Director Pascale Allotey at Think20 (T20) Inception Conference: People, Planet, and Prosperity

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  • 2021•02•11     Kuala Lumpur

    UNU-IIGH Director, Professor Pascale Allotey, has stressed the importance of embedding principles of global equity into COVID-19 recovery plans as part of the opening panel for this year’s Think20 (T20) inception conference (8th – 9th February). Prof. Allotey reminded the audience that in our increasingly globalised world, life will not return to ‘normal’, new or otherwise, until we are all assured of the pathway to prevention, an important counter argument to the current waves of ‘vaccine nationalism’ observable globally.

    Prof. Allotey also highlighted that the process of ensuring equitable access to vaccines opens up an opportunity to revisit debt relief initiatives, interest free loans, and other models that would enhance the ability of developing countries to in turn, increase their investments in global public goods, putting them in a stronger position to engage in COVAX and other related programs. Indeed, COVAX has been touted as an example of how global public investment, a proposed new development financing approach, can be used fund the development of global public goods.

    “…the process of ensuring equitable access to vaccines opens up an opportunity to revisit debt relief initiatives, interest free loans, and other models that would enhance the ability of developing countries to in turn, increase their investments in global public goods…”

    Current holders of the G20 presidency, Italy, has outlined three priority areas: People, Planet, and Prosperity. Prof. Allotey serves as a co-chair on this year’s T20 task force on global health and COVID-19. The T20 is the ‘ideas bank’ that accompanies the annual G20 meeting, bringing together leading think tanks and research centres to provide evidence-informed policy recommendations to G20 leaders. Prof. Allotey’s involvement in T20 continues IIGH’s engagement with the process. In recent years UNU-IIGH has contributed to policy briefs on universal health coverage and global public goods for health.

    Over the next four months, IIGH researchers will work with co-authors at institutions globally on the development of policy briefs addressing the topics of health inequities, gender and health, and schools and education, all within the context of COVID-19, for consideration by the health ministers of the G20.

    You can watch the inception conference in full here.

    Professor Allotey’s Interventions*

    Q: Access to vaccines is today’s overarching concern of both governments and the public. It is indeed fairly clear that global equitable access to Covid-19 vaccines is a key precondition to get the pandemic under control but especially developing countries are facing major obstacles to obtain access to vaccinations. How could the G20 help overcome such obstacles?

    Early leadership by WHO and partners in establishing the ACT-Accelerator partnership (Access to COVID-19 Tools) is a clear illustration of the importance of multilateralism. The ACT-Accelerator is organized into four pillars of work: diagnostics, treatment, vaccines and health system strengthening. The vaccines pillar, COVAX, started with a strong equity rhetoric, but, the actual release of the vaccine shifted that to a wave of vaccine nationalism. This was unfortunate, but unsurprising given the combination of scarcity of a critical resource, political interests, and evolutionary protectionism.

    However, we now know the vaccine landscape. There are multiple suppliers and products, and growing evidence on efficacy and safety. As such, there should be less pressure to scramble, and a return to a focus on global equity, recognising the unequal purchasing power across countries. Course correction to the principles of global equity is critical both across and within countries. Like the scramble to vaccine nationalism there is already evidence of the use and abuse of power and politics to define the categories of prioritised or essential personnel – the idea of protection of the most vulnerable does not feature in the policies of a number of low- and middle-income countries and accountability will be meaningless without some clear guiding principles and standards.

    A colleague in Europe showed me her number and a date symbolising her place in the queue for the COVID vaccine. For her, it is a symbol of an end to chronic uncertainty. And yet, there are countries that are not even in the global queue. There will be no end to chronic uncertainty anywhere, or a path to economic recovery, if developing countries remain unvaccinated. Current concerns and further lockdowns related to the risks of ongoing viral mutations that are resistant, or less susceptible, to current health technologies are just one example. In addition, developing countries carry a significant proportion of production for the global economy. 60% of world GDP by 2030. Perhaps not the best example for public health, but a thriving chocolate industry is dependent on the ongoing health and survival of cocoa farmers in Ghana.

    “There will be no end to chronic uncertainty anywhere, or a path to economic recovery, if developing countries remain unvaccinated.”

    The pandemic has illuminated just how deeply unequal our world is. The response, however, has to go beyond age-old charitable models; we have an opportunity to engage with both the causes of, and the long-term solutions for, global equity. From the perspective of the G20, ensuring equitable access to vaccines opens up an opportunity to revisit debt relief initiatives, interest free loans, and other models that would enhance the ability of developing countries to in turn, increase their investments in global public goods, putting them in a stronger position to engage in COVAX and other related programs. The G20 needs to recognise the relevance of regional blocks such as the African Union and regional development banks as partners in the global effort.

    So, to summarise – the G20 can:

    • End vaccine nationalism and increase trust in the multilateral system.
    • Recognise that none of us returns to normal, new or otherwise, until we are all assured of the pathway to prevention.
    • Engage with initiatives that enable developing countries to be at the table to discuss access for their populations.
    • Additional investment from the G20 countries into equitable access is a good investment for all our futures.

    Not just because it makes economic sense, but also because it is the right thing to do.

    Q: Another crucial issue for ensuring global health is the collection and sharing of reliable and updated data on epidemics, possibly at the earliest stages of the outbreaks. To this aim, what the G20 and the World Health Organization do?

    Data are usually treated as a commodity, with monetary, personal, and professional value. The sharing of data is complicated by issues of privacy, confidentiality, national, professional, and regional regulation – often for good reason. But the pandemic has seen an incredible generosity in data sharing that has made vaccine development and testing – usually a multi-year endeavour – possible in a few months. The genetic sequence of SARS-CoV-2 and clinical trial results were released almost in real time, which has supported joint learning. WHO has established platforms for learning and sharing expertise as questions arise about the clinical management, prevention and related health issues. Again, a process enabled through trust in a multilateral system.

    However, there is always room to do better. There has been a mushrooming of data platforms that are often duplicative, inefficient, and of unclear quality. Capacity to optimise the analysis and interpretation is often limited to a handful of institutions in the global north, which leads to the control of the narrative about what works, regardless of context. Low- and middle-income countries are often reduced to data collectors for scientists who generate the real knowledge in institutions in the global north.

    So what should WHO and the G20 do?

    • Invest in, and strengthen established national and regional bodies – I refer for instance to the WHO regional health observatories, the centres for diseases control, national data warehouses etc. The hard work has been done in establishing their credibility, the public function, and the infrastructure. A concrete proposal would be to enhance their function and ensure they remain depoliticised. We do not need to reinvent new wheels.
    • Strengthen the collection and sharing of disaggregated data – by gender, by ethnicity, by indigeneity and socioeconomic status – as many of the social determinants that we know will be relevant to the effort to leave no-one behind.
    • Recognition of different types of data – there is only so much that we can learn from the current measurable indicators in epidemiology
    • And finally, data sharing offers an opportunity to establish mechanisms for coordination between governments, the private sector and philanthropy to tie together the critical areas of regulation, sharing, accountability and scale up.

    *some minor edits for clarity. Thank you to UNU-IIGH Senior Visiting Fellow, Dr Swee Kheng Khor, for conducting background research.