Must consider six essential areas: political leadership, international rules, sustained financing, equitable countermeasures, an authoritative WHO, independent monitoring

As global efforts to ensure pandemic readiness and response enter a critical new phase, leaders of a seminal review of the response to the COVID-19 pandemic urge the United Nations General Assembly to commit to reforms that leave no gaps through which a pandemic threat can again overwhelm countries and kill millions.

In a new publication, Her Excellency Ellen Johnson Sirleaf and the Right Honourable Helen Clark provide a global road map that if implemented in full, will contribute to protecting the world’s peoples from the development of another devastating pandemic like COVID-19. The leaders underscore the role of the UNGA to commit to a comprehensive reform agenda that can ensure the multisectoral, multilateral collaboration required, led by Heads of State and Government.

The new report, titled “A Road Map for a World Protected from Pandemic Threats” warns that patchy and limited implementation of recommendations from previous reports reviewing major outbreaks, including Ebola in West Africa in 2014-2016, left gaps and contributed directly to the COVID-19 outbreak becoming a pandemic.

“COVID-19 caused complex, and devastating shocks to every country, and has long-term impacts for economic and social recovery. Let us never repeat it,” said Ellen Johnson Sirleaf, former President of Liberia and former Co-Chair of the Independent Panel for Pandemic Preparedness and Response.

“We will face new pandemic threats. The UNGA must draw on the hard lessons from COVID-19 and honour the memory of the many millions of people who have died, to commit to comprehensive reforms that leave no gaps in the system this time.”

Opportunity: UNGA High-Level Meeting
On 20 September this year, the UNGA is convening a High-Level Meeting on Pandemic Prevention, Preparedness and Response. The Independent Panel for Pandemic Preparedness and Response recommended such a high-level meeting as pandemic impacts extend well beyond the health sector and must involve the leadership of Presidents and Prime Ministers nationally, regionally and globally. This is a message former Independent Panel members will bring to the multi-stakeholder hearings in New York next week.

“At a time of difficult geopolitical divide, the UN General Assembly High-Level Meeting presents an historic opportunity to demonstrate the power of multilateralism and political leadership, and choose human collaboration to overcome the threat of pathogens that could materialise anywhere, anytime,” said Helen Clark, former Prime Minister of New Zealand and Co-Chair of the Independent Panel.

“A transformed system must rapidly identify and contain pandemic threats, and if that is not possible, be able to respond quickly and effectively to give maximum protection to societies and economies.”

Key role of countries and regions 
The new report stresses that countries must invest in national preparedness for new pandemic threats as if they could emerge tomorrow. With the right reforms in place, the new report says, panic and scramble can be avoided when the next health threat emerges. The role of regions is also stressed, including regional groupings of countries, banks and health institutions.

Concise UNGA Political Declaration 
Globally, the UNGA must commit to a political declaration that ensures a comprehensive package covering six essential areas. The report stresses that such commitment can make the difference between a world protected from pandemic threats and a new pandemic.

The six essential areas of global commitment are the following:

1. International rules: including goals, principles, rights and obligations for pandemic prevention, preparedness, and response. The World Health Assembly processes towards negotiation of a pandemic accord and amended International Health Regulations should be fully supported to reach successful conclusions. 
    
2. Independent monitoring: to promote accountability, a fully independent, multi-sectoral expert monitoring board should be established complementary to the new international legal instrument. This monitoring board would collect and analyze information from multiple sources, and regularly publish public reports.
    
3. An equitable, operational ecosystem for pandemic countermeasures that is truly ‘end to end’ to serve public health goals. It should be based on a global commons model, regional resilience, openness, and technology sharing. It must begin with regional research and development of diagnostics, vaccines, and therapies that can stop outbreaks when and where they occur.
    
4. Sufficient financing for preparedness and for emergencies: Mobilization of most of these funds is a national responsibility, but there are gaps that must be filled particularly to support low- and middle-income countries.

For preparedness, it is estimated that US$10.5 billion is required annually for low- and middle-income countries. So far about 10% of that has been committed to The Pandemic Fund. A financing plan for the Fund is essential, and should include serious consideration of a global public investment model. Other funding sources must also be rallied, including the regional banks, commitment to the “Bridgetown Agenda” and the Africa Epidemics Fund.

For emergencies, US$50-$100 billion must be made available immediately when a pandemic threat materialises to support low- and middle-income countries to avert catastrophic economic and social consequences, and ensure purchase of pandemic supplies. The political declaration can commit to a mechanism to mobilize these funds. 
 

1. An independent, authoritative WHO: To tackle the next health threat with pandemic potential, Member States must support WHO to have the authority, independence, and funding required to play its essential role: to support countries to minimise the risks of health emergencies, and to minimise their health consequences.
    
2. Political leadership from Presidents and Prime Ministers: pandemic threats are complex global crises with impacts extending well beyond the health sector. They are economic, social, and security matters. Health ministers and the World Health Organization do not have the mandate or the power to rally Heads of State and Government to ensure preparedness and response across all relevant sectors. This gap was one of the major failures that led to the catastrophic multi-sectoral impacts of COVID-19.

Therefore, the former Independent Panel and others continue to call for an independent high-level global health threats council, comprised of Heads of States and Government, to ensure sustained multi-sectoral focus on pandemic preparedness and response. Such a council could be linked to, or be part of a multi-sectoral emergency platform as proposed by the Secretary-General, intended to manage existential complex shocks to the planet.

The Road Map concludes with a call for bold and cohesive reforms in 2023. The co-authors remind stakeholders that since Severe Acute Respiratory Syndrome (SARS) emerged twenty years ago, a new major international health threat has occurred every five or six years, culminating in COVID-19 and its devastating cost to human lives, and in major setbacks to progress on the Sustainable Development Goals and for countries that could least afford the impact.

The co-authors conclude that: “Application of lessons learned, scientific findings, and the potential of solidarity gives us the opportunity to prevent such devastation in future. The UNGA High-Level Meeting on Pandemic Prevention, Preparedness and Response this year will provide world leaders the opportunity—at a key moment—to choose to protect humanity. It is an opportunity we cannot miss.”
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The report: A Road Map for a World Protected from Pandemic Threats

More about the Independent Panel: The former Co-Chairs led The Independent Panel for Pandemic Preparedness and Response. together with 11 distinguished panelists. They spent eight months rigorously reviewing various dimensions of the pandemic. In May 2021 the Co-Chairs submitted their evidence-based landmark report entitled COVID-19: Make it the Last Pandemic to the World Health Assembly. They made recommendations which, taken as a package, could transform the international system in a way that could make it the last pandemic of such devastation.The Independent Panel was established by the World Health Organization (WHO) Director-General in response to the World Health Assembly resolution 73.1 issued in May 2020.

The recommendations of The Independent Panel for Pandemic Preparedness and Response have helped to lay the groundwork for ongoing reforms to the international system. Former Independent Panel Co-Chairs and members continue to advocate for implementation of the full package of recommendations due to concerns about the failure to implement recommendations of past high-level reviews of major outbreaks. Their interest is to see a fit-for-purpose, transformed, and effective international system for pandemic preparedness and response. The former Co-Chairs and members continue to do this work in their own time because of the serious implications of lack of transformative change being made.

For more background information see: www.TheIndependentPanel.org.

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