A radical rewrite of the global framework to prevent and respond to health threats is needed to make Covid-19 “the last pandemic”, according to a group of former world leaders and experts. “Our message is simple and clear – the current system failed to protect us from the Covid-19 pandemic. And if we do not act to change it now, it will not protect us from the next pandemic threat, which could happen at any time,” said former Liberian president Ellen Johnson Sirleaf. After Wuhan, it’s time for global response reset: Covid-19 probe chief Alongside former New Zealand prime minister Helen Clark, Sirleaf co-chaired a panel of 13 experts charged by World Health Organization chief Tedros Adhanom Ghebreyesus with working out how a disease outbreak in China became a global crisis. The group’s members included former leaders, diplomats, and aid organisation heads from countries such as the US, China, Saudi Arabia and India. After an eight-month evaluation, the Independent Panel for Pandemic Preparedness and Response has delivered its report, headlining its recommendations with a call to establish a multibillion dollar financing mechanism to prepare and respond to pandemics, as well as a permanent council of world leaders focused on global health threats, and a pandemic treaty. The panel wants a new and transparent system to detect and monitor outbreaks around the world, along with a strengthening of the WHO’s purse and powers. And it said world leaders should commit to these reforms at a UN summit in four months’ time. “We say that half-measures won’t do, if the world is going to avert another catastrophe like Covid-19,” Clark said. Delays and discord, outmoded systems and a lack of preparation hampered responses to the new coronavirus around the world, the panel said. Over several hundred pages, its report and accompanying documents lay out what went wrong, who was affected and what needs to happen next – swift action to address gaping inequalities in access to vaccines and prevent the next pandemic. The report highlighted how nationalism and tensions between countries – such as the US and China – hampered international cooperation in responding to the pandemic. It also noted a “lost month” in February when countries around the world failed to take action, despite access to news about overwhelmed hospitals and mass deaths in early epicentres. But it was light on casting blame for failures on individual countries, instead focusing on overall systems and the need to reform international rules on disease outbreaks and the WHO’s power to investigate them. What happened in Wuhan With Covid-19, the first test of those rules was in China’s central city of Wuhan, where the virus was first flagged at the end of 2019. Critics, including then US president Donald Trump, said the WHO had erred in trusting information from China, which was accused of not being transparent about what was happening in Wuhan. That included a three-week gap between the official announcement of a mysterious pneumonia and confirmation it could spread between people. The panel said “information about cases and their characteristics was not available quickly enough” in the early days of the disease. “Evidence collected by the panel suggests that action should be taken to ensure an even more rapid and efficient early response in the future,” it said in a document accompanying the report. WHO wants end to ‘panic-then-forget’ approach to epidemics While the WHO warned that human-to-human transmission was possible before it was confirmed by China, the panel found the health agency could have advised countries to assume that it was. The panel also determined that the situation was likely to have met the necessary criteria for the clarion call designation of “public health emergency of international concern” on January 22 – eight days before the declaration was made by Tedros. “The emergence of Covid-19 was characterised by a mix of some early and rapid action, but also by delay, hesitation and denial, with the net result that an outbreak became an epidemic and an epidemic spread to pandemic proportions,” it said. Avoiding those problems at the critical early stage of the next pandemic would require a redesign of surveillance and alert systems, including a hi-tech reboot to identify outbreaks “based on full transparency by all parties”, it said. It would also require more access and power for the WHO – which countries had been reluctant to grant the last time global rules were revised, following the Sars outbreak in 2002-03 – it said, calling for the UN body to be empowered to investigate pathogens with pandemic potential in all countries at short notice, with standing, multi-entry visas for international experts. The proposed measures are in sharp contrast to the WHO’s response to Covid-19. The agency spent months laying the groundwork for an international team to head to Wuhan and investigate the origins of Covid-19. Its experts were vetted by Beijing, which blocked their entry at the last minute, before they eventually spent four weeks in Wuhan, more than a year after the outbreak. An earlier team went to China in February, during Wuhan’s outbreak, but with a limited mandate. “Sensitivities about sovereignty surely should not delay alerting the world of the threat of a new pathogen with pandemic potential,” Clark said at a media briefing on the report. China braces for international backlash in a post-coronavirus world Global debacle The panel found most countries failed to enact immediate emergency responses, despite the WHO’s declaration and evidence that a deadly pathogen was on the move. “There were clearly delays in China, but there were delays everywhere … after [the declaration] this month of inaction by so many was also contributing hugely to the fast spread of the disease,” Clark said. To avoid similar delays in future, countries must boost national contingency plans, undergo regular peer reviews and get clearer guidance from the WHO, the panel said, while warning that the expanded international system it envisaged went beyond nations and the WHO. “Multilateralism has been in a bad space for a number of years, and that has undermined the institutions and means that even something like fighting a pandemic can become very polarising,” Clark said. One recommended step was the establishment of an 18-member global health threats council which, unlike existing bodies on pandemics, would be made up of current heads of state or government and have US$5 billion to US$10 billion a year to help countries get their systems ready to catch outbreaks or respond to them – with the ability to disburse US$50 billion to US$100 billion if a pandemic was declared. The money would come from country contributions to a dedicated financing facility. Vaccine crisis The panel also recommended a permanent, well-funded “end-to-end” platform for vaccines, tests and drugs to address the gaping inequalities to vaccine access which experts say will prolong the Covid-19 pandemic. But in the short term, the panel is calling for the WHO and World Trade Organization to immediately convene the major vaccine makers and persuade them to share their Covid-19 vaccine technology with other manufacturers. “If actions do not occur within three months, a waiver of [intellectual property rights] should come into force immediately,” it said. Panel member Mark Dybul welcomed last week’s backing by the US for a proposal to waive Covid-19 vaccine patents and pointed to “converging messages around the world” that were dovetailing with the panel’s vision for collective action. “Covid-19 has caused a crisis so deep and wide that presidents, prime ministers and heads of international and regional bodies must now urgently accept their responsibility to transform the way in which the world prepares for and responds to global health threats,” the former head of The Global Fund to Fight Aids said. “Numerous champions on the global health and political scene support our vision.”