To coincide with the 74th World Health Assembly, Devex hosted a three-day summit, Devex @ WHA 2021, to dig deeper into the global health community’s top challenges, from equitable vaccination rollout to future pandemic preparedness. Here are seven top takeaways:
1. Strengthen WHO with more sustainable funding
To better equip the World Health Organization for future challenges, it must be empowered with greater autonomy and funding, panelists agreed during a discussion on WHO reform. Debate continued, however, on whether this should be achieved through hiking member states’ assessed contributions or by boosting untied funds through shifting to a replenishment model, such as that used by Gavi, the Vaccine Alliance, and The Global Fund to Fight AIDS, Tuberculosis and Malaria.
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Björn Kümmel, deputy head of the global health division at Germany’s Federal Ministry of Health, and chair of a member state working group on sustainable funding for WHO, noted that a reliance on voluntary contributions means less than 20% of the WHO’s funding is predictable, hindering its ability to make long-term plans.
2. Empower decision-makers with real-time data
Intelligent use of real-time data can help transform health systems from being reactive to proactive, predictive, and eventually preventative, argued Dr. Ann Aerts, head at the Novartis Foundation.
The complex nature of the current pandemic — with COVID-19 patients, for example, often suffering worse health outcomes if they have underlying conditions such as diabetes or cardiovascular disease — has required a more joined-up, data-driven response than ever before. Aerts also called for a simultaneously strengthened focus on such chronic or noncommunicable conditions.
One example is AI4BetterHearts, a global data collaboration between Novartis Foundation, Microsoft AI4Health, and other partners that uses artificial intelligence and advanced data analytics to combine, mine, and analyze heart health data. This kind of approach can help policymakers identify which groups are at higher risk for acute events and make better decisions about their care, Aerts said.
3. Create a rapid and agile alert system for health emergencies
Under international health regulations, WHO currently lacks the legal right to demand access to member states for inspections of disease outbreaks or to publish findings without their permission, noted Helen Clark, co-chair of the Independent Panel for Pandemic Preparedness & Response.
The IPPPR argued in its recent report that this weakened the global pandemic response. It recommended for WHO to establish a new global surveillance and alert system for health emergencies, with the WHA also granting WHO authority to publish information about outbreaks with pandemic potential immediately and to gain short-notice access to sites and samples.
4. Coordinate for more equitable vaccine rollout
To ensure an effective and equitable vaccine rollout, the world needs a coordinated plan with full visibility of global supplies and the ability to direct them to the countries and populations most in need, argued Gabrielle Fitzgerald, co-founder of Pandemic Action Network.
High-income countries must also make good on dose-sharing promises rapidly, rather than waiting until their own populations have been vaccinated first, panelists agreed during the Vaccine Equity: Challenges & Solutions session.
Most African countries prepared solid vaccination plans, with vaccinations often starting as soon as doses were delivered, noted Dr. Richard Mihigo, immunization and vaccine development program coordinator at WHO’s Regional Office for Africa.
But supplies have been lower than expected, partly because of suspended shipments to COVAX by the Serum Institute of India amid an infection spike in that country. At the time of the event, only around two doses per 100 people had been administered in Africa, compared with some 25 per 100 globally, he said.
As second doses become due but future supplies remain uncertain, many African countries now face a dilemma over whether to continue expanding first-dose rollout to high-risk populations or reserving supplies for second doses, added Dr. Austin Demby, Sierra Leone’s Minister of Health and Sanitation.
5. Invest in local infrastructure and technology transfer to boost local manufacturing capacity
An inequitable distribution of vaccine manufacturing capacity — with facilities currently concentrated in high-population centers such as India, China, North America, and Europe, where vaccine demand is also high — must also be tackled, noted Richard Hatchett, CEO at the Coalition for Epidemic Preparedness Innovations.
AU launches Partnership for African Vaccine Manufacturing
Delays, scarcity, and uncertainty have marred the rollout of COVID-19 vaccines across Africa. In response, there have been calls from health and economic experts to increase local capacity to manufacture vaccines.
The African Union’s vaccine strategy includes, for example, a push to increase local manufacturing, with Senegal, Rwanda, and South Africa identified as countries with high potential to become hubs, as long as they receive sufficient financial support and technological transfer.
The world needs a more flexible manufacturing capacity that can ramp up COVID-19 vaccine production when needed but be cheaply idled or repurposed for routine vaccination production at other times, argued AstraZeneca CEO Pascal Soriot. Investment is also needed in cold chain and other supply chain infrastructure, panelists highlighted.
Opinion was divided over the efficacy of intellectual property waivers, with skeptics such as Thomas Cueni, director-general at the International Federation of Pharmaceutical Manufacturers and Associations, arguing they might undermine big pharmaceutical companies’ trust in the network of partnerships that has been critical for rapid vaccine development and distribution.
6. Continue R&D in new vaccines, mRNA technology against COVID-19, and other diseases
R&D must continue to develop vaccines that protect against multiple COVID-19 variants and potential future coronaviruses while compressing development timelines, said CEPI’s Hatchett.
Recent advances in mRNA technology could unleash a wave of new vaccines being developed for a range of pathogens, including long-neglected diseases such as tuberculosis, said Helen Fletcher, professor in immunology at the London School of Hygiene & Tropical Medicine.
Technology transfer is also crucial so low- and middle-income countries can drive research agendas to focus on pathogens of most relevance to them and manufacture vaccines locally with full intellectual property rights, she added, noting that this would also make mRNA vaccines more affordable.
7. Tackle vaccine hesitancy sensitively
Tackling vaccine hesitancy is vital to ensuring all vaccine supplies sourced through COVAX or other means are administered at speed, according to Heidi Larson, professor of anthropology, risk, and decision science at LSHTM.
Broader anxieties around technology and government control, as well as a proliferation of channels for disinformation, have contributed to unexpectedly high levels of distrust around vaccination in many countries. Such concerns must be listened to and countered sensitively at local, national, and international levels.
How governments and the health community approach COVID-19 vaccination will have long-term impacts on acceptance of other vaccines or health interventions, she said.
This should include demonstrating to communities that their other health challenges are not being deprioritized in favor of COVID-19 vaccination. “If people don’t feel well treated, if they feel dismissed or judged or excluded, that will be the thing they remember,” she said.
About the author
Helen Castell@flippinowl
Helen Castell is a London-based financial journalist with nearly 20 years’ experience covering trade, energy and risk for TXF, Shares Magazine, Global Trade Review, Newsbase, Trade Finance Magazine and other Euromoney publications. At Devex, she writes about development banking, private sector engagement and funding trends. She studied English Literature at Sheffield University and International Journalism at London’s City University, and speaks English, Spanish and Japanese.
