This month, a group of 40 experts in infectious disease and public policy from around the world published the results of a major new review of the global response to the Covid-19 pandemic, along with recommendations for how to emerge from this pandemic and prepare for future threats in public health. They also sought to draw lessons about how to better address other overarching global threats like climate change and achieving the United Nations’ Sustainable Development Goals for 2030. Prof. Jeffrey Sachs of Columbia, a prominent cheerleader for the SDGs, was a major contributor to the effort. Unfortunately, while their advice might have been useful two years ago for the pandemic, it seems unlikely to be heeded as countries increasingly choose to act as though the pandemic is over.
Assembled as a special global commission by The Lancet, the highly regarded medical journal, the commission was tasked with investigating various aspects of the Covid pandemic. According to a comment from some of the authors, their mandate was “to help speed up global, equitable, and lasting solutions to the pandemic.”
The group’s report pulls no punches. An editorial published by the journal alongside the study says that it “lays bare what has been nothing less than a massive global failure—a failure of rationality, transparency, norms of public health practice, operational coordination, and international solidarity.”
While the report itself is scathing, its findings will sadly come as a surprise to almost no one. Government responses came too slowly, the authors note. They let vulnerable populations fall through the cracks. Their attempts to combat disinformation were unsuccessful. “The result was millions of preventable deaths and a reversal in progress towards sustainable development for many countries,” the editorial continues. By the end of May, the study’s authors report, there were nearly 7 million reported global deaths from Covid, with more than twice that — a total of more than 17 million deaths — believed to be attributable to Covid but not accurately counted. Thousands are still dying each day around the world from the disease (over 400 daily in the U.S. alone, on average).
The authors blame much of this on a lack of cooperation among governments. Failures on this front, they write, include delays in notification about the original outbreak, a lack of equitable distribution of important supplies, taking too long to acknowledge that Covid is airborne, poor coordination about strategies to prevent transmission, insufficient funding, and a shortage of useful data, among others.
Perhaps the most useful part of the report comes in its recommendations for how we emerge from the pandemic. Proving that hope does indeed spring eternal, even as the authors acknowledge two-plus years of global cooperation failure, they say that “putting such cooperation into place is still urgent.” They recommend that governments remain vigilant about new virus variants and sound the alarm about waning immunity, both from natural infections and vaccines, which keeps populations at high risk of infection. They also call for coordinated surveillance systems. However, as more and more countries relax mitigation measures and stop collecting key data, that seems unrealistic. And the commission tasks the World Health Organization with the responsibility to ensure mass immunization across all countries. Oddly, the authors call for further investigation into the origin of the SARS-CoV-2 virus responsible for Covid, even though there is now fairly broad scientific consensus and strong evidence to indicate that the virus spilled over from an animal or animals at the Huanan seafood market in Wuhan, China.
While these recommendations seem exceedingly unlikely to be enacted, especially on a global scale, the authors also addressed what needs to happen to prepare us better for future pandemics. Here, perhaps, there is a chance at least for individual governments and public health agencies to step up. The review also advises strengthening the World Health Organization with new regulatory authority — including the ability to investigate outbreaks on the ground without political interference — and with a bigger budget to allow it to oversee and coordinate the response to new infectious diseases. The commission calls for a new global surveillance system that would build on existing programs and add new capabilities in disease forecasting and mitigation strategies.
“It is certain that future pandemics will arise from interactions between humans and animals,” the group writes. Whether that happens a year from now or 100 years from now, being prepared for it can only help. While our response to the Covid pandemic may have been a failure, we could still salvage something from this crisis if we learned important lessons and used them to do better next time.