Leaving no one behind in the wake of COVID-19

In the global response to the COVID-19 pandemic, we saw unparalleled collaboration between academia, government, industry and regulators. The result was billions of vaccine doses developed and supplied to help protect the world from the devastating impact of the virus.

Yet more than two years later, despite a plentiful supply of vaccines, equitable access remains a pressing challenge in many parts of the world. And while COVID-19 vaccines have undoubtedly helped to save millions of lives, for some people – such as the immunocompromised – immunisation alone does not offer adequate protection from the disease.

While the fight against COVID-19 is not over, we must take lessons from this to help the world respond even better to future pandemics. To ensure no one is left behind, we must act without delay and foster healthcare systems that are sustainable, resilient and capable of administering large-scale vaccination programmes and other measures to protect people.

Our world responded to this pandemic with a truly global effort – developing multiple, effective vaccines at record speed. At the time of writing, more than 11.6 billion vaccine doses have been administered globally.

At AstraZeneca, we made broad and equitable access to our vaccine a key principle of our response to the pandemic. As part of this principle, we are proud to have been the first manufacturer to join the COVAX facility, an initiative established by CEPI, Gavi, WHO, and UNICEF at the start of the pandemic working for global equitable access to COVID-19 vaccines.

Yet, while some countries are seemingly emerging from the pandemic, many parts of the world remain unprotected because of low vaccination rates, especially in low-income countries. Although supply has been a limiting factor in the past, the greater issue is now one of distribution. The impact of this is felt particularly hard in Africa, where only 17% of the population was reported to be fully vaccinated as of May 2022.

The global community now needs to shift our efforts and support countries to successfully deliver the vaccines they receive – especially for the crucial last-mile delivery. Many countries need help to establish reliable cold chain capacity, build more robust data systems, tackle vaccine hesitancy and address gaps in local workforces.

While vaccines remain our strongest first-line defence, we must also support the two per cent of the global population who are immunocompromised and for whom vaccines may not offer adequate protection.

More than 40% of those hospitalised with breakthrough infections despite a previous vaccination are immunocompromised; they are not adequately protected by a vaccine alone and are at high risk of becoming seriously ill if they were to become infected. The continued threat posed by potential exposure to COVID-19 means they are enduring prolonged anxiety and suffering that affects their quality of life. For many of these people, there is no end to the pandemic in sight.

For this reason, alongside the measures described earlier, it's important that methods to support immunocompromised patients are also strengthened. This includes communicating specific information about the safety measures that should be maintained by this community, including continued mask-wearing, access to free COVID-19 testing, access to additional therapeutic options and providing advice and support for continued self-isolation.

Governments and health leaders must act now to address the unmet needs of immunocompromised people.

Beyond COVID-19, our world will face both new and unresolved healthcare challenges. A survey of 134 countries showed that the pandemic significantly impacted healthcare delivery, with chronic care and other services severely compromised in at least 44% of the countries studied. Solutions to these issues require all of us to think differently.

That’s why we must continue efforts that accelerate clinical trials and regulatory approvals to allow the global health community to respond to the next pandemic with even greater efficiency. By further accelerating and harmonising these processes we can develop life-saving products, such as vaccines, even quicker. In doing so, we will help to minimise systemic disruption to other essential health services and support CEPI’s 100-Days Mission – an ambition to develop a vaccine against emerging diseases in as little as 100 days.

Importantly, if we truly want to avoid a repeat of human suffering on the scale seen during the COVID-19 pandemic, we now must face the bigger task of building resilient and sustainable health systems equipped for future crises. We have to develop strategies that support timely diagnosis and care in the face of disruption, and fund healthcare systems that allow for stable and effective workforce planning even as they have to grow in line with population demand.

Public-private partnerships, brought to the fore during the pandemic, will be central to achieving this. A partnership-driven approach that considers lessons learned from the COVID-19 pandemic, such as the Partnership for Health System Sustainability and Resilience (PHSSR), can help to strengthen global health system resilience. Ongoing cross-sector action will be essential if we want to ensure health systems can better withstand future crises.

I’m optimistic that the lessons we’ve learned during the pandemic will help us fight the next one more effectively – ensuring greater global health equity, protecting vulnerable populations and creating a fairer and healthier future. And let’s be clear: we must not fail, because we all have a pledge to fulfil – that no one is left behind.