The COVID-19 pandemic has severely disrupted the world’s most advanced economies and even challenged their comprehensive healthcare systems. While previous outbreaks such as the Human Immunodeficiency Virus (HIV), the Middle East Respiratory Syndrome (MERS) and Ebola predominantly affected developing nations in the south, COVID-19, on the other hand, has rampaged through major global economies including China, the United Kingdom (UK) and the United States (US). This indicates that every single person on earth, regardless of nationality or economic status, has a shared susceptibility to the virus.
Considering the approximately 250 million reported cases and 5 million deaths worldwide as of early November, it seems irrefutable that the collective international state response towards the 2019 outbreak of the virus was patchy and unorganised. The US, renowned for being a global leader, faced pressure in providing a model response for other nations to follow, but due to their possible lack of foresight of the outbreak’s magnitude, such expectations were not met.
What Went Wrong?
In an article by Scientific American, scientists and public health experts alike stated that one of the major faults in the US’s response during the early critical days of the pandemic was the consistent downplaying of the virus’ threat to the public. There was an observed constant repudiation of the virus as akin to that of “a regular flu” by then US President Donald Trump, which likely led to increased difficulties in addressing the situation. Furthermore, warnings from the US Centers for Disease Control and Prevention’s (CDC) of the virus’ possible severe impact on public health were taken lightly and quickly dismissed.
Media coverage of Trump’s rhetoric and trivialisation of the outbreak also seemed to disrupt the relaying and conveying of important, factual, scientific information to the public, contributing to the erosion of trust in various stakeholders including the media and science-based government institutions. Moreover, Trump’s decision to cut ties with the World Health Organisation (WHO) and other organisations within the United Nations (UN), added to the numerous challenges faced by multilateral stakeholders and greatly impacted their roles in devising solutions for the health crisis.
The UK was likewise criticised for its response. Initially, Prime Minister Boris Johnson similarly saw the risk of the virus as “moderate” and attempted to pursue herd immunity. According to a parliamentary report, the UK’s delay in imposing lockdowns contributed to an unnecessary loss of lives, being “one of the most important public health failures [the UK] has ever experienced”. Countries like Brazil also exercised the same downplaying of the outbreak and allegedly denied the importance of precautionary measures, which too, possibly led to the surge of infections in the country.
Despite massive implications that arose from countries’ ineffective and delayed responses, the US’ speedy development of vaccines became the light at the end of the tunnel. Within a year, Pfizer BionNTech and Moderna produced safe vaccines that had approximately a 95 per cent efficacy in preventing severe symptoms. This brought hope to nations worldwide for a means to eradicate the virus and an end to the bleak situation. However, this “good news” turned out to be a double-edged sword, for issues of vaccine inequity and vaccine nationalism among others quickly arose.
Vaccine Distribution: The Harsh Reality
Wealthy countries like the UK and the US raced to protect their citizens and were able to secure enough vaccines to cover over twice their populations, surpassing the WHO’s target of countries to vaccinate 10 per cent of their population by September this year. On the contrary, more than 50 developing countries received the shorter end of the stick and suffered a shortage and inaccessibility to vaccine supplies, rendering them incapable of reaching the inoculation targets. Thus, even with the production of enough doses to cover every person (both the privileged and vulnerable) globally, inequity and slow distribution of the vaccines resulted in a continuous wave of fatalities and infections, primarily taking a toll on the poorest nations.
This unequal distribution ultimately led to variants of the virus emerging, which seemed to undermine the efforts of countries that had already reached their inoculation targets. At a John F. Kennedy Forum in March, Dr Michael Mina, assistant professor of epidemiology at Harvard T.H. Chan School of Public Health, stated that these variants can “potentially become blind to immune systems that have already been vaccinated”, denoting that a new pandemic can arise from such strains.
Research by the Rockefeller Foundation revealed that variants have a higher rate of developing among predominantly unvaccinated populations where the virus is most transmissible and infectious. The Delta variant has already proved to be more infectious ripping through vaccinated populations, and even the solution of booster shots is said to be a counterintuitive approach that can set back worldwide vaccination supplies that could have been administered to vulnerable nations whose populations have yet to receive a single dose.
“As long as we continue to have mass transmission due to inequities in vaccine distribution, we are all at risk”, Dr Mina warns. Simply put, as long as parts of the world population continue to be unvaccinated, more variants may continue to emerge and wreak havoc into global economies and healthcare systems affecting all globally, thereby prolonging the pandemic. That said, with the Delta variant being the so-called culprit for newer infections in rich and highly inoculated nations, perhaps world leaders of these nations have been taught a painful lesson similar to the collective sentiment shared by many international organisations including the UN and the WHO that “no country is safe until every country is safe”.
A Call for Vaccine Equity Across Nations
In light of vaccine inequity, the WHO has outlined targets in its Strategy to Achieve Global COVID-19 Vaccination by mid-2022 targetting a 40 per cent vaccination rate in every country by the end of this year and 70 per cent by mid-2022. With some countries still far off from this year’s target as of November, Dr Tedros Adhanom Ghebreyesus, Director-General of the WHO, declared that “economically, epidemiologically and morally, it is in all countries’ best interest to use the latest available data to make life-saving vaccines available to all.” Meaning, vaccination targets need to be globally aligned and coordinated for targets to achieve the greatest impact in order to facilitate the recovery of the global economy and further safeguard public health.
International organisations have also stepped up in response. The Global Alliance of Vaccines and Immunisation (GAVI) is currently co-leading international efforts to ensure equitable access to COVID-19 vaccines through an initiative known as COVAX which has distributed over 435 million vaccines to 144 countries worldwide as of early November.
COVAX has also collaborated with governments to aid in supply and distribution. The countries include the US, UK and China, all of which have committed to donating over a billion doses altogether. However, the delivery of the vaccines still falls short of the countries’ pledges due to issues in supply chains and manufacturing.
An Increasingly Turbulent Global Health Landscape in Need of Global Health Diplomacy
Essentially, the entire international response from the initial downplaying of the outbreak to the vaccine inequity and its consequences and lastly to the emergence of COVAX to solve these issues shows one key aspect — the growing need for global health diplomacy.
According to a guide by the Graduate Institute of International and Development Studies in Geneva, Global Health Diplomacy (GHD) refers to the multi-level and multi-actor negotiation processes that shape and manage the global policy environment for health in health and non-health fora. In the WHO’s perspective, GHD also connects various elements pertaining to public health, law, international affairs and economics, all of which play a part in shaping the global policy climate for health.
It seems that diplomacy in global health used to be treated as a lower political issue, mainly because while certain countries seemed equipped to confront challenges posed by modern global health threats, others may not have the same capabilities due to their status and power in the world arena, hence often placing their priorities on domestic aspects instead. Moreover, government-level negotiations were commonly carried out for issues pertaining to war, trade and peace. Global health issues, to put it simply, were not as securitised.
However, with COVID-19 and its lessons to the world taking the global stage, global health has become an increasingly important aspect of foreign policy. As such, new skills and measures are required to negotiate and discuss health-related issues concerning other interests. Due to the progressively interconnected global landscape, health crises can no longer be resolved through simply safeguarding national self-interests and being inward-looking. States need to engage in political negotiations and resolutions involving other world leaders and a whole range of non-state actors in order to more effectively address issues concerning public health.
Global Solidarity, More Needed Than Ever
The pandemic has seen a wide display of nations and communities putting their own interests first, with rather little consideration in working towards an initial coordinated system-wide response. All of the situations it has put the world through set a reminder — we are only as strong as our weakest link. Only when countries work together towards a unified goal, can we then be able to better combat challenges that take place on a global scale.
The UN’s Sustainable Development Goal 3 (SDG 3) outlines the goal to “ensure healthy lives and promote well-being for all at all ages”. Rescaling Universal Health Coverage (UHC) remains the cornerstone to ensuring that the full spectrum of quality health services is received equally worldwide. Developing nations are most in need of such bolstering and it is crucial that wealthier and developed nations immediately assist them in that aspect.
Strong financial structures are key to strengthening such systems as people in poverty are usually unable to acquire the necessary health services due to their circumstances. Thus, collective funding by governments and private sectors are required. As the UN suggests, these stakeholders can contribute to public health functions by making evidence-based policies, improving information systems and data analysis, better communication and community outreach to empower individuals and their families to manage their own health and subsidies to the public health institutes and programmes.
Thus, while initiatives like COVAX and The Access to COVID-19 Tools (ACT) Accelerator have solidified the international unified response towards tackling the pandemic, world leaders and international stakeholders have a lot more steps to take to keep such devastating impacts of health crises at bay. There should be a global effort to prepare for coordinated and concrete steps to take in the future to better prepare for what may come in the global health landscape.
If the world fails yet again to confront global issues with global solutions, we may not be able to live through the economic, political, health and social repercussions that may arise from the next global health crisis. The COVID-19 pandemic serves as an urgent call for global solidarity and the need to revisit global health diplomacy to address health issues that transcend borders, to which only then, can the health of nations be safeguarded.
