The upcoming World Health Assembly in May is not the finish line for fixing the global system for preventing and responding to pandemics. According to Dr. Mike Ryan, WHO’s executive director for health emergencies and newly appointed deputy director-general, it's just the starting gun.
This is a preview of Devex CheckUp
Sign up to this newsletter for exclusive global health news and insider insights, in your inbox every Thursday.
There’s a lot to fix in the system, from supply chains to ensuring innovations reach those most in need, and that will take a long time to implement. But he’s still hoping member states will be able to lay the foundation with a pandemic agreement next month.
“A house built on sand will never be stable. [But] no one is suggesting that this full, complete mechanism house can be built in the next six weeks,” Ryan said Wednesday during an event discussing the pandemic treaty and amendments to the International Health Regulations at the Graduate Institute in Geneva.
“We're asking our member states to create the starting line, systematic improvement in how we do business. And it's going to take years and it may take decades. God knows I've been at this … for 30 years,” he said.
Ryan’s remarks came just as the latest draft text of the pandemic agreement and a proposed resolution for its adoption at the WHA went public. The text reflects some of the disappointments insiders expressed after the session of the Intergovernmental Negotiating Body last month, and some say this draft is actually worse than the last one. There is no new fund to help countries implement the agreement, and it’s unclear where the money will come from.
Instead, the proposed resolution asks member states to establish another set of intergovernmental working groups to define and operationalize some of the most contested issues in the pandemic negotiations,including One Health and the WHO Pathogen Access and Benefit-Sharing System. Many of the decisions are also being left to the Conference of the Parties.
Some think that may be the right direction to take. But postponing key decisions comes with its own risks. Political attention for dealing with pandemics is waning, and some states already had limited capacities to negotiate the treaty over the last two years. Some worry that deferred decisions may lead to nothing at all, as was the case with the TRIPS waiver for COVID-19 tests and treatments.
But the biggest risk is that the world is still unprepared to manage new pandemic threats.
“The world is facing a dangerous type of mpox in the [Democratic Republic of Congo], H5N1 in cattle herds in the US, record levels of dengue, multi-country surges of cholera, and large outbreaks of measles all at once,” Helen Clark, who was co-chair of The Independent Panel for Pandemic Preparedness and Response, told me via email. “We’ve lost time. A new pathogen could appear anytime, anywhere. And we’re just not ready for it.”
Read: Experts warn about deferring hard parts of pandemic treaty for later (Pro)
ICYMI: Latest pandemic treaty draft text still has 'many weaknesses'
Doing the math
Speaking of preparing for pandemics, the need to build vaccine manufacturing capacities on the African continent is one of the key takeaways from the COVID-19 pandemic. Some pharmaceutical companies announced plans to build vaccine manufacturing facilities in various African countries.
But cracks are beginning to appear in those plans. Last week, Moderna announced its decision to put its planned messenger RNA vaccine manufacturing facility in Kenya on hold, after failing to sell any COVID-19 vaccines on the continent since 2022. The company said previous orders of its vaccine were canceled and resulted in $1 billion in losses and write-downs.
The decision didn’t sit well with the Africa Centres for Disease Control and Prevention, which issued a strongly worded statement calling Moderna’s move a demonstration that the company’s commitment “is in fact not to vaccine equity and access to vaccines,” and “only serves to perpetuate the inequity that characterized the response to the Covid–19 pandemic.”
Last year, Bloomberg reported that BioNTech is also revising its original plans to build vaccine plants in places such as South Africa, although the company had already established a modular vaccine factory in Rwanda and aims to start vaccine production from Kigali in 2025.
Read: Africa CDC calls out Moderna for 'abandoning' vaccine equity commitment
3 steps forward
It’s not just vaccines, however. There’s also a push to strengthen clinical trials on the African continent. The Pan-African initiative known as PANTHER, launched in late 2022, aims to lay the groundwork for speedy trials of vaccines or drugs in case of an outbreak.
But much needs to be done to transform Africa into a “clinical trials powerhouse,” writes Monique Adams of pharmaceutical giant Sanofi in an opinion piece for Devex. That would require trust building, addressing barriers to clinical trial participation, and providing participants continued care after the trial has concluded, she says.
Opinion: Boosting Africa clinical trials is crucial for health equity
Background reading: Pan-African platform aims to hasten clinical trials
Where did the money go?
Donors spent $47.9 billion on humanitarian aid in 2022 in support of the Sustainable Development Goals. But how much aid went to health, and which recipient country topped the list? Check out our latest funding analysis to find out.
Read: Nearly $450B was spent on the SDGs — where did it go? (Pro)
+ Not yet a Devex Pro member? Start your 15-day free trial today to access all our expert analyses, insider insights, funding data, exclusive events, and more.
One big number
$100 billion
—That’s how much World Bank President Ajay Banga hopes to raise for the International Development Association’s replenishment this year — but that can only happen if donors step up to the challenge. As Banga said during this week’s World Bank-IMF Spring Meetings: “We are an instrument of the ambition of our donors. I can’t fabricate money out of thin air.” If donors are able to provide $28 billion to $30 billion, the bank could leverage that on capital markets to reach the $100 billion amount, he said.
The IDA’s replenishment is critical for funding global health security and addressing health-related issues linked to climate change, according to experts. It is one of the most anticipated fundraising events of the year.
ICYMI: The 4 most important calls for global health funds in 2024
Read more: World Bank's Banga wants 'largest of all time' IDA replenishment (Pro)
What we’re reading
Nigeria’s health regulator found that child cough syrup Benylin has high levels of a toxic substance, prompting the country and five other African countries to issue recalls. [Reuters]
A U.K. study found people suffering from long COVID still have inflammatory proteins in their blood, potentially explaining symptoms and guiding treatment. [BBC]
The global stockpile of cholera vaccine has run out, but three new vaccine makers are joining efforts to replenish supplies. [The New York Times]
About the author
Jenny Lei Ravelo@JennyLeiRavelo
Jenny Lei Ravelo is a Devex Senior Reporter based in Manila. She covers global health, with a particular focus on the World Health Organization, and other development and humanitarian aid trends in Asia Pacific. Prior to Devex, she wrote for ABS-CBN, one of the largest broadcasting networks in the Philippines, and was a copy editor for various international scientific journals. She received her journalism degree from the University of Santo Tomas.
