On Monday, May 18, the 73rd World Health Assembly (WHA) opened as a virtual forum for the first time in its history. WHA brought together the World Health Organization’s (WHO) 194 Member States against the backdrop of the COVID-19 pandemic and its far-reaching health, economic, and political impacts.
The WHO budget crisis (triggered by the suspension of U.S. funding) was top of mind over the course of the Assembly. Some countries, like France and the U.K., lauded WHO efforts to control the pandemic. French President Emmanuel Macron noted, “We need a strong WHO to tackle COVID-19, and the WHO is us, its member states.” Others, like the United States, offered harsh criticisms, with U.S. Secretary of Health and Human Services Alex Azar asserting: “We must be frank about one of the primary reasons this outbreak spun out of control: There was a failure by this organization [WHO] to obtain the information that the world needed. And that failure cost many lives.”
This week, Germany and France announced a joint proposal to aid the EU’s recovery. German Chancellor Angela Merkel and French President Emmanuel Macron proposed establishing an EU-backed €500 billion (US $584 billion) bailout fund to support countries most affected by the pandemic. The proposal outlines a plan for strategic stockpiles of medical equipment as well as a coordinated vaccine procurement process and diversification of supply chains for distribution.
It is clear that the road to recovery is long and uncertain. Multilateral cooperation and cross-sector partnerships will be critical as we continue to navigate the path to a “new normal.” This week’s edition of Rabin Martin’s COVID-19 Briefing explores the outcomes of this year’s World Health Assembly and implications for the pandemic response, multilateral cooperation, and private sector efforts in the months ahead. We also examine the impact of COVID-19 on patients with unrelated health conditions, including Alzheimer’s, HIV, and rare diseases, and how to make sure they don’t get left behind. Please find our earlier COVID-19 Briefings here.
In the U.S. 93,471 people have lost their lives to COVID-19. New research from Columbia University estimates that 36,000 deaths could have been averted if the country had introduced social distancing measures one week earlier.
“COVID-19: What Comes Next?” A Conversation with Laurie Garrett
On Tuesday, May 19, Rabin Martin hosted a WHA side-event with Pulitzer Prize-winning journalist and global health expert Laurie Garrett and Rabin Martin CEO Jeff Sturchio. The virtual fireside chat focused on the urgent need for global health leadership to address the rapidly evolving COVID-19 crisis. Laurie and Jeff discussed thought-provoking questions and dire predictions around the pandemic and the global response. Setting the tone for the conversation, Jeff opened with a blunt question: “Given that we had opportunities to prepare, why didn’t we?”
Laurie’s response was equally direct: “There is no parallel. We have to stop looking to influenza as a comparison,” she warned. While emphasizing the uniqueness of the current crisis, Laurie offered a historical lens. Referring to the HIV/AIDS epidemic, she reminded the audience of the significant challenges in creating a vaccine or therapeutic – and the danger of hinging a response on a cure. “Don’t forget HIV emerged in the public’s mind in 1981. We still don’t have a vaccine. We still don’t have a cure.”
Given our lack of preparedness and failure to invest in public health, Laurie asserted, “We don’t have a response, we have panic.” This panic is causing paralysis, in some case impeding action across all levels of government. Inaction will exacerbate and extend the length of the crisis such that we may not “beat” the virus but rather see it become endemic: “The virus is going to keep coming back. We’ll have sparks that turn into wildfires. We need capacity to fight wildfires.”
Jeff and Laurie also addressed what Jeff termed a false dichotomy between addressing economic fallout and. fighting the public health crisis, noting how the two are intertwined. In terms of the path forward, Laurie urged greater attention to ensuring an equitable response given that, as global efforts currently stand, too many vulnerable populations are being left behind. COVID-19 did not cause inequities, but has brought to light the flawed health systems that result in disparities in access. “Even if we had the magic pill tomorrow, the ‘we’ would be a very small portion of the planet,” she said.
The conversation ended on a sobering note. Warning of the challenges ahead, she said, “We’re just in the first pages of the first chapter of a very long novel.” The collaboration and speed of innovation – especially in the vaccines arena – has been inspiring, but that same speed may compromise the integrity of decisions. “We’re racing so fast that we’re risking making a mistake…A mistake can be irreversible.”
A recording of the event may be found here.
World Health Assembly: Key Takeaways
Dr. Tedros Adhanom Ghebreyesus, Director-General, WHO
Access to health technologies
This year’s WHA had a condensed agenda, spanning two days (May 18-19). The opening plenary session included statements from regional and national leaders about the importance of ensuring availability and accessibility of technologies to combat the coronavirus pandemic. By the end of the Assembly, member states adopted by consensus a landmark resolution calling for both the intensification of efforts to control the pandemic and for equitable access to and fair distribution of all essential health technologies toward this end.
Access to novel technologies to fight COVID-19 was a point of contention over the course of the WHA. Prior to the Assembly, on Friday, May 15, WHO and Costa Rica previewed an initiative to ensure access to COVID-19 health products for all. The proposed technology platform will pool data, knowledge, and intellectual property for existing and new technologies. The goal is to encourage open sharing of information to support production of the most effective diagnostics, treatments, and vaccines and facilitate efforts to scale up global availability and increase access.
“We need to unleash the full power of science, without caveats or restrictions, to deliver innovations that are scalable, usable, and benefit everyone, everywhere, at the same time,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus. President Carlos Alvarado of Costa Rica emphasized the need for public-private cooperation: “Our proposal relies on solidarity. It’s a Solidarity call to action to Member States, to academia, to companies, research institutions, and cooperation agencies, based on global social responsibility.”
The private sector is working to limit delay in both discovering and delivering treatments and vaccines. By forging new partnerships with governments, multilateral organizations, and research institutions, industry is accelerating timelines for drug and vaccine development at a record pace, with pledges to ensure access and share information.
WHO under pressure
“This is the time for cooperation. This is the time for science and solidarity. This is the time for all humanity to rally around a common cause. And you can count on Europe to always play for the team.”
Ursula von der Leyen, President, European Commission
Leading up to the Assembly, WHO was put under a microscope by some stakeholders for the perceived lack of speed and effectiveness of its pandemic response. In the final resolution, Member States endorsed the recommendation for an independent review of the global response, including an assessment of the WHO’s performance. While some challenged WHO’s efficiency (U.S. President Donald Trump threatened to permanently cut all funding and withdraw U.S. membership), Member States broadly affirmed their continued support.
In addressing the Assembly, President Moon Jae-in of South Korea noted his country’s support of WHO efforts to develop vaccines and treatments, urging cooperation and equitable distribution. In a similar endorsement, China pledged $2 billion to the COVID-19 response and committed to equitable access to vaccines. Five Chinese companies are currently exploring vaccine candidates.
Following this abridged meeting, the World Health Assembly plans to reconvene later in the year to address the full scope of their mandate.
COVID-19: Impacts on Patient Populations
Chirfi Guindo, Executive Vice President, Global Marketing, Market Access & Customer Innovation, Biogen
COVID-19 is disrupting healthcare as we know it. Reports of suspended access to critical services surrounding childbirth, immunizations, and essential treatments are growing around the world, particularly in lower-income settings. We are on the path to a crisis of converging healthcare challenges of potentially disastrous proportions. UNAIDS Executive Director Winnie Byanyima warned of “colliding epidemics”: in sub-Saharan Africa, more than 500,000 additional AIDS-related deaths could be caused by six months of COVID-19-related disruptions to HIV treatment.
Similarly, the Lancet projects that COVID-19 will cause spikes in child and maternal mortality around the world due to breakdowns in supply chains and declining use of health services. These challenges “will be more catastrophic for mothers and children than COVID-19 itself,” said UNICEF Executive Director Henrietta Fore. According to modeling by Johns Hopkins Bloomberg School of Public Health, up to 1.2 million children under 5 years of age could die in the next six months.
Traditional models of healthcare have been upended. Rabin Martin spoke with a few of our clients and partners about some of the most critical issues facing patients and special populations right now.
SPOTLIGHT ON NEUROLOGICAL CONDITIONS: A Conversation with Chirfi Guindo, Biogen
Chirfi Guindo is Executive Vice President, Global Marketing, Market Access & Customer Innovation, Biogen.
Q: Older populations have been hit especially hard in this pandemic, particularly in assisted-living facilities in the U.S. When it comes to older populations, what are you most concerned about with COVID-19, given the strain it is putting on health systems?
I worry about misinformation. I worry about older people dying of other preventable illnesses because they are afraid to go to the hospital to get care. We have seen that in Massachusetts – there has been an decrease in patients seeking care for strokes, myocardial infarction, and other acute conditions that disproportionately affect older citizens. I am concerned about what will happen to patients when they are not engaged in care to slow progressive diseases like Alzheimer’s and Parkinson’s Diseases. Patient groups have an essential role in helping patient navigate the current uncertainty and we are supporting their efforts with information and resources.
Q: People living with Alzheimer’s Disease and dementia depend on their relationships with caregivers for emotional and medical support. How do social distancing and isolation measures affect patients’ care and well-being?
Patient advocates across therapeutic areas are trying to figure out how to use telemedicine and virtual engagement to provide support, but there are different challenges for patients with more advanced neurodegenerative disease. Biogen is investing to accelerate telemedicine and innovation in engagement models for patients, providers, payers, and all stakeholders. We have the apps for MS patients, Cleo and Aby, which provide real-time access to nurse educators, who are available to answer questions and provide tailored tips to help manage symptoms and reduce stress. Additionally, we are developing specific apps for other patient populations and their caregivers. This is just the beginning of digital engagements we will see in the years to come.
Q: Biogen was one of the first organizations in the U.S. to be hit hard by COVID-19. How did the company respond?
The COVID-19 pandemic has had a very direct, very personal impact on our Biogen community. When we learned that a number of our colleagues were ill, we did not know the cause was COVID-19, but we immediately notified public health authorities and took steps to protect our employees and limit the spread.
These included actions that have now become commonplace, such as quarantines, strict travel bans, and working from home. We were one of the first companies to implement such a response and worked very closely with the Massachusetts Department of Health.
Even though Biogen’s focus is neuroscience, we are also determined to help find ways to help fight this pandemic. Thus far, we have committed $10 million from the Biogen Foundation to non-profit organizations and health care systems. We also helped initiate a consortium with the Broad Institute of MIT and Harvard, and Partners Healthcare to form a COVID-19 biobank to provide scientists with access to a large collection of biological and medical data to advance knowledge and search for potential vaccines and treatments. It will include blood samples and other data from volunteers, including Biogen employees and their close contacts.
SPOTLIGHT ON HIV: A Conversation with Paul Schaper, Merck & Co., Inc.
Paul Schaper is Executive Director, Global Public Policy, Merck & Co., Inc.
Q: What are your greatest concerns about COVID-19’s impact on people living with HIV, given the strain it is placing on health systems around the world?
My greatest concern is that the COVID-19 pandemic will cause an interruption in the care and treatment of people living with HIV, reversing the gains we have made over the past several decades. The estimates of the potential increases in HIV, TB, and malaria infections and deaths due to such interruptions are a stark warning that we need to be vigilant in reinforcing our responses to these diseases, as we simultaneously address the direct threats from COVID-19. I also worry that the pandemic will be used as a pretext by some governments to suppress the rights of marginalized populations, such as LGBTQ populations.
Q: Given fears around the potential “colliding epidemics” of HIV and COVID-19, how do we ensure we do not backslide in our fight against HIV?
It will take a multisectoral response – governments, civil society, and the private sector – to mitigate risks of losing the gains that we have made in advancing HIV care for people around the world. I commend organizations, such as the Global Fund, and countries for taking rapid and dramatic steps to ensure uninterrupted HIV care. For example, certain health authorities have allowed those on HIV treatment to increase the reserve of medicines that they have at home to ensure continuous supply and reduce trips to the pharmacy or doctor’s office. But we must not forget that many people face unstable housing, food insecurity, unsafe domestic living situations, and difficulties accessing medical care – these challenges are being made even more difficult by the COVID-19 pandemic.
Q: How do you think the private sector can best contribute to ensure that those living with HIV continue to get the care they need?
The private sector has taken significant steps already to address the challenges of COVID-19. Most fundamentally, healthcare companies have worked to ensure that the supply chains of HIV medicines are secure so that we are able to provide those on treatment with uninterrupted supply of their medicine – for those in developed and developing countries, equally.
At the same time, work continues around developing new HIV prevention technologies and treatments so that we can address the unmet needs in HIV that existed well before the emergence of COVID-19 and that may present an even greater challenge in this new world. Many companies, including Merck, have also stepped up with philanthropic contributions to support community-based organizations that provide critical services for people living with HIV and other conditions. This is an especially difficult time for NGOs that are dealing with increased demand for services while facing decreases in fundraising. The private sector is playing a role in helping to fill that gap.
SPOTLIGHT ON RARE DISEASE: A Conversation with Uzma Atif & Linn Parrish, Takeda
Uzma Atif, PhD, MPH is Scientific Director, Global Patient & Scientific Affairs, Takeda
Q: How is the disruption in healthcare posed by COVID-19 affecting those with a rare disease?
Efforts related to stopping the COVID-19 pandemic are causing a disruption of care for many rare disease patients, especially as a gap in treatment or other essential services may pose a very serious threat to their health and wellbeing. There may be a lack of access to centers in certain geographies where telemedicine consults may not be easily available.
For rare disease patients receiving treatment that requires infusion therapies, having access to home healthcare, including home infusion care, is of vital importance. In addition, patients with rare diseases would need to connect to a network of telehealth psychosocial counseling services, special education, distance learning teachers, and homeschooling tools and resources.
Takeda is co-chairing a multi-disciplinary Global Commission to accelerate the time it takes to diagnose a rare disease, leveraging technology. One of the pilot projects we are supporting involves telegenetic consultations to address the global shortage of geneticists.
The project (based at Children’s National Hospital in Washington, DC) uses virtual tools – such as facial recognition, video visits, and a triaging system – to deliver genetic assessments and counseling remotely to patients and primary care physicians. So far, the project has been able to decrease the average wait time for a patient to see a specialist from 3-4 months to only 6-8 days. This is an incredible achievement that is all the more relevant during the current global health pandemic. These virtual tools are also allowing clinicians to collaborate better, have more frequent and efficient visits with patients, and expand access to patients in rural areas.
SPOTLIGHT ON DISPLACED PERSONS: A Conversation with Thomas Gensemer, International Rescue Committee
Thomas Gensemer is Interim Vice President, Communications, International Rescue Committee.
Q: What are the biggest challenges you’re seeing in the COVID-19 response from a humanitarian standpoint, and particularly with displaced persons? What issues do you see persisting once the immediate outbreak is over?
Right now, as citizens of donor countries are, quite understandably, looking inward given the scale of the pandemic and the needed response at home, I’d put our biggest challenge as awareness. The sheer fact that nearly 1% of the world’s population lives in highly vulnerable situations, often including a prolonged or permanent state of displacement in living conditions not conducive for good health, is not something the modern world has adequately grappled with.
And once the immediate outbreak is over, we have to address the fact that it has caused us to move backwards in so many other areas: malnutrition, education for girls, major upticks in domestic/gender-based-violence, etc. All of these are inextricably linked to the bigger awareness challenge.
Q: How can actors across sectors collaborate to mitigate the pandemic’s impacts? What actions can we put in place for longer-term resilience?
The global recovery from COVID-19 offers a unique opportunity to address longstanding shortcomings of our global humanitarian system. The interconnectedness of these challenges is ever more obvious, as are the limitations of our traditional government and NGO remedies. Now, with the singularity of the threat and focus COVID-19 offers, is the time to rethink protocols, funding gaps, and accountabilities at all levels and in all regions. We can no longer apply yesterday’s remedies to today’s global problems.
Q: How can the private sector, in particular, assist organizations like IRC and others doing critical on-the-ground work to reach more populations in need?
Public-private partnerships are key to right-sizing foreign aid budgets and bringing needed innovation, entrepreneurship, and scale to the work. Global philanthropy, big business, and governments are all needed, and cooperation between them is essential to maximize the opportunity. Essential services and financial resources need to get to the front lines. We can no longer let our silos and bureaucratic blinders limit the possibilities.
On Friday, May 15, President Donald Trump announced “Operation Warp Speed” to accelerate the development, manufacturing, and distribution of a vaccine. The initiative aims to have 300 million doses of a vaccine available for Americans by January 2021. Moncef Slaoui, former head of vaccines at GlaxoSmithKline, has been appointed as Chief Advisor, and General Gustave F. Perna has been appointed Chief Operating Officer.
From the Experts
“This pandemic has shaken up the status quo and laid bare a lot of our country’s deep-seated problems – from massive economic inequality to ongoing racial disparities to a lack of basic health care for people who need it.”
Barack Obama, former President, United States
Saturday, May 16
“No country can solve this problem alone. We must work together.”
Angela Merkel, Chancellor, Germany
Monday, May 18
“The euphoria of the stock market is coming from wearing blinders about the history of vaccines.”
Laurie Garrett, author,
The Coming Plague: Newly Emerging Diseases in a World Out of BalanceTuesday, May 19
“We at WHO will never, ever give up. Our focus is fighting the COVID-19 pandemic with every tool at our disposal. Our focus is on saving lives.”
Tedros Adhanom Ghebreyesus, Director-General, WHO
Wednesday, May 20
Reports from International Governments and Bodies
- WHO COVID-19 Information and Guidance
- WHO Situation Reports, May 18, May 19, May 20
- CDC Coronavirus Resource Page
- COVID-19 Health Systems Response Monitor
- NCD Alliance COVID resources relevant to NCDs
Funding and Policy Trackers
- International Monetary Fund Policy Tracker
- Kaiser Family Foundation Coronavirus Policy Tracker
- U.S. Chamber of Commerce Foundation Corporate Aid Tracker
- Devex Interactive Funding Tracker
Resource Pages and Market Research Literature
- JAMA Resource Center
- The Lancet COVID-19 Resource Centre
- 2019 Novel Coronavirus Research Compendium (NCRC)
- National Academy of Medicine COVID-19 News and Resources
- WIPO COVID-19 IP Policy Tracker
- The COVID Tracking Project
- PharmaIntelligence: Coronavirus – What will the Impact Be?
- Health Affairs Resource Center
- STAT Preparedness Tool
- International Association of National Public Health Institutes COVID-19 Resources
- Primary Health Care Performance Initiative Forum
- U.S. Global Leadership Coalition COVID-19 Issue Briefs
- Prevent Epidemics Weekly Science Review
What We’re Reading
- ‘I Can’t Turn My Brain Off’: PTSD and Burnout Threaten Medical Workers – Jan Hoffman, The New York Times
- Accelerating Covid-19 Therapeutic Interventions and Vaccines (ACTIV): An Unprecedented Partnership For Unprecedented Times – Francis Collins and Paul Stoffels, JAMA
- How to Snuff Out The Next Pandemic– David Ecker, Scientific American
- Move Over, Moderna: Why Pfizer May Be the Better Bet to Deliver a Vaccine by Fall – Nathan Vardi, Forbes
- • Why Deborah Birx is the Real Power Doctor – Jonathan Swan, Axios
- Different Approaches to a Coronavirus Vaccine – Jonathan Corum, Knvul Sheikh, and Carl Zimmer, The New York Times
- A quarter of Americans are hesitant about a coronavirus vaccine: Reuters/Ipsos poll – Joseph Ax and Julie Steenhuysen, Reuters
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About Rabin Martin
Rabin Martin is a global health strategy firm working at the intersection of private sector capabilities and unmet public health needs. Rooted in our mission to improve health for underserved populations, we design strategies, programs and partnerships that both deliver public health impact and drive business results. We leverage our deep knowledge and networks across a wide range of geographies and health areas to develop tailored solutions for every client engagement. We have helped many clients create bold global health initiatives and innovative multi-sector partnerships. Our specific areas of expertise include infectious disease and vaccines, non-communicable diseases, rare diseases, maternal and child health, and universal health coverage. Our clients and partners include multinational health care companies, multilateral institutions, government agencies, large foundations and leading NGOs. Rabin Martin is part of the Omnicom Public Relations Group.
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Omnicom Public Relations Group is a global collective of three of the top global public relations agencies worldwide and eight specialist agencies in public affairs, marketing to women, fashion, global health strategy and corporate social responsibility. It encompasses more than 6,000 public relations professionals in more than 330 offices worldwide who provide their expertise to companies, government agencies, NGOs and nonprofits across a wide range of industries. Omnicom Public Relations Group delivers for clients through a relentless focus on talent, continuous pursuit of innovation and a culture steeped in collaboration. Omnicom Public Relations Group is part of the DAS Group of Companies, a division of Omnicom Group Inc. that includes more than 200 companies in a wide range of marketing disciplines including advertising, public relations, healthcare, customer relationship management, events, promotional marketing, branding and research.