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Covid-19: Global response was too slow and leadership absent, report finds

BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1234 (Published 13 May 2021) Cite this as: BMJ 2021;373:n1234
  1. Jacqui Wise
  1. Tenterden, UK

The covid-19 pandemic was a preventable disaster with weak links at every point in the chain of preparedness and response, according to a high level review panel.

The report from the Independent Panel for Pandemic Preparedness and Response, Covid-19: Make it the last pandemic, concluded that the alert system was too slow, the World Health Organization was underpowered, and global political leadership was absent.1

The report was commissioned by the WHO director general in response to a resolution at the World Health Assembly made in May 2020. The 13 member panel spent eight months reviewing the evidence on the spread, actions, and responses to the pandemic.

The report says covid-19 has been a terrible wake-up call and “the 21st century’s Chernobyl moment.” It says that the system, as it stands now, is unfit to prevent another novel and highly infectious pathogen, which could emerge at any time, from developing into a pandemic.

Panel co-chair, Ellen Johnson Sirleaf, former president of Liberia, said, “The shelves of storage rooms in the UN and national capitals are full of reports and reviews of previous health crises. Had their warnings been heeded, we would have avoided the catastrophe we face today. This time must be different.”

The report says that clinicians in Wuhan, China, were quick to spot unusual clusters of pneumonia of unknown origin in late December 2019. But the formal notification and emergency declaration procedures under international health regulations were too slow and time was lost. WHO should have declared a global emergency a week earlier than it did on 30 January, the panel found.

Too many countries then took a “wait and see” approach and as a result February 2020 was a “lost month” when steps could and should have been taken to contain the spread of SARS-CoV-2. Only a minority of countries set in motion comprehensive and coordinated measures that managed to contain and stop the spread of the virus. Many countries only started to act when hospitals began to be overwhelmed. Countries with the poorest results had uncoordinated approaches that devalued science and denied the potential impact of the pandemic.

The report makes several recommendations to halt the current spread of SARS-CoV-2 and to prevent a future outbreak from becoming a pandemic:

  • ● High income countries should commit to provide at least one billion vaccine doses by September 2021 for distribution to low and middle income countries through Covax

  • ● Major vaccine producing countries and manufacturers should meet to agree to voluntary licensing and technology transfer. If this doesn’t occur within three months, a waiver of intellectual property rights should come into force immediately

  • ● The G7 should immediately commit to provide 60% of the $19bn (£14bn; €16bn) needed for the Access to Covid-19 Tools Accelerator in 2021 for vaccines, diagnostics, therapeutics, and strengthening of health systems

  • ● A Global Health Threats Council should be created with the power to hold countries accountable

  • ● A global disease surveillance system should be established with the authority to publish information without the approval of countries concerned

  • ● The independence, authority, and financing of WHO should be strengthened, including increasing member state fees

  • ● All national governments should update their preparedness plans against targets to be set by WHO.

Panel co-chair, Helen Clark, the former prime minister of New Zealand, said, “The tools are available to put an end to the severe illnesses, deaths, and socioeconomic damage caused by covid-19. Leaders have no choice but to act and stop this happening again.”

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