Sept. 15, 2022 -- A new report detailed "massive global failures" in the response to COVID-19 and called for improved multilateral cooperation.

Widespread global failures at multiple levels in the response to COVID-19 led to millions of preventable deaths and reversed progress made towards U.N. goals for sustainable development in many countries, according to a new Lancet COVID-19 Commission report.

Globally, there have been an estimated 17.7 million excess deaths due to COVID-19, and this number is likely to be an under-estimate, the authors of a linked editorial write. They said that the new report "lays bare what has been nothing less than a massive global failure -- a failure of rationality, transparency, norms of public health practice, operational coordination, and international solidarity.”.”

The Lancet report on lessons for the future from the COVID-19 pandemic is the result of 2 years of work from 28 of the world's leading experts in public policy, international governance, epidemiology, vaccinology, economics, international finance, sustainability, and mental health – including Professor Andy Haines of the London School of Hygiene and Tropical Medicine, -- and consultations with over 100 other contributors to 11 global task forces. The Commission combed through evidence from the first 2 years of the pandemic with new epidemiological and financial analysis to outline recommendations that will help end the ongoing COVID-19 pandemic emergency, lessen the impact of future health threats, and achieve long-term sustainable development.

Response Too Cautious and Too Slow

The report was critical of the World Health Organization, which, the authors said, acted "too cautiously and too slowly" on important matters, which included warning about the human transmissibility of the virus, declaring an international public health emergency, supporting international travel protocols to slow virus spread, and endorsing public use of face masks as protective gear. In addition, the WHO was criticized for not recognizing the airborne transmission of the virus soon enough.

WHO officials welcomed the "overarching" recommendations of the Commission's report, which it said aligned with their commitment to "stronger global, regional and national pandemic preparedness, prevention, readiness and response..” It highlighted how the organization endorsed the recommendation that its central role in global health should be strengthened, and that reforms "should include a substantial increase of its core budget.”

However, it said that there were "several key omissions and misinterpretations in the report, and took issue with the Commission's criticism "regarding the public health emergency of international concern and the speed and scope of WHO's actions," and went on to detail a lengthy timeline of its actions in its defense.

Governments also came under fire for a lack of adequate coordination on policies to contain the pandemic, including travel protocols, testing strategies, and advice to the public, and for being too slow and too cautious in their response. The report also found that most national governments were unprepared, paid too little attention to the most vulnerable groups in their societies, and were "hampered by a lack of international cooperation and an epidemic of misinformation.”

The COVID-19 response has shown several aspects of international cooperation at its best – public-private partnerships to develop multiple vaccines in record time, actions of high-income countries to financially support households and businesses, and emergency financing from the International Monetary Fund and World Bank, the authors said. However, the "lack of cooperation among governments" for the financing and distribution of key health products, including vaccines, personal protective equipment, and resources for vaccine development and production in low-income countries, has come at "dire costs," they said.

'Staggering' Human Toll’

"The staggering human toll of the first 2 years of the COVID-19 pandemic is a profound tragedy and a massive societal failure at multiple levels," said Jeffrey Sachs, chair of the Commission, professor at Columbia University, and president of the Sustainable Development Solutions Network.

The report's authors highlighted how the epidemic control was "seriously hindered" by opposition to routine public health and social measures by the public – such as the wearing of masks and vaccination.

"We must face hard truths," Sachs said. "Too many governments have failed to adhere to basic norms of institutional rationality and transparency; too many people have protested basic public health precautions, often influenced by misinformation; and too many nations have failed to promote global collaboration to control the pandemic."

Public policies paid too little attention to the most vulnerable groups in society and did not properly address the profoundly unequal effects of the pandemic, said the authors.

Planning for the Future

To control the pandemic, the Commission proposed that all countries adopt a vaccination-plus strategy, combining widespread vaccination with appropriate public health precautions and financial measures. "The faster the world can act to vaccinate everybody, and provide social and economic support, the better the prospects for exiting the pandemic emergency and achieving long-lasting economic recovery," Salim S. Abdool Karim, professor at the Mailman School of Public Health at Columbia University, and Commission co-author, said. .

To prepare for future pandemic health threats, the Commission recommended strengthening national health systems and the adoption of national pandemic preparedness plans, with actions to improve coordinated surveillance and monitoring for new variants, protect groups experiencing vulnerability, and create safer school and workplace environments by investing in ventilation and filtration.

To improve the world's ability to respond to pandemics, the Commission said the WHO needed to be transformed and bolstered by a substantial increase in funding and greater involvement from heads of state representing each region to better support decision-making and actions, especially on urgent and controversial matters.

The Commission proposed five essential pillars to fight emerging infectious diseases: prevention, containment, health services, equity, and global innovation and diffusion. If these pillars are to be achieved, it said that "governments, regulators, and institutions must be re-oriented toward society as a whole", rather than the interests of individuals - a concept the Commissioners called "prosocialty.”

"Without this shift, the world is vulnerable and unable to tackle effectively any global threat," they warned.