IHP news 610 : Perseverance - International Health Policies

IHP news 610 : Perseverance
( 26 Feb 2021)

The weekly International Health Policies (IHP) newsletter is an initiative of the Health Policy unit at the
Institute of Tropical Medicine in Antwerp, Belgium.

Dear Colleagues,

When the first vaccine doses distributed by COVAX landed in Ghana earlier this week, it felt a bit
like the Perseverance’s landing on Mars. Ouf! At last. Neil Armstrong probably also nodded
approvingly from heaven, when hearing some of the rhetoric: “Wonderful words from @UNICEF
Covax Coordinator Gian Gandhi as the first ACTA flight hits the ground in Ghana: « A short flight, and
small step to reduce inequities in vaccine access... but a huge achievement that’s been almost 10
months in the making». Anyway, encouraging and great news, not a day too soon.

Still, the picture on global vaccine equity remains bleak in the short term, for the reasons you know.
Yes, there is a growing movement behind vaccine equity, as dr. Tedros claimed last week, and
multilateralism made a cautious comeback at the G7 summit (with Covax getting a (much needed)
shot in the arm). WHO officials can now be (a bit) more optimistic about successfully getting around
2 billion vaccine doses to at least 20% of the populations of 92 lower-income economies by the end
of 2021. But they shouldn’t get carried away too soon, as this (excellent) COVAX “state of affairs”
piece in Stat argued: “more is needed to ensure global vaccine access”. A quote from Kenneth
Shadlen put things in perspective: “It would be great if COVAX can help us avoid a worst-case
scenario of poor countries having no vaccines until 2022 or later. That’s an accomplishment that we
can celebrate, but we should also recognize the accomplishment for what it is – avoiding a worst-
case scenario.” Even if there are probably also epidemiological and cost-effectiveness arguments
complicating the vaccine equity debate a bit in some (of the relatively less hit) regions of the world,
the last thing you want in this pandemic is that social spending in LMICs gets cut even more than
already is the case, because they have to purchase vaccines at "above rich world" prices.

Over here in Europe, ‘Team Europe’ and Emmanuel Macron’s version of global solidarity continues
to contain a strong dose of geopolitics, but perhaps that was always unavoidable, given how most
leaders are wired. What is far less unavoidable, though, is the continued opposition of rich countries
(with big pharmaceutical industries) to the TRIPS waiver proposal, where things remain deadlocked.
Against that backdrop, the question has to be raised, as Sophie Harman pointed out in a tweet,
“whether COVAX was set up to avoid any discussion on IP and TRIPs waivers for COVID vaccines. Is
COVAX part of problem not solution to #PeoplesVaccine?”

I wouldn’t go that far. COVAX (and ACT-A) are no doubt needed on the journey towards a “People’s
Vaccine” in this grossly unfair and imperfect world of ours, even if they clearly don’t suffice. On the
latter, Nick Dearden (Global Justice Now), put it like this after the G7 meeting: “The Elephant in the
Zoom” remains Big Pharma patents. And so, borrowing a line from NASA, I hope global civil society
‘Perseveres’ with its essential battle to overcome the artificially constrained supply, and (in the
process) the current global vaccine distribution “zero-sum game”. Fortunately, People’s Vaccine
proponents have some great allies like Winnie Byanyima and John Nkengasong – not to mention the

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Holy See! And perhaps dr. Tedros can also give a hand, by tweeting on the TRIPS waiver:
‘Perseverance’ ?

Over to the US administration then, and the “new wind” that comes with it . When I see Joe Biden’s
calm demeanor, just “getting to business” and “doing what needs to be done”, I wonder to what
extent you also see the (somewhat sad) difference between (at least some) in his generation, and
the “neoliberalized individuals” we have all become in the past 30 years, consciously or
subconsciously, (self-)branding and competing with each other all the way till the very destruction of
our planet. I’m not a big fan of Branko Milanovic’s writings on degrowth, but sadly, this assessment
in a blog by him this week was spot on: “capitalism, and thus both the relentless search for profit
and the value system that places wealth on the pedestal, is more dominant than ever. Had
degrowers preached material abstinence in 13th century Europe or 10th century Byzantium it might
have had more appeal. Commercial society, capitalism, numerical abilities were far less developed
than today. But now, the relevance of moral preaching of abstinence is close to zero. …”.

But let’s end this intro with dr. Tedros. As some pointed out, WHO statements targeting specific
countries are rare, but Tedros did single out Tanzania last week (for good reason). At Monday’s
WHO media briefing, dr. Tedros also lashed out at High-Income countries for snapping up vaccine
supplies. No prizes to be won for which criticism is most important in this world of ours.

Enjoy your reading.

Kristof Decoster

Featured Article

The Future of Global Health Leadership: reflections of the
IWG Fireside Chat

Ghiwa Nasser Eddine, Laura Haywood, Malvikha Manoj, Magali Collonnaz (all are IWG members)

The International Working Group for Health Systems Strengthening (IWG) is an international
collaborative of emerging public health professionals committed to meaningful health systems
reform. To better understand what makes a leader, we hosted a fireside chat in December, called
‘Looking Back, Looking Forward’, with three trailblazers in their fields: Dr. Kabir Sheikh, Dr. Rene
Loewenson, and Dr. Roopa Dhatt. The discussion aimed to explore the paths that these three
individuals have paved in the field of global health and to inspire conversations and actions for reform.
Three essential lessons emerged:

 1. Advocacy rooted in core values: Identifying a core vision, mission, and goals, and centering
 them within a strong value system that can guide your advocacy efforts, can help rally other
 like-minded collaborators towards your cause.

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2. Collective successes over Individual successes: In public health, as is common across many
 other spaces, the success of one requires the success of many.
 3. People-centered comprehensive public health: Public health professionals should always
 consider, engage and work with the members of the community as the most critical aspect of
 every initiative they intend to implement.

Following this, IWG members had a ‘think in’ to reflect on the speakers’ ideas and collate different
recommendations that emerging public health professionals may consider insightful in setting their
own paths.

Study the history of global health, and critically examine who holds power as well as how your work
shapes the distribution of power. Global health emerged from a colonial legacy and it could be argued
that these tendencies are still perpetuated in modern times in different ways. Power imbalances
across gender, race, and geography are still abundant in the space. As emerging global health leaders,
we have a responsibility to question how this history has shaped the mistrust and division that exists
within public health, and then commit to tangible actions to address these issues.

Identify, adhere to, and come back to your values and convictions regularly. Values can be critical
drivers that shape aspirations and intentions in the field of global health. Our ‘values’ are not simply
words to write down, but they are actions to live by.

Find your team. Collaborate. In order to strengthen health systems that work for all, we need diverse,
empowered voices on the team. We should continue to ask who is at the table, and perhaps more
importantly, who is not at the table; and why. If the table is not big enough, create a new one.

Negative emotions can be a powerful tool for deeper and more meaningful discussions and actions,
and can lead to positive reform if channeled well. Channel negative emotions into positive strategies
and understand that what we feel is “wrong” or “unjust” can go a long way in helping us address the
issues we are passionate about.

Global health is a complex, dynamic, and fulfilling field. Ultimately, it is up to each of us to be the
change we want to see around us: the pandemic has opened a window of opportunity for us to step
up and move towards a more just vision for public health.

Full article: https://iwghss.org/2021/02/09/iwg-fireside-chat/

Acknowledgements: We would like to thank Dr. Roopa Dhatt, Dr. Rene Loewenson, and Dr. Kabir Sheikh for their meaningful
and thoughtful remarks during the IWG Fireside Chat, as well as their feedback on this output: their constructive suggestions
and ideas have helped shape the final output published here.

We would also like to thank our fellow IWG Global Lecture Series working group members (in alphabetical order): Bronte
Davies, Faye Roderos, James Coughlan, Lynn Bust, Mabel Aoun, Meena Taffazoli, Nuria Gallego, Philip Dambisya, Pushpak
Mahajan, and Reiner Tamayo.

For more information about the IWG, stay connected on our social media platforms: Website, Facebook, Twitter, Instagram.

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Highlights of the week

Global Tax Justice

Tax Justice Network - Heads of state launch historic UN plan to stamp out global
tax abuse
https://www.taxjustice.net/press/heads-of-state-launch-historic-un-plan-to-stamp-out-global-tax-
abuse/

“A group of heads of state from around the world are today launching a blueprint for a UN tax
convention and a new intergovernmental tax body under the UN to radically tackle rampant global
tax abuse, which is currently estimated to cost countries over $427 billion in lost revenues to tax havens
every year. The report from a high-level UN panel, provides a comprehensive set of
recommendations that reflect in full the policy platform created by the Tax Justice Network since its
formal establishment in 2003. The panel identifies tax abuse and other illicit financial flows as a
systemic problem that “robs billions of a better future” and that can only be addressed by “nothing
less than a transformation of the global financial system” led at the United Nations….”

“… The seminal blueprint was prepared by the UN High-Level Panel on International Financial
Accountability, Transparency and Integrity, which launched in March 2020 to study the impact of tax
abuse, money laundering and illicit financial flows on the ability of states to meet the UN’s Sustainable
Development Goals by 2030. … … signalling the strongest levels of global support to date for efforts
to bring international taxation under the mandate of the UN. … … The high-level UN panel’s report
draws scathing conclusions on the current patchwork of international tax rules and structures that
have been largely set by the OECD … The high-level UN panel sets out 14 recommendations in its
ambitious blueprint to “free the global economy from illicit financial practices”, most monumental of
which are the adoption of a UN tax convention and establishment of an intergovernmental body on
tax matters under the UN. The panel states these actions would allow international tax standards to
be established through an open and inclusive legal instrument with universal participation. In practice,
these two actions would shift the power to set global tax rules away from the OECD, which has held
the seat of power on global tax for 60 years, to the United Nations This would then make it possible
to push forward the policy package laid out in the rest of the recommendations made by the high-level
UN panel, and which reflects in full the policy platform long advocated for by the global tax justice
movement…”

Related blog by Alex Cobham: A tide-turning moment in the global struggle for tax justice.

Coverage: Euractiv - Global agreement on corporate tax rates needed, UN report states

G7 summit (UK: virtual host)

G7 Leaders declaration: https://www.g7uk.org/joint-statement-of-g7-leaders-19-february-2021/

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HPW - US & G7 Countries Make US$ 4.3 Billion In New Commitments To COVAX –
Novavax Commits 1.1 Billion Doses
https://healthpolicy-watch.news/us-g7-countries-make-us-7-5-billion-in-new-commitments-to-
covax-novavax-commits-1-1-billion-doses/

“The United States is donating an additional US$2 billion to the COVAX facility over the next two
years to facilitate the equitable distribution of COVID-19 vaccines to low- and middle-income
countries, while the pharma company Novavax will provide a total of 1.1 billion doses of its vaccine
to COVAX – a gesture that could increase the available vaccine supplies for the global facility by one-
third for 2021. The commitment by the US was met by an EU announcement that it would be
doubling its COVAX funding, adding an additional €500 million and bringing its total contribution
to €1 billion. Germany pledged an additional US$1.8 billion to the Access to COVID-19 Tools (ACT)
Accelerator, the majority of which will go towards COVAX, the vaccine platform. Japan committed
US$79 million to COVAX as well as Unitaid, and Canada pledged US$59 million. The commitments
bring the total funding for the ACT Accelerator to US$10.3 billion, leaving a funding gap of US$22.9
billion for 2021 to fully fund the Accelerator’s work. In addition, the UK and France commited to
share some of their surplus doses with low-and middle-income countries after a report that rich
countries have stockpiled at least 1 billion vaccine doses more than they need to immunize all of their
citizens….”

PS: a few days later, Germany also committed to sharing doses (HPW)

See also the Guardian - G7 pledges extra $7bn towards Covid vaccines for world's poorest

Guterres on the need for a G20 emergency task force: “… the UN secretary general said the current
effort to distribute doses equitably was chaotic and that a global emergency plan to fight the virus
was needed. … The UN secretary general, however, told the Munich Security Conference that 75%
of vaccines had been monopolised by 10 countries, while more than 100 countries had not received a
single dose. António Guterres suggested that the wider G20 group of countries should set up an
emergency team that could create a global vaccination plan. It should bring together countries,
companies, international organisations and financial institutions with the “necessary power,
scientific expertise and production and financing capacity”, he said, adding that he could mobilise
the entire UN system for the task. … Bill Gates said the world’s poorest countries were at least six
months behind the vaccine progress of the wealthy….” “

PS: via Euractiv - Paris to bring African vaccine strategy on the table at EU virtual summit (25 Feb):
“When EU heads of states and government hold an online meeting on Thursday (25 February), they
will discuss a proposal by French President Emmanuel Macron to send 13 million doses of COVID-19
vaccines to African countries. ”

FT - G7 leaders vow to boost vaccine supplies to developing world

View from the World Bank: “… David Malpass, president of the World Bank, welcomed what he said
was a new “spirit of international cooperation” by G7 nations and its enlarged commitments to
Covax. “I’m cautiously optimistic that, as the new vaccines are approved and there’s competition
within the market between suppliers, that is going to begin to unlock the supply,” he said. However,
Malpass said that a lack of transparency of contracts and delivery schedules was hampering the
effort to get vaccines to developing countries quickly. “It’s unclear which of the manufacturers have

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committed to which of the delivery schedules and how much has been committed to Covax,” he said.
He also said that some manufacturers were diverting supplies to wealthier countries that had agreed
to pay more for doses rather than poor ones through discounted rates negotiated by Covax and
bodies such as the African Union. “The manufacturers are reluctant to commit the doses to
developing countries while they have the chance to sell it, or provide it, at a higher price to the
advanced economies,” he said….”

Global Justice Now - G7 vaccine pledge is ‘fig leaf’ for global apartheid
N Dearden; https://www.globaljustice.org.uk/news/2021/feb/19/g7-vaccine-pledge-fig-leaf-global-
apartheid

Civil society isn’t convinced yet of the ‘breakthrough’. “Communiqué falls short on urgent lack of
supply caused by Big Pharma’s patents – ‘The Elephant in the Zoom” .

AP - UK to push at G-7 for global standard on ‘vaccine passports’
AP;

“ Britain plans to use its presidency of the Group of Seven economic powers to push for an
internationally recognized system of vaccine passports that could allow world travel to resume,
though Prime Minister Boris Johnson acknowledged Tuesday that the idea raises “complex” ethical
issues….”

Guardian - UK urged to take lead in easing debt crisis in developing countries
https://www.theguardian.com/world/2021/feb/21/uk-urged-take-lead-easing-debt-crisis-
developing-countries-g7

“Boris Johnson should use upcoming G7 presidency to insist UK banks join debt suspension
schemes, campaigners say. “ “Boris Johnson should use his presidency of the G7 this year to insist
that UK banks take part in the global push to alleviate a new developing country debt crisis, a
campaign group has urged. The Jubilee Debt Campaign (JDC) said there was a special responsibility
on Britain to act, as it released new figures showing that London-based banks were the largest
owners of debt issued by poor countries. With steps being taken in New York to make debt
restructuring easier, the JDC said the UK was now the most important country when it came to
unblocking multilateral debt relief efforts….”

And some links:

GAVI - G7 backs Gavi's COVAX Advance Market Commitment to boost COVID-19 vaccines in world’s
poorest countries (press release)

Devex - Inoculating UK population before donating vaccines undermines country's claim to
pandemic leadership, experts say

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Other Global health governance & financing news

BMJ Editorial - The case for an international pandemic treaty
H Nikogosian & I Kickbusch; https://www.bmj.com/content/372/bmj.n527

“A treaty would protect lives, livelihoods, security, and human rights.”

“…The debate around whether—and where—an international pandemic treaty or other strong
international framework should be negotiated is likely to take centre stage globally in the coming
months. In our view, any decision to negotiate a global health treaty should meet three criteria: the
problem should be of a global concern and growing magnitude; transnational factors must play a
dominant role; and existing instruments must be inadequate. Pandemics meet the first two criteria,
and probably the third given ongoing debate about the adequacy of the International Health
Regulations during covid-19. In principle, a new treaty could be negotiated under the auspices of
WHO, the UN, or both….”

They conclude: “…A pandemic treaty under the joint auspices of WHO and the UN seems the most
viable way forward given the urgency and the implications of the current pandemic beyond health to
livelihoods, economies, security, solidarity, and human rights. If a treaty is deemed not immediately
feasible, a UN framework with built-in power and mandate to negotiate a treaty could be the road
to take.”

Stat - Dozens of institutional investors push for ‘fair and equitable’ Covid-19
response
https://www.statnews.com/pharmalot/2021/02/23/covid19-coronavirus-vaccine-who-covax-
fidelity/

“Nearly 150 institutional investors that oversee combined assets worth more than $14 trillion have
issued a joint call for a “fair and equitable” global response to the Covid-19 pandemic, and they
intend to huddle with health care companies to make progress on that goal. The investors are eyeing
three efforts, starting with greater financing for the ACT Accelerator partnership … They also plan
to work with the Access to Medicines Foundation, a nonprofit that tracks pharmaceutical industry
progress on widening access to its products, to promote “cross-industry partnerships.” These
partnerships would be focused on accelerating R&D, expanding production, creating equitable
pricing strategies, and establishing voluntary licensing agreements for vaccines and medicines. In
addition, the investors plan to explore the feasibility of innovative finance mechanisms for
national and global Covid-19 responses, similar to new vaccine bonds or social bonds being issued
for Covid-19 programs. Last year, for instance, Novartis (NVS) sold bonds tied directly to its progress
in making medicines accessible in certain low- and middle-income countries. … … Among the 148
institutional investors that support the effort are Asset Management One, Fidelity International,
Nordea, Sumitomo Mitsui Trust Asset Management and Alliance Bernstein. Their goal is to achieve
for Covid-19 and pandemic preparedness what investors have done for the Paris Conference and
subsequent UN Climate Change Conferences….”

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Lancet World Report – New WTO leader faces COVID-19 challenges
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00507-9/fulltext

“Ngozi Okonjo-Iweala is the first woman and the first African to lead the World Trade Organization.
She already faces scrutiny over intellectual property rights in the pandemic. John Zarocostas reports.”

“Her comments [on a “Third Way”] have drawn a mixed response. Germán Velásquez, special
adviser on policy and health of the South Centre, told The Lancet that “her statement is in fact
against the proposal from India and South Africa”, and critically noted that Okonjo-Iweala's
statement “was more on voluntary licences and voluntary agreements by the manufacturers. We
know very well that it is useless.”” The only help that can come from the WTO is the use and the
promotion on the acceptance of the promise on the use of the flexibilities of the TRIPS agreement
and the main possibility is the compulsory licence system”, he noted….”

“…Rohit Malpani, a Unitaid board member and consultant, told The Lancet: “She must find a way
to build consensus to support the petition by low and middle income countries (led by South Africa
and India) to temporarily suspend all intellectual property rules for COVID-19 medical
technologies. The need for a waiver was already apparent last October, and with the ever-widening
disparity of access to vaccines, it is now impossible to ignore.”…”

Guardian - Reporting on WTO's first female head 'sexist and racist', say African UN
leaders
https://www.theguardian.com/global-development/2021/feb/23/reporting-on-wto-first-female-
head-sexist-and-racist-say-african-un-leaders-ngozi-okonjo-iweala

“Senior African leaders at the UN have criticised the “sexist and racist” language used in coverage of
the appointment of Ngozi Okonjo-Iweala as the new president of the World Trade Organization….”

Trade Beta blog - Ngozi Okonjo-Iweala is the new WTO chief, but let’s not get
carried away
P Ungphakorng; https://tradebetablog.wordpress.com/2021/02/15/n-o-i-new-wto-chief/

Insightful blog on what (reasonably) can be expected from a WTO boss. “The director-general’s
powers are limited, so don’t expect miracles. And don’t blame her if problems stay unresolved.”

Guardian - Italy 'misled WHO on pandemic readiness' weeks before Covid
outbreak
https://www.theguardian.com/world/2021/feb/22/italy-misled-who-on-pandemic-readiness-weeks-
before-covid-outbreak

“(IHR) Preparations not reviewed since 2006 but self-reporting in February 2020 claimed they were at
highest level. “

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Devex - With scarce funding for ACT-A, 'everything moves slower': WHO's Bruce
Aylward
https://www.devex.com/news/with-scarce-funding-for-act-a-everything-moves-slower-who-s-
bruce-aylward-99195

“ The World Health Organization-led Access to COVID-19 Tools (ACT) Accelerator is considering the
potential of a burden-sharing model to unlock much needed financing. The global initiative remains
severely underfunded almost 10 months since its launch in April 2020, although it received
a financing boost from G-7 leaders last week. Under the concept of burden sharing, countries will be
asked to contribute based on their gross domestic product per capita and economic openness,
as defined by the International Monetary Fund. Projected asks include more than $5 billion for the
United States alone, although this is not yet final and still being discussed with country officials.

“… … . But even with the additional funding boost at the G-7 last Friday, it is still short of $22.9
billion. … Compared to the U.S. government’s Operation Warp Speed and the European Union, the
COVAX Facility’s “war chest is not big enough,” the WHO official said.”

 “Aylward has also commented on emerging narratives against COVAX. “I see people announcing
that, ‘Oh we want to do this with COVAX, but COVAX isn't ready’ … but COVAX was ready in
December. That is a self-fulfilling prophecy,” he said. “If you don't want to donate vaccines through
COVAX, or you don't want to finance … COVAX, you don’t want to buy your vaccines through it, you
know, admit it that you want to jump the queue, or admit that you know you want to do a bilateral
deal with a friendly country or something else, but don't blame COVAX,” he added….

“… Insufficient funding also prevents WHO and its multilateral partners from buying test kits for
which it has volume and price guarantees. Lack of testing can lead to the virus spreading in
populations undetected. “Look at the map of where COVID diseases [are] today and where variants
are today. There [are] holes all over it. There's insufficient testing out there. We don’t know the
enemy well enough,” Aylward said. …. … The funding crunch can impact COVID-19 treatment too.
While there’s now an effective treatment against severe COVID-19, Aylward said dexamethasone
works if a patient is also given oxygen. But a number of countries are experiencing oxygen supply
shortages, including those in sub-Saharan Africa. Oxygen can be challenging to deliver to countries,
too. …. With insufficient funding, “everything moves slower … that's the bottom line,” Aylward
said.”

Wilson Center (Transatlantic Series) - A transatlantic cure to the pandemic and
structural global health shortcomings?
R Van de Pas & L van Schaik; https://www.wilsoncenter.org/article/transatlantic-cure-pandemic-
and-structural-global-health-shortcomings

With a number of recommendations for US-EU cooperation in improving global health governance.

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Telegraph - UK government creates new 'global health' team to tackle pandemic
and beyond
https://www.telegraph.co.uk/global-health/science-and-disease/uk-government-creates-new-
global-health-team-tackle-pandemic/

“The new directorate in the Foreign, Commonwealth and Development Office is a sign of a renewed
focus on global health post Covid-19.”

“…The new team will prioritise tackling the pandemic as well as coming up with strategies for how
to prevent the next threat. Bringing down the huge numbers of preventable deaths of mothers and
babies around the world is also at the top of the to-do list.”

Münich Security conference (last weekend)

UN News - UN chief to security meeting: ‘2021 must be the year to get back on track’
“By exposing deep fissures and fragilities, “COVID-19 has x-rayed the world”, the UN chief told the
Munich Security Conference on Friday, while acknowledging that today’s vulnerabilities go “well
beyond” pandemics and public health.”

Reuters - More than 200 groups urge G20 to back IMF issuance to help poor
countries in pandemic
https://www.reuters.com/article/us-g20-imf/more-than-200-groups-urge-g20-to-back-imf-issuance-
to-help-poor-countries-in-pandemic-idUSKBN2AO2ZR

Ahead of a G20 meeting: “Jubilee USA Network, Oxfam and 215 other civil society groups on
Wednesday urged Group of 20 finance officials to back an issuance of $3 trillion of the IMF’s own
currency, or Special Drawing Rights, to help countries weather the COVID-19 pandemic. In an open
letter to the International Monetary Fund and G20 finance ministers, the groups said a new
allocation of SDRs would boost the reserves of all countries and avoid pushing low- and middle-
income countries further into debt distress. G20 finance ministers and central bankers will discuss a
possible SDR issuance - a move akin to a central bank printing money - when they meet by video
conference on Friday. Proponents note that such a move will not add cost for the IMF members.
Italy, which leads the G20 this year, is pushing for a smaller $500 billion allocation of SDRs, which
can be converted to hard currency by IMF members - a move backed by France, Germany and
others, but still lacking support from Washington.”

But the US stance seems to be changing. Via FT: “US Treasury secretary Janet Yellen has taken the
first steps to reverse Washington’s opposition to more financial support for low-income countries
through the IMF to help ease the economic impact of the pandemic. In a letter to her G20
counterparts on Thursday, Yellen signalled her provisional support for a new allocation of special
drawing rights (SDR) — the IMF’s reserve currency which is used to supplement member countries’
official reserves….”

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And via Devex: “ The letter also called for greater support of a rapid global vaccination program,
which Yellen called “the strongest stimulus we can provide to the global economy.”

“G-20 leaders are likely to wait for an IMF needs assessment before making their decision … …
While these issues are likely to come up at the G-20 meeting Friday, approval of new SDRs would
come at the IMF meeting in April at the earliest.”

On the agenda of the G20 meeting: fiscal and monetary policy support for the COVID recovery, debt
moratoriums, financial inclusion and international taxation.

Columbia University symposium on COVID-19 vaccine
development, strategy and implementation (22-26 Feb)

https://www.pgh.cuimc.columbia.edu/symposium-vaccines-and-global-health-covid-19-vaccine-
development-strategy-and-implementation

Columbia University convenors “put together a group of 25 outstanding speakers who have been
intimately involved with all aspects of COVID-19 vaccine development, strategy, and implementation.
We are delighted to present this five-day virtual symposium at the cusp of the world’s transition to
controlling the COVID-19 pandemic…”

Remarkably, global civil society was absent from the line-up, as far as I can tell. And most speakers
seemed to be focusing on ACT-A (including Covax) – hardly mentioning the TRIPS waiver proposal.
(#globalhealthhegemony ?)

Co-organized by WHO, the Bill & Melinda Gates Foundation, and the NIAID.

Some coverage: HPW - ‘Rapid Response Platforms’ Enabled COVID-19 Vaccine Development, Says
Fauci

Covid key news

Focus on global trends, key WHO messages & other new initiatives.

Two sad milestones this week: the US passed 500000 deaths, Brazil 250000…

WHO says global deaths down 20% since last week; cases declining for six
straight weeks
Guardian;

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“The World Health Organization says that global deaths from coronavirus-related complications
have declined by 20% in the last week, with cases dropping for the sixth consecutive week
worldwide. Deaths have been falling for three consecutive weeks….”

Via Cidrap News:

“Some 66,000 deaths were reported last week, according to the UN agency’s latest update on the
disease, which was issued on Wednesday. WHO said deaths have fallen in all regions except the
Western Pacific, which recorded a six per cent increase. New infections also decreased by 11 per
cent over the same period in four out of six regions. However, South-East Asia and the Eastern
Mediterranean reported small increases of two per cent and seven per cent respectively. Globally,
there have been nearly 111 million cases of COVID-19 since the start of the pandemic, and more
than 2.4 million deaths….”

Global COVID-19 cases fell for the sixth week in a row. See WHO’s weekly snapshot.

G-7 Commitments Of US$4.3 Billion Not Enough – Rich Countries Need To Stop
COVID Vaccine Hoarding to Open Access Bottleneck, Says WHO Director General
https://healthpolicy-watch.news/g-7-commitments-of-us4-3-billion-welcome-but-rich-countries-
need-to-stop-covid-vaccine-surpluses-stop-hoarding-says-who-director-general/

Tedros lashed out at WHO’s first media briefing of the week. For good reason.

“Despite Friday’s commitment by G-7 countries to donate another US$ 4.3 billion to a global COVID
vaccine campaign, World Health Organization Director General, Dr Tedros Adhanom Ghebreyesus
has accused high-income nations of still undermining equitable vaccine rollout by “doing deals”
with manufacturers that deplete supplies available to the COVAX global vaccine facility. Speaking
at the WHO’s biweekly media briefing, Tedros thanked the G-7 and the European Union for the new
donations – but stressed that money was not enough: “If there are no vaccines to buy, money is
irrelevant. Currently, some high-income countries are entering contracts with vaccine manufacturers
that undermine the deals that COVAX has in place and reduce the number of doses COVAX can buy,”
said Dr Tedros….”

HPW - COVAX Sets Up ‘No-Fault’ Compensation Fund
“… Earlier in the day COVAX announced that the WHO had reached an agreement with a global third
party insurance provider, ESIS Inc, to administer a no-fault vaccine injury compensation programme
for the 92 low- and middle-income countries and economies eligible for donor support to their
vaccine campaigns….”

For more detail, see WHO - No-fault compensation programme for COVID-19 vaccines is a world first

“New programme makes compensation available to eligible individuals in 92 low- and middle-income
countries without need to resort to law courts; This is the first and only global vaccine injury
compensation mechanism; The programme is funded by a small levy on each dose supported by the
Gavi COVAX AMC…”

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And more coverage via Reuters – WHO agrees compensation fund for serious COVAX vaccine side
effects

“… The WHO-agreed plan, which has been under discussion for several months, is designed to cover
serious side effects linked to any COVAX-distributed vaccines until June 30, 2022, to COVAX’s Advance
Market Commitment-eligible economies - a group of 92 poorer states which includes most African
and Southeast Asian countries. The programme will be financed initially from donor funding to the
AMC as an extra charge on all doses of COVID-19 vaccines distributed through COVAX. Applications
can be made via a portal at www.covaxclaims.com from March 31, 2021, the WHO said….”

COVID-19 Emergency Oxygen Response
https://stoppneumonia.org/covid-19-emergency-oxygen-response-2/

The Access to COVID-19 Tools Accelerator (ACT-A) announced a COVID-19 Emergency Oxygen
Response to help the worst-affected low- and middle-income countries (LMICs) ensure that no more
COVID-19 patients die for lack of oxygen. Unitaid and the Wellcome Trust established a COVID-19
Emergency Oxygen Taskforce* as part of the ACT-A “Therapeutics” pillar.

See also WHO - COVID-19 oxygen emergency impacting more than half a million people in low- and
middle-income countries every day, as demand surges

“…New assessments show US$90 million immediate funding required to meet urgent need in up to
20 low- and middle-income countries (LMICs). Unitaid and Wellcome will make an immediate
contribution of up to US$20 million in total for the emergency response. COVID-19 Oxygen
Emergency Taskforce brings together key organisations working on oxygen access under ACT-
Accelerator Therapeutics pillar, as COVID-19 surges and preventable deaths occur…”

Via FT - “Aid agencies are ready to disburse more than $90m in funding for emergency oxygen
supplies in low income countries struggling to treat patients with Covid-19, ahead of a broader
campaign to raise $1.6bn in the coming months. Wellcome and Unitaid have pledged an immediate
$20m, as part of a plan to accelerate support for medical oxygen, and will oversee $1.6bn freshly
allocated for oxygen as part of the therapeutics unit of Act-A, a World Health Organization
programme which is developing tools to tackle the pandemic. The World Bank, which with the Global
Fund to Fight Aids, Tuberculosis and Malaria oversees the separate health systems division of Act-A,
is also preparing to allocate $90m to meet requests from health ministries and support large-scale
oxygen plant construction….”

Coverage via HPW - Oxygen Is Life – Particularly for COVID-19 Treatment – New Taskforce Aims To
Raise US$1.6 billion For Supplies In Low- and Middle-Income Countries

Guardian - China did 'little' to hunt for Covid origins in early months, says WHO
document
https://www.theguardian.com/world/2021/feb/23/china-did-little-hunt-covid-origins-early-months-
says-who-document

“Summary from visit last year reveals Chinese officials offered scant details.”

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“… The two-page internal travel report is a summary of the WHO programme manager and
mission leader Peter Ben Embarek’s trip to China between 10 July and 3 August 2020, which was
described as an advance WHO mission to study the Covid-19 virus and “review work done so far on
the origin of the virus”….”

CNN Exclusive: WHO panel to recommend 'deeper' study of early Covid-19 clues
https://edition.cnn.com/2021/02/21/china/who-covid-19-origins-intl/index.html

“The World Health Organization's preliminary report into the origins of the novel coronavirus will
recommend more extensive contact tracing of the first known patient with Covid-19 in Wuhan,
China, as well as the supply chain of nearly a dozen traders in the Huanan seafood market, which is
thought to have played a role in the early spread of Covid-19 in late 2019, according to investigators
familiar with the draft report…..”

WP (Editorial Board)- Opinion: The U.S. should reveal its intelligence about the
Wuhan laboratory
https://www.washingtonpost.com/opinions/global-opinions/the-us-should-reveal-its-intelligence-
about-the-wuhan-laboratory/2021/02/22/da0e9e90-753f-11eb-9537-496158cc5fd9_story.html

Fair point: “The US possesses classified intelligence information about illnesses in the autumn of
2019, before the global pandemic, at the Wuhan Institute of Virology, or WIV, which was carrying
out research on bat coronaviruses very similar in genetic makeup to the pandemic virus. The
intelligence should be declassified, and soon. … … Full transparency is needed from China but also
from the United States. The intelligence behind Mr. Pompeo’s statements should be declassified,
with proper protection for sources and methods. The truth matters, and the United States should not
hide any relevant evidence.”

Guardian - Human rights in the time of Covid: 'a pandemic of abuses’, says UN
head
https://www.theguardian.com/global-development/2021/feb/22/human-rights-in-the-time-of-
covid-a-pandemic-of-abuses-says-un-head

“The world is facing a “pandemic of human rights abuses”, the UN secretary general António
Guterres has said. Authoritarian regimes had imposed drastic curbs on rights and freedoms and had
used the virus as a pretext to restrict free speech and stifle dissent. Writing exclusively in the
Guardian, Guterres said the Covid-19 pandemic had rolled back years of progress on human rights,
and that abuses had “thrived because poverty, discrimination, the destruction of our natural
environment and other human rights failures have created enormous fragilities in our societies”.
There has been a global crackdown on opposition activists and human rights defenders,
increased attacks on journalists and moves to curb free speech, censor the media, roll out invasive
tracking apps and put in place extreme surveillance measures, many of which are likely to far outlast
the virus….”

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AP - Tanzania’s president admits country has COVID-19 problem

https://apnews.com/article/pandemics-tanzania-coronavirus-pandemic-east-africa-africa-
7f3aa308d7b117ef6fef77fab0ed7cb0

“Magufuli, speaking at the chief secretary’s funeral in a nationally televised broadcast on Friday,
urged the nation to participate in three days of prayer for unspecified “respiratory” illnesses that had
become a challenge in the country. … … The director-general of the World Health Organization,
Tedros Adhanom Ghebreyesus, has added his voice to growing calls for Tanzania to acknowledge
COVID-19 for the good of its citizens, neighboring countries, and the world, especially after a
number of countries reported that visitors arriving from Tanzania tested positive for the virus.
Tedros in a statement on Saturday called Tanzania’s situation “very concerning” and urged
Magufuli’s government to take “robust action.” …”

As mentioned by some, it’s not often WHO singles out a country.

Telegraph - Flourishing anti-vax movement threatens to derail immunisation
campaigns in Africa
Telegraph

“The continent has traditionally been pro-vaccination but false claims - often pushed by prominent
politicians - are gaining traction.”

Guardian - All countries must be vaccinated to end pandemic, says World Bank
chief
https://www.theguardian.com/business/2021/feb/22/all-countries-must-be-vaccinated-to-end-
pandemic-says-world-bank-chief

“David Malpass says delivery systems must be improved in poorer nations as world prepares for
next crisis.”

Excerpts: “…Serious capacity constraints on vaccination programmes pose the biggest threat to the
World Bank’s ambitious goal that all 7 billion people across the globe should be offered Covid-19
protection within a year, its president has said. In an interview with the Guardian, David Malpass
said delivery systems in poor countries and the fact that so many vaccines were going to rich
countries were more important factors than money in ensuring success. Malpass said beating the
pandemic required all countries to be immunised and that the global community should already be
preparing for the next crisis…. … An increase in the number of available vaccines would help, Malpass
said, but there also needed to be action in poor countries to tackle logistical bottlenecks, to expand
healthcare delivery systems and to develop communication strategies to prepare people for
vaccine programmes. …. … Malpass said there was a need to accelerate progress on debt relief so
that poor countries had more financial firepower to tackle the pandemic. “We need to broaden the
definition of sustainable debt and base it on the ability to provide basic health care, education and
investments in climate. Resources should be going to things that build for the future. If too big a
proportion is going to creditors that undermines sustainability”, he said, urging public and private
creditors to sign up to a global debt relief initiative.”

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WHO manifesto for a healthy recovery from Covid-19
https://www.who.int/docs/default-source/climate-change/who-manifesto-for-a-healthy-and-green-
post-covid-recovery.pdf?sfvrsn=f32ecfa7_8v

“Prescriptions and Actionables for a Healthy and Green Recovery”.

“The following WHO prescriptions and accompanied actionables are practical steps for implementing
the WHO Manifesto for a healthy recovery from COVID-19. They aim at creating a healthier, fairer
and greener world while investing to maintain and resuscitate the economy hit by the effects of
COVID-19…. … Six WHO prescriptions, and a comprehensive set of key actionables, for achieving
healthier environments is provided accordingly…”

HPW - Global Citizen Launches ‘Recover Better Together’ Campaign
https://healthpolicy-watch.news/global-citizen-launches-recover-better-together-campaign-guinea-
launches-ebola-vaccinations-nigeria-zambia-studies-show-high-sars-cov2-infections/

“Vaccinating all of Africa’s health workers would need half a percent of all the doses that the G-7
countries have purchased, according to Global Citizen CEO Hugh Evans. On Tuesday, Global Citizen
launched a five-point ‘Recover Better Together’ plan for the world, aimed at getting millions of
citizens behind ending COVID-19 for all, ending the hunger crisis, resuming learning for children,
fully protecting the planet, and advancing equity for all. “First we must focus on achieving sufficient
worldwide vaccine coverage to break the chain of transmission, including, for the poorest nations,”
Evans told a media briefing convened jointly with the World Health Organization, and addressed by
world leaders including European Commission president Ursula von der Leyen, US Special Envoy in
Climate John Kerry and South African president Cyril Ramaphosa….”

See also Reuters - EU backs donating COVID-19 shots to African health workers

“European Commission President Ursula von der Leyen on Tuesday supported a call by French
President Emmanuel Macron to donate COVID-19 vaccines to health care workers in Africa, as a
star-studded event was announced to support equitable distribution. “Vaccines are still scarce
everywhere but it is in our common interest to share,” von der Leyen said in a webcast with the
World Health Organisation (WHO). “And I therefore support President Macron’s proposal to donate
vaccine doses that are necessary to vaccinate health care workers in Africa.”…”

Stat - Backed by Google, epidemiologists launch a sweeping Covid-19 data
platform
https://www.statnews.com/2021/02/24/global-health-covid19-data-records/

It started as “a spreadsheet, started by a group of international epidemiologists, to collect and
openly share granular data on individual Covid-19 cases around the world. Today, that project
launched its complete website, Global.health, which will enable open access to more than 5 million
anonymized Covid-19 records from 160 countries. Each record can contain dozens of data points
about the case, including demographics, travel history, testing dates, and outcomes. The project is
supported by $1.25 million in funding and other resources from Google.org, with additional
support from the Rockefeller Foundation, and is led by academics from the University of Oxford,

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Harvard, Northeastern, Boston Children’s Hospital, Georgetown, University of Washington, and Johns
Hopkins Center for Health Security. …”

See also Research consortium including Oxford University and Google.org announce new platform to
track COVID-19 data.

UN Human Rights Council to call for equitable access to vaccine
https://genevasolutions.news/global-health/un-human-rights-council-to-call-for-equitable-access-
to-vaccine

“Ecuador plans to call for the equitable and universal access to vaccines in the 46th session of the
Human Rights Council, amidst the pandemic that is ravaging countries worldwide.”

“The Geneva-based Human Rights Council is set to take up the pandemic as a human rights issue
during its 46th session - building upon debates in sister organizations, such as the World Health
Organization and the World Trade Organization. Ecuador has announced that it will be proposing a
new HRC resolution calling for equitable vaccine access in response to pandemics and other health
emergencies, during the upcoming weeks of the session, which began on Monday. The draft
resolution, which Geneva Solutions was able to consult states concerns about measures that have
restricted exports of the vaccines, with the proposal requesting the report by the UN high
commissioner…”

Reuters – Debilitating 'long-COVID' may have severe health, social impacts: WHO
Reuters;

“ Thousands of COVID-19 patients continue to suffer serious, debilitating and lingering symptoms
many months after their initial bout of infection, with major social, health and economic
consequences, European health experts said on Thursday. Publishing a World Health Organization-
led guidance report on the condition, often referred to as “long COVID” or “post-COVID syndrome”,
experts said around one in 10 COVID-19 patients are still unwell 12 weeks after their acute infection,
and many suffer symptoms for far longer. “This is a condition that can be extremely debilitating.
Those suffering from it describe a varying combination of overlapping symptoms... (including) chest
and muscle pain, fatigue, shortness of breath ... brain fog (and) many others,” said Martin McKee, a
professor at the European Observatory on Health Systems and Policies who led the report. Hans
Kluge, the WHO’s European regional director, said long-COVID could have “severe social, economic,
health and occupational consequences”.

WHO Policy brief - In the wake of the pandemic: preparing for long Covid.

See also UN News - WHO-backed policy brief calls for action to address ‘long COVID’.

Cidrap News - WHO unveils pandemic game plan
https://www.cidrap.umn.edu/news-perspective/2021/02/european-countries-battle-more-covid-
19-flare-ups

 17

“The WHO yesterday posted its Strategic Preparedness Response Plan documents, which detail its
plan for battling COVID-19 this year. Last week, the group's director-general said $1.96 billion is
needed to meet the plan's six goals, which range from driving down virus transmission to countering
misinformation to ensuring equitable access to vaccine….”

And some links:

HPW - The European Medicines Agency’s COVID-19 Vaccine Leaks: Hacks, Regulatory Pressures And
Manufacturing Concerns

Reuters - Moderna sees $18.4 billion in sales from COVID-19 vaccine in 2021

Covid science

BMJ (News) - Covid-19 will become endemic but with decreased potency over
time, scientists believe
https://www.bmj.com/content/372/bmj.n494?utm_source=twitter&utm_medium=social&utm_ter
m=hootsuite&utm_content=sme&utm_campaign=usage

“The SARS-CoV-2 coronavirus will not be eradicated but will become endemic, continuing to circulate
in pockets of the global population for years to come and causing outbreaks in regions where it had
been eliminated, scientists working in the field believe.”

WEF - COVID-19: what happens if some countries don’t vaccinate?
A Kalebi; https://www.weforum.org/agenda/2021/02/covid-19-equal-vaccine-nationalism-
government-public-health/

“The pandemic can only be contained if every population has equal access to vaccines, which will
prevent the virus from mutating. …. …” Vaccination must be treated as a global issue, or no one will
be truly be safe.”

“In countries where no significant proportion of the population is vaccinated, there is a huge risk of
sustained community spread of COVID-19 over a prolonged period. The longer the period of
sustained community spread, the more likely that the virus will mutate. And this means it could be a
breeding ground for the new coronavirus – SARS-CoV-2 – to mutate into more aggressive variants.
The mutated variants from the unvaccinated population will be able to infect even those in the
vaccinated population….”

Nature - Why COVID vaccines are so difficult to compare
https://www.nature.com/articles/d41586-021-00409-
0?utm_source=twt_nnc&utm_medium=social&utm_campaign=naturenews

 18

“Despite the widespread roll-out of several vaccines, it could be months before they can be ranked.”

“Given the demand for speed amid limited supplies, any effort to rank the vaccines must take into
account not only their reported effectiveness, but also supplies, costs, the logistics of deploying
them, the durability of the protection they offer and their ability to fend off emerging viral
variants. Even so, many people might find it hard to look away from clinical-trial results that suggest
an efficacy gap … … … And the vaccines were studied at different times in various countries. Each
trial can only offer a snapshot of protection against the viral variants that were dominant in that
time or place, says Kennedy. “That number relates to a particular point in time,” he says. “How that
translates into protection over one to two years is not the same.”….”

Guardian - One vaccine dose gives high protection from severe Covid, evidence
shows
https://www.theguardian.com/world/2021/feb/22/one-vaccine-protection-severe-covid-evidence

“First real data from mass vaccinations programmes in England and Scotland is promising…” (both
for Pfizer & AstraZeneca vaccines)

“The first real data from the mass vaccination programmes is promising, and although the results do
not include evidence that they prevent transmission completely, there is data to show they are
stopping some people becoming infected, which should slow the spread of coronavirus. Three studies
came to similarly positive conclusions about the protection offered by the vaccines – one in Scotland
and two in England – although they were set up to look at the effects in different groups of people….”

Nature (News) - How ‘killer’ T cells could boost COVID immunity in face of new
variants
Nature;

“In the race against emerging coronavirus variants, researchers are looking beyond antibodies for
clues to lasting protection from COVID-19.”

Nature News - Can COVID vaccines stop transmission? Scientists race to find
answers
https://www.nature.com/articles/d41586-021-00450-z

“Controlling the pandemic will require shots that prevent viral spread, but that feature is difficult to
measure.”

WSJ - In Hunt for Covid-19 Origin, WHO Team Focuses on Two Animal Types in
China
https://www.wsj.com/articles/in-hunt-for-covid-19-origin-who-team-focuses-on-two-animal-types-
in-china-11613665015?reflink=desktopwebshare_twitter

 19

“Investigators say ferret badgers and rabbits sold at Wuhan market could have played a role in the
spread to humans.”

Nature (News) - Superspreading drives the COVID pandemic — and could help to
tame it
https://www.nature.com/articles/d41586-021-00460-x

“Uneven transmission of the SARS-CoV-2 coronavirus has had tragic consequences — but also offers
clues for how best to target control measures.”

Telegraph - Coronavirus cases are falling globally, but the big question is: why?
Telegraph;

“ For the sixth consecutive week infections have plummeted worldwide. Our Global Health team
looks at what might explain the fall in cases.” It’s a mix of reasons, apparently.

And some links:

Guardian - Nigeria survey suggests 23% of Lagos residents had Covid last year

Stat - FDA scientists endorse J&J’s Covid vaccine, as new data shed light on efficacy

Stat - Moderna ready to test version of Covid-19 vaccine aimed at worrisome variant

NYT - A New Coronavirus Variant Is Spreading in New York, Researchers Report

“The variant contains a mutation thought to help the virus dodge the immune system, scientists
said.”

Reuters - In boost for COVID-19 battle, Pfizer vaccine found 94% effective in real world

See also Stat - Pfizer-BioNTech vaccine performs as well in the real world as in clinical trials, new
study concludes.

Covid vaccine access

With updates on COVAX, the TRIPS Waiver proposal, vaccine diplomacy and much more.

Reuters - First COVID-19 vaccine doses dispatched by COVAX arrive in Ghana
https://www.reuters.com/article/uk-health-coronavirus-ghana-vaccines-idUSKBN2AO0NZ

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