Google any list of the most successful public health interventions of this century or the last, and vaccines will be at the very top. Infectious diseases such as smallpox, measles, diphtheria and pertussis (whooping cough) were once prevalent and killed indiscriminately. Smallpox is now eradicated, polio is on its way out, and measles, diphtheria, pertussis and a wide range of other preventable diseases have been decimated in places where proven vaccines are both affordable and accessible.
Enter Covid-19, which has skyrocketed vaccines to the top of the global agenda. Right now, we don’t know how to beat this “novel” virus that is cutting its swath through human populations for the first time in history. What we do know is that our best chance lies with the discovery of a vaccine. Every day brings a sliver of news – about a vaccine candidate that shows some promise in animal testing or one that could advance to human trials – and the world waits with bated breath in urgent hope that scientists and researchers will make the breakthrough that can save all of us from this disease that is devastating our communities and economies.
It almost seems too much to hope for. Except that we have done it before.
Under the leadership of the World Health Organization, smallpox, which is estimated to have killed 300 million people in the 20th century alone, became the world’s first eradicated disease – entirely through vaccination, combined with robust surveillance, community engagement and global coordination. We are on the cusp of eradicating polio – an achievable goal that will not only fulfil a moral obligation to the world’s most vulnerable, but reap cumulative savings of $14bn by 2050 if we finish the job. Vaccines have contributed to cutting child and maternal mortality virtually in half since the year 2000 (53% and 44%, respectively) – mostly due to huge expansions in access to immunisation. Vaccines have been an uncategorical success, and millions upon millions of people are alive today because of them.
This week, the UK government will convene key partners and countries from around the world at the Global Vaccine Summit. This gathering represents a critical moment to advance collective solutions for Covid-19-related vaccines and to redouble collective commitment and resources to the essential work of routine immunisation for other preventable diseases. During the summit and over the coming months, the following four issues should be kept foremost in mind.
First, vaccines work impressively well, but their gains can be reversed without sustained commitment. Even before Covid-19, the world was seeing a worrying resurgence of measles after being on a path towards elimination and saving more than 21 million lives in the last two decades alone. After Covid-19, measles now may come roaring back, with more than 117 million children in 37 countries at risk of missing planned vaccines this year, according to the Measles & Rubella Initiative. Similarly, wild poliovirus, which was present in only two remaining countries before Covid-19 began, may once again challenge us despite decades of hard-won progress. Indeed, one of the tragic, lesser told consequences of the pandemic is the interruption to immunisations that could leave millions of children at risk of disease and death from vaccine-preventable diseases.
Second, simply developing a vaccine for Covid-19 won’t be enough unless it is widely and globally accessible. We need to embrace the unprecedented scale of partnership between governments, business, international organisations such as the UN and WHO, non-profits, and scientists and researchers, that is necessary to tackle the access and equity challenge seriously. These types of partnerships are possible and have helped save lives at scale before – from the Global Polio Eradication Initiative to the Global Fund, Coalition for Epidemic Preparedness Innovations, and Gavi, the Vaccine Alliance. The recent launch of the Access to Covid-19 Tools (ACT) Accelerator, globally coordinated by the WHO, is an important step that will help harness the power of global partnerships to accelerate equitable development of Covid-19 diagnostics, treatments and vaccines.
We also need to take whatever ambition we muster for Covid-19 and extend it to other diseases and vulnerable populations. Whether these are families facing cholera in Somalia due to increased flooding, refugees in Cox’s Bazar, Bangladesh, at risk of diphtheria, or thousands of children vulnerable to growing measles outbreaks in the Democratic Republic of the Congo.
Third, we must make smarter choices about how we emerge from this crisis and rebuild better health systems. The window for action is short and diminishing by the day. As countries begin to transition out of lockdown, immunisation campaigns that were paused because of Covid-19 are likely to restart. This is a crucial period during which we can strengthen and rebuild the delivery systems necessary to distribute vaccines – from those that are currently available such as measles and polio, to those we hope are still to come.
Finally, leaders gathering virtually at the Global Vaccine Summit on Thursday 4 June need to show bracing ambition in pledging new funds for Gavi, the Vaccine Alliance. At the UN Foundation, we are focused on finding innovative solutions to tackle collective challenges. Gavi, a unique public-private partnership between governments, key UN agencies, the vaccine industry, private sector and civil society, is a model of what works. It has been responsible for some of the most breathtaking health gains of the last generation – accelerating access to new vaccines and increasing immunisations in poor countries. Gavi has set a goal of at least $7.4 bn that is needed to save a staggering 7-8 million lives – overwhelmingly children under five – in the next few years alone. Some countries have already stepped up, including the UK, Norway, Canada, Spain, Italy, Ireland, New Zealand and Japan. Others need to follow.
Now more than ever, we need world leaders to step up. By showing generous support of Gavi, they can demonstrate the collective values and leadership we need to secure a healthy future. Now is the time to double down on vaccines. Doing so will aid us in the collective fight against Covid-19, as well as our broader fight to make sure that every child, regardless of where they live, has the ability to grow up healthy and realise their fullest potential.
Gro Harlem Brundtland is former director-general of the World Health Organization and former prime minister of Norway
Elizabeth Cousens is president of the UN Foundation