The 77th general assembly of the United Nations (UNGA77) recently ended in New York. While the agenda was packed as per usual, topics on global health threats like the COVID-19 pandemic noticeably took a back seat. This highlights the prevailing shift by governments globally to turn the page on the pandemic while it is still ongoing. Thanks to vaccines and new treatments, COVID-19 is a much different threat in 2022 than when it first emerged in 2019. However, the scale of its impact on almost every aspect of population health worldwide is undeniable, ongoing and will reverberate for many years to come.
In this context I moderated a virtual event at the Science Summit at the General Assembly about meeting the Sustainable Development Goals (SDGs) through inclusive research and development (R&D) and equitable access. You can see the entire meeting here, which was co-organized by the Drugs for Neglected Diseases initiative (DNDi), MMV, and TB Alliance. You can watch the full session at this link.
Gains on the diagnosis and treatment of HIV are severely threatened, the mortality from Tuberculosis and case numbers are on the rise and childhood immunizations are in peril among other concerning losses in global health. In the eagerness to declare victory and move on, are we missing the opportunity to build on the momentum of the COVID-19 response to improve pandemic preparedness and to draw important lessons to address older disease threats that existed before the pandemic?
The COVID-19 pandemic showed us how transformative political will and investing in research and development (R&D) can be. mRNA vaccines for COVID-19 went from bench into arms in just under 12 months. Operation warp speed which made this possible, was bankrolled by the United States government and cost an estimated $18 Billion in investment . It is estimated that COVID-19 vaccines have prevented 14.4 million deaths in 185 countries and territories.The inequities in access to vaccines and therapeutics in low- and middle-income countries limited the impact in these settings and cast a shadow on this triumph.
It is important to pair investments in research and development (R&D) for addressing global health threats with investments aimed at ensuring equitable and sustainable implementation and access for populations everywhere. To achieve the third sustainable development goal of health for all will require much more that reactive responses in a time of crisis. The satellite event of the UNGA77, the UN Science summit brought together key actors in the global health space to reflect on the challenges of attaining these goals. So, what will it take to disrupt the status quo, to restore the gains lost during the pandemic and to ensure that future approaches draw important lessons from past mistakes? Three key areas were highlighted:
Strengthening the funding landscape and keeping funders engaged
With the world-facing many colliding global health challenges as well as geopolitical crises across many regions, it is increasingly difficult to keep diseases of poverty and neglected on the political agenda. Global health actors must continuously engage with police makers and funding agencies to emphasize what is gained through investing in tackling disease. For example investing in emerging disease surveillance could avert future outbreaks which may affect a larger population and have a cascade of consequences well beyond the public health sector. This can be done by highlighting success stories where investments are creating a positive impact and modelling the projected effects of sustained funding on reducing the burden of disease.
Engaging community activists and incorporating their feedback into implementation strategies and planning
The biggest successes in tackling diseases of poverty and neglect happen when the most impacted communities are engaged in developing and implementing the solutions to tackle the issues that affect them. Without paying attention and providing a seat at the table to members of the community a lot of the approaches are likely to be unsuccessful. This requires building trust within communities, recognizing the power dynamic that exist between researchers and the communities they serve and why that could be harmful and learning to incorporate important feedback from the communities when these conversations are initiated.
Developing a system for measuring and reporting results
Reporting on what gets done and gaining a better understanding on what needs to be measured to ensure science is sufficiently funded and optimally used to deliver health for all is an area that continues to struggle. Without adequately measuring the impact of investments in R&D in global public health it is challenging to have a clear picture of what areas need strengthening. Developing transparent systems for reporting will also serve as a tool for keeping funders engaged as well as motivation to actors working in this space where often progress may seem slow.
Neglected diseases and emerging infections remain are among the biggest threats we continue to face. Just in the last year we have seen the re-emergence and global spread of monkeypox, a long neglected zoonotic virus infection; Polio is making a resurgence in places where it was previously eliminated, and several African countries have had to deal with outbreak of deadly hemorrhagic fevers. This should serve as a clarion call for global solidarity to proactively address these threats and make the necessary investments to find solutions and ensure their equitable access to communities globally.
Written by Boghuma K. Titanji
