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WHO Independent Panel Diagnoses 13
Key Failings In Pandemic Preparedness And Response To COVID-19
An independent panel
of experts from around the world convened by the World Health
Organization released its findings in May 2021.
In blunt language, the
panel calls the pandemic a “preventable disaster” and says the world
quickly needs a new international system for pandemic preparedness and
response.
In reviewing the
events of the pandemic, the panel identified 13 key failings at
critical points in time as the outbreak and the response to it led to
a full-blown outbreak. Had different actions or decisions been taken,
the experts believe, significantly less morbidity and mortality would
have occurred or would not be still occurring.
The panel issued a
separate set of 7 recommendations to address these failings (see
related article in this issue).
Bright Spot
The bright spot in the
response is the rapid development and deployment of highly effective
and safe vaccines against SARS CoV-2. The speed of development was
unprecedented and the development of these vaccines is widely
considered to be a major scientific achievement. Unfortunately, the
same level of effort and financing did not go into the distribution
and administration of the vaccine and the inequitable utilization of
the vaccine has been one of the key failings.
Useful Framework
Many of these failings
will be recognized by epidemiologists and other health professionals
who have been involved with or followed the evolution of the pandemic.
The list by the panel provides a framework for dissecting the response
to the pandemic as will likely happen frequently over the next months
and years as analysts and observers seek to identify the lessons
learned from the pandemic.
The critical failings
according to the panel were:
1. Despite warnings
about the risk of a pandemic and what needed to improve in order to be
prepared, “the world had not taken these issues seriously” and the
world was not prepared.
One striking finding
is that preparedness metrics gathered ahead of time failed to predict
weaknesses. The panel states “the thing that all these measures had in
common was that their ranking of countries bore no relation to the
countries’ success in containing COVID-19.”
2. The alert or
surveillance system to detect novel fast-moving respiratory pathogens
is not fast enough, has legal constraints, and is not premised on
applying the precautionary principle.
3. Countries had to
experience the cases and deaths in their own locations before taking
serious action.
According to the
panel, “It was not until the number of COVID-19 cases increased
dramatically at home that governments took serious action to prevent
transmission. February was a lost month of opportunity to contain the
outbreak, even as the evidence of infections spreading globally was
apparent. Timing mattered—early recognition of the COVID-19 threat and
quick responses kept the epidemic small.”
4. The health system’s
front line was not ready.
Missing elements
according to the panel were adequate supplies, proper protective
equipment, better staffing, childcare support, mental health support,
and income support for those whose risk from working was too high.
5. There was a
scramble and competition for supplies
“There was a lack of
rapid and dedicated financing at the right scale and decentralized
manufacturing and procurement capacities.
6. Improved means of
communication were both an asset and a liability.
While the world now
has the capacity to communicate rapidly through multiple platforms,
social media also was the source of disinformation and
misinformation. According to the panel, “rapid and clear
communication has been a matter of life and death during this pandemic
and will continue to be with the intensification of vaccination and
public health control measures.”
7. The speed of the
scientific and R&D response to COVID-19 was unprecedented but had
limited participation from low and middle income countries
8. Countries failed to
act together in their mutual interest
According to the
panel’s report, “The multilateral system as a whole failed to take
collective responsibility. There is no alternative to multilateral
cooperation.” Despite this reality, rivalries prevailed. The report
continues, …”Understanding the political economy of incentives and
barriers to international agreement is a vital task that needs to draw
on research disciplines much wider than done today.”
9. Economies took
major hits
“The US$22 trillion
impact of the COVID-19 pandemic is the biggest shock to the world’s
economy in three-quarters of a century. The return on investment in
pandemic preparedness is vast. The US$72 billion estimated cost for
preparedness corresponds to less than 1% of the total cost as we know
it right now”, according to the report.
10. The pandemic
affects everyone, but not everyone is affected equally.
Inequality has been
the determining factor explaining why the COVID-19 pandemic has had
such differential impacts on peoples’ lives and livelihoods.
11. Vaccine
nationalism prevailed
According to the
report, effective vaccine allocation and distribution based on public
health needs has failed. There is an immediate need for political
agreement for redistribution of available and soon-to-come vaccine
doses.
12. Building forward
better, realizing the sustainability vision
The present global
socioeconomic crisis has its root causes in the failure to pursue
sustainability and resilience as our main objectives.
13. An uncertain
future with mutant SARS-CoV-2
Moving from the
mindset of fighting to stop a pandemic to acknowledging it will be
with us for the future is going to be difficult. It requires judgments
as to what level of ongoing COVID-19 spread and disease impact would
be acceptable, and whether to tolerate different degrees of impact in
different communities and countries. Countries which have adopted
elimination strategies are unlikely to want to abandon them. A world
living with endemic, seasonal SARS-CoV-2 infection will require
continuous, vigorous, and effective surveillance
and public health measures. There will be
challenges of
both logistics and equity— viral variation will in all probability
produce the need for repeated vaccinations. Leaving out countries will
not only be inequitable, but a danger to public health.
To read the report, visit:
https://bit.ly/2TsutMF
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