“The pandemic has brought out the best—and worst—of humanity: Fortitude and fear; solidarity and suspicion; rapport and recrimination. This contagion exposes the fault lines, inequalities, injustices and contradictions of our modern world. It has highlighted our strengths, and our vulnerabilities. Science has been hailed and scorned. Nations have come together as never before, and geopolitical divisions have been thrown into sharp relief. We have seen what is possible with cooperation, and what we risk without it.” – WHO Director-General, Dr. Tedros Adhanom Ghebreyesus, in remarks at the 73rd World Health Assembly, May 18, 2020
There was eloquence and generosity and there was hope at the first virtual World Health Assembly, on May 18-19. There was heartfelt sorrow for those we have lost to COVID-19. Despite technical difficulties of a large online meeting, the messages came through loud and clear as a chorus of more than 100 country representatives, including presidents and ministers of health, took the floor for their allotted time. They were resolute: COVID-19 knows no borders and for most there was a sense that in the new world, global cooperation remains the only way forward. The critical important of health system strengthening was voiced time and again. Robert T.L.V. Browne, the Minister of Health of Saint Vincent and the Grenadines, called public health “a life raft on tempestuous seas.”
This year’s proceedings centered exclusively on the virus that has spread across the world, infecting more than 5 million people, though many highlighted the need, now more pressing than ever, for universal health care and fair and equitable access to medicines. A political pall was thrown over the proceedings as the United States took aim at China and the World Health Organization over their response to the virus, threatening to end U.S. funding to WHO. Others jumped in with financial commitments to make up for the potential loss of resources, including China.
Seeing a leadership gap, the European Union offered up a strong resolution, which passed unanimously, that called for an independent evaluation of WHO’s handling of the pandemic.
Many applauded health care workers. Others highlighted issues that won’t go away, even as COVID-19 rages—not only full and fair access to vaccines and epidemic preparedness, but also the impact COVID-19 will have on those with noncommunicable diseases, and the need for women’s health and reproductive rights.
Below are five key issues that stood out at the 73rd World Health Assembly.
1. The United States-China Feud Took the Limelight
Though solidarity was the order of the day, with calls from many countries for a united global front against the virus, the United States-China debate over the handling of COVID-19 was what captured media attention.
President Trump threatened to permanently cut off U.S. funding to WHO and revoke its membership if the agency doesn’t make changes to curb its “pro-China” bias. Chinese President Xi Jinping’s response: A US$2 billion initiative for the organization—more than triple the United States’ annual voluntary contribution to WHO.
The fallout extended to a fight over Taiwan’s request to participate in the WHA, with no clear resolution. There is no doubt that rocky U.S.-China relations will have critical implications for global health, the economy and beyond.
2. Walking the Talk: Nations Rise to the Challenge
Despite the backdrop of the U.S.-China feud, most member nations took the opportunity to make calls for unity, cooperation and collaboration to contain the damage caused by the pandemic. And where the U.S. threatened to take funds away, others stepped up.
- As mentioned, China’s Xi Jinping announced a two-year, US$2 billion funding initiative for COVID-19 response.
- Germany announced that it has doubled its contribution to the WHO Health Emergencies program to 50 million euros and offered a contribution of 176 million euros for WHO’s response including the search for a vaccine.
- Japan announced a US$100 million COVID-19 fund (led by Sony) of which US$10 million will be contributed to the WHO and other organizations including Doctors without Borders (MSF).
As the current host of the G20 and an influential actor in the Middle East, Saudi Arabia responded to WHO calls for funding by allocating US$80 million to help with emergency preparedness and training.
3. Filling the Leadership Gap: The European Union Resolution
The European Union’s resolution was welcomed for its diplomacy and ability to rise above the fray. It calls for an impartial, independent and comprehensive investigation of WHO’s global response to the pandemic and encourages the global health community to work in close cooperation to ensure equitable access to COVID-19 medicines, therapeutics and vaccines worldwide. The resolution also called for member states to facilitate equitable and affordable access for all and to pool intellectual property for all COVID-19-related medical interventions,under WHO leadership.
The resolution was unanimously accepted by member states, although the U.S. voiced concerns and dissociated itself from waiving intellectual property rights and from a section that guarantees sexual and reproductive health care services during the pandemic.
As a part of our tobacco control work, Vital Strategies’ STOP initiative released an open letter to WHA73 delegates requesting they prioritize the implementation of a tobacco control treaty known as the WHO Framework Convention on Tobacco Control (FCTC). Over 100 organizations and individual tobacco control advocates signed on to the letter highlighting our shared concern that the resolution failed to address the serious challenges posed by the tobacco industry during the crisis.
4. Spotlight: Africa CDC
More a player than ever, Africa Centres for Disease Control and Prevention was singled out repeatedly by delegates, within the continent and beyond, for its contributions toward helping contain the pandemic in Africa and for its welcome understanding of the complex context and the toll public health and social measures, such as physical distancing and stay-at-home orders, impose on countries that are fragile politically and economically. Having played a critical role in managing the Ebola outbreak, they have a running start not only on how to reduce the new virus’ spread but on what an empathetic response would need to be.
Vital Strategies, through its Resolve to Save Lives initiative, has collaborated closely with Africa CDC, WHO and other partners on a report titled “Responding to COVID-19 in Africa: Using Data to Find a Balance.”The report provides critical data and guidance to adapt the COVID-19 response to local needs and capacities in Africa.
5. Leaving Nothing Behind: Health Challenges Remain
“We cannot and we should not return to normal. We have to turn everything around and there has never been a better time in history to strengthen our efforts in order to ensure better nutrition and to include environmental health as an indivisible determinant of human health and to include it permanently in our agendas as part of the Sustainable Development agenda.” – Secretary of State for Health from Mexico, Dr. Jorge Alcocer Varela.
While the meeting was wholly focused on COVID-19, member states have other large and looming health concerns on their minds, too. Delegates brought much-needed attention to key issues in health that we can’t afford to put aside, including the world’s largest killer, noncommunicable diseases, as well as maternal and child health, and immunization programs, something the United Kingdom called our best defense against disease.
Norway and Mexico weighed in on chronic disease and the vulnerability of those with noncommunicable disease conditions, as well as environmental concerns, food security, and likely setbacks to long and hard-fought battles to reduce hunger.
New Zealand, successful in its containment of COVID-19, argued that addressing COVID-19 means focusing on older people and protecting all vulnerable populations, and noted that a vaccine won’t be much use if it’s not equitably distributed.
Norway agreed and committed US$1 billion to GAVI, a public-private global health partnership with the goal of increasing access to immunization in poor countries. Japan committed US$76 million. Contributions also came from Italy, Spain, Ireland and Finland for vaccine development and deployment.