Recovering from COVID-19:
The test we cannot fail

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or almost two years, the world has been in the grips of one of the greatest global challenges in recent history. The stark images as all humanity dealt with COVID-19 remain etched in our minds. Healthcare workers outnumbered by patients but fighting with incredible strength and resilience to save every patient. Empty roads, empty airports, empty schools, empty offices and empty treasuries. All engulfed in an eerie silence, interrupted by the sounds of slogans in solidarity with our front-line workers.

In the Maldives, as foreign minister, I had a front seat to see the enormous impact on our country and our economy. As in many other small island countries reliant on tourism, the economy was the first casualty. A vibrant, thriving nation came to a standstill, overnight. When flights stopped and tourists stopped arriving on our shores, we effectively became a ‘no income’ country.

Our first priority was to respond quickly to the health impacts. We boosted testing capacity, established treatment facilities, and mobilised and trained healthcare workers. As a net importing country, securing essential food and commodities was especially crucial. Minimising the impact on our economy was our second, equally important priority. Stimulus packages and income support were distributed. Social security, including universal health insurance, single parent support and elderly pensions, continued.

There are many lessons that a small country like the Maldives learnt in the wake of the pandemic. Lessons that can be extrapolated globally.

First, the inequalities in the international system have been exposed like never before. The virus demonstrated equity in its impact and spread of devastation, but the multilateral system’s response was unequal. With the varying degrees of shock due to disruptions in supply chains and decreased revenues, asymmetries in the ability to deal with the pandemic and access resources, shortages of life-saving drugs and the digital divide, it is abundantly clear that we are in different boats.

Second, the importance of global cooperation has been underscored to an extent that might not have been felt since the end of World War Two. In the Maldives, we would have been unable to attend to the impacts of COVID-19 – be it on health or the economy – without the support of our bilateral and multilateral partners. The adage ‘no one is safe until everyone is safe’ should be the mantra of revitalising multilateralism. But we did not need a pandemic to remind us of the value of strength in unity.

From the initial stages of the pandemic, when information and advice to policymakers and healthcare workers were crucial, to the mobilisation and deployment of medical supplies, medicines and protective gear and, finally, to the research and development of vaccines in record time, throughout this pandemic we can see the important role that global solidarity, international cooperation and multilateralism could play.

Historical lessons

Expectations for global solidarity – reinforced by self-interest – were high after the scare of severe acute respiratory syndrome in 2003, when WHO members negotiated the revised International Health Regulations and ratified them in 2005 as an international legally binding framework. But within less than 10 years, health diplomacy was confronted with the failure of countries and international agencies to respond effectively to the first Ebola outbreak, which began in West Africa in early 2014. Once that outbreak was over, the cycle of panic and neglect began again: health diplomats called for a reinforcement of the IHR, a reform of the WHO, the creation of a contingency fund and the establishment of a global health emergency workforce. Among the most important moves was the establishment of the WHO Health Emergencies Programme in 2016 at the request of the World Health Assembly. But the two most important lessons from Ebola were that countries needed to fulfil their obligations under the IHR effectively and that they needed to empower WHO financially and politically. The COVID-19 crisis has made it clear that these lessons were not heeded and that the danger is high that they will not be heeded again.

Today, in 2021, we are at a similar point: various review committees have repeated many of the calls from decades past. This time, because of the significant economic and social global impacts, these matters are also debated at the G7 and the G20. There is a strange irony: the very actors that did not deem it necessary to invest in pandemic preparedness are now tasked with finding financial solutions and supporting them with their political clout. This incongruity also applies to the proposal to establish a High-Level Global Health Threats Council at the United Nations that would oversee countries’ willingness to prepare and respond to pandemics.

It is simple. The greatest potential for global solidarity lies with the WHO – an organisation that builds on its ownership by 194 countries. Yet countries are not willing to finance their own organisation adequately through their assessed contributions (AC). Independent expert reviews have been clear – now is the time to act. Increasing AC to cover at least half of WHO’s core budget is an essential investment – the sums are minimal compared with the billions that might be paid into new mechanisms. Many countries remain sceptical about negotiating a Global Pandemic Treaty that would strengthen WHO’s hand in emergency preparedness and response. But reliable financing and political clout through a treaty would make all the difference to global solidarity. It would constitute a straightforward multilateral solution