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The following statement—from Global Health Council, supported by the Global Health Technologies Coalition—was delivered at the 74th session of the World Health Assembly on agenda items 17: WHO’s work in health emergencies and strengthening preparedness for health emergencies and 18: Mental health preparedness for and response to the COVID 19 pandemic.More than a year into the COVID-19 pandemic, over one billion vaccine doses have been delivered globally. Yet access to vaccines and other lifesaving tools has not been equitable. The pandemic has spotlighted health inequities, which allow the virus to continue to spread, mutate, and overwhelm health systems—leaving marginalized populations further behind. These inequities were not borne of COVID-19 and inadequate investment and policy responses risk further widening the gap.We applaud WHO efforts to address inequities through strengthened international cooperation and support negotiations to improve international pandemic preparedness. Collective action is critical to end this pandemic, achieve equitable recovery, and create stronger, resilient systems and WHO must be in the lead. We support calls to maximize dose sharing through COVAX, fully fund the ACT-Accelerator, and commit political leadership to oversee response and recovery. We welcome the Director-General’s update on implementation of resolution WHA73.1—which acknowledges COVID-19 disruptions to essential health services—and urge Member States to increase investment in health systems to ensure continuity of services in pursuit of health for all. We need a holistic approach to health system strengthening. To prepare for future health emergencies, WHO and Member States must urgently improve global coordination, increase sustainable financing for preparedness, and invest in better and more effective surveillance systems and field epidemiology training. National and global responses to future health emergencies, must include:Investment in national leadership positions and action plans to increase global health security to fully reach IHR compliance;Prioritization of regional research and manufacturing capacity;Strengthened medical and pharmaceutical supply chains in advance of health emergencies; andIncorporation of pathogen spillover prevention and zoonotic risk assessment. Member States, WHO, and other stakeholders must promote an all-of-society approach to health system strengthening and pandemic preparedness that includes civil society engagement and addresses inequities at their roots. WHO must be well-resourced to prioritize a comprehensive preparedness agenda that ensures systems and services reach the last mile so that everyone is protected from future health emergencies. 

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign up now to receive our weekly R&D News Roundup email. On Wednesday, the US Food and Drug Administration (FDA) announced the Pfizer/BioNTech COVID-19 vaccine can be safely stored at refrigerator temperatures for up to a month, an expansion from the previous five-day limit. The authorization followed Pfizer’s submission of data to the agency supporting extended refrigerator storage of undiluted, thawed vials. The European Medicines Agency also authorized the change last week. The relaxed storage requirement should lead to more widespread availability of the vaccine by facilitating the ability of vaccine providers, such as community doctors’ offices, to receive, store, and administer the vaccine, according to Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research. The Sanofi/GlaxoSmithKline (GSK) COVID-19 vaccine candidate generated strong levels of neutralizing antibodies in recipients across all ages studied, according to phase 2 trial results announced by the companies last week. No safety or tolerability concerns arose in the trial. The two-dose vaccine is a recombinant protein vaccine and does not require an elaborate cold chain for storage and distribution. Sanofi and GSK also noted that high neutralizing antibody levels were generated after a single dose in participants with evidence of prior SARS-CoV-2 infection, which could suggest its value also as a booster used after an initial vaccination series. A large, international phase 3 trial is set to begin in the coming weeks, and the companies also plan to conduct studies targeting various variants of concern.The United States committed to sending an additional 20 million COVID-19 vaccine doses to other countries last week, following an initial announcement that it would share 60 million doses of the AstraZeneca vaccine, which has not yet been authorized by the FDA. In Monday’s announcement, the Biden administration committed to sharing surplus supplies of the FDA-authorized Pfizer, Moderna, and Johnson & Johnson vaccines, in addition to the AstraZeneca vaccine doses, for a total of 80 million doses sent overseas in the next six weeks. Currently, only 0.3 percent of all COVID-19 vaccine doses administered worldwide have been given in low-income countries.

Today’s Global Health Summit was a moment to address the ongoing urgent needs to combat COVID-19, reflect on the lessons learned over the past year, and start the process of laying out a tangible road map for addressing not just the current pandemic, but the systemic inequities and challenges in the global health ecosystem that have been exposed and exacerbated by COVID-19. World leaders developed a set of principles through the Rome Declaration, which is set to guide the ongoing discussions in various multilateral fora and provide the foundation around which partners will engage in the coming months.GHTC welcomes the research-related commitments in the declaration, especially the call by G20 leaders to “invest predictably, effectively and adequately, in line with national capacities, in domestic, international and multilateral cooperation in research, development, and innovation, for health systems tools and non-pharmaceutical measures, considering issues of scalability, access, and manufacturing from an early stage.”We support the pledge by G20 leaders to support low- and middle-income countries to build expertise and develop local and regional manufacturing capacities for medical countermeasures. We are also pleased to see the declaration call for an expansion of international financial institution mandates to provide investment in country preparedness capacity, which we believe could provide new, sustainable, and catalytic funding for vital research capabilities, including laboratory infrastructure, clinical trial networks, workforce development, and surveillance and pathogen sharing platforms to low- and middle-income countries.While the Rome Declaration includes some high-level priority guidelines for how research and development (R&D) fits into the ongoing global health security reform discussions, it is disappointing to see research not be enshrined more explicitly as a central pillar of preparedness or as a missing element of the International Health Regulations and other global frameworks. While outlining the need for more R&D investment and coordination is a good start, GHTC would have welcomed a more substantial call for developing clear coordination mechanisms to assess R&D capacity gaps, as well as specific pathways for how G20 leaders will seek to boost manufacturing capacity in low- and middle-income countries. The recent Independent Panel for Pandemic Preparedness and Response report highlighted more concrete recommendations on possible models and frameworks, and we hope that G20 leaders will start to delve into the details and build tangible proposals for advancing global health security that include R&D as a fundamental element.The time has come to move from declaration to action. We look forward to further engagement by G20 countries and other stakeholders at next week’s World Health Assembly to start to define the intricacies of new frameworks and reform efforts to the global health architecture, and hope that R&D more concretely factors in as a key element of health preparedness.