access to them. Of course, anti-vaxxers sow havoc everywhere but the more accurate picture I have, from my visits to Africa and Asia, is of the mother and her family who walk miles, queue for hours, even wait for days for vaccines to be delivered, because she knows from her experience of polio, diphtheria and tuberculosis that the best chance of her family surviving is getting the shots into their arms.
Her determination - her faith in the power of medicine to save lives - is a moral summons to respond. But the latest outbreak also reminds us of a practical imperative: that if we fail her, so too we fail our own families and communities by allowing the virus free rein to mutate and return to haunt even the fully vaccinated. With last year's World Health Organization (WHO) forecast - of 200 million more cases by and 5 million more deaths by September this year - now looking more like an underestimate the grim truth remains that until no one anywhere lives in fear, then everyone everywhere will have to live in fear.
Instead of lurching from COVID crisis to COVID crisis, we must find the resolve to make 2022 the year when we finally bring the virus fully under control. Ours is not a fraught choice between boosters and vaccinating the world. We are manufacturing enough vaccines - 11.1 billion already, 19.8 billion by June - to immunize the whole world. But it is an inescapable and unacceptable fact that of the billions of vaccines administered, only 0.9% ended up in low-income countries, while nearly 70% have been administered in high and upper-middle-income countries. Of tests, only 0.5% have been administered in low-income countries, and even basic medical equipment such as oxygen and oral therapeutics remain a luxury, let alone ventilators.
An estimated 500 million of the already poor are being pushed further into extreme poverty because of payments they have to incur for health care and the pitifully low 4.8% full vaccination rate for low-income countries and the 9.96% rate in Africa are a grim reproach that we appear to value human life in the South, far less and far more cheaply, than in the North. These inequalities are not just a medical failure but a moral lapse, a stain on our global soul.
The great global challenge of 2022 must be to wipe away that stain by finding the money to bridge the yawning divide between the world’s protected rich and unprotected poor - and in so doing end the indefensible but perennial underfunding of global health.
I know from my experience of the 2009 financial crisis, when the world economy was underpinned with $1.1trillion of support that, in the words of Keynes about a previous emergency, "anything we can actually do, we can afford". In the first weeks of 2022, we need to achieve for the world what Britain is attempting for our own citizens: to deploy every available nurse, enlist every available community health worker, provide every available test and treatment, commandeer every known distribution agency, and summon up the support of the military where necessary- and show that just as Coca Cola can get to faraway places not listed on maps and Pfizer can deliver vaccines by drones, then, so too, must we get jabs into arms across communities that have never before known adult vaccinations.
So the richest economies should immediately underwrite the urgent request for $23.4 billion - which includes $1.5 billion to finance the WHO - from ACT-Accelerator, the coordinating agency for vaccines, diagnostics, and therapeutics. It may sound like a huge sum but is more than 200 times smaller than the $5.3 trillion the IMF estimates will be the Covid- induced loss of economic output by 2025. The $23 billion breaks down to just 10p a week, to be paid by every citizen of the Global North, and would be the best investment in world history. Surely making the difference between life and death is worth more than the price of the cheapest biscuit?
There are four potential sources of sustainable long-term funding to cover this $23 billion, an additional $24 billion to build in-country capacity to administer tests and treatments, and the $10 billion required annually, recommended by three independent reviews, to prepare for and prevent future pandemics, all of which could be pledged at the Vaccines Conference, to be recalled by President Biden at the outset of 2022.
First, the international community should agree a formula to share the costs fairly between countries in the same way that we fund UN peacekeeping, the International Monetary Fund and the World Bank, and in the 1960s levied countries to eliminate smallpox. We can no longer rely on the ad hoc, piecemeal lottery of global health funding that is more akin to a whip-round at a charity fundraiser than a serious attempt to move beyond begging bowl politics. The purest public good of all - control of infectious disease - should be first on the list for a multilateral burden - sharing agreement to finance the WHO and global health, with America and Europe each offering around 25% of the costs and the rest of the world contributing based on capacity to pay.
Second, we must rectify the profound failure of the global system that Covid has exposed. The WHO and those with the global remit to act have the least resources, while the IMF and the multilateral development banks command the most resources without the specific mandate to act. Another $10b of World Bank resources, a new IMF vaccine facility and $100 billion of the new international money - Special Drawing Rights - should be immediately deployed to build health systems in low-income countries.
Third, we need to be more innovative by using guarantees from the Global North to source the funds we need. Just $2 billion of guarantees can be leveraged to create an international financial facility for health that, with $1.5 billion of grants, could raise $10 billion of additional resources for poorer countries.
Finally, we should consider how we can increase the proceeds from UNITAID’s solidarity levy that since 2006 has raised $1.25 billion from hypothecating airline taxes to global health and, with big Pharma now admitting it has not done enough, companies, who will benefit from the resumption of trade, should be asked to join with foundations in our mission to make Covid history.
Hope is resilient, but it is also fragile. Hope dies when countries hoard vaccines that others desperately need, when the richest fail to honor solemn promises made to the poor and when we place profit before people. But hope can come alive this year and what once seemed impossible can become possible. This will begin with first one wealthy country, then two, then a half dozen, and then all uniting together, resolving to stop the march of this lethal disease - not only to save lives but to affirm we value all human lives equally.
By these acts of solidarity, thousands of mothers, like those I have met across Africa, who are today waiting to see whether a world that fell apart in 2020 and 2021 will come together in 2022, will discover, to their relief, that we do indeed feel the pain of others and that we do believe in something bigger than ourselves.