Editor’s update, June 17, 2021: At the G7 summit, member countries committed to sharing at least 870 million COVID-19 vaccine doses over the next year. While this pledge is welcome, it falls short of the 1 billion target touted in the lead-up to the summit and only a small fraction of the 11 billion doses still needed to vaccinate 70 percent of the global population. Additionally, no new financial commitments were made to the Access to COVID-19 Tools Accelerator, which is facing a US$18.1 billion funding gap. In a positive directional step, leaders promised to “explore options for building consensus this year, around sustainable global health and health security financing,” and affirmed that they “support efforts to accelerate manufacturing capacities of COVID-19 tools on all continents…and in particular will strive to support African efforts to establish regional manufacturing hubs.” However, there was no clear guidance on how the G7 will transform these high-level pledges into concrete action. Overall, member states affirmed the sustained importance of research and development for COVID-19, promising “to continue our investment in cutting edge research and innovation,” expand genomic sequencing and sharing, and build upon existing innovation and collaboration.
This weekend, leaders from the G7 will come together in Cornwall, England, for the first in-person summit of this group in two years, after last year’s meeting was cancelled and high-profile geopolitical rows caused much acrimony at previous convenings. Leaders are seeking to revive multilateralism and highlight that this forum can still play a significant role in shaping and responding to major world events. Their most urgent task will be to tackle the global pandemic and particularly address the unequal distribution of COVID-19 tools, as well as start to build additional long-term infrastructure and capacities both regionally and globally to prevent future health outbreaks. Greater coordination around innovation and greater investment in research and development (R&D) capacities as part of health system strengthening and pandemic preparedness should play a crucial role in these discussions, and G7 leaders must seize the moment to take bold action and reimagine the future of global health security.
G7 leaders take first steps to create improvements to the global health security architecture
Last week, health ministers already took several steps toward scientific collaboration to address current and future health threats by making concrete pledges in their G7 Health Ministers’ Declaration. This included adopting a new therapeutics and vaccines clinical trials charter, which sets out shared principles to accelerate the speed with which clinical trials generate robust evidence and lead to quicker adoption of new tools in this and future pandemics. This charter will strengthen collaboration in large-scale international trials and enable greater diversity of participants, including pregnant people and children.
Health ministers also agreed to develop a shared set of principles that could incentivize the development of and access to both novel and existing antimicrobial products and ensure a sustainable antimicrobial R&D ecosystem, including resilient and diverse supply chains and greater manufacturing capacity. They also underscored the important contributions of several initiatives and organizations, including the Global Antibiotic Research and Development Partnership as well as Global AMR R&D Hub, which push for accelerating the development of novel technologies to fight antimicrobial resistance.
Scientific capabilities, including pathogen genomics, also have a vital part to play in surveillance and development of new tools, and leaders also sought to create platforms to enable greater collaboration through the United Kingdom’s New Variant Assessment Platform, as part of a focused global effort to strengthen surveillance of potential COVID-19 variants of concern and potential future priority pathogens.
While these decisions represent progress and are welcome steps in the right direction, with the pandemic still raging in much of the world, both immediate COVID-19 needs and larger reform efforts will have to be addressed simultaneously during the Leaders’ Summit.
The time for bold action is now
Global leaders must take immediate decisive action to fully fund the Access to COVID-19 Tools Accelerator (ACT-A) and fill urgent gaps for all aspects of the current global framework, including the diagnostics and therapeutics pillars. This means G7 leaders should pledge 60 percent of the US$19 billion required for ACT-A in 2021 during this weekend’s summit. This would ensure that organizations like the Coalition for Epidemic Preparedness Innovations are properly resourced to advance R&D, ensuring that vaccines are keeping up with variants and that diagnostics and other medical countermeasures are not neglected as part of the global response efforts.
Testing, oxygen therapies, and therapeutics are central to combatting the pandemic and must be recognized through continued investment. This is especially relevant given that fewer than one in five health facilities across Africa had access to COVID-19 tests in 2020. To address these imbalances, further innovation is needed to ensure appropriate, high-quality rapid tests and other health tools are affordable and available everywhere. Donor countries must scale up the production of tests, treatments, and health commodities, including oxygen, and accelerate low- and middle-income country (LMIC)-led R&D to ensure greater equitable access globally.
Many advocates are also expecting G7 leaders to finally deliver on vaccine sharing, release more vaccine doses to COVAX, and commit to a clear strategy for global vaccination. While the politics of prioritizing their own domestic populations represents a continuing factor for global leaders, especially with G7 countries not having reached herd immunity at home, there are clear epidemiological and ethical imperatives to accelerate the pace of vaccine shipments abroad. The Biden administration did take a major first step with the announcement that the US government will purchase 500 million doses for LMICs, with 200 million doses being shared by the end of this year. Now other donor nations must follow suit and raise their ambition at this forum and scale up their own dose sharing pledges and allocation strategies. G7 leaders should pledge 2 billion doses at the Leaders’ Summit, delivering 1 billion by the end of August and the second billion by the end of 2021, and as part of this delivery, ensure that 250 million additional people in LMICs have actually received their doses by the end of August in parallel with national vaccine rollout plans.
Laying the groundwork for future pandemic response frameworks
We have seen during this pandemic how essential scientific collaboration has been, and how investment in R&D spurred unprecedented innovation of new vaccines and other health technologies in record time. These successes continue to be hampered by a lack of equitable access, unpredictable and insufficient funding, and a lack of clear coordination frameworks. G7 leaders have an opportunity this weekend to also start to outline a road map for the future and make concrete commitments to reform efforts for the pandemic preparedness ecosystem. This includes leveraging existing multilateral institution resources in new ways, unlocking sustainable financing for global health innovation by making R&D investments eligible for financing from the World Bank and other international financial institutions, and creating new financial mechanisms for pandemic preparedness. This new capital would support LMICs in securing new resources to strengthen their research, laboratory, surveillance, and manufacturing capabilities, and ensure that all countries have pathways to gain access to the innovations and health technologies they need to respond to health outbreaks.
The pandemic has elevated and highlighted the importance of science, the power of partnerships, and the necessity of investing in R&D to ensure that countries are equipped with the vital tools to respond to major health outbreaks. G7 leaders must now ensure that the pressing challenge of global equity is addressed and use the political momentum to create the kind of game-changing reforms that enshrine greater scientific coordination and clear preparedness structures that allow for a more equitable and comprehensive global response to future health threats. This summit is a test for G7 leaders, especially for the United Kingdom as host, as the group must come together to ensure that any new commitments to strengthening the health security architecture do not come at the expense of decades of investments in other health R&D areas.