At the World Leaders Forum on Wednesday, Director-General Tedros Adhanom Ghebreyesus of the World Health Organization addressed global vaccine inequality, outlined areas for improvement, and asserted that health is a human right that is worth the cost.

The last time the Director-General was at Columbia for 2017’s World Leaders Forum, he talked about the 1918 flu pandemic, unaware of course that a new pandemic was only two years away. According to Tedros, the world was not prepared for what lay ahead.

In 1918, New York’s Director of Public Health for schools, Dr. S. Josephine Baker, argued to keep students in school, as the schools provided a framework to monitor for illness, provide healthcare, and move students to areas with better ventilation. (Many students lived in areas with a lot of crowding and restricted access to healthcare.) According to Tedros, this is one of the reasons New York City did better than other cities that kept schools closed.

He was quick to clarify that “I’m not saying whether I think schools should be open or closed now – that depends on the local situation, based on a careful risk assessment,” and that his point was that the decision to open schools in 1918 was based on such a risk assessment.

However, a hundred years later, the world at large was unprepared for COVID-19. According to Tedros, “we might have vaccines, but a lack of moral, political and legal authority has fuelled the COVID-19 pandemic,” citing an eroding trust in science, geopolitical “fault lines” being “exposed and widened,” and global inequality as reasons the pandemic has continued.

He then went into more detail on global vaccine inequality, saying that more than 75% of the world’s COVID-19 vaccine supply has gone to middle and high-income countries, while lower-income countries have gotten less than half of a percent of the supply. According to Tedros, in Africa, less than 4% of the population is fully vaccinated.

The WHO’s targets for vaccination are to have 40% of every country fully vaccinated by the end of 2021 and to raise that number to 70% by the middle of 2022. This is possible, Tedros said, “but only if the countries and companies that control the global vaccine supply do their part.” According to Tedros, high-income countries have pledged 1 billion doses of the COVID-19 vaccine to be donated, but less than 15% of these doses have actually been donated.

He called on the high-income countries and companies that control the supply of vaccines to follow through on donating their doses and to share the technology, knowledge, and intellectual property to allow other countries to produce their own vaccines.

“We need a global realization that no country can vaccinate its way out of this pandemic in isolation from the rest of the world,” he said, noting that the longer the rest of the world isn’t vaccinated, the longer the global economy will suffer because of COVID-19, and the more time the virus has to mutate and become more dangerous.

When Bwog asked if there are any reasons to be optimistic for the future of vaccine equality, Tedros cited the increased capacity of more countries to produce their own vaccines. However, he said, the number of countries that produce vaccines will still be small compared to the number of countries that will need them. This is one of the reasons the WHO is advancing a “pandemic treaty,” which could address problems with exporting vaccines equitably.

After addressing vaccine inequality, Tedros outlined four areas that need to be addressed in the wake of the COVID-19 pandemic: we need better global governance, better financing for global pandemic preparedness and response, better ways of detecting and responding to pandemic-level threats earlier, and a more empowered WHO to coordinate and be the cornerstone of all of these efforts.

The aforementioned “pandemic treaty” would be part of improved global governance, which would “provide a much-needed overarching framework for global cooperation, setting the rules of the game, and enhancing solidarity among nations.” According to Tedros, this will be discussed at a Special Session of the World Health Assembly in November.

Better financing, he said, needed to focus on improving financing for “local health security,” citing primary health care systems as “an essential first line of defense against outbreaks, but also against other communicable and non-communicable diseases, and for the health impacts of pollution and climate change.”

As for detection systems, he cited a few ongoing initiatives, including WHO Hub for Pandemic and Epidemic Intelligence in Berlin for sharing knowledge and improving health threat surveillance, the WHO BioHub in Switzerland for storing and sharing the actual pathogens, and the Universal Health and Preparedness Review, which is an advisory group designed to improve member states’ health emergency preparedness.

He ended his remarks by reminding the audience that now is the time to prevent another tragedy, and that “the pandemic has taught us that health is not a luxury, but the foundation of social, economic and political stability.”

“Health is not a cost to be contained, but an investment to be nurtured. And health is not a privilege, but a fundamental human right.”

Image via World Leaders Forum Zoom