Our past pandemic investments are roadmaps to defeating COVID globally

When the G-20’s health and finance ministers announced the creation of a global panel to fight pandemics last week, it was immediately met with criticism for failing to pledge any new funding to combat the coronavirus still ravaging our world’s poorest countries. There is no doubt that this criticism is justified. 

As we focus on funding, we must also tackle the critical issue of vaccine equity. While there is undoubtedly a moral and public health imperative for equitable global distribution of vaccines, it would be a mistake to think that equity can be achieved by focusing on supply alone. It is crucial that supply be buttressed by essential commitments to meaningful access and uptake of this lifesaving tool. Without these commitments, our global fight will sadly fall devastatingly short.

Much-needed answers to help ensure vaccine equity can be found by taking a hard look at the strengths of existing platforms, networks and systems created to address the challenges caused by AIDS, malaria and tuberculosis in low-income countries. If we are to truly prepare for the future, we must build efficiently on the strong bases already in place and expand and adapt them to meet the needs of COVID-19 and whatever viral nightmares come next.  

Through the capacities created by The President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria over the past two decades, vital investments have been made to enhance low-income country surveillance, monitoring and reporting systems as well as supply chains, laboratory networks and prevention and treatment services. These capacities are key to the ability of countries and communities to detect and respond to COVID-19 and new emerging pathogens and prevent their spread. Similarly, partnership with country leaders to prepare and expand the health workforce has been an invaluable anchor for progress.  

Health infrastructure supported by these investments has already served a critical role in collecting and using data on COVID-19 infections, as well as delivering test kits, personal protective equipment, and laboratory reagents. In addition, it has put infection prevention and control measures in place in thousands of health clinics, while also deploying large numbers of healthcare workers to support vaccine readiness and administration.  

We have learned from the global fight against AIDS that a pill alone is not the same as lifesaving treatment — in the same way that we have seen here in the U.S. that an available vaccine dose alone is not the same as persuading someone to be inoculated and ensuring access to these essential services. These experiences highlight the critical role that community mobilization plays in addressing misinformation, generating demand and ensuring user-friendly access.  Trusted local partners and non-governmental organizations that are “of the community” are vital to promoting vaccine literacy and securing vaccine equity. If people don’t have the knowledge of the deadly risk of COVID-19, the information about the safety, efficacy and urgency of the vaccine and the support they need to access this lifesaving opportunity, they will remain at risk.  

Finally, a financing mechanism is needed to support low-income countries with on-the-ground delivery. The Global Fund was founded to tackle the biggest pandemics in the world, and it should be at the center of pandemic preparedness and response going forward.  The Fund’s core strength is deploying disease-fighting interventions at scale. For over two decades, it has delivered real results while reinforcing underlying health systems. A January study published in The Lancet determined that over a third of Global Fund-supported programming promotes global health security. The Global Fund has strengths needed for effective pandemic preparedness, including partnerships in over 120 low- and middle-income countries; strong accountability and independent oversight mechanisms; inclusive governance structure; and a history of using U.S. investments to leverage contributions from donors outside the U.S. and from partner countries themselves. 

Likewise, PEPFAR has successfully leveraged a whole of government approach bringing together the capacities of seven U.S. agencies while respecting the key strengths of each. The Global Fund and PEPFAR are capable of immediately playing an expanded role in pandemic preparedness, proven by their agile ability to provide support quickly and effectively during the COVID-19 pandemic.

If we want result-oriented, human rights-based pandemic preparedness that is focused on vaccine equity, the Biden administration and Congress would be wise to leverage what we already know works rather than seek to reinvent the wheel. To do otherwise would be at best a missed opportunity and at worst the loss of countless lives.  

Senator Bill Frist was Senate Majority leader from 2003 to 2007.  Ambassador Eric Goosby is a professor of Medicine, UCSF and former U.S. Global AIDS coordinator and U.N. special envoy on Tuberculosis.