People standing in a line with masks on.
Credit: Tuane Fernandes Silva

3. The Panel's call for immediate actions to stop the COVID-19 pandemic

The Panel is concerned and alarmed about the current persistent high levels of transmission of SARS-CoV-2, which are driving illness and deaths, and about the development of virus variants all of which continue to impose an intolerable burden on societies and economies.

Countries have varied significantly in their application of public health measures to keep the spread of the virus in check. Some have sought to contain the epidemic aggressively and drive towards elimination; some have aimed at virus suppression; and some have aimed just to mitigate the worst impacts. Countries with the ambition to aggressively contain and stop the spread whenever and wherever it occurs have shown that this is possible. Given what is known already, all countries should apply public health measures consistently and at the scale the epidemiological situation requires. Vaccination alone will not end this pandemic. It must be combined with testing, contact-tracing, isolation, quarantine, masking, physical distancing, hand hygiene, and effective communication with the public.

Alongside these non-pharmaceutical measures, vaccine rollout needs to be scaled up urgently and equitably across the world. A number of effective vaccines are now approved. Current production capacity, however, is stretched close to its limits, and vaccination coverage is far from being at the scale needed to reduce the burden of illness and curb transmission globally.

The uneven access to vaccination is one of today’s pre-eminent global challenges. High-income countries have over 200% population coverage of vaccine doses, obtained mainly through bilateral deals with manufacturers to secure existing and future stocks. In many cases low- and middle-income countries have been shut out of these arrangements. In the poorest countries, at the time of finalising this report, fewer than 1% of people have had a single dose of vaccine. The COVID-19 Vaccines Global Access Facility (COVAX Facility), rapidly established with the intention of ensuring global, equitable access, is making good progress but has been hampered in that goal by a lack of sufficient funds and by vaccine nationalism, and now, vaccine diplomacy.

There are 5.7 billion people in the world aged 16 and over. All need access to safe and effective COVID-19 vaccines. This is not some aspiration for tomorrow—it is urgent, now.

To prepare ourselves for new phases of the COVID-19 pandemic and to respond effectively, a global strategy with clear goals, milestones and priority actions is needed. The significant inequity in vaccine access must be addressed immediately, as it is not only unjust, but also threatens the effectiveness of global efforts to control the pandemic. Variants may still emerge that our vaccines cannot manage. The more quickly we vaccinate now, the less likelihood there is of ever more variants emerging. One action which can be taken now is an equitable redistribution of available vaccine doses. Scaling up the development and supply of therapeutics and of diagnostic tests is also very urgent to save lives.

Moreover, to prepare for likelihood of of COVID-19 becoming endemic and to address inequity in vaccine access in a more sustained way, manufacturing capacity of mRNA and other vaccines must urgently be built in Africa, Latin America and other low- and middle-income regions. Vaccine manufacturing is highly specialized and difficult. Boosting production takes time so enabling it must begin now. It requires agreements on voluntary licensing and technology transfer.

There are 5.7 billion people in the world aged 16 and over. All need access to safe and effective COVID-19 vaccines. This is not some aspiration for tomorrow – it is urgent, now. COVAX has secured 1.1 billion vaccine doses and has optioned 2.5 billion more.  Before the end of April, one billion vaccine doses were administered, overwhelmingly in high-income or upper-middle-income countries. The Panel joins with political and faith leaders across the world and calls for an all-out effort to reach the world’s population with vaccines within a year and set in place the infrastructure needed for at least 5 billion booster doses annually.

Immediate action to end COVID-19 must be guided by explicit strategies with measurable milestones. The Panel recognizes the WHO COVID-19 Strategic Preparedness and Response Plan for 2021  provides useful technical guidance but the Panel’s view is that there is a need for a higher level roadmap for ending the pandemic with clear targets, milestones and dates.

A nurse wearing a face shield prepares to give an elderly person in a wheelchair their COVID vaccination while a young man waits to the side. Credit: Mindy Tan

The Independent Panel makes the following urgent calls

  1. Apply non-pharmaceutical public health measures systematically and rigorously in every country at the scale the epidemiological situation requires. All countries to have an explicit evidence-based strategy agreed at the highest level of government to curb COVID-19 transmission.
  2. High income countries with a vaccine pipeline for adequate coverage should, alongside their scale up, commit to provide to the 92 low- and middle-income countries of the Gavi COVAX Advance Market Commitment, at least one billion vaccine doses no later than 1 September 2021 and more than two billion doses by mid-2022, to be made available through COVAX and other coordinated mechanisms.
  3. G7 countries to commit to providing 60% of the US$ 19 billion required for ACT-A in 2021 for vaccines, diagnostics, therapeutics and strengthening health systems with the remainder being mobilised from others in the G20 and other higher income countries. A formula based on ability to pay should be adopted for predictable, sustainable, and equitable financing of such global public goods on an ongoing basis.
  4. The World Trade Organization and WHO to convene major vaccine-producing countries and manufacturers to get agreement on voluntary licensing and technology transfer arrangements for COVID-19 vaccines (including through the Medicines Patent Pool). If actions do not occur within three months, a waiver of intellectual property rights under the Agreement on Trade-Related Aspects of Intellectual Property Rights should come into force immediately.
  5. Production of and access to COVID-19 tests and therapeutics, including oxygen, should be scaled up urgently in low- and middle-income countries with full funding of US$ 1.7 billion for needs in 2021 and the full utilization of the US$3.7 billion in the Global Fund’s COVID-19 Response Mechanism Phase 2 for procuring tests, strengthening laboratories and running surveillance and tests.
  6. WHO to develop immediately a roadmap for the short-term, and within three months scenarios for the medium- and long-term response to COVID-19, with clear goals, targets and milestones to guide and monitor the implementation of country and global efforts towards ending the COVID-19 pandemic.
Endnotes