The Lancet Commission on lessons for the future from the COVID-19 pandemic published in the journal on September 14, has issued a set of recommendations for future plans and has also castigated the World Health Organization (WHO) for acting “too cautiously and too slowly” on several important matters.
The Lancet COVID-19 Commission was established in July 2020, with four main themes: developing recommendations on how to best suppress the epidemic; addressing the humanitarian crises arising from the pandemic; addressing the financial and economic crises resulting from the pandemic; and rebuilding an inclusive, fair, and sustainable world. 28 commissioners were appointed, all of them global experts in public policy, international cooperation, epidemiology and vaccinology, economics and financial systems, sustainability sciences, and mental health.
The report is bluntly critical of not just the WHO, but also the role of governments across the world: “As of May 31, 2022, there were 6.9 million reported deaths and 17.2 million estimated deaths from COVID-19, as reported by the Institute for Health Metrics and Evaluation. This staggering death toll is both a profound tragedy and a massive global failure at multiple levels.”
Also read: Lancet report highlights ‘massive global failures’ in COVID-19 response
The WHO comes in for criticism for acting slowly on multiple issues – including warning about the human transmissibility of the virus, to declare a Public Health Emergency of International Concern, to support international travel protocols designed to slow the spread of the virus, to endorse the public use of face masks as protection and to recognise airborne transmission of the virus.
The commissioners recorded that it was the countries in the WHO’s Western Pacific region who had rich experience of dealing with SARS that reacted with urgency to the outbreak and pursued a suppression strategy conducive to low mortality.
The report further talks of inadequate co-ordination among governments to contain the pandemic, including travel protocols, testing strategies, public health and social measures, commodity supply chains, data standards and reporting systems, and advice to the public, despite the very high interdependence among countries. They did record that epidemic control was indeed seriously hindered by public opposition to routine public health and social measures, masking and getting vaccinated, indicating low confidence in the government and low health literacy. Profoundly unequal effects of the pandemic were not countered effectively by public policy and inequities governed the outreach measures, the report charges.
Further, the report makes a strong case for sustaining high rates of vaccination coverage, indicating that economic recovery depends on this, and low rates of new, clinically significant COVID-19 infections. While “emergency global financing from the International Monetary Fund, the World Bank, and regional development banks had a salutary role, although much larger financial flows from high-income to low-income regions were warranted.”
