Good morning and good afternoon to all of you, and thank you for the invitation to speak to you.
I’m very glad to be back at Columbia, albeit virtually.
As you know, the first major speech I gave after my election as Director-General in 2017 was at the World Leaders Forum at Columbia, on the subject of health security.
I began my remarks by describing the 1918 flu pandemic, which erupted during the First World War, and although it killed more people than the war itself, the pandemic was quickly forgotten and its lessons went unheeded.
I said then that a devastating epidemic could start in any country at any time, and kill millions of people, because we are not prepared.
I said that global health security is only as strong as its weakest link – no one is safe until we are all safe.
And I said that we do not know where or when the next global pandemic will occur, but we do know that it will exact a terrible toll on human life, and on the global economy.
It gives me no pleasure that the COVID-19 pandemic matches the scenario I outlined that day so closely. I wish I was wrong.
But WHO has been ringing the alarm bell for years, and so have others.
Before the COVID-19 pandemic struck, people would often ask me what kept me awake at night. I would answer without hesitation: a global pandemic of a respiratory virus.
The COVID-19 pandemic has demonstrated that indeed, the world was not prepared.
More than 110 million cases of COVID-19 have now been reported to WHO from around the world, and more than 2.5 million people have lost their lives.
But we do see signs of hope. Globally, the number of reported cases has now declined for six consecutive weeks, and the number of deaths has declined for three weeks in a row.
This trend is a reminder that even though we are discussing vaccines today, COVID-19 can be suppressed and controlled with proven public health measures.
And indeed, that is exactly what many countries have done.
We must remember that although this is a global pandemic, not all countries have responded in the same way, and not all countries have been affected in the same way.
One of the greatest tragedies of the pandemic is that since it started, the whole world has had the tools to control it, but not all countries have used them effectively.
It’s important to emphasize that even as vaccines start to roll out around the world, vaccines will complement, and not replace, the public health measures that we know work.
But there is no question that vaccines are the shot in the arm we all need, literally and metaphorically.
The development and approval of safe and effective vaccines less than a year after the emergence of a new virus is an incredible scientific achievement that must change our expectations for what is possible in future vaccine development.
I would like to pay tribute to the researchers, trial participants, and public-private partnerships that have made this possible.
The lightning speed at which COVID-19 vaccines have been developed is no accident. In fact, it has been years in the making.
As Tony Fauci said during our WHO media briefing yesterday, much of the basic science underpinning these vaccines was done years ago as part of the quest for a vaccine against HIV.
For WHO, part of the story of COVID-19 vaccines goes back to the West African Ebola outbreak, from 2014 to 2016.
Although the Ebola virus had been identified four decades earlier, and despite years of academic and biodefense research, there were no proven Ebola vaccines, and research had stalled at the preclinical level.
In response, WHO brought together a global consortium to facilitate the rapid development and evaluation of several vaccine candidates.
In Guinea, we coordinated an innovative phase 3 trial and hired and trained national staff to conduct it.
Four months later, preliminary efficacy data were announced.
By that stage, the outbreak was waning, and the vaccines arrived too late to benefit the majority of those affected.
But the vaccines developed then have been a vital tool in subsequent and current simultaneous but unrelated Ebola outbreaks in the Democratic Republic of the Congo and Guinea.
In fact, Ebola vaccination in Guinea started today, and vaccination in DRC began last week.
The West African Ebola outbreak gave rise to vaccines, but it also gave rise to WHO’s Research and Development Blueprint for epidemics, a strategy to facilitate the rapid development of vaccines, diagnostics and therapeutics in response to outbreaks.
The R&D Blueprint, published in 2016, defined a list of priority diseases, including SARS, MERS and coronaviruses in general, as well as the unknown pathogen called “Disease X”, and established a research roadmap for each of them.
One of the first roadmaps developed was for the MERS-coronavirus, which had, at that time, infected 1600 people and caused almost 600 deaths.
Much of the work done on developing vaccines for MERS laid the groundwork for the development of vaccines against the new coronavirus, SARS-CoV-2.
As you know, on New Year’s Eve 2019, WHO was notified of a cluster of cases of pneumonia of unknown cause in Wuhan, China.
Within two weeks, Chinese researchers identified a novel coronavirus as the cause of the outbreak, and sequenced and published its genome.
The same week, WHO held the first of a series of calls of the Global Coordination Mechanism for Research and Development.
Then in February last year, WHO brought together more than 300 leading researchers from around the world, in line with the R&D Blueprint, to identify and accelerate a research roadmap for COVID-19.
By April, WHO had published a range of products to guide vaccine development, including target product profiles, core protocols for vaccine trials, animal models, assays and more.
And we have continued to track vaccine development globally.
Most recently, WHO has provided emergency use listing for three vaccines, including the Pfizer-BioNTech vaccine and two versions of the AstraZeneca vaccine.
WHO emergency use listing gives the green light for COVAX to buy vaccines, and enables countries to expedite their own regulatory approval to import and roll out vaccines.
But as we often say, it’s not vaccines that save lives, it’s vaccinations.
Since the beginning of the pandemic, we knew that vaccines would be a vital tool for controlling it.
But we also knew from experience that the equitable distribution of vaccines would not just happen.
Antiretrovirals for HIV were first approved in 1996, but more than a decade passed before the world’s poor got access to them.
In the same way, when the H1N1 pandemic erupted in 2009, vaccines were developed but by the time the poor got access, the pandemic was over.
So in April last year, with support from France, Germany, the European Commission and a coalition of partners including Gavi, CEPI and others, WHO launched the Access to COVID-19 Tools Accelerator.
The aims of the ACT Accelerator were twofold: to facilitate the rapid development of vaccines, diagnostics and therapeutics for COVID-19, and to distribute them equitably.
The first objective has been achieved; the second is in jeopardy.
At the beginning of the year, I issued a call to action to ensure that vaccination of health workers and older people is underway in all countries within the first 100 days of this year.
So far, more than 210 million doses of vaccine have been administered globally.
More than half are in just two countries, and more than 80% are in 10 countries.
I’m pleased to say that the first shipments of doses through COVAX are being sent today.
But many countries are yet to administer a single dose.
We understand that governments have an obligation to protect their own people.
But the best way to do that is by suppressing the virus everywhere at the same time.
The more the virus circulates, the more opportunity it has to mutate in ways that could render vaccines less effective. We could end up back at square one.
And in our interconnected world, the longer the pandemic persists anywhere, the longer global trade and travel will be disrupted, and the longer the recovery will take.
Vaccine equity is not just a moral imperative; it’s an economic and strategic imperative. It’s in every country’s own best interests.
WHO and our partners in the ACT Accelerator have laid the groundwork. We have created a dose-sharing mechanism, set up rapid processes for emergency use listing, set up indemnification and no-fault compensation mechanisms and completed readiness assessments in almost all countries.
Through our 150 country offices, we have been working closely with countries to prepare them to roll out vaccines as rapidly as possible.
This is great news, but we still face significant challenges to realizing the promise of the ACT Accelerator and COVAX.
First, we still face a financing gap of at least 22.9 billion dollars for the ACT Accelerator this year.
Last week, G7 countries committed 4.3 billion U.S. dollars in new funding, and several countries committed to sharing doses with COVAX.
This is very welcome, but we need all countries to step up.
The longer this gap goes unmet, the harder it becomes to understand why, given this is a tiny fraction of the trillions of dollars that have been mobilized for stimulus packages.
Second, we call on all countries to respect COVAX contracts and not compete with them.
Some countries continue to sign bilateral deals while other countries have nothing.
We continue to hear about high-income countries that express support for COVAX in public, but in private enter contracts that undermine it, by offering higher prices and reducing the number of doses COVAX can buy.
And third, we need an urgent scale-up in manufacturing to increase the volume of vaccines.
That means innovative partnerships including tech transfer, licensing and other mechanisms to address production bottlenecks.
None of these challenges is insurmountable.
The world has already proven that in the face of an unprecedented threat, we can do unprecedented things.
With proven public health measures, rapid diagnostics, oxygen and dexamethasone and vaccines, we have all the tools we need to bring the pandemic under control.
Whether we do is not a test of science; it’s a test of character.
Thank you.