For more than a year, the world has confronted a devastating COVID-19 pandemic, which is far from over. In the run-up to the Global Health Summit, the European Commission and the Italian Presidency of the G20 consulted widely with civil society and the scientific community on how to achieve sustainable health security preparedness and response, and prevent future global health crises. These are some of their key messages:
- Recognising the right to Universal Health Coverage
Because health is a universal right, pandemic preparedness and response need to be part of actions guaranteeing access for everyone to affordable and high-quality health care, services and products. Representatives from civil society and scientists recommend placing a particular focus on the health of women and girls, and of vulnerable populations such as elderly persons, young people, migrants, refugees, the LGBTQI community, people living with HIV and others.
- Promoting One Health approach
Because multiple causes from environmental changes, to population movements, to diseases jumping from animals to humans - are favouring the emergence and transmission of epidemics, civil society representatives and scientists recommend multi-sectoral collaboration and actions at all levels. They also stress the need to invest more in international bodies, such as the World Health Organization, to help coordinate and to provide technical support to health systems.
- Ensuring equitable access to medical tools to fight COVID-19
Scientists consider access for all to vaccines and other medical tools (diagnostics, medicines and oxygen) as the top priority. They recommend reinforcing testing, treatment and development of next generation vaccines in the shortest possible time and the development of safe and effective therapeutics for all stages of the disease, including for ‘long COVID’.
- Investing in scientific research & development before, during, and between health crises
Research and innovation has been one of the bright spots in the COVID-19 response. Scientists recommend accelerating research on easily deployable and affordable therapeutics, vaccines and diagnostic technologies and platforms. An immediate high priority is the rapid development of vaccines effective against all relevant viral variants and of a universal coronavirus vaccine.
- Reinforcing disease surveillance, data collection, analysis and sharing at all levels
COVID-19 has shown the critical need for early and reliable information on emerging outbreaks and for constant coordination and collaboration between countries and regions. Scientists recommend strengthening countries’ capacities for data collection and analysis and developing well-funded global and regional networks for pathogen surveillance. Scientists also consider it important to invest in surveillance of animal, human and environmental settings, in order to detect potential pandemics. Rapid sharing of data and information on outbreaks and on other health issues is essential.
- Strengthening and protecting scientific advice
Scientific evidence is crucial to developing sound public health policy and mitigation measures. Scientists recommend ensuring the independence of experts and government advisory bodies and guarding against the politicisation of science. Scientists also consider as a high priority reinforcing mechanisms for rapid advice in times of crisis, in order to reduce as much as possible delays between scientific information becoming available and decision-making.
- Reinforcing regional manufacturing capacities and hubs
Scientists consider it important to invest immediately in global manufacturing capacity and to decentralise production of vaccines and other medicinal products. Significant investment is needed to scale up manufacturing capacity in all regions and to lower costs. They also recommend developing suitable voluntary licensing, patent and technology transfer models, thus reinforcing capacity for decentralised production of vaccines and therapeutics in public health emergencies.
- A long-term investment in pandemic preparation
Representatives of civil society recommend creating a global fund for pandemic preparedness. Countries should spend up to 5% of their GDP on health. Given the inequities in vaccination coverage and the economic effect of the COVID-19 pandemic, civil society representatives and scientists recommend supporting low and middle-income countries.
- Increasing donors’ coordination and commitment
Because we need to fund the rollout of vaccines and reach global immunization coverage of at least 70%, development assistance should be increased to reach the 0.7% of GDP target. Civil society representatives recommend new pledges and commitments in view of a possible International Pandemic Treaty, thus avoiding parallel arrangements and ensuring donor coherence.
- Investing in strengthening of health systems
Civil society considers it essential to create a long-term resilience not only to respond to future pandemics, but also to protect significant earlier gains like successful research into - and treatments for - HIV, tuberculosis and malaria. Short-term investments should expedite vaccine delivery and underpin rollout costs, estimated to be about five times the cost of a dose and currently not covered under COVAX.
Civil society representatives and scientists recommend longer-term investments to cover whole health systems. Scientists also recommend supporting training programmes and conducting regular simulation exercises, in order to develop the knowledge and skills of public health workers in all countries and equip them better to face future pandemics.
- Promoting health as a global public good and reforming international trade
Health should be recognised as a global public good and countries should urgently reform current international trade agreements, to include incentives and sanctions and help low- and middle-income countries to secure critical COVID-19 products. Countries should also deliver on their promises of vaccine sharing, not leaving any country behind.
- Engaging local community and civil society in decisions
Regional approaches are critical to bringing international solutions to fruition. While the coordination of pandemic preparedness and response must be global, there is a need for local ownership, in which civil society plays a key role. Representatives of civil society consider as necessary and essential the involvement of local communities and civil society during the Global Health Summit process and beyond. Moreover, scientists consider as important to society communicating transparently with the public, for example by addressing anti-science sentiment and vaccine hesitancy and by promoting science information.
- Making best use of the digital transformation
The pandemic has highlighted the stark digital divide between and within countries. A key lesson is that in a global health crisis, knowledge is power. Investments in digitalisation for health will require coherent and interoperable systems that facilitate monitoring and decision-making at global and national levels, while ensuring robust and people-centred data governance within and across countries.
Both representatives from civil society and scientists recommend investing in digital innovation and infrastructure, data science, artificial intelligence, and in modelling and forecasting.
Main recommendations resulting from the GHS Civil society consultation