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1.
SSRN; 2022.
Preprint in English | SSRN | ID: ppcovidwho-336309

ABSTRACT

In response to the COVID-19 pandemic, a suite of international initiatives has been developed to strengthen and reform the global architecture for pandemic preparedness and response (PPR), including proposals for a pandemic treaty, financial intermediary fund, and mechanisms for equitable access to medical countermeasures, among others. These proposed initiatives seek to draw upon critical lessons gleaned from the ongoing crisis by addressing gaps in health security and traditional public health functions. However, to date, there is insufficient consideration of the vital role of universal health coverage and robust primary health care in sustainably, equitably, and efficiently safeguarding health systems from future public health threats. The international community must not repeat the mistakes of past health security efforts that ultimately fueled the COVID-19 catastrophe – in particular, by overlooking the importance of coherent, multisectoral health systems. This paper outlines major (though often neglected) gaps in PPR, and identifies opportunities to reconceptualize health security by scaling up universal health coverage. We then propose a comprehensive set of recommendations to help inform the development of key PPR mechanisms across three themes – legal governance, financing mechanisms, and supporting initiatives. By synthesizing approaches that simultaneously strengthen global health architecture for both health security and universal health coverage, we aim to provide tangible solutions that equitably meet the needs of all communities while ensuring resilience to future pandemic threats.

2.
Lancet ; 398(10316): 2109-2124, 2021 12 04.
Article in English | MEDLINE | ID: covidwho-1598178

ABSTRACT

Understanding the spread of SARS-CoV-2, how and when evidence emerged, and the timing of local, national, regional, and global responses is essential to establish how an outbreak became a pandemic and to prepare for future health threats. With that aim, the Independent Panel for Pandemic Preparedness and Response has developed a chronology of events, actions, and recommendations, from December, 2019, when the first cases of COVID-19 were identified in China, to the end of March, 2020, by which time the outbreak had spread extensively worldwide and had been characterised as a pandemic. Datapoints are based on two literature reviews, WHO documents and correspondence, submissions to the Panel, and an expert verification process. The retrospective analysis of the chronology shows a dedicated initial response by WHO and some national governments, but also aspects of the response that could have been quicker, including outbreak notifications under the International Health Regulations (IHR), presumption and confirmation of human-to-human transmission of SARS-CoV-2, declaration of a Public Health Emergency of International Concern, and, most importantly, the public health response of many national governments. The chronology also shows that some countries, largely those with previous experience with similar outbreaks, reacted quickly, even ahead of WHO alerts, and were more successful in initially containing the virus. Mapping actions against IHR obligations, the chronology shows where efficiency and accountability could be improved at local, national, and international levels to more quickly alert and contain health threats in the future. In particular, these improvements include necessary reforms to international law and governance for pandemic preparedness and response, including the IHR and a potential framework convention on pandemic preparedness and response.


Subject(s)
COVID-19/epidemiology , Pandemics , Animals , COVID-19/transmission , China/epidemiology , Disease Outbreaks , Global Health/legislation & jurisprudence , Humans , Information Dissemination , International Cooperation , International Health Regulations , Risk Assessment , SARS-CoV-2/isolation & purification , Time Factors , World Health Organization , Zoonoses/virology
11.
Nat Med ; 27(6): 964-980, 2021 06.
Article in English | MEDLINE | ID: covidwho-1232071

ABSTRACT

Health systems resilience is key to learning lessons from country responses to crises such as coronavirus disease 2019 (COVID-19). In this perspective, we review COVID-19 responses in 28 countries using a new health systems resilience framework. Through a combination of literature review, national government submissions and interviews with experts, we conducted a comparative analysis of national responses. We report on domains addressing governance and financing, health workforce, medical products and technologies, public health functions, health service delivery and community engagement to prevent and mitigate the spread of COVID-19. We then synthesize four salient elements that underlie highly effective national responses and offer recommendations toward strengthening health systems resilience globally.


Subject(s)
COVID-19/epidemiology , Global Health , Pandemics , Public Health , COVID-19/prevention & control , COVID-19/virology , Delivery of Health Care , Government , Government Programs , Humans , SARS-CoV-2/pathogenicity
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