The Independent Panel for Pandemic Preparedness and Response (IPPPR) issued a report earlier this week with recommendations on improving global pandemic preparedness. AIDS Healthcare Foundation (AHF), the world’s largest provider of HIV/AIDS care globally, has characterized the report as a restatement of previous well-reasoned but unimplemented attempts at global public health reforms. These most recent suggestions leave the World Health Organization (WHO) to carry on a central role in future pandemic responses despite criticizing its poor performance during COVID-19.
Certain aspects of the IPPPR report are consistent with another recently published study by 21 leading public health thinkers in The Lancet Public Health – "A global public health convention for the 21st century." However, the latter describes the failures of the current global public health system, recommends radical changes at the World Health Assembly (WHA) that go beyond the WHO, and calls for a new global public health architecture.
The IPPPR was convened by WHO Director-General Tedros Adhanom Ghebreyesus in response to a WHA resolution adopted in May 2020. The secretariat for the IPPPR is located at the Geneva Health Campus, a short walk from the WHO headquarters.
"The IPPPR report from Geneva is more of the same ineffective banter. It offers up recommendations, which inexplicably do not fundamentally change the structure of global public health governance that is rooted in the WHA, and by default, the WHO," said AHF President Michael Weinstein. "This report failed because, despite COVID-19 being a global catastrophe, the authors refused to call for a new architecture that demands transparency and accountability and neglected to call out any bad players. Despite the blatant repeated failures of the WHO to respond to outbreaks, they want to give it even more responsibilities and authority to fight pandemics."
"While there might be some similarities between these two reports – all recommendations are not created equal," said Dr. Jorge Saavedra, Executive Director of the AHF Global Public Health Institute at the University of Miami and a contributing author of the Lancet paper. "The nearly two hundred health ministers who make up the WHA represent their respective governments. They elect the WHO director-general and vote to decide what the WHO should or shouldn’t do. No one person should have that many country-level bosses."
Every outbreak is unique, but there are things that can be done to better prepare for them and ensure they do not turn into pandemics. Transparency, accountability, and coordination must be the cornerstone of an effective global public health system that protects all people worldwide. Under the current WHA structure, the WHO has largely failed to implement and maintain these principles while responding to COVID-19 during Dr. Tedros’s tenure.
"The WHA needs radical change to emulate other more efficient, transparent governance models, such as the Board of the Global Fund to Fight AIDS, TB and Malaria—which is much smaller and has regional representation of governments," added Dr. Saavedra. "This Board gives voice and voting power to representatives of other relevant stakeholders from the private sector, civil society and communities affected by the diseases. It also allows for input from technical partners, including the WHO and World Bank, among others."
As health ministers prepare to meet at the WHA at the end of May, countries should consider adopting a new Global Public Health Convention—one that will truly change the structure of global health. Otherwise, the world will continue to repeat the devastating mistakes of the ongoing pandemic.
AIDS Healthcare Foundation (AHF), the largest global AIDS organization, currently provides medical care and/or services to over 1.5 million clients in 45 countries worldwide in the US, Africa, Latin America/Caribbean, the Asia/Pacific Region and Europe. To learn more about AHF, please visit our website: www.aidshealth.org, find us on Facebook: www.facebook.com/aidshealth and follow us on Twitter: @aidshealthcare and Instagram: @aidshealthcare
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