The WHO-commissioned report “Covid-19: Make it the Last Pandemic” argues the global alarm system needs overhauling to prevent a similar catastrophe.
The catastrophic scale of the Covid-19 pandemic could have been prevented but a "toxic cocktail" of dithering and poor coordination meant the warning signs went unheeded.
The Independent Panel for Pandemic Preparedness and Response (IPPPR) said a series of bad decisions meant Covid-19 went on to kill at least 3.3 million people so far and devastate the global economy. The panel was jointly chaired by former New Zealand prime minister Helen Clark and former Liberian president Ellen Johnson Sirleaf, a 2011 Nobel Peace Prize laureate.
Early responses to the outbreak detected in Wuhan, China in December 2019 "lacked urgency", with February 2020 a costly "lost month" as countries failed to heed the alarm, said the panel.
The panel of experts who reviewed the World Health Organization’s response to the coronavirus pandemic says the UN health agency should be granted “guaranteed rights of access” in countries to investigate emerging outbreaks, a contentious idea that would give it more powers and require member states to give up some of theirs.
WHO's main failings
The panel did not spare the WHO, saying it could have declared the situation a Public Health Emergency of International Concern – its highest level of alarm – on January 22, 2020.
Instead, it waited eight more days before doing so.
Nevertheless, given countries' relative inaction, "we might still have ended up in the same place", said Clark.
It was only in March after the WHO described it as a pandemic – a term that is not officially part of its alert system – that countries were jolted into action.
The panel pointed out the WHO's Emergency Committee did not recommend travel restrictions, due to WHO's International Health Regulations, which "serve to constrain rather than facilitate rapid action" and needs revamping.
Countries failed to protect people'
In the report released on Wednesday, the panel faulted countries worldwide for their sluggish response to Covid-19, saying most waited to see how the virus was spreading until it was too late to contain it, leading to catastrophic results.
The group also slammed the lack of global leadership and restrictive international health laws that “hindered” WHO’s response to the pandemic.
Institutions "failed to protect people" and science-denying leaders eroded public trust in health interventions, the IPPPR said in its long-awaited final report.
'Panel fails to call out bad actors'
Some experts criticised the panel for failing to hold WHO and others accountable for their actions during Covid-19, describing that as “an abdication of responsibility.”
Lawrence Gostin of Georgetown University said the panel "fails to call out bad actors like China, perpetuating the dysfunctional WHO tradition of diplomacy over frankness, transparency and accountability.”
“The situation we find ourselves in today could have been prevented,” Sirleaf said.
Beyond the call to boost WHO's ability to investigate outbreaks, the panel made an array of recommendations, such as urging the health agency and the World Trade Organization to convene a meeting of vaccine-producing countries and manufacturers to quickly reach deals about voluntary licensing and technology transfer, in an effort to boost the world's global supply of coronavirus shots.
Recommended: Shorter DG tenures, WHO empowered
The panel of independent experts called for setting up a new global system for surveillance of disease outbreaks that could spark a pandemic.
WHO should be empowered to dispatch experts to investigate outbreaks at short notice, obtain pathogen samples and publish information without prior government approval, it said.
Clark said the global diseases surveillance system needed to be overhauled, with WHO's role strengthened.
“WHO should have the powers necessary to investigate outbreaks of concern, speedily guaranteed rights of access, and with the ability to publish information without waiting for member state approval,” she said.
The WHO and WTO should convene governments and drugmakers to hammer out an agreement on voluntary licensing and technology transfers to boost vaccine production, the report said.
If that fails to happen within three months, a waiver of intellectual property rights under the WTO's Agreement on Trade-Related Aspects of Intellectual Property Rights should come into force immediately, it said.
A new funding model should be set up to halt the system of earmarking funds in the U.N. agency's budget and to increase member states' fees.
The experts called for setting up a Global Health Threats Council, to be led at the head of state and government level, to maintain political commitment to pandemic preparedness.
An international pandemic financing facility should be established to mobilise $5 billion to $10 billion annually for pandemic preparedness, they said.
The panel also suggested that WHO's director-general, currently Tedros Adhanom Ghebreyesus of Ethiopia, should be limited to a single seven-year term. As it stands, the WHO chief is elected to a five-year term that can be renewed once.
The suggestion to limit the tenure of WHO's top leader appeared in part designed to ease the intense political pressure that WHO director generals can face.
Sophie Harman, a professor of international politics at Queen Mary University of London, said the panel's recommendations were unlikely to be entirely welcomed by WHO's member countries, and thus, unlikely to be implemented.
“Which states would actually allow WHO in to investigate an outbreak without their permission?” she asked.
Last year, the Trump administration repeatedly inveighed against the agency's handling of the pandemic – taking aim at WHO's alleged collusion with China.
An Associated Press investigation in June found WHO repeatedly lauded China in public while officials privately complained that Chinese officials stalled on sharing critical epidemic information with them, including the new virus’ genetic sequence.
WHO 'failed' in scientific leadership of Covid
Many doctors fatigued after treating Covid-19 patients said any reform of WHO should include an evaluation of its ability to properly assess the science of an emerging health threat.
David Tomlinson, a British physician who has been campaigning for health workers during the pandemic in the UK, said WHO “failed on the most fundamental aspect” in its scientific leadership of Covid-19. He said WHO's failure to acknowledge that much coronavirus transmission happens in the air has “amplified the pandemic.”
WHO has said coronavirus spread can happen in limited circumstances in the air but recommended against mask-wearing for the general public until last June.
Clare Wenham, a professor of global health policy at the London School of Economics, said the report overall was good but questioned its support for the UN-backed program for coronavirus vaccines called COVAX, which relies on a “donation” model.
Of the millions of Covid-19 vaccines administered to date, developing countries have received just 7 percent, WHO said this week.
“(COVAX) is not addressing one of the main problems, which is we need to rapidly ramp up production of the vaccines and distribution of vaccines,” she said. "And it’s still working on the model of a finite number that’s only able be produced by a certain few manufacturing locations.”
Overall, she suggested politicians needed to budge more than technical institutions like WHO.
“The problems aren’t technical. The problems are political. The problems are about like: How do you get governments to behave and think about things beyond their own borders?" Wenham said. “I don’t think that has been resolved.”