Preview: Experts say ‘myriad’ failures fueled the pandemic

A panel of experts found the localized outbreak of COVID-19 in Wuhan, China, progressed to a pandemic because of a “myriad” failures in pandemic preparedness and response.

During an emergency meeting of African health ministers on Saturday, former Liberian President Ellen Johnson Sirleaf, who is co-chair of the Independent Panel for Pandemic Preparedness and Response, gave a preview of the final report the expert panel will release on May 12.

In May 2020, amid criticisms of how the World Health Organization handled the response, the World Health Assembly asked WHO Director-General Tedros Adhanom Ghebreyesus to initiate an independent review of the international response to COVID-19 and to report to the assembly at its meeting at the end of this month.

The panel conducted its own research and interviews, reviewed literature, and hosted roundtable events and town-hall style meetings with experts and front-line health workers to reach its conclusions, and concluded that WHO is not sufficiently empowered to investigate and confirm dangerous outbreaks rapidly, Sirleaf said.

WHO’s investigations into the outbreak were constrained by the International Health Regulations and the procedures under which the agency operates are “not conducive to the taking of a precautionary approach.” She added that member states have failed to adequately fund WHO and that funds for pandemic preparedness and response are “too often too little and too late.”

She said that the global community needs to empower WHO with the clear authority to investigate outbreaks of concern rapidly and there must be clear criteria for the agency on when to declare a public health emergency of international concern.

WHO made this declaration following a month of “relative inaction” where many countries relied on a “wait and see” approach rather than preparing for the spread of the virus, she said. In those early days, many countries, including some of the wealthiest, “devalued science, denied the disease severity, delayed response, and sowed distrust among their citizens,” she said.  

This happened despite years of warning countries that they need to prepare for pandemics, she said, adding that international rankings showing how prepared countries were inaccurate and that “many of those who scored most highly [had] the worst response to COVID-19.” These rankings failed to take into account the role of political leadership, trust in institutions, and social cohesion, she said.

“We need to recognize that every hour counts as actions need to be faster than the spread of the virus,” said Precious Matsoso, director of the Health Regulatory Science Platform at the University of the Witwatersrand. Matsoso is a member of the panel of experts. “Health threats must be elevated to the highest level and they need to be addressed to the same degree of concern and resolve, as all other major societal, political, and security challenges.”

Sirleaf said a “greatly improved” system for disease surveillance and alert is needed, describing the current one as “an analog system operating in a digital age.”

Sirleaf emphasized the need to build political leadership at a global level around pandemic preparedness and response.

“Although health ministers and health systems are vital components, pandemic preparedness is a whole of government effort,” she said.

The experts will recommend a council, composed of political leadership with the power to put recommendations by the panel of experts into action, as well as a political declaration by countries to commit to implementing the recommendation with a mechanism for their actions to be monitored.

There is also a need for a financial instrument flexible enough to allow for quick funding surges in response to dangerous outbreaks, which provide financing immediately without bureaucratic hurdles.  

The published report should be used to “ensure that COVID-19 is the last pandemic to cause devastation on a scale we are witnessing today,” Sirleaf added.