COVID-19 was a global nightmare. More than 7 million recorded deaths, and an excess mortality of millions more. International cooperation tested for real in an unprecedented emergency. The pandemic’s total price tag amounted to almost 14 trillion dollars, with the global economy contracting more than 3 percent in 2020 alone. The number of extreme poor around the world went up for the first time in a generation. Even today, millions suffer long-term effects of the virus and economic ramifications remain visible in many countries.
The pandemic was traumatic for many of us – and many have tried to forget it. Not just the lockdowns, empty streets, and facemasks, but the extraordinary pressures on health systems; outsize impacts on vulnerable groups; and the need for unprecedented social protection and stimulus packages. But this – understandable – reaction also means that we may not capture all the lessons that must be learned if we are to avoid making the same mistakes in the future.
A new OECD report aims to do just that. The product of collaboration between more than 60 organisations, it evaluates international cooperation and development assistance during the pandemic, including the contentious issue of vaccine distribution.
Evaluating the response: what did donors do well?
In April 2020, donor countries met to consider how development cooperation should respond to COVID-19. OECD/DAC members committed to protect their ODA budgets, ensuring that pandemic-related funding would supplement existing financing, and promised to support least-developed countries (LDCs) and other countries in need.
The new joint evaluation shows that the donor community largely lived up to these commitments, at least initially. Tremendous effort went into adjusting programmes across sectors to deliver support and help governments respond. Aid budgets increased from 0.30% of DAC members' Gross National Income in 2019 to 0.33% in 2021. Commitments for COVID-19 assistance drove a significant upsurge in health funding while not diverting from efforts to fight other diseases. The response was well-targeted, with LDCs and other vulnerable countries seeing the largest increases in health assistance and overall funding. COVAX, a collaborative mechanism to ensure that the most vulnerable people received COVID-19 vaccines, delivered almost 2 billion doses. As a result, an average of 45% of the population across 123 developing countries was fully vaccinated by July 2023.
Where did efforts fail?
However, the evaluation also spotlights many ways in which the international response fell short. Particularly crucial was the failure to ensure equitable global access to vaccines, with production centred in more advanced countries.
In a context of limited global vaccine supply, equitable and effective allocation processes are crucial. During the COVID-19 pandemic, however, the absence of mechanisms to review and align overall vaccine distribution meant that the needs of many partner countries went unmet. Of the nearly 1 billion vaccine doses donated to developing countries in 2021, for example, about one-third were surplus stock from donor countries – i.e., not specifically purchased for partners. Many high-income countries purchased far more doses than their populations required, reducing global availability and delaying access for developing countries, in some cases permanently. Also, ad hoc bilateral donations were poorly coordinated with multilateral efforts. These systemic shortcomings led to stark disparities in vaccination rates between countries, eroding trust and undermining the huge efforts put into COVAX.
What’s next for pandemic prevention?
Pandemics are global public bads. They demand coordinated, international efforts to quickly detect health threats, disseminate knowledge and implement solutions based on agreed protocols and procedures. Resources must be moved swiftly to partners, not only in the health sector, but to buffer the economic downturns that result from containment. Vulnerable population groups, as well as people with specific vulnerabilities to the pandemic, should be prioritised. All of this must be built on top of strong, equitable national public health systems.
Of course, this comes with a price tag. But it doesn’t have to be an expensive one.
According to WHO and the World Bank, USD 10.5 billion a year in increased global health spending could cover a systemic approach to pandemic prevention, preparedness and response (PPPR). Compared to the millions of lives lost and trillions of dollars in world-wide costs that resulted from COVID-19, this should be manageable. But it’s also not a given amid massive donor cuts to health sector funding; shrinking aid budgets; increasing humanitarian needs, including for Gaza and Sudan; and the need for continued strong support for Ukraine.
Still, we need to focus on the long game. The world can’t afford not to learn from COVID-19 or fail to implement effective PPPR. We must ensure that when the next pandemic comes, our increasingly limited resources are well spent and do not undermine crucial international development and humanitarian efforts. Next year’s United Nations High-Level Meeting on PPPR will be a unique opportunity to draw political conclusions from the joint evaluation.
