[NEW DELHI]* Global failures on multiple levels led to a “staggering death toll” from COVID-19 and the reversal of advances made towards UN development goals, a report by the Lancet’s Commission on the pandemic says.
“Too many governments have failed to adhere to basic norms of institutional rationality and transparency,” the commissioners wrote in the report published 14 September in the Lancet medical journal, calling for better multilateral cooperation to draw an end to the health crisis and tackle future threats.
The virus has killed more than 6.5 million people and infected 606 million since the start of the pandemic in 2020, according to the World Health Organization (WHO).
“In my opinion, WHO has failed to work with low- and middle-income countries to make their health management systems robust enough to face regular or ‘mundane’ health problems.”
Thekkekara Jacob John, former professor of clinical virology at the Christian Medical College in Vellore, India
A study published May in BMJ Global Health found that people living in developing countries are nearly twice as likely to die from the disease compared with people living in high-income countries.
“This staggering death toll is both a profound tragedy and a massive global failure at multiple levels,” said the 45-page Lancet report, addressed to UN member states, UN agencies and others groups, including the G20 and G7.
It said the WHO had acted “too cautiously and too slowly” in matters like warning about the human spread of the virus, announcing a Public Health Emergency of International Concern, backing face mask use, and acknowledging airborne transmission.
The WHO said in a published response that, while many of the Commission’s recommendations were aligned with its own assessments, the report also carried “several key omissions and misinterpretations”.
The Commission criticised a lack of international funding for low- and middle-income countries (LMICs) to tackle COVID-19 as well as failure to secure sufficient international supplies and equitable distribution of medicines, protective gear and vaccines.
“Developing countries are inherently more vulnerable to global shocks than high-income countries,” said Jeffrey Sachs, chair of the Lancet Commission and a professor at Columbia University in New York, US.
Sachs told SciDev.Net: “Effective responses to the pandemic, in terms of public health measures, for example vaccine coverage, and medical care, require financial and health-system resources that are mostly lacking in poorer countries.”
The report looked at the first two years of the pandemic with input from 28 international experts and in consultation with more than 100 others.
In the majority of countries, according to the Commission, the COVID-19 pandemic distracted “resources and policy attention” away from long-term targets, reversing progress towards the SDGs.
Established in 2015 by the UN General Assembly, the SDGs comprise 17 interlinked international goals targeted to be achieved by 2030 to end poverty and make sure that “no one is left behind”.
A group of 57 low-income countries – as defined by the International Monetary Fund (IMF) – face a financing gap of $300–$500 billion per year to achieve the SDGs, “and this gap has increased as a result of the pandemic”, says the report.
South-East Asia saw huge variations in its capabilities in relation to health systems, as well COVID-19 treatment, transmission and deaths, the Commission said.
In the first year of pandemic, countries like Malaysia and Bangladesh witnessed sharp increases in infections compared with Sri Lanka, Cambodia and Thailand, where contact tracing, face masks, and physical distancing were effectively implemented.
Africa might have seen large waves of COVID-19 infection. However, most cases in the region were not reported, in part because they did not cause severe disease, the report suggested. In South America, confirmed new cases reached 60 per million population in May 2020, “and then never decreased below that rate until the end of 2021”, it adds.
Gopal Sankaran, professor of public health at the West Chester University, US, told SciDev.Net that the COVID-19 pandemic took the world by surprise and low-income countries were no exception.
Lack of well-established health infrastructure, an overstretched health workforce, and inadequate surveillance contributed to the failure to mount and sustain an effective pandemic response, he said.
“The interconnected sectors of health, education, and employment have experienced great setbacks [due to COVID-19] in most nations and more severely in [low-income countries] and LMICs, slowing, halting, or pushing back the progress in SDGs 3 [good health and well-being], 4 [quality education], and 8 [decent work and economic growth],” he said.
On SDG financing, the Lancet Commission recommended increasing the cash available to countries. Sachs said he was “part of a UN process recommending an ‘SDG stimulus’ of around $500 billion per year for developing countries”.
The Commission makes a number of other recommendations including that all the countries around the world should take up a “vaccination-plus strategy” – where widespread vaccination is combined with public health precautions and financial measures.
It also calls for strengthening of the WHO as well as expansion of its Science Council.
Thekkekara Jacob John, former professor of clinical virology at the Christian Medical College in Vellore, India, told SciDev.Net: “In my opinion, WHO has failed to work with low- and middle-income countries to make their health management systems robust enough to face regular or ‘mundane’ health problems.”
*This article was edited on 20 September 2022 to include the name of the author and the dateline.
This piece was produced by SciDev.Net’s Global desk.
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