WHO to recommend a global health board to oversee pandemic preparation and response
A World Health Organisation commission is set to recommend the creation of a global health board to oversee the world’s preparation and responsiveness to future pandemics, according to a former UK civil servant who sits on the commission.
The Pan-European Commission on Health and Sustainable Development was convened to analyse countries’ response to the COVID-19 pandemic and recommend reforms and investments to improve the resilience of health and social care systems. Speaking at an event hosted by the London-based think-tank the Institute for Government last week, Sir Suma Chakrabarti said it would make a number of recommendations, with the global health board being its most important.
Global health oversight
Chakrabarti, formerly a UK permanent secretary and president of the European Bank for Reconstruction and Development, said the health board would be created by the G20 and would model the financial stability board created after the global financial crisis of 2008.
“This would identify failure in the provision of global health goods, focus on preparedness and responsiveness to global health crises and marshal support from the international community in terms of mobilising resources,” he said.
Chakrabarti explained that the commission – which is chaired by Professor Mario Monti, a former Italian prime minister – will also suggest the establishment of an international scientific committee on health threats.
This would work along the lines of the UN’s Intergovernmental Panel on Climate Change, according to Chakrabarti. “It would assess existing evidence, create consensus on where action was needed and fill in the gaps of knowledge. Surveillance in health systems has got to be strengthened,” he said.
Alongside other expected recommendations, the commission will press for WHO assessments of health systems to be mandatory in order to identify weak spots and build up global public health capacity ready for the next pandemic. There would also be a push to turn Covax, the WHO body working on the equitable manufacture and distribution of COVID-19 vaccines, into a permanent organisation.
“It is about resourcing too,” explained Chakrabarti. “If you look at what is spent on public health, it really is quite small. We have to make sure funding is available for a more equitable response to pandemics.”
Chakrabarti added that both institutional and financial reform agendas will emerge from the commission “ready for debate”.
Reforming mindsets
The biggest lesson from this pandemic is that COVID-19 is here to stay and “we have to come to terms with that”, said Una O’Brien, former permanent secretary at the UK’s Department for Health.
“The story of the 20th century and into the 21st century is an immense achievement in getting on top of infectious diseases and that has embedded itself so profoundly in our psyche that we find it difficult to get beyond ‘this will be over’,” she said. That mindset has also undermined preparedness, O’Brien added, but “we can’t think like that any more.”
The response to pandemics must change, O’Brien argued. While it is vital to get vaccines out, with only 1.9% of Africa’s population vaccinated, the international community must build the capacity of lower-income countries to respond to future pandemics, she said.
“We can’t rely on the process of turning up, surge and retreat,” she explained. “We have think more deeply and fundamentally about building capacity in health systems across the world.”
The UK’s Wellcome Sanger Institute represents the type of infrastructure that is needed globally, said Gagandeep Kang, professor of microbiology at India’s Christian Medical College. She argued that the institute’s COVID-19 genomics initiative and surveillance work, which traces new variants and transmission, should be rolled out in lower-income countries.
“We need a global agenda to put surveillance where diseases are likely to emerge and build the centres and strengths there,” she said. “Turning the model on its head might be the only way to go.”
Without a step-up in global vaccination and surveillance, COVID-19 could “rage unchecked” leading to many more variants that will be able to evade immunity, she warned. “And we might have to vaccinate the world again, and again and again.”
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