A Year After Declaring COVID-19 an Epidemic: It's Time to Take the World from the Brink of a Catastrophic Moral Failure

​March 11, 2021 is a landmark in the history of COVID-19.  It marks one year since the World Health Organization  (WHO) declared the COVID-19 outbreak, a pandemic. It is also a defining moment in the USA when President Biden signed the US$1.9B American Rescue Plan (Relief Bill)  giving  hope for the economic and social redemption  to  many citizens and small businesses. This anniversary also coincides with a period when due to the  collective scientific  response, there is a better understanding  of the crisis and the rollout of vaccines. Yet there remains cynicism in some quarters of whether the world is better prepared for the next pandemic and the lessons learned from  the failures of detection, preparation, and cooperation;   political repercussions; and  missteps  that have resulted in 2.6 million deaths worldwide and 528,000 in the USA.       
 
Preparing for the next Pandemic 
 
According to an article  "How the Pandemic Changed the World"   (Foreign Affairs, March 10, 2021), time is running out in “Preparing for the Next Pandemic.”  This preparation, it advocates,  requires governments, businesses and public health leaders  acting  now with decisiveness and purpose to avoid another global catastrophe. “Terrible as it is, COVID-19 should serve as a warning of how much worse a pandemic could be—and spur the necessary action to contain an outbreak before it is again too late”.   The article refers to a 2017  book (which  I haven’t read) Deadliest Enemy: Our War Against Killer Germs by  MICHAEL T. OSTERHOLM  and  MARK OLSHAKER, two notable scientists. The Book  accordingly  illustrates the epidemiology of  SARS, MERS, and a number of other recent outbreaks—the 2009 H1N1 flu pandemic that started in Mexico, the 2014–16 Ebola epidemic in West Africa, the 2015–16 spread of the Zika flavivirus from the Pacific Islands to North and South America.  It states that although the diseases differed from one another in different ways including  their clinical presentations and, degree of severity and clinical  presentation, they all came as surprises when they shouldn’t have.  
 
 
Politics and Security Fears Crippling the Collective Response
 
Politics and security fears have been characterized by Yanzhong Huang in  Foreign Affairs  (January 28, 2021) as crippling the collective global response.  Within months of COVID-19’s initial discovery in Wuhan, China, in December 2019, Trump, took to calling COVID-19 the “China virus,” blaming  Beijing for having “instigated a global pandemic.” Chinese state media fired back, insisting that “though COVID-19 was first discovered in China, it does not mean that it originated from China".  Now Biden’s pledge to hold a summit of democracies to tackle COVID-19 aimed at asserting US diplomatic leadership of the free world, risks reinforcing this divisive narrative, carving the globe into two political camps in the face of a common global challenge.     Amid the current pandemic, governments have repeatedly forsaken opportunities for consultation, joint planning, and collaboration, opting instead to adopt nationalist stances that have put them at odds with one another and with the WHO. The result has been a near-total lack of global policy coherence.
 
 
The Dismal Multilateral Response to the Pandemic 
 
This reflects, in part, the decisions of specific leaders, especially Chinese President Xi Jinping and former U.S. President Donald Trump. Their behavior helps explain why the WHO struggled in the initial stages of the outbreak and why forums for multilateral coordination, such as the G-7, the G-20, and the UN Security Council, failed to rise to the occasion. This is contrasted with an era when the multilateral ecosystem of global public health arrangements blossomed alongside the WHO and its International Health Regulations, including the Global Alliance for Vaccines and Immunization (now called GAVI, the Vaccine Alliance), the Global Health Security Agenda, the World Bank’s Pandemic Emergency Financing Facility, and the Africa Centers for Disease Control and Prevention. 
 
 The uncoordinated, chaotic, and state-centric international response to COVID-19 sharply contrasted with the international response to the 2009 H1N1 pandemic and to the 2014 Ebola outbreak.  In 2009, health authorities from major powers, including China and the United States, exchanged technology and information about the spread of the swine flu virus and accelerated the development of a vaccine—a collaboration that helped combat that virus and a later one, the H7N9 avian influenza, which easily could have become a pandemic in 2013 but did not. Then in 2014, major powers responded to calls from the United Nations and the WHO to send health aid to West Africa to help fight the Ebola virus. China and the United States in particular forged a close partnership—working together to construct treatment centers and direct medical supplies—that played an important role in turning the tide against Ebola.
 
 
Vaccine Nationalism will  Delay Winning the Fight vs COVID-19
 
A year after the declaration of the pandemic, the development and approval of safe and effective vaccines  is a stunning scientific achievement. At the same time WHO ACT Accelerator and the COVAX vaccines pillar have been laying the groundwork for the equitable distribution and deployment of vaccines. Referring to the gap and inequity in access to vaccines, WHO Director General,  Tedros Adhanom Ghebreyesus, identified the vaccine access gap.   He is clear that the recent emergence of rapidly-spreading variants makes the rapid and equitable rollout of vaccines all the more important. He pointed out that more than 39 million doses of vaccine have now been administered in at least 49 higher-income countries. “Just 25 doses have been given in one lowest-income country. Not 25 million; not 25 thousand; just 25."  He  said, " I need to be blunt: the world is on the brink of a catastrophic moral failure – and the price of this failure will be paid with lives and livelihoods in the world’s poorest countries".
 
 
 
Conclusions  COVID -19 and the Moral Imagination
 
Writing in The  Lancet,  (January 22, 2021) Said Patel and Christine Phillips implore us to respond with purpose to the challenges outlined: 
 

• Preparing for the next pandemic;
• Political divisiveness and security fears crippling the collective response; the dismal multilateral response to the pandemic; 
• Vaccine nationalism that will  delay winning the fight vs COVID-19. 

 
In their  view it is within the purview of our moral imagination to turn this crisis into an opportunity of hope. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00151-3/fulltext
 
"The COVID-19 pandemic offers an opportunity to break with the past and imagine the    world anew. It also  offers a “cosmopolitan moment”, when the existing order is destabilized  to open up a new arena of moral and political responsibility.  In this cosmopolitan moment, the global community could come together to create new institutions or mechanisms to address the structural causes of global inequity and promote the wellbeing of people and the planet.”
 
 
Eddie Greene