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We must realise global health requires a coordinated effort – editorials

The ongoing pandemic, with over 79 million people infected and 1.7 million lives lost, has become the most destructive infectious disease outbreak in recent human history with unprecedented human, social and economic costs. Countries are struggling to respond to new infections and virus mutations through a mix of containment measures- periodic lockdowns, domestic and international border-sealing and available, limited medical solutions.

International trade and domestic economies were the first to take a hit. By the end of the second quarter, international trade was almost one-fifth less compared to second quarter of 2019. As 2020 closes out and vaccines are getting emergency use approvals, the Covid-19 shock is expected to cause a seven to nine per cent fall in global trade.

Countries that were growing economically pre-pandemic, are now witnessing worrying trends. For instance, pre-Covid, unemployment in the United States (US) was at a half-century low but by the second quarter of 2020, its Gross Domestic Product (GDP) plunged by nearly 31.4% – a record held previously only by the Great Depression. In the United Kingdom (UK), unemployment hit a three-year high and over 800,000 people lost their jobs. Emerging and fledgling economies like India and South Africa are also experiencing historic contractions.

But the impact of Covid-19 isn’t limited to economics and trade. It has magnified fault-lines, exacerbated inequities and inequalities and resulted in shadow pandemics such as mental health crises, violence against women, and disruptions in critical health services, possibly reversing recent improvements. It has forced hundreds of thousands of skilled and unskilled workers out of jobs and is expected to push an estimated 88-115 million into extreme poverty. Countries, rich and poor, have been affected by an economic emergency. Several low- and middle-income countries, battling existing political instability and conflict, coupled with weak health systems infrastructure have borne the worst of this impact. The pandemic has underscored that the world needs to rethink policies and programmes to bring back some semblance of equality and stability in societies. It needs to view global health as a security issue.

For too long, the concept of security has assumed an anthropomorphised ‘other’ – an ‘us’ seeking existential security from another state or organisation. Here, state security is threatened in physical or cyber battle by potentially rational or irrational actors, who driven by distrust or ambition or power dynamics, launch threats to a state’s security. While these can be checked with negotiation, mediation and arbitration, or destruction, i.e. war; in case of disease, such an understanding is limited. Disease, and resulting hunger and poverty can cause destabilisation, political unrest, civil disorder, and international conflict– all of which threaten international peace and security. Covid-19 has also shattered the illusion of international collaboration. In the last two decades, these have emphasised good health and well-being, especially through the Millennium Development Goals and Sustainable Development Goals. But in the wake of Covid-19, countries that could launch a coordinated effort to check the impact of the pandemic have resorted to inward-looking policies. Ending the pandemic must be a global goal and a critical determinant of foreign policy, trade, and economic co-operation.

Protectionism, isolationism, as seen through vaccine nationalism has reversed the efforts of international bodies and platforms to place health at the centre of the global development agenda. Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance; and the World Health Organization are working with governments and vaccine manufacturers to expedite vaccine research and ensure that the vaccine, when available, is accessible to all. But to ensure success wealthier countries must join hands and lend their support so that all countries can roll-out the vaccine, almost in parallel.

As we see the light at the end of the tunnel, as vaccines get rolled out across the world, we need to collectively recognise that global health determines economic trajectories and requires a coordinated, concerted effort. To reap the benefits of globalisation, to ensure an equal world, global health must be central to international collaboration. It determines social and economic development for all. And peace is the logical result.

Anjali Nayyar is executive vice-president, Global Health Strategies This article is co-authored by Pratyush Pranav and Anindita Bose, senior associates at Global Health Strategies.

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