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Reform or Revolution in Global Health?

A treaty focused on pandemic preparedness and response, like that being championed by world leaders today, could improve global health security. But the COVID-19 crisis exposed more than just our lack of preparedness; it also highlighted the extent – and consequences – of systemic health inequities.

CAPE TOWN/RIO DE JANEIRO/BRUSSELS – The World Health Organization’s governing body of health ministers has responded to a call from dozens of world leaders for a new international treaty for pandemic preparedness and response, and will hold a special session in November devoted to such a treaty. It is a positive step. But the global response to COVID-19, and adequate preparation for future pandemics, requires much more.

As the COVID-19 crisis has shown, the current global health infrastructure is simply not up to the task of managing – let alone preventing – a pandemic. But the pandemic has also shown that we must not focus only on infectious-disease outbreaks. We must also respond to the pandemic of inequity that the crisis has highlighted.

Every year, more than 16 million people in low- and middle-income countries die from preventable causes. The vast majority are relatively poor, have limited access to education, are marginalized, or live in low-income countries. In other words, as the WHO’s Commission on Social Determinants of Health pointed out more than a dozen years ago, “Social injustice is killing people on a grand scale.”

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