Putting Pandemic Preparedness Reforms to the Test

Putting Pandemic Preparedness Reforms to the Test: A Look at the Global Response to Recent Health Emergencies

Last updated February 15, 2023

Written by: Noor Shakfeh, Senior Global Health Policy Associate, United Nations Foundation

Three years ago, the Director-General of the World Health Organization (WHO), Dr. Tedros Adhanom Ghebreyesus, declared the COVID-19 outbreak a Public Health Emergency of International Concern (PHEIC) and made recommendations for how Member States could reduce the spread and impact of the virus. Many Member States did not take meaningful action until a month later in March 2020, rendering February 2020 “a lost month.” In addition to being slow to action, Member States were also underprepared. According to the then newly released 2019 Global Health Security Index by the Johns Hopkins Center for Health Security and the Nuclear Threat Initiative, no country was fully prepared for a pandemic.

But, at the 73rd World Health Assembly in 2020, the annual meeting of Member States to the WHO, pandemic preparedness and response (PPR) was made a priority. The Assembly adopted the COVID-19 response resolution acknowledging the need for all relevant stakeholders to work together at the national, regional, and global levels to ensure that no one is left behind. This decision laid the groundwork for Member States to pursue high-level reforms over the coming years to ensure the world is better prepared for and able to rapidly respond to future pandemic threats.

Today, key efforts towards strengthening the global capacities for PPR have begun to take shape at the international, regional, and national levels. Among these vital reforms are the establishment of the Pandemic Fund at the World Bank, the Intergovernmental Negotiating Body (INB) to draft and negotiate a pandemic accord, the Working Group on Amendments to the International Health Regulations (2005) (WGIHR), and the United Nations General Assembly decision to host a high-level meeting on PPR in September 2023. Combined, these processes give Member States the opportunity to solidify lessons learned from the COVID-19 pandemic and build collective action for PPR.

Several health emergencies have already tested the progress made through these reforms, including the international spread of mpox, the Sudan ebolavirus outbreak in Uganda, and the surge in COVID-19 cases following the end of China’s zero-COVID policy. Each of these emergencies posed a serious threat, and the world was notably quicker to action than with the COVID-19 outbreak. For instance, the PHEIC declaration without the consensus of the Emergency Committee for the mpox outbreak marked a clear move towards a “no regrets” approach by WHO’s Director-General. The international community rallied to deliver the Sudan ebolavirus candidate vaccines to Uganda in seventy-nine days, the fastest mobilization of a candidate vaccine in recent history.

These milestones reflect a meaningful shift in the world’s capacity to prepare for and respond to outbreaks. Equally, it also signals countries’ willingness to rapidly mobilize to mitigate the impacts of serious outbreaks. However, the global response to these threats was not without challenges. Though the world has an approved vaccine for mpox, limited supply and concentrated manufacturing capacity meant lower income countries were shut out of supplies. Member States of the World Trade Organization (WTO) have also continued to struggle to achieve consensus on intellectual property issues related to COVID-19 countermeasures. On balance, this closer examination demonstrates that the world still has a long way to go on the metrics that really matter: equity and global solidarity.

Indeed, reinforcing equity and global solidarity has proven challenging at all levels and across the various multilateral arenas. These issues have especially come to the fore among Member States’ ongoing discussions towards the pandemic accord and the International Health Regulations amendments, where equity and solidarity stand at the root of many of the divisive issues being considered by Member States.

Still, with so many high-level processes underway this year, 2023 is poised to be one of the most consequential years for PPR reform. Member States will have several opportunities across various multilateral fora to deliver on their promises to ensure the world is better prepared for the next pandemic. While solidarity prevailed in earliest days of pandemic, Member States will now need political courage to manifest their reforms. To ensure success, they must act quickly and utilize all the political and legal tools made available to them via these high-level moments. Furthermore, civil society and non-state actors have a key role in promoting accountability to progress. Without a doubt, this must be the year Member States relentlessly push for technical solutions, and, more importantly, political solutions for PPR.