In 1974, there were 218,367 cases of smallpox; by 1980 the disease was gone. The World Health Organization led that global fight and eliminated smallpox. A disease spread by airborne droplets that killed almost one-third of those infected was progressively contained until it was eradicated.
Now, as then, global health solidarity is the single most important factor in the defeat of a pandemic. Whatever tools available — whether public health practices, diagnostics, or eventually medicines and vaccines — only through a globally coordinated response can the coronavirus pandemic be ended and people and livelihoods protected. As long as COVID-19 remains unchecked anywhere in the world, it’s a threat everywhere.
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The WHO and other international and regional health organizations are the vital nerve centers of a global pandemic response. Today, more than ever, they must be supported. The WHO opened its annual meeting this week amid rising tensions between China and the United States, which has accused the health organization of spreading Chinese “disinformation” about the coronavirus pandemic.
President Trump sharpened his rhetoric on Monday, saying on Twitter that the United States will permanently halt its $400 million contribution to the WHO if it does not “commit to major substantive improvements in the next 30 days.”
For its part, the WHO has committed to an independent review of its coronavirus response after the crisis has passed. That will be a valuable and essential exercise. But for now, all sides need to move on. There is a pandemic to fight.
The global struggle against COVID-19 is just beginning. From Brazil to India to Russia, to a hodgepodge of states, cities, and towns across the United States, the exponential rise of disease and death continues. And the resources to fight the disease fall far short of the need.
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Since declaring the coronavirus a global health pandemic on March 11, the WHO has relied on global health solidarity to invest extensively in epidemiological surveillance, partner coordination, provision of essential supplies, and technical support for countries to prevent, contain, or minimize its spread. Poor countries in particular rely on the WHO for experts who serve as first responders, and for access to testing kits and personal protective equipment.
The WHO has bought and shipped PPE to 135 countries, and supplied 1.5 million diagnostic kits to 129 countries (as of May 1). It is leading a consortium to rapidly support access to COVID-19 health products and diagnostics for 140 low- and middle-income countries. The allocation is based on mapping by WHO country offices and the Africa Centers for Disease Control and Prevention of each country’s population, health system vulnerability, and testing capacity. This work requires increased funding during a pandemic, and every nation has a vital role to play.
Those at the forefront of epidemic response know the meaning of solidarity in global health.
Long before COVID-19, global funding and coordination has yielded the standardized approaches needed to control disease. For example, between 2014 and 2016, 60 donors contributed $459 million to the WHO’s Ebola response fund, enabling it to institute standardized surveillance, rapid diagnosis, case isolation, and management. The WHO established over 60 specialized treatment units capable of admitting 3,000 patients, and thereby ended the disease outbreak in West Africa.
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Organizations like the Global Fund and the Pan American Health Organization also invest shared pools of the world’s money to defeat global disease threats like AIDS. The Global Fund has saved an estimated 32 million lives from HIV, tuberculosis, and malaria by approaching these diseases from a global perspective, rather than leaving each country to succeed or succumb on its own. The Pan American Health Organization helped lead the elimination of polio, measles, rubella, and neonatal tetanus across the Americas.
The WHO is the only global organization capable of leading collaborative action on the scale needed to end the coronavirus pandemic. Its operations must be fully funded, not scaled back. Furthermore, pulling resources from the WHO would force countries that rely on its assistance to take on more debt, thereby crippling their future prospects for recovery.
Indeed, collaboration is equally crucial for economic survival and recovery from the pandemic, and encompasses organizations beyond the WHO. No country has escaped the crippling economic impacts of this pandemic but low- and middle-income countries stand to be devastated. Many are already at risk of failing to meet loan repayments to their creditors, and debt servicing already absorbs 22 percent of revenues in Africa. Countries that already have weak health systems and a high proportion of their populations living under the poverty line are the most vulnerable.
Organizations like the International Monetary Fund, the World Bank, and the G20 are mobilizing increased funding for loans and debt relief. This includes IMF’s Rapid Credit Facility and increased lending programs, and the World Bank’s $160 billion loan plan to support 65 poor countries over the course of 15 months. These programs are meant to assist the poor and help countries recover from the economic consequence of COVID-19.
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While loans or temporary debt relief programs could help in the short run, the additional accumulation of massive debt exposes countries to greater post-pandemic poverty and could condemn generations to misery, poor health, and greater susceptibility to future health crises.
It is not enough to do things the way they have always been done. Only through creative collaboration, deeper commitment, and global health solidarity can the world triumph over the coronavirus pandemic.
The road back to normal — however that looks — is one we must travel together.
Anatole Manzi is deputy chief medical officer at Partners In Health, assistant professor of global health at University of Global Health Equity, and an Aspen New Voices Fellow.