Preparing for next pandemic: End of Covid-19 as a public health emergency

Recently, the World Health Organization (WHO) declared Covid-19 as no longer a public health emergency drawing mixed reactions from experts and advocates for Covid-19 pandemic preparedness, prevention and response. For a country like Malawi with very low vaccination coverage, the WHO’s announcement represents a huge shift in the public health order where misconceptions, misinformation and myths remain strong. DINGAAN MITHI writes

According to WHO’s Coronavirus Dashboard which has collated key statistics since early in the pandemic, the cumulative cases worldwide now stand at 765 million with nearly seven million deaths.

As of 30 April, a total of more than 13.3 billion vaccine doses have been administered worldwide.

For Malawi, Covid-19 vaccination coverage is still very low. As of March 2023, some 7.2 million vaccine doses have been administered, the deaths cumulatively stand at 2,686 and about 88,613 confirmed cases.

Vaccination rates in the country are still below 25 percent, while the Ministry of Health set a target of 70 percent by April, 2023.

WHO’s Director General, Dr. Tedros Ghebreyesus, after consulting the high-level scientific body of experts within the UN agency, declared that Covid-19 was no longer a global public health emergency but he warns it still remains a public health threat.

He said the virus – first made a public health emergency of international concern by the WHO chief on 30 January, 2020 – was here to stay.

“It is still killing and it is still changing. The risk remains of new variants emerging that cause new surges in cases and deaths,” he said.

He said that the decision had not been made lightly. For the past year, the WHO-led Emergency Committee had been carefully examining the data, on the right time to lower the alarm.

For over 12 months, the pandemic “has been on a downward trend”, he said, with immunity increasing due to the highly effective vaccines developed in record time to fight the disease, and infections. Death rates have decreased and the pressure on once overwhelmed health systems, has eased.

“This trend has allowed most countries to return to life as we knew it before Covid-19”, Tedros added.

Speaking in March 2023 at a multi-stakeholder dialogue on Covid-19 organized by Journalists Association Against AIDS (JournAIDS) and Christian Aid, co-chair of the Presidential Taskforce on Covid-19, Wilfred Chalamira Nkhoma warned that Covid-19 was still a public health challenge and there was a need to scale up vaccine uptake and tackle misinformation which has remained a factor in reducing vaccine coverage across the country.

“Covid-19 is not over, we must work hard to increase vaccine coverage in the country. The country still needs more awareness and behavioural change to tackle misinformation and disinformation that are leading to low vaccine uptake,” Nkhoma said.

Nkhoma also added on the need for legislation to be put in place for increasing access to Covid-19 vaccine as well as recognizing pandemic preparedness, prevention and response (PPPR) and ensuring that climate health nexus is put at the centre of health policies.

At present, WHO through an Intergovernmental negotiating body (INB) are still working a draft for the Pandemic Treaty or the Pandemic Accord which some countries fear will take away sovereignty and influence of such nations.

Apart from the treaty, WHO with backing of the World Bank established the Global Pandemic Fund.

On February 3, 2023, the Pandemic Fund Governing Board approved $300 million in financing for its first round of funding to help developing countries better prepare for and respond to future pandemics.

Projects to be financed by the first round of funding will prioritise strengthening comprehensive disease surveillance and early warning, laboratory systems, and human resources/public health workforce capacity. This is in line with the International Health Regulations (IHR) (2005) and other internationally endorsed legal frameworks and consistent with a One Health approach.

Malawi also stands to benefit from the Pandemic Fund to ensure it can prepare better for future pandemics. However, WHO’s declaration on ending Covid-19 as a public health emergency has not gone down well with advocates.

US based organization, AVAC which supports various organizations in Malawi, including JournAIDS through a Covid-19 media science café program painted a gloomy picture on WHO’s statement.

“Yes we must prepare for future pandemics. But the end of the emergency does not mean the Covid-19 pandemic is over,” said AVAC media advisor, Kay Marshall in a WhatsApp message.

One of media science café conveners based in Zambia, Zarina Geloo questioned if WHO’s declaration could have a dampening effect on Africa’s push for home-grown manufactured vaccines.

“I wonder how much vaccines will go to waste. Will this [WHO announcement] have a dampening effect on the push for African produced vaccines,” wondered Geloo

In his regular weekly briefing in Geneva, WHO chief, Ghebreyesus, said the agency would launch its fourth Strategic Preparedness and Response Plan (SPRP) issued by the UN health agency, since the first at the start of the Covid-19 emergency, in February 2020.

This update outlines how countries can “transition from an emergency response, to long-term, sustained management of Covid-19”, he said, over a two-year period.

He said an estimated one in 10 infections now results in what’s commonly known as “long Covid”, “suggesting that hundreds of millions of people will need longer-term care” moving forward.

“As the emergence of the new XBB.1.16 variant shows, the virus is still changing, and is still capable of causing new waves of disease and death, Tedros said and added “But this virus is here to stay, and all countries will need to learn to manage it alongside other infectious diseases.”