Lessons for building a better framework for global health

It is surprising to think that when the last Paris Forum on La Paz was held, in November 2020, no vaccine against covid-19 had yet been approved.

Just over a year later, more than 7 billion doses have been administered, preventing countless deaths and helping turn the tide of the pandemic in many countries.

However, this scientific triumph is overshadowed by the impossibility of ensuring that all people benefit from it.

At the time of this writing, more than a third of the world's population is fully vaccinated.

However, in Africa, this percentage is only 7%.

This situation is unacceptable, and we must urgently change it.

Any threat to global solidarity is a threat to global security and stability.

Any threat to global solidarity is a threat to global security and stability

All governments have a responsibility to protect their own people.

However, the failure of some of them to share critically important resources (including: information, biological samples, and tools, the latter in turn including vaccines, tests, and other supplies) has deprived their counterparts in many countries of low and lower middle income of the ability to fulfill that mandate.

The covid-19 pandemic will not be the last.

That is why, as we recover and rebuild from this crisis, we must also take steps to ensure that we can cope with future disease outbreaks within a realm of effective cooperation and collaboration, rather than the realm of chaos and confusion that has exacerbated the current crisis.

The global response to the pandemic has been the subject of much analysis.

And there have been many recommendations for measures that would allow us to detect the next disease outbreak early, and that way we can either prevent it from becoming an epidemic (let alone a pandemic), or we can guarantee a quick and effective response.

All of these reviews and reports highlight four themes.

First, global governance must be more inclusive, equitable and accountable.

The current global health and safety architecture is complex and fragmented, and voluntary mechanisms have not produced the necessary level of collective action.

This is why I advocate for the creation of a new international instrument, such as a treaty, to guide preparedness and response to pandemics. By providing a general framework for global cooperation, including clear rules of the game, such an instrument could significantly boost solidarity between countries. The member states of the World Health Organization (WHO) will discuss this initiative this month [in November], at a Special Session of the World Health Assembly.

Second, we need more and better funding for pandemic preparedness and response. This includes a substantial increase in domestic investment, as well as increased international financing to support low- and lower-middle-income countries. It is essential that any financing mechanism is created through existing financial institutions; the creation of other new mechanisms would further fragment the global health architecture. Furthermore, such mechanisms should not be financed solely with voluntary development assistance, as this would intensify competition for already scarce resources. Rather, we propose to create a Global Fund for Health Threats in order to pool additional resources,This could be established at the World Bank in the form of a Financial Intermediaries Fund, and could be financed by countries and regional organizations on the basis of burden sharing.

Third, we must design and implement better systems and instruments for multisectoral health surveillance. WHO has already started building such tools. On September 1, we inaugurated the new WHO Information Center on Pandemics and Epidemics in Berlin, which will provide the world with better data and analytics to support the detection of, and response to, public health emergencies. Subsequently, I had the honor of joining French President Emmanuel Macron, in Lyon, in celebrating the opening ceremony of the WHO Academy, which will use innovative technologies to expand access to high-quality continuing education for healthcare workers. of the world.

Other initiatives are being developed, such as a WHO global BioHub, this is a Swiss-based pathogen storage and exchange center, and the Universal Health Examination and Preparedness; Following the model of the Universal Periodic Review (UPR) used by the United Nations Human Rights Council, the Universal Health and Preparedness Review will use peer review to increase accountability and transparency among member states of WHO, as they identify gaps and build capacity for pandemic preparedness and response.

Finally, we need a strengthened, empowered and sustainably funded WHO that is at the center of the global health framework.

With 194 member states and 152 country offices, WHO stands out for its global mandate, reach and legitimacy.

However, in recent decades, it has been progressively weakened by a debilitating imbalance between assessed (mandatory) contributions and voluntary and assessed contributions.

This distorts our budget, limiting our ability to attract and retain top talent, and limiting us in meeting the expectations of our Member States.

The world must now invest in an organization that truly represents and works for the health of all countries

The pandemic has highlighted the critical importance of global health security. The further weakening of WHO and the further fragmentation of the institutional framework for global health are among the greatest risks threatening such security. The world must now invest in an organization that truly represents and works for the health of all countries.

In the coming months and years, other crises will inevitably demand our attention.

But we must not lose sight of the importance of strengthening global health security.

If the world continues on its current path, we will only cause our health to deteriorate, with devastating economic and political consequences.

However, if we embrace new ideas and work together in solidarity, we can build a future that is healthier, safer, fairer and more peaceful.

Tedros Adhanom Ghebreyesus

is Director General of the World Health Organization (WHO). 

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