By Dr. Gyan Pathak
Even as the new COVID-19 infections are declining and countries across the world are withdrawing the curbs they had imposed, including the mandatory requirement of wearing mask and physical distancing, a latest IMF working paper says that the pandemic is not over, and the health and economic losses continue to grow.
It is now evident that COVID-19 will be with us for the long term and there are very different scenarios for how it could evolve from a mild endemic scenario to a dangerous variant scenario, the study titled “A Global Strategy to Manage the Long-Term Risks of COVID-19” has emphasized.
This realization calls for a new strategy that manages both the uncertainty and the long-term risks of COVID-19. There are four key policy implications of such a strategy the authors of the paper have said.
First, we need to achieve equitable access beyond vaccines to encompass a comprehensive toolkit. Second, we must monitor the evolving virus and dynamically upgrade that toolkit. Third, we must transition from the acute response to a sustainable strategy towards COVID-19, balanced and integrated with other health and social priorities. And fourth, we need a unified risk-mitigation approach to future infectious disease threats beyond COVID-19.
Infectious diseases with pandemic potential are a threat to global economic and health security, the authors have reminded the world, while suggesting that the international community should recognize that its pandemic financing addresses a systemic risk to the global economy, not just the development need of a particular country.
Additionally, the paper says, the international community should allocate additional funding to fight pandemics and strengthen health systems both domestically and overseas, which will require about $15 billion in grants this year and $10 billion annually after that.
More than 6 million people have died according to official estimates. However, other studies have estimated the actual death toll ranging from 16 to 20 million, which is approximately equal to that of World War I. IMF’s World Economic Outlook 2022 has projected the cumulative output loss from the pandemic through 2024 to be about $13.8 trillion.
The global economic recovery continues to be constrained, says the paper, by unequal access to tools to prevent and treat COVID-19 and uneven policy support to address the impact of the pandemic. The several challenges facing the global economy, such as supply disruptions, inflation, and persistent uncertainty, follow from the fact that the world remains in the pandemic’s grip.
The paper has pointed out the insufficient progress toward the global targets set by ACT Accelerator and the IMF Pandemic Proposal for the delivery and use of available countermeasures. On vaccines, 86 countries did not meet the 40 per cent vaccination target by the end of 2021, and disparities in vaccine access and uptake remain significant. Under current trends, over 100 countries are unlikely to meet the 70 per cent vaccination target set for mid-2020 – and several may never reach it.
On tests, the daily target was set at 1 per 1000 people, and about two in three developing economies continue to test below this target despite the Omicron wave. Meanwhile, high-income countries are testing 80 times more than low-income countries.
There are similar gaps in access to oxygen, treatments, and personal protective equipments. There is also an imbalance across countries when it comes to disease surveillance underpinned by testing and genomic sequencing – an important tool for indentifying new virus strains and developing adequate vaccines and treatments. The paper draws conclusion from this that we detect variants where we have capabilities to detect them, not necessarily where they are occurring.
As we go through, many vaccinated and infected people will have some protection due to immune response. However, the growing evidence show that vaccines do not represent “silver bullets” against the evolving SARS-CoV2 virus, and it is probable that it will never be eradicated and will continue to evolve in human and animal populations.
Considering these, the paper has proposed a central post-Omicron pivot in global priorities to manage both the uncertainty and the long term risks of COVID-19, while warning about the risk of emergence of a more transmissible and more virulent than Omicron.
The study foresees at least four possible scenarios in post-Omicron world, which are based on the conceptualized scenarios of earlier studies published in 2022 by Jeremy Farrar and the WHO. These are “Mild” Endemic, “Injurious” Endemic, “Disruptive” Endemic, and “Dangerous Variant” Scenario.
In Mild Endemic Scenario world can gradually focus less on health shock and prioritize restoring the economy. In Injurious Endemic Scenario, the world will need to ensure equitable access to antivirals. However, the clinical pathway for administering these treatments requires early detection of the virus, thereby making it important to also scale up testing capacity.
In Disruptive Endemic Scenario it would be important to have strengthened public health measures in place, such as rapid testing, to ensure minimal disruption of daily life. Further, if immunity is not durable, regular boosters may be necessary, increasing the importance of regional manufacturing capacity to ensure equitable access to vaccines. It would also be necessary to deal with the Dangerous Variant Scenario, which will also require the global rollout of all tools. More accelerated scaling up of R&D investments, strengthened genomic surveillance to detect new variants early, and enhanced in-country health systems to rapidly deliver medical tools will be critical priorities. Further, the regional manufacturing and distribution capacity will need to be optimized for matching the speed of infection.
The scenarios may play out differently in different parts of the world depending on many factors with ongoing risks to all. Therefore, we have no option but devise comprehensive and dynamic toolkit. The refreshed ACT Accelerator budget of $23.4 billion is a good starting point, the study says, which can be updated as required. However, it mentioned lack of financing for a balanced and integrated global response. So far only about $18.7 billion in grant form for the ACT Accelarator has been raised. The IMF Pandemic Proposal had identified a grant need of $35 billion, so a gap of about $15 billion remains. Moreover, there are many hidden scars that need to be addressed, because the pandemic has exacerbated inequality, poverty, unemployment, learning poverty and so on. The world needs a unified approach for solution to the problem. (IPA Service)