Rudderless COVID recovery: We need a real road map from somebody

By Scott C. Ratzan, Kenneth H. Rabin and Lawrence O. Gostin

Hope for global control of COVID-19 seems both nearer and more elusive. The U.S. and UK have vaccinated more than half of their populations and begun to re-open their economies. The rest of Europe is catching up. The East Asian economic powers are also doing well, though there has been worrisome news from Osaka. Most of the developing world still awaits a vaccine, and India spirals out of control. So, what is the WHO saying right now about vaccinating the world against COVID-19?

As the days get longer in the Northern Hemisphere, hope for global control of COVID-19 seems both nearer and more elusive. The U.S. and UK have vaccinated more than half of their populations and begun to re-open their economies. The rest of Europe is catching up. The East Asian economic powers are also doing well, though there has been worrisome news from Osaka, Japan’s second largest city.

Most of the developing world still awaits a vaccine, and India spirals out of control.

In Geneva, the World Health Organization (WHO) has just convened its 74th annual World Health Assembly, where 194 countries will discuss COVID-19 vaccination and new variants of concern that may threaten progress. A few weeks thereafter, the G7 countries will meet in London to help chart a course for an economic system that has absorbed $10 trillion in economic losses.

So, what is the WHO saying right now about vaccinating the world against COVID-19?

Earlier last week, the WHO’s Independent Panel for Pandemic Preparedness and Response, chaired by former New Zealand Prime Minister and former UN Development Program Director, Helen Clark, published a bleak post-mortem of global management of COVID-19, suggesting that millions more will likely die from it. They concluded: “Current institutions, public and private, failed to protect people from a devastating pandemic…without change, [they] will not prevent a future one.”

WHO Director General Tedros Adhanom Ghebreyesus has praised the success of vaccination efforts. Yet, just as the U.S. approved COVID-19 vaccine use in adolescents over age 12, he has suggested that wealthier countries should divert vaccines away from their children and teenagers and instead donate them to low-income countries. (https://www.bbc.com/news/world-57114734).

While the WHO Member States engage in dialogue on the pandemic response, strengthening health systems and equitable vaccine allocation, a neighboring institution in Geneva, the World Trade Organization, is figuring out whether to force the pharmaceutical industry to waive its COVID-19 vaccine patents and share the recipe and manufacturing know-how among all qualified producers.

Individual countries continue to scramble in their COVID response.

Dr. Anthony Fauci, the top U.S. health adviser, recently suggested that America move away from herd immunity as a vaccination program goal. Meanwhile, CDC director Dr. Rachel Walensky,  announced a few days ago that vaccination has proved so effective against COVID-19 illness and transmission that mask wearing was essentially unnecessary for the fully vaccinated.

Her sweeping recommendation on masks by the CDC caught numerous business leaders and public health leaders off-guard, requiring them to quickly develop new policies and guidelines. That task was further complicated by a political climate that will not tolerate any meaningful sort of vaccine credential, leaving people to simply trust that the unmasked person next to them in their local Walmart (a store where nearly 220 million shop and more 2.3 million employees work worldwide) really has gotten his or her shots. Piecemeal approaches to create a vaccine passport or credential on COVID transmissibility status are under development, and a lot of people seem to want them.

Are we out of the woods, or are we about to wander right back into them?

The U.S. Council for International Business (USCIB) recently launched an international business coalition called Business Partners to CONVINCE [COVID-19 New Vaccine Information Communication and Engagement]. A number of businesses are already contributing their organizational expertise, capacity for innovation, and communication resources to this global effort to help build trust and ensure a strong, timely worldwide recovery from COVID-19. Many companies have developed specific initiatives to advance vaccine literacy and uptake, educating their employees, suppliers, and customers to be open to vaccination; to strengthen healthcare systems to meet vaccine demand with readily available access; and advocate for investments in digital health communication to support vaccination as a global societal norm.

One thing we have learned is that anyone who gets a vaccine really is protected from serious complications or death from COVID-19, and that the benefits of vaccination overwhelmingly exceed its risks. Another is that if we vaccinate enough people, we will protect society from the threat of COVID-19 and diminished the health risk from new variants that threaten to disrupt our path back to normalcy.

But we still urgently need a clear road map to take us from this promising moment to the point that we can say clearly that we are on the road to real recovery, a Covid-protected world. Global herd immunity should remain an aspirational goal. Getting as close as possible to achieving it is likely to be the only way we can live with a degree of normalcy in the presence of a virus that will be literally floating in our global environment for the rest of our lives.

Right now, with health leaders together for the World Health Assembly, a specific, focused, actionable roadmap could be drafted based on multisectoral, expert input and endorsed by health leaders, offering concrete hope to stem the pandemic by 2023. If the world’s health leaders cannot draw this roadmap, the G7 Heads of State should step in next month and do it for them.

Scott C. Ratzan, MD, MPA is Distinguished Lecturer at the CUNY Graduate School of Public Health and Health Policy. He is co-founder of CONVINCE and Founding Editor of the Journal of Health Communication

Kenneth H. Rabin, PhD, is Senior Scholar at the CUNY Graduate School of Public Health and Health Policy

Lawrence O. Gostin, JD, is University Professor at Georgetown University School of Law; Founding O’Neill Chair in Global Health Law; Faculty Director of the O’Neill Institute for National and Global Health Law; and Director, World Health Organization Collaborating Center on National & Global Health Law

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