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“Health is a human right”: How the world can make up progress lost to COVID
The state of public health in the developing world bears some deep scars from the COVID-19 pandemic. Over the past three years, immunization rates have dropped to levels not seen in three decades. 2 billion people are facing "catastrophic or impoverishing" health spending worldwide according to the World Health Organization. And governments in the Global South are taking on more and more debt at the expense of investment in health and social services.
Kate Dodson, the Vice President of Global Health Strategy at the UN Foundation, is on the frontlines of the fight to give the most vulnerable people in the world access to proper healthcare. She works to connect experts and innovators with the UN, and find resources to support their work.
She’s calling on governments to invest in basic elements of public health, including primary care access, and properly remunerating healthcare workers — the majority of whom are women, worldwide. And more fundamentally, she wants leaders to treat health as a human right that all deserve to enjoy.
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Former Brazilian President Jair Bolsonaro leaves his home following a search operation in Brasilia.
Bolsonaro’s home raided over alleged COVID vax fraud
Bolsonaro has long maintained that he never got the shot, which he once said could turn people into crocodiles. But late last year, his official status was reportedly changed to “vaccinated,” possibly to facilitate entry to the US, where he spent a few months in South Florida licking his wounds, eating KFC, and hanging with the Trumps after narrowly losing his reelection bid to left-wing nemesis Lula.
Bolsonaro has denied any wrongdoing, but vaccine records seem like a mere foot fault compared to some of the other legal troubles stalking the right-wing firebrand. He’s facing separate probes over allegedly inciting the Jan. 8 riots in Brasilia, illegally profiting by selling jewels gifted to him by Saudi Arabia, and potentially violating the law by seeking to undermine the credibility of the country’s electoral systems last year.
We’re waiting to see what charges are ultimately leveled at Bolsonaro, and we remind you that although he is out of power, his party controls the largest number of seats in Parliament. He’s also the face of the opposition in a deeply polarized country.
What’s next for the WHO?
As the World Health Organization celebrates its 75th anniversary on April 7, it is preparing to put the COVID-19 pandemic behind it by declaring an end to the public health emergency sometime later this year. Yet it won’t be easy for the UN agency to rehabilitate its reputation after the criticism received for its handling of the world’s worst health crisis in 100 years.
We asked Eurasia Group public health expert Laura Yasaitis to provide some perspective on the WHO’s long history and where it goes after COVID.
As it turns 75, what are the WHO's main accomplishments?
Probably the most outstanding was the complete eradication of smallpox, a remarkable example of international coordination to achieve a public health goal. WHO officials worked with countries to encourage widespread vaccination, as well as donations of the vaccine, and the US and the Soviet Union were both major donors. WHO consultants were dispatched around the world to identify and respond to outbreaks quickly, even in war-torn and poverty-stricken locations such as Somalia, which saw the last natural case in 1977.
The WHO’s efforts to improve childhood vaccination around the globe have also brought about the near eradication of polio, while efforts to prevent and treat malaria have helped dramatically reduce the range of the disease and improve outcomes for those infected.
And failures?
As the organization has grown and taken on an expanded mission, it has become overstretched and overly bureaucratic. These shortcomings were blamed for the slow response to the Ebola outbreak that began in West Africa in 2014 and lasted until 2016.
Yet many of the organization’s perceived failures can be traced to the constraints within which it operates. Only 16% of its budget comes in the form of dues. The rest comes from large donors and is earmarked for specific causes, which means the WHO is limited in pursuing its own priorities. Furthermore, it relies on the goodwill of countries to follow its recommendations; even the legally binding International Health Regulations, which require reporting of specific diseases and public health events, are essentially unenforceable.
What did the WHO do well during the pandemic?
The WHO helped coordinate data sharing among countries, providing invaluable information that helped experts to track and better understand the novel virus. Without a central source of trusted scientific information, it may have taken the world far longer to understand what it was up against. The WHO also co-led COVAX, which aimed to equitably distribute COVID vaccines to all countries, rich or poor. While the group fell far short of this goal – largely because wealthy nations hoarded the initial production of most vaccines – the framework it established may provide a model for future pandemics.
What did it not do so well?
The WHO has been faulted – including by an independent committee it established to review its response – for waiting an extra week before declaring a Public Health Emergency of International Concern, the highest level of emergency. Much of the delay was attributed to its regulations on reporting of public health incidents, which forced slow consideration of the data. These regulations also recommend against declarations that could hurt a country’s economic activity. Furthermore, the organization’s messaging – it does not officially define the term “pandemic” and didn’t use the term until two months after a PHEIC was declared – was faulted for its lack of urgency. That may have contributed to inconsistent and ineffective responses at the national level.
What about its relationship with China?
The WHO was accused of unwarranted deference to China early in the pandemic, both in delaying its PHEIC declaration, and in the public praise lavished on the country for its initial response. The most prominent criticism came from Donald Trump, who in July 2020 declared that the US would withdraw from the organization (though US President Joe Biden reversed the decision when he took office). The WHO-China relationship soured somewhat after the first phase of an investigation into the virus’s origins, which included the lab leak theory, even if “extremely unlikely”; China vehemently opposed any mention of the possibility. Then, earlier this year, China refused to release data revealing the scale of a massive outbreak, despite its legally binding commitments to do so. Yet WHO officials praised the limited releases of data, and largely avoided criticizing the country despite what international experts asserted were highly inaccurate official infection and mortality rates.
Will we ever know where the virus came from?
At this point, it’s unlikely, at least with enough certainty to convince the vast majority of skeptics given that the science has become highly politicized. China has stonewalled further WHO-led investigations after the lab-leak theory was included in the phase one report, forcing the WHO to quietly abandon plans for additional study. Other independent research continues; for example, data released last month supported animal-human transmission as the original source. However, given the length of time that has passed, and the many people who have made up their minds on both sides, it’s far more likely that the issue will continue to be a political football.
In light of all this, how is the WHO reforming itself?
There have been many calls for reforming the WHO and its powers to grant it more authority to investigate and respond to disease outbreaks. However, given the importance of assuring member states’ sovereignty, and the political and economic implications of being named the source of a major disease outbreak, establishing an independent, powerful, WHO remains an uphill battle. Nonetheless, some reforms are being pursued that will allow increased independence. It was recently announced that sources of the organization’s funding would shift over time to be at least 50% comprised of membership dues by 2030-2031.
What is the WHO doing to ensure it's better prepared for the next pandemic?
The WHO is trying to learn from the mistakes of the past few years. The most ambitious effort may come in the form of a new legally binding pandemic prevention, preparedness, and response treaty. A draft presented in February lays out a framework to ensure equitable distribution of vaccines and treatments and provide incentives for poor countries to participate in the data sharing that is needed. However, a big question is whether the provisions will be backed by adequate enforcement mechanisms. The WHO’s authority and credibility has been badly damaged by the pandemic, a situation that will need to be rectified if it is to lead a global health response to the next pandemic.
Edited by Jonathan House, Senior Editor, Eurasia Group.
An elderly woman walks past a poster encouraging seniors to get vaccinated against COVID in Beijing.
What We’re Watching: Beijing vax mandate, DRC-Rwanda tensions
Beijing gets China's first COVID vax mandate
Somewhat late to the party compared to many parts of the world, China introduced on Wednesday its first COVID vaccine mandate in Beijing. Starting next week, residents of the capital will need to show proof of vax to enter most public spaces as authorities scramble to contain a new outbreak of a more infectious omicron subvariant. Oddly enough for an authoritarian state, China shunned mandates early in the pandemic because most people agreed to get vaxxed on their own, which helped keep the virus under control until late 2021. While nearly 90% of the population is fully vaccinated, inoculation rates among the elderly — those most vulnerable to becoming seriously ill or dying from COVID — are lower because many older Chinese adults are wary of getting jabs. What's more, China's vaccines are not as effective as Western mRNA jabs against new variants, so perhaps the goal of Beijing's mandate is to keep the unvaccinated elderly at home without implementing a citywide lockdown like in Shanghai. How will this affect Xi Jinping's zero-COVID policy? If major outbreaks are reported, expect other big Chinese cities to follow Beijing's lead.
DRC & Rwanda go head to head
This week, the Democratic Republic of the Congo President Félix Tshisekedi and his Rwandan counterpart, Paul Kagame, are meeting to discuss rising tensions along their shared border. In the eastern DRC, which borders both Rwanda and the Uganda, the M23 — a DRC rebel group claiming to defend DRC ethnic tutsis that wreaked havoc in the region in 2012 — has gained ground. Things heated up when the DRC recently blamed Rwanda for supporting the M23, which Rwanda denies. But conflict has been a constant in the region since the Rwandan genocide of 1994. Since then, the area has seen two wars, violence by more than 100 militant groups, peacekeeping missions, and humanitarian crises. Still, the eastern DRC remains one of the richest areas in the world for minerals used in technology, so it’s an area ripe for investment — and targeting. In April, the DRC tied itself to the economic interests of other countries in the region by joining the East African Community, which includes both Rwanda and Uganda. We'll keep an eye on how this messy situation plays out as the DRC and Rwandan leaders talk through their issues.Podcast: How we overcome infectious disease with a public health renaissance
Listen: Former CDC chief Tom Frieden says he's stunned by how infectious COVID is compared to other diseases. The pandemic isn't over yet, he tells Ian Bremmer on the GZERO World podcast, thanks to long COVID plus the fact that we can't predict how the virus will play out in the future. Frieden's advice for everyone is to get vaxxed and boosted, to "keep yourself out of the hospital and, quite frankly, out of the morgue," since new variants could emerge, making the virus more deadly.
He also shares his thoughts on why China needs to transition to "almost" zero-COVID, the post-pandemic need to invest more in public health, and whether we should worry about monkeypox. Until we put more money toward research, he adds, we won't be able to control infectious diseases — rather, they will continue to control us.
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Ian Bremmer: Zero COVID no longer works, and China will pay a price
For Ian Bremmer, China has the strongest political governance of any major economy today. Sometime that's good, and has allowed China to become the world's second largest economy.
But there's also a downside we're going to see this year, Bremmer said during a livestream conversation to launch Eurasia Group's annual Top Risks report. China's zero-COVID policy, which worked incredibly well in 2020 to respond to the pandemic, no longer works because the virus has changed.
However, Xi Jinping is so invested in his strategy that he'll likely double down on it in 2022 — at the expense of more shutdowns and closures in global supply chains. Xi himself has not left the country since January 2020 — hampering China's own diplomatic ability.
"China cannot move towards living with the virus" until it has its own mRNA vaccines — and that means it'll be a very tough year for the country, and its leader.
Watch the full discussion on Top Risks 2022.
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A cow, a prostitute, a nose ring: The best vax incentives of 2021
If you were a little hesitant about getting the COVID vaccine, what would it take to change your mind? Cash? Free beer? Tickets to the big game? Doughnuts? A car? A lifetime fishing license? Or is all of that too tame to get you to roll up your sleeve?
Throughout 2021, governments and companies around the world tried all kinds of crazy incentives to get people jabbed. Here are five that we loved — one of which is made up. Can you spot the fake?
Bakas for Vaccines. In the Philippine town of San Luis, the vaccinated are entered in a monthly raffle to win a cow (a “Baka” in Tagalog), delivered to the winner’s door by the mayor himself. Each jab counts as an entry, so the double-vaxxed have twice as big a shot at winning. Still, despite this bovine bonus, the Philippines has one of the lowest vaccination rates in Southeast Asia, at just 44 percent.
Nose ring and a hand-blender anyone? Goldsmiths in the Indian city of Rajkot, in the state of Gujarat, banded together to open a vaccination site that offered free gold nose pins for women who get the jab. The prize for men was a free hand blender! Among the most populous Indian states, Gujarat has the second highest rate of full vaccination, at 86 percent.
Joints for jabs. Back in June, the US state of Washington offered free, pre-rolled marijuana joints to anyone 21 and older who could prove they’d received at least one jab. Washington was the first US state to legalize cannabis, back in 2012, and it ranks an impressive tenth overall in vaccination rates in the US, with 68 percent. But they could surely roll up some more spliffs to get that number even higher.
Rum punches COVID in the face. The Galleon rum distillery in Curaçao is giving out free shots of their stuff to anyone who gets the jab — but that’s just an aperitif. Everyone also enters a raffle where the grand prize is to snorkel for 15 minutes through a gigantic vat that’s filled with Galleon rum and outfitted with an LED-lit “shipwreck” — a replica of one of the famous, treasure-laden galleons that sunk off the nearby Venezuelan coast in the 17th century, giving the distillery its name. If you can survive that, then COVID doesn’t stand a chance — vaxxed or not.
Coitus against COVID. A Viennese brothel is using the world’s oldest profession to encourage uptake of the world’s newest vaccine. The women of Fun Palast (Fun Palace) offer a free 30-minute fling to anyone who gets vaccinated on site. Carnal encouragements notwithstanding, Austria still has one of Western Europe’s lowest vaccination rates.
Subscribers to our daily newsletter,Signal,learnedthe bogus one, as did our Instagram followers. Swipe through here to see if you correctly identified the fake!
Podcast: COVID Vaccine in Record Time - What Now? Moderna Co-Founder Noubar Afeyan
Listen: The pandemic's US death toll shows no signs of abating and the holiday season's spike will likely dwarf any surge that came before it. But in the midst of this dark winter there are glimmers of hope, as the first of the COVID-19 vaccines have nearly arrived (or, depending on when you read this, already have). On the GZERO World podcast, Ian Bremmer interviews Noubar Afeyan, the co-founder of a leading vaccine developer Moderna. They'll discuss distribution plans, the revolutionary science behind Moderna's vaccine, and how a company younger than Twitter became a frontrunner in the race to end the pandemic.
Subscribe to the GZERO World Podcast on Apple Podcasts, Spotify, Stitcher, or your preferred podcast platform to receive new episodes as soon as they're published.